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Sample records for ophthalmic fungal keratitis

  1. Clinical utility of voriconazole eye drops in ophthalmic fungal keratitis

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    Daoud Al-Badriyeh

    2010-05-01

    Full Text Available Daoud Al-Badriyeh, Chin Fen Neoh, Kay Stewart, David CM KongCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Victoria, AustraliaAbstract: Fungal keratitis is one of the major causes of ophthalmic mycosis and is difficult to treat. The range of common antifungal agents available for fungal keratitis remains inadequate and is generally associated with poor clinical outcomes. Voriconazole is a new generation triazole antifungal agent. Only marketed in systemic formulation and, with broad-spectrum activity and high intraocular penetration, voriconazole has demonstrated effectiveness against fungal keratitis. Systemic voriconazole, however, is not without side effects and is costly. Voriconazole eye drops have been prepared extemporaneously and used for the treatment of ophthalmic fungal keratitis. The current article sought to review the literature for evidence related to the effectiveness and safety of topical voriconazole and its corneal penetration into the aqueous humor of the eye. The voriconazole eye drops used are typically of 1% concentration, well tolerated by the eye, and are stable. Despite existing evidence to suggest that the eye drops are effective in the treatment of fungal keratitis, more studies are needed, especially in relation to using the eye drops as first-line and stand-alone treatment, preparation of higher concentrations, and optimal dosing frequency.Keywords: voriconazole, fungal keratitis, eye drops, corneal penetration

  2. [Fungal keratitis].

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    Bourcier, T; Sauer, A; Letscher-Bru, V; Candolfi, E

    2011-10-01

    Fungal keratitis (keratomycosis) is a rare but severe cause of infectious keratitis. Its incidence is constant, due to steroids or immunosuppressive treatments and contact lenses. Pathogens often invade corneas with chronic diseases of the ocular surface but fungal keratitis is also observed following injuries with plant foreign objects. The poor prognosis of these infections is related both to fungal virulence, decreased host defense, as well as delays in diagnosis. However, new antimycotic treatments allow better management and prognosis.

  3. Fungal keratitis

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    Sonal S Tuli

    2011-02-01

    Full Text Available Sonal S TuliUniversity of Florida, Gainesville, FL, USA  Clinical question: What is the most appropriate management of fungal keratitis?Results: Traditionally, topical Natamycin is the most commonly used medication for filamentous fungi while Amphotericin B is most commonly used for yeast. Voriconazole is rapidly becoming the drug of choice for all fungal keratitis because of its wide spectrum of coverage and increased penetration into the cornea.Implementation: Repeated debridement of the ulcer is recommended for the penetration of topical medications. While small, peripheral ulcers may be treated in the community, larger or central ulcers, especially if associated with signs suggestive of anterior chamber penetration should be referred to a tertiary center. Prolonged therapy for approximately four weeks is usually necessary.Keywords: fungal keratitis, keratomycosis, antifungal medications, debridement

  4. Climate change and predicted trend of fungal keratitis in Egypt.

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    Saad-Hussein, A; El-Mofty, H M; Hassanien, M A

    2011-06-01

    Rising rates of invasive fungal infections may be linked to global climate change. A study was made of the trend of ophthalmic fungal corneal keratitis in the greater Cairo area of Egypt and its association with climate records during the same period. Data on diagnosed cases of fungal keratitis were collected from records of ophthalmic departments of Cairo University hospital and atmospheric temperature and humidity for the greater Cairo area were obtained from online records. Statistical analysis showed a significant increase in the relative frequency of keratomycosis during 1997-2007. The rise correlated significantly with rises n min,mum temperature and the maximum atmospheric humidity in the greater Cairo area over the same period (after exclusion of the effect of the maximum atmos pheric temperature). The predicted increase in keratomycosis up to the year 2030 corresponds to predicted increases in CO2 emissions and surface temperature from climate change models for Egypt.

  5. Fungal keratitis in Lattice dystrophy

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    Chatterjee Samrat

    2010-01-01

    Full Text Available We report a case of fungal keratitis occurring in a patient with lattice dystrophy. A 57-year-old farmer presented with a corneal ulcer following probable entry of paddy husk in the right eye, of one month duration. Corneal scraping revealed pigmented fungal filaments while culture grew Alternaria alternata. Treatment with 5% natamycin eye drops and 1% atropine healed the infection in four weeks. We would like to draw attention to the fact that the cornea in lattice dystrophy is prone to frequent erosions and is a compromised epithelial barrier to invasion by microorganisms. Patients must be made aware of this fact and should seek attention at the earliest following any trivial trauma. Management of minor corneal abrasions in them should be directed at healing the epithelium with adequate lubricants and preventing infection with topical antibiotic prophylaxis.

  6. Nattrassia mangiferae causing fungal keratitis

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    Kindo A

    2010-01-01

    Full Text Available We report a case of fungal keratitis caused by the coelomycetous fungus Nattrassia mangiferae in a 70 year old gentleman, agriculturist by occupation, with a history of injury to his right eye. The scraping showed narrow septate fungal hyphae on a KOH mount, isolation of a fast growing black mould, which demonstrated hyphae and arthroconidia of varying widths typical of the Scytalidium synanamorph (S. dimidiatum. The formation of the pycnidia, which at maturity, expressed conidia. The patient was started on topical itraconazole one hourly and topical atropine thrice a day. The patient was lost to follow up hence we are not able to comment on the final outcome of the patient.

  7. Fungal Keratitis - Improving Diagnostics by Confocal Microscopy

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    Esben Nielsen

    2013-12-01

    Full Text Available Purpose: Introducing a simple image grading system to support the interpretation of in vivo confocal microscopy (IVCM images in filamentous fungal keratitis. Setting: Clinical and confocal studies took place at the Department of Ophthalmology, Aarhus University Hospital, Denmark. Histopathological analysis was performed at the Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark. Methods: A recent series of consecutive patients with filamentous fungal keratitis is presented to demonstrate the results from in-house IVCM. Based upon our experience with IVCM and previously published images, we composed a grading system for interpreting IVCM images of filamentous fungal keratitis. Results: A recent case series of filamentous fungal keratitis from 2011 to 2012 was examined. There were 3 male and 3 female patients. Mean age was 44.5 years (range 12-69, 6 out of 17 (35% cultures were positive and a total of 6/7 (86% IVCM scans were positive. Three different categories of IVCM results for the grading of diagnostic certainty were formed. Conclusion: IVCM is a valuable tool for diagnosing filamentous fungal keratitis. In order to improve the reliability of IVCM, we suggest implementing a simple and clinically applicable grading system for aiding the interpretation of IVCM images of filamentous fungal keratitis.

  8. Fungal keratitis associated with ocular rosacea.

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    Jain, Vandana; Shome, Debraj; Sajnani, Manoj; Natarajan, Sundaram

    2010-06-01

    In order to report fungal keratitis in patients of ocular rosacea, a retrospective review of all cases of fungal keratitis was undertaken. Cases in which ocular rosacea coexisted were identified and included in the study. The clinical course of patients thus identified was studied from the medical records and outcomes were evaluated. A total of three cases of fungal keratitis with coexisting ocular rosacea were identified. All three patients were known cases of acne rosacea with an intermittent, irregular treatment for the same. Previous history of contact lens use, ocular surgery or trauma was not present in any of the cases. Microbiological evaluation revealed Aspergillus flavus as the causative organism in two patients and an unidentified hyaline fungus in the third. Patients received simultaneous therapy for fungal keratitis and ocular rosacea. The ocular surface completely stabilized and the infiltrate resolved in all three cases. The chronic ocular surface changes and induced inflammation in ocular rosacea, along with the instillation of topical steroids for therapy, may create an environmental milieu favorable for fungal keratitis. Microbiological evaluation should be considered, even in cases of suspected sterile keratitis, prior to treatment with topical steroids, so as to prevent the possible worsening of an associated infective corneal condition.

  9. [Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey].

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    Kalkan Akçay, Emine; Açıkgöz, Ziya Cibali; Can, Mehmet Erol; Celikbilek, Nevreste; Dereli Can, Gamze; Cağıl, Nurullah

    2013-10-01

    Fungal keratitis, an eye infection with poor prognosis, is difficult to treat and can lead to loss of vision. Among filamentous fungi Scedosporium spp. rarely lead to fungal keratitis. Here we present a case of keratitis caused by Scedosporium apiospermum. A 61-year-old female patient was admitted to our hospital with the complaints of right eye pain and decreased vision after a foreign body trauma to the right eye. The patient was diagnosed as keratitis by biomicroscopic examination. Conjunctival swabs collected from both eyes were inoculated onto sheep blood agar, chocolate agar, eosin methylene blue agar and Sabouraud dextrose agar. Corneal scrapings from the right eye were inoculated onto the same solid media by "C-streak" method, and in brain-heart-infusion broth by immersion. While gram-stained smears of conjunctival swabs showed no significant finding, smears of corneal scrapings revealed abundant neutrophils and profuse septate hyphae. Fungal keratitis was diagnosed and topical enhanced amphotericin B (0.5 mg/ml) therapy was initiated with netilmicin sulfate and oxytetracycline HCl plus polymyxin B sulfate. At the 10th day of therapy a mold growth was detected in corneal scraping cultures and was identified microscopically as S.apiospermum. Based on the relevant literature, therapy was changed to enhanced topical voriconazole (2 mg/ml) applied hourly, plus systemic voriconazole administration. At the third day of treatment, reduction of epithelial defect and decline in the focus of keratitis were observed. In the following days, however, a progression occurred in the focus of keratitis and 5% natamycin ophthalmic suspension was added to the therapy. Since the patient did not respond to any of the medical treatments, therapeutic penetrating keratoplasty was planned; yet, the patient refused the operation and was discharged with her own request. As far as the local literature was concerned, this is the first report of keratitis caused by S.apiospermum in

  10. Fungal keratitis - improving diagnostics by confocal microscopy

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    Nielsen, Esben; Heegaard, S; Prause, J U;

    2013-01-01

    -69), 6 out of 17 (35%) cultures were positive and a total of 6/7 (86%) IVCM scans were positive. Three different categories of IVCM results for the grading of diagnostic certainty were formed. Conclusion: IVCM is a valuable tool for diagnosing filamentous fungal keratitis. In order to improve...

  11. Acanthamoeba and Stenotrophomonas maltophilia keratitis with fungal keratitis in the contralateral eye

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    Thomas F Mauger

    2010-10-01

    Full Text Available Thomas F Mauger, Rebecca Ann Kuennen, Reynell Harder Smith, William SawyerDepartment of Ophthalmology, The Ohio State University, Columbus, OH, USAPurpose: The purpose of this study is to describe the diagnosis, course, and outcome of a case of Acanthamoeba and Stenotrophomonas keratitis with a fungal keratitis in the contralateral eye.Methods: A case of Acanthamoeba and Stenotrophomonas keratitis was diagnosed with confocal microscopy and cultures with confocal diagnosis of fungal keratitis in the fellow eye.Results: During the initial treatment of the Acanthamoeba and Stenotrophomonas keratitis, the contralateral eye developed a keratitis that demonstrated hyphae in the corneal stroma with confocal microscopy consistent with fungal keratitis.Conclusions: Bilateral chronic keratitis cannot be assumed to be caused by the same organism and independent cultures, and confocal microscopy needs to be performed to direct appropriate therapy.Keywords: Acanthamoeba, Stenotrophomonas, confocal, fungus, keratitis

  12. Epidemiological, clinical and laboratory findings of infectious keratitis at Mansoura Ophthalmic Center, Egypt

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    Badawi, Amani E; Moemen, Dalia; El-Tantawy, Nora L

    2017-01-01

    AIM To analyze the epidemiological, clinical and laboratory findings of infectious keratitis. METHODS A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols. RESULTS Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor (51.4%), followed by diabetes mellitus (15.1%). Cultures were positive in 110 scraping samples (44.5%): 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 (4.5%) samples. The most common fungal pathogen was Aspergillus spp. (41%). The most common bacterial isolates were Staphylococcus aureus (38.2%) and Pseudomonas aeruginosa (21.8%). CONCLUSION Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration. PMID:28149778

  13. Acanthamoeba and Stenotrophomonas maltophilia keratitis with fungal keratitis in the contralateral eye

    OpenAIRE

    2010-01-01

    Thomas F Mauger, Rebecca Ann Kuennen, Reynell Harder Smith, William SawyerDepartment of Ophthalmology, The Ohio State University, Columbus, OH, USAPurpose: The purpose of this study is to describe the diagnosis, course, and outcome of a case of Acanthamoeba and Stenotrophomonas keratitis with a fungal keratitis in the contralateral eye.Methods: A case of Acanthamoeba and Stenotrophomonas keratitis was diagnosed with confocal microscopy and cultures with confocal diagnosis of fungal keratitis ...

  14. Hypopyon in patients with fungal keratitis

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    XU Ling-juan; SONG Xiu-sheng; ZHAO Jing; SUN Shi-ying; XIE Li-xin

    2012-01-01

    Background Hypopyon is common in eyes with fungal keratitis.The evaluation of the clinical features,culture results and the risk factors for hypopyon and of the possible correlation between hypopyon and the treatment outcome could be helpful for making treatment decisions.Methods The medical records of 1066 inpatients (1069 eyes) with fungal keratitis seen at the Shandong Eye Institute from January 2000 to December 2009 were reviewed retrospectively for demographic features,risk factors,clinical characteristics,laboratory findings and treatment outcomes.The incidence of hypopyon,the fungal culture positivity for hypopyon,risk factors for hypopyon and the effect of hypopyon on the treatment and prognosis were determined.Results We identified 1069 eyes with fungal keratitis.Of the 850 fungal culture-positive eyes,the Fusarium species was the most frequent (73.6%),followed by Altemaria (10.0%) and Aspergillus (9.0%).Upon admission,562 (52.6%)eyes with hypopyon were identified.The hypopyon of 66 eyes was evaluated via fungal culturing,and 31 eyes (47.0%)were positive.A total of 194 eyes had ocular hypertension,and 172 (88.7%) of these eyes had hypopyon (P <0.001).Risk factors for incident hypopyon included long duration of symptoms (P <0.001),large lesion size (P <0.001) and infection caused by the Fusarium and Aspergillus species (P <0.001).The positivity of fungal culture for hypopyon was associated with duration of symptoms and lesion size.Surgical intervention was more common in cases with hypopyon (P <0.001).Hypopyon was a risk factor for the recurrence of fungal keratitis after corneal transplantation (P=0.002).Conclusions Hypopyon is common in patients with severe fungal keratitis and can cause ocular hypertension.About half of the hypopyon cases were positive based on fungal culture.Long duration of symptoms,large lesion size and infection with the Fusarium and Aspergillus species were risk factors for hypopyon.The presence of hypopyon

  15. [Double-blind method of using solcoseryl ophthalmic gel and 2,4% cysteine in ophthalmic gel in patients with chronic recurrent keratitis and keratitis sicca].

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    Krzystkowa, K M; Hydzikowa, M; Szpytma, R

    1991-06-01

    A double blind study with Solcoseryl compounds in ophthalmic gel and with 2.4% cystein in ophthalmic gel was performed in the period 1985-1988; it was used in 18 cases: with chronic recurrent keratitis (11 patients) and sicca keratitis (7 patients). Observed was the influence of these compounds on the epithelialization of the cornea, on the improvement of corneal transparency, the diminutation of the troubles connected with dessication of the eye in sicca keratitis. In spite of the small number of cases the observations were interesting. In patients with a chronic recurrent keratitis the influence of both compounds showed to be beneficial for the condition of the cornea. In patients with keratitis sicca one could observe a better tolerance of the Solcoseryl ophthalmic gel which could be applied for a longer period in comparison with cystein in gel.

  16. Clinical utility of caspofungin eye drops in fungal keratitis.

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    Neoh, Chin Fen; Daniell, Mark; Chen, Sharon C-A; Stewart, Kay; Kong, David C M

    2014-08-01

    Treatment of fungal keratitis remains challenging. To date, only the polyenes and azoles are commonly used topically in the management of fungal keratitis. Natamycin, a polyene, is the only antifungal eye drop that is commercially available; the remainder are prepared in-house and are used in an 'off-label' manner. Failure of medical treatment for fungal keratitis is common, hence there is a need for more effective topical antifungal therapy. To increase the antifungal eye drop armamentarium, it is important to investigate the utility of other classes of antifungal agents for topical use. Caspofungin, an echinocandin antifungal agent, could potentially be used to address the existing shortcomings. However, little is known about the usefulness of topically administered caspofungin. This review will briefly explore the incidence, epidemiology and antifungal treatment of fungal keratitis. It will focus primarily on evidence related to the efficacy, safety and practicality of using caspofungin eye drops in fungal keratitis.

  17. [Confocal microscopy for the diagnostics of fungal keratitis].

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    Daas, L; Viestenz, A; Bischoff, M; Hasenfus, A; Seitz, B

    2016-09-01

    Fungal keratitis is a rare but very serious eye disease in industrial nations with a frequency of 1-5 % of all forms of keratitis from microbial causes. We present two patients with keratitis of primary unknown cause. Using confocal microscopy fungal filaments could be identified that partially showed a parallel configuration (like "railway tracks"). Thus, the correct diagnosis can often be made and suitable therapy can be non-invasively initiated even before the results of in vitro cultivation (fungal culture), polymerase chain reaction (PCR) and histological investigations are available.

  18. Matrix regeneration therapy:a solution to enhance healing in fungal keratitis

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    Siti Raihan Ishak; Ahmad Nurfahmi Akhtar Ali; Hayati Abdul Aziz; Mohtar Ibrahim; Denis Barritault; Wan Hazabbah Wan Hitam

    2014-01-01

    Corneal ulcers, especially of fungal origin, are a relatively common clinical entity within the spectrum of keratitis in tropical countries. The persistence of a non-healing epithelial defect is a known complication of these ulcers. Despite advances in medical therapy, the management of this condition is still challenging. CACICOL20® is a new ophthalmic matrix therapy that has been proved efficient as a corneal healing agent. To the best of our knowledge there have been reports of the limited use of matrix therapy in ocular healing, specifically in fungal keratitis. We report 2 cases of the efficacy of it as an adjuvant to topical amphotericin B in treating non-healing epithelial defects secondary to fungal corneal ulcers.

  19. Matrix regeneration therapy: a solution to enhance healing in fungal keratitis

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    Siti Raihan Ishak

    2014-01-01

    Full Text Available Corneal ulcers, especially of fungal origin, are a relatively common clinical entity within the spectrum of keratitis in tropical countries. The persistence of a non-healing epithelial defect is a known complication of these ulcers. Despite advances in medical therapy, the management of this condition is still challenging. CACICOL20® is a new ophthalmic matrix therapy that has been proved efficient as a corneal healing agent. To the best of our knowledge there have been reports of the limited use of matrix therapy in ocular healing, specifically in fungal keratitis. We report 2 cases of the efficacy of it as an adjuvant to topical amphotericin B in treating non-healing epithelial defects secondary to fungal corneal ulcers.

  20. Simultaneous bilateral fungal keratitis caused by different fungi.

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    Prajna Venkatesh

    2002-01-01

    Full Text Available Fungal keratitis is an important cause of corneal disease in the tropical world. We report a rare presentation of simultaneous bilateral corneal ulceration caused by different fungi.

  1. A Rare Devastating Complication of Lasik: Bilateral Fungal Keratitis

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    H. Taylan Sekeroglu

    2010-01-01

    Full Text Available Purpose. To report an unusual case of severe bilateral fungal keratitis following laser in situ keratomileusis (LASIK. Method. A 48-year-old man developed bilateral diffuse corneal infiltration two weeks after LASIK. The corneal scrapings revealed fungal filaments but cultures were negative. Results. The corneal ulceration was improved on the left eye whereas spontaneous perforation occurred and finally evisceration was needed on the right eye despite topical and systemic antifungal treatment. Conclusions. Fungal keratitis, especially with bilateral involvement, is a very rare and serious complication of LASIK surgery. Clinical suspicion is crucial because most of fungal keratitis are misdiagnosed as bacterial keratitis and can lead serious visual results, even eye loss.

  2. Successful treatment of Beauveria bassiana fungal keratitis with topical voriconazole.

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    Ogawa, Akiko; Matsumoto, Yukihiro; Yaguchi, Takashi; Shimmura, Shigeto; Tsubota, Kazuo

    2016-04-01

    We describe a 66-year-old woman who suffered from fungal keratitis after corneal transplantation. The causative organism was identified as Beauveria bassiana on the basis of morphological characteristics and the sequence of the internal transcribed spacer region of the ribosomal RNA gene. The patient was successfully treated with topical voriconazole (VRCZ) use only. We, hereby, present the first report of a case with B. bassiana fungal keratitis that responded to topical antifungal VRCZ treatment.

  3. Short imidazolium chains effectively clear fungal biofilm in keratitis treatment.

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    Liu, Lihong; Wu, Hong; Riduan, Siti Nurhanna; Ying, Jackie Y; Zhang, Yugen

    2013-01-01

    Fungal keratitis is a leading cause of ocular morbidity throughout the world. However, current therapies against fungal keratitis are often ineffective. Herein, we have developed the amphiphilic main-chain imidazolium polymer (PIM-45) and oligomer (IBN-1) materials that can efficiently inhibit the growth of fungi with low minimal inhibition concentration (MIC) values and clear the fungal biofilm, while displaying minimal hemolysis. In vivo keratitis treatment indicates that topical solutions of these polyimidazolium salts (PIMSs) are safe and as effective as that of amphotericin B, the most commonly used agent for the treatment of Candida albicans (C. albicans) keratitis. Compared to the costly and unstable amphotericin B and fluconazole, PIM-45 and IBN-1 are easy to prepare, inexpensive and stable. They can be stored in phosphate-buffered saline (PBS) solutions with long shelf life for routine topical use.

  4. Ineffectiveness of intrastromal voriconazole for filamentous fungal keratitis

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    Niki M

    2014-06-01

    Full Text Available Masanori Niki, Hiroshi Eguchi, Yuki Hayashi, Tatsuro Miyamoto, Fumika Hotta, Yoshinori MitamuraDepartment of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima-shi, JapanPurpose: The purpose of this study is to describe the ineffectiveness of intrastromal voriconazole injection for filamentous fungal keratitis by contrasting the effectiveness for yeast keratitis.Methods: We examined seven fungal keratitis patients prospectively. All yeast was identified by molecular phylogenetic analyses of the chromosomal regions coding for the D1/D2 domain of the large-subunit 26S ribosomal RNA gene. All filamentous fungi were identified by the sequencing of internal transcribed spacers of the ribosomal DNA gene regions. Approximately 0.1 mL of voriconazole diluted with saline to 1.0% was injected with a 30-gauge needle inserted obliquely into the three to five clear cornea sites around the abscess. All subjects were administered natamycin ointment and oral itraconazole. When needed, intravenous micafungin, voriconazole, and/or intracameral voriconazole were added. Clinical courses were observed by the slit lamp microscope. Histopathology was examined when the corneas were removed.Results: All cases that were caused by yeast healed quickly after injections. Two cases of keratitis caused by Fusarium, and one case caused by Aspergillus, did not heal completely. In the Fusarium cases, additional antifungal medications (3.0% topical voriconazole and intravenous injection of micafungin were needed. After optical penetrating keratoplasty in one of the cases, fungi were found in the deep stroma of the removed cornea. In the case of Aspergillus keratitis, pathological findings also showed fungi deep in the stroma of the removed cornea and the keratitis recurred after therapeutic penetrating keratoplasty.Conclusion: Intrastromal voriconazole injection is successful in treating yeast keratitis. However this is not the

  5. Clinical experiences in fungal keratitis caused by Acremonium

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    Kim SJ

    2014-01-01

    Full Text Available Seong-Jae Kim,1,2 Yong-Wun Cho,1 Seong-Wook Seo,1,2 Sun-Joo Kim,2,3 Ji-Myong Yoo1,21Department of Ophthalmology, 2Gyeongsang Institute of Health Science, 3Department of Laboratory Medicine, Gyeongsang National University, College of Medicine, Jinju, KoreaPurpose: To report the predisposing risk factors, clinical presentation, management, and therapeutic outcomes of fungal keratitis caused by Acremonium.Methods: This is a retrospective study of cases with Acremonium fungal keratitis that presented to our tertiary referral center between January 2006 and August 2012. Patient demographic and clinical details were determined and reported.Results: Five cases of fungal keratitis from Acremonium species were identified in five patients (three males, two females. The mean age of the patients was of 73.4±5.46 years, with a mean follow-up time of 124±72 days. All patients had a history of corneal trauma with vegetable matter. Four cases were unresponsive to initial treatment (0.2% fluconazole, 0.15% amphotericin B and required topical 5% natamycin, and, in two out of five cases, topical 1% voriconazole.Conclusion: The most common risk factors for Acremonium fungal keratitis was ocular trauma. When a corneal lesion is found to be unresponsive to the initial treatment, we should consider adding or substituting topical natamycin or voriconazole for treatment.Keywords: Acremonium, fungal keratitis, natamycin, prognosis, voriconazole

  6. Evaluation of Diagnostic Sensitivity of Wet Preparation Microscopy Using KOH for Detection of Fungal Agents from Keratitis Patients

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    Neeta D Khokhar, Summaiya A Mulla, Latika N Shah, Geeta M Vaghela

    2013-01-01

    Full Text Available Background: Keratitis is a common ophthalmic condition mostly caused by fungi. Apart from fungal culture, wet preparation using 10% Potassium hydroxide (KOH for microscopic detection of fungal elements is a rapid and accurate method of laboratory diagnosis. Purpose: This prospective study was undertaken in order to evaluate the diagnostic sensitivity of wet preparation microscopy using KOH for detection of fungal agents from keratitis patients. Methodology: 103 samples of clinically suspected patients of keratitis attending tertiary care hospital between march 2010 and june 2011 were included. Samples like corneal swabs, corneal scrapings, corneal button, and corneo-scleral rim were collected aseptically after slit lamp examination, then transported to microbiology laboratory. Samples were processed for direct microscopy (gram stain and 10% KOH wet mount preparation and culture. Culture positive isolates were identified based on morphology and standard biochemical tests. Data entry and analysis was done statistically. Results: From 103 samples, fungal culture was positive in 12%. Different fungus isolates include Aspergillus flavus (67% and Candida spp (25% were the leading fungi followed by Curvularis (8%. Direct microscopical examination using KOH wet preparation and gram’s stain had detected fungal elements in 83% and 75% samples respectively against culture results. Conclusion: Aspergillus flavus (67%, Candida spp (25% and Curvularia spp (8% was most common cause of fungal keratitis. Wet mount with KOH can be relied upon as the single most important screening tool for rapid diagnosis of fungal corneal ulcer and treatment should be dispensed on its basis.

  7. Fungal keratitis due to Schizophyllum commune: an emerging pathogenic fungus.

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    Reddy, Ashok Kumar; Ashok, Rangaiahgari; Majety, Madhavi; Chitta, Megharaj; Narayen, Nitesh

    2016-07-12

    Fungal keratitis due to Schizophyllum commune is very rare. In this study, we report the clinical and microbiological profile of five patients with fungal keratitis due to S. commune. Direct microscopic examination of corneal scrapings from all five patients showed septate branching hyaline fungal filaments. Similarly, in all five patients Sabouraud dextrose agar (SDA) plates inoculated with corneal scrapings showed white, cottony colonies on the second day of incubation. Lactophenol cotton blue stained wet preparation of 7-day-old colonies on SDA revealed clamp connections and no spores. The fungus was identified by its characteristic clamp connections, fan-shaped bracket fruiting body with pinkish-grey longitudinally split-radiating gills. The phenotypic identification of one of the five isolates further conformed by ITS sequencing. Treatment outcome was available for two of the five patients; in these two patients, the keratitis resolved with topical natamycin. © 2016 Blackwell Verlag GmbH.

  8. Distinguishing fungal and bacterial keratitis on clinical signs

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    Astrid Leck

    2015-06-01

    Full Text Available In many settings, laboratory support for the diagnosis of the type of microbial keratitis is not available. Experienced ophthalmologists have long maintained that it is sometimes possible to distinguish fungal from bacterial microbial keratitis on the basis of clinical signs. Formal data to support this view are limited, and it is important to establish the validity of such claims to understand whether signs can reliably guide clinical decisions. In addition, antifungal treatment is often in limited supply and prohibitively expensive. Therefore, it is not feasible or desirable to prescribe empirical antifungal therapy to every patient who presents with microbial keratitis in tropical regions, where fungal infections are more frequent. Here we review research to determine whether it is possible to reliably distinguish bacterial and fungal infection clinical features alone.

  9. Review of clinical and basic approaches of fungal keratitis

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    Wu, Jie; Zhang, Wen-Song; Zhao, Jing; Zhou, Hong-Yan

    2016-01-01

    Fungal keratitis (FK) is a serious disease which can cause blindness. This review has current information about the pathogenesis, limitations of traditional diagnosis and therapeutic strategies, immune recognition and the diagnosis and therapy of FK. The information of this summary was reviewed regularly and updated as what we need in the diagnosis and therapy of FK nowadays. PMID:27990375

  10. Effect of topical application of terbinafine on fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    LIANG Qing-feng; JIN Xiu-ying; WANG Xiang-lan; SUN Xu-guang

    2009-01-01

    Background Fungal keratitis is a rare but serious corneal disease that may result in loss of vision.The poor prognosis might be due to limited treatment option.This study aimed to evaluate the clinical efficacy of 0.25% terbinafine eye drops comparing with 5% natamycin suspension on fungal keratitis.Methods A retrospective clinical trial was performed on 90 patients presenting with direct smear and/or culture positive fungal keratitis at Beijing Tongren Hospital,Beijing,China from January 2006 to May 2008.Corneal ulcers were categorized as mild or severe.Forty-five patients were treated with topical terbinafine and the next 45 cases received topical natamycin hourly.Results Filamentous fungi were found in corneal scrapings among all 90 cases.Fungal cultures were positive in 64 patients (71%).Species of Fusarium and Aspergillus were the principal isolates.Forty (89%) patients showed favorable response to terbinafine,while forty-two (93%) patients exhibited favorable response to natamycin (P >0.05).The mean course of treatment was significantly showed in the terbinafine treatment group than natamycin group ((26.5±11.2) days versus (19.3±6.4) days;P <0.05).In terbinafine group,twenty patients with ulcers smaller than 4 mm had favorable outcome,while 20 of 25 patients with ulcers more than 4 mm in diameter had favorable response (P <0.05).Twenty-seven patients with depth of infiltration less than half of stroma thickness had favorable response to terbinafine,while 13 of 18 patients with depth of infiltration more than half of stroma responded to terbinafine.This difference was statistically significant (P<0.05).Conclusions Our findings suggest that topical terbinafine is an effective antifungal drug for the management of filamentous mycotic keratitis,particularly in cases with smaller and shallower ulcers.Its mean duration of treatment was longer than natamycin.

  11. Etiological Analysis of Fungal Keratitis and Rapid Identification of Predominant Fungal Pathogens.

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    He, Dan; Hao, Jilong; Gao, Song; Wan, Xue; Wang, Wanting; Shan, Qiushi; Wang, Li

    2016-02-01

    Fungal keratitis is a worldwide-distributed refractory and potentially blinding ocular infection caused by various fungi. It is necessary to investigate the etiological and epidemiological characteristics of this disease and establish a rapid and specific pathogenic identification method. Here, we isolated and identified fungal pathogens of 275 patients with presumed fungal keratitis from Jilin Province, China, and conducted statistical analyses of epidemiological information. The positive rate of fungal culture was 72.0 %. Fusarium sp. was the most common genus among 210 fungal isolates. The predominant species were Fusarium solani, Aspergillus fumigatus, and Candida glabrata, which accounted for over 50 % of the isolated organisms. Corneal trauma and previous use of drugs were the most important predisposing factors. In addition, a multiplex polymerase chain reaction (PCR) was designed with species-specific primers of the three species that could identify them with amplicons of approximately 330 bp from F. solani, 275 bp from A. fumigatus, and 230 bp from C. glabrata. Additionally, PCR with fungal universal primers and multiplex PCR were performed using DNA prepared by an improved DNA extraction method from corneal scrapings. With this method, fungal pathogens from corneal scrapings could be specifically and rapidly identified within 8 h. The culture-independent rapid identification of corneal scrapings may have great significance for the early diagnosis and treatment of fungal keratitis.

  12. Fungal keratitis caused by Macrophomina phaseolina – A case report

    Science.gov (United States)

    Premamalini, T.; Ambujavalli, B.T.; Vijayakumar, R.; Rajyoganandh, S.V.; Kalpana, S.; Kindo, Anupma J

    2012-01-01

    A 70 year old female patient presented with complaints of pain, watering and swelling in the right eye. She gave a history of fall, as she was walking in the paddy field of her farm. Ophthalmological and Microbiological investigation revealed a fungal keratitis with an unusual fungus Macrophomina phaseolina which is primarily a plant pathogen, with a potential to cause human infections especially in immuno-compromised patients. The patient responded well to the antifungal treatment with Oral Voriconazole with absence of recurrence and dissemination. PMID:24371757

  13. Fungal keratitis caused by Macrophomina phaseolina - A case report.

    Science.gov (United States)

    Premamalini, T; Ambujavalli, B T; Vijayakumar, R; Rajyoganandh, S V; Kalpana, S; Kindo, Anupma J

    2012-01-01

    A 70 year old female patient presented with complaints of pain, watering and swelling in the right eye. She gave a history of fall, as she was walking in the paddy field of her farm. Ophthalmological and Microbiological investigation revealed a fungal keratitis with an unusual fungus Macrophomina phaseolina which is primarily a plant pathogen, with a potential to cause human infections especially in immuno-compromised patients. The patient responded well to the antifungal treatment with Oral Voriconazole with absence of recurrence and dissemination.

  14. [Several problems of diagnosis and treatment in fungal keratitis in China].

    Science.gov (United States)

    Shi, Wei-yun; Wang, Ting

    2013-01-01

    Fungal keratitis is one of major blindness disease in corneal infection. At present, mistake and missed diagnosis were often happened in Fungal keratitis. Initial doctor was insufficient knowledge of diagnosis. There were not to do etiology examination in corneal fungal infection, and lead to some case getting worse during medicinal treated. Highly ratio patients need controlled infection by corneal transplantation due to severe lack antifungal eye drops, and poor understood the way of antifungal medicine in clinic. Finally, Fungal keratitis is still one of major intractable disease in corneal infection, because some doctor were short of experience to hold surgical opportunity and indication, and corneal donor severe shortage in China.

  15. Effects of lactoferricin B against keratitis-associated fungal biofilms.

    Science.gov (United States)

    Sengupta, Jayangshu; Saha, Suman; Khetan, Archana; Sarkar, Sujoy K; Mandal, Santi M

    2012-10-01

    Biofilms are considered as the most important developmental characteristics in ocular infections. Biofilm eradication is a major challenge today to overcome the incidence of drug resistance. This report demonstrates the in vitro ability of biofilm formation on contact lens by three common keratitis-associated fungal pathogens, namely, Aspergillus fumigatus, Fusarium solani, and Candida albicans. Antifungal sensitivity testing performed for both planktonic cells and biofilm revealed the sessile phenotype to be resistant at MIC levels for the planktonic cells and also at higher concentrations. A prototype lens care solution was also found to be partially effective in eradication of the mature biofilm from contact lenses. Lactoferricin B (Lacf, 64 μg/ml), an antimicrobial peptide, exhibited almost no effect on the sessile phenotype. However, the combinatory effect of Lacf with antifungals against planktonic cells and biofilms of three fungal strains that were isolated from keratitis patients exhibited a reduction of antifungal dose more than eightfold. Furthermore, the effect of Lacf in lens care solution against biofilms in which those strains formed was eradicated successfully. These results suggest that lactoferricin B could be a promising candidate for clinical use in improving biofilm susceptibility to antifungals and also as an antibiofilm-antifungal additive in lens care solution.

  16. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

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    Fadzillah Mohd-Tahir

    2012-01-01

    Full Text Available Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27% were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41% cases of positive isolates. Of these, in eleven cases (23.40% patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34% cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future.

  17. Successful salvage treatment of Lecythophora mutabilis keratitis with topical voriconazole

    Directory of Open Access Journals (Sweden)

    Bora Yüksel

    2011-09-01

    Full Text Available Fungal keratitis is an important ophthalmic problem in the developing world. Filamentous fungi are the most frequently reported pathogens in fungal keratitis. This report aimed to present a case with Lecythophora mutabilis keratitis that treatment failure was seen with topical and systemic amphotericin B lipid complex. Then she was treated successfully topical voriconazole. J Microbiol Infect Dis 2011;1 (2: 75-77

  18. 真菌性角膜炎%Fungal Keratitis

    Institute of Scientific and Technical Information of China (English)

    谢立信; 马琳

    2005-01-01

    真菌性角膜炎(fungal keratitis)是严重的致盲性眼病,其发病多与外伤有关,特别是植物性外伤。其早期诊断、早期治疗对防盲、治盲意义重大。目前,眼科医生对该病的诊治经验尚不足,加之缺乏有效的抗真菌药物,真菌性角膜炎已成为当今感染性角膜炎中最棘手的问题。我们需积极积累经验,深入进行真菌性角膜炎的临床和基础研究。

  19. Fungal keratitis in the United Kingdom 2003-2005.

    Science.gov (United States)

    Tuft, S J; Tullo, A B

    2009-06-01

    To describe the incidence and current management of fungal keratitis in the United Kingdom. Cases were identified prospectively through the British Ophthalmologic Surveillance Unit (BOSU) from December 2003 to November 2005. Questionnaire data were requested at diagnosis and at 6 months follow-up. Inclusion criteria were a positive culture or microsopic proof from a scraping or biopsy, and a normal residence in the United Kingdom. Data were available on 39 confirmed cases at diagnosis and 34 cases at follow-up. The minimum average annualised incidence was 0.32 (95% CI, 0.24-0.44) cases per million individuals. In 22 cases (56%), only Candida was isolated and 14 of these (63%) had prior ocular surface disease treated with topical steroid. A filamentary fungus infection was more common in male patients (P=0.02), often following trauma, and the differences in risk factors between types of fungal infection was statistically significant (PUnited Kingdom. It provides evidence of frequent delay in diagnosis after presentation to eye departments, inconsistent management, and poor outcome. Issues that can now be addressed.

  20. Rapid detection of fungal keratitis with DNA-stabilizing FTA filter paper.

    Science.gov (United States)

    Menassa, Nardine; Bosshard, Philipp P; Kaufmann, Claude; Grimm, Christian; Auffarth, Gerd U; Thiel, Michael A

    2010-04-01

    Purpose. Polymerase chain reaction (PCR) is increasingly important for the rapid detection of fungal keratitis. However, techniques of specimen collection and DNA extraction before PCR may interfere with test sensitivity. The purpose of this study was to investigate the use of DNA-stabilizing FTA filter paper (Indicating FTA filter paper; Whatman International, Ltd., Maidstone, UK) for specimen collection without DNA extraction in a single-step, nonnested PCR for fungal keratitis. Methods. Specimens were collected from ocular surfaces with FTA filter discs, which automatically lyse collected cells and stabilize nucleic acids. Filter discs were directly used in single-step PCR reactions to detect fungal DNA. Test sensitivity was evaluated with serial dilutions of Candida albicans, Fusarium oxysporum, and Aspergillus fumigatus cultures. Test specificity was analyzed by comparing 196 and 155 healthy individuals from Switzerland and Egypt, respectively, with 15 patients with a diagnosis of microbial keratitis. Results. PCR with filter discs detected 3 C. albicans, 25 F. oxysporum, and 125 A. fumigatus organisms. In healthy volunteers, fungal PCR was positive in 1.0% and 8.4% of eyes from Switzerland and Egypt, respectively. Fungal PCR remained negative in 10 cases of culture-proven bacterial keratitis, became positive in 4 cases of fungal keratitis, but missed 1 case of culture-proven A. fumigatus keratitis. Conclusions. FTA filter paper for specimen collection together with direct PCR is a promising method of detecting fungal keratitis. The analytical sensitivity is high without the need for a semi-nested or nested second PCR, the clinical specificity is 91.7% to 99.0%, and the method is rapid and inexpensive.

  1. Comparison on the sensitivity of laboratory diagnosis technology in the diagnosis of fungal keratitis

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    Peng-Fei Chen

    2015-08-01

    Full Text Available AIM: To analyze the correlation and clinical significance of fungal smear, fungal culture and pathological examination in the diagnosis of fungalkeratitis. METHODS:One hundred and ten cases(110 eyeswith fungal keratitis from January 2012 to December 2014 were collected. The results of fungal smear, fungal culture and pathological examination results were analyzed retrospectively. Fungal smear was detected by 10% KOH wet microscopy and gram staining microscopy. Fungal culture was used potato dextrose agar(PDAmedium. The specimens of pathological examination were from corneal transplantation surgery. paraffin section, HE and hexamine silver and PAS staining was used in the pathological examination. RESULTS:Of the 110 cases of fungal keratitis, fungal smear positive were observed in 50 cases(45.5%, fungal culture positive were observed in 55 cases(50.0%; pathological examination positive were observed in 88 cases(80.0%. Fifty cases were both fungal smear and pathological examination positive and 22 cases were both fungal smear and pathological examination negative. The coincidence rate of fungal smear and pathologic examination was 65.5%. Fifty-five cases were both fungal culture and pathological examination positive and 22 cases were both fungal culture and pathological examination negative. The coincidence rate of fungal culture and pathologic examination was 70.0%. In the 60 cases of fungal smear negative results, 38 cases(63.3%were confirmed positive through pathological examination. In the 55 cases of fungus culture negative results, 33 cases(60.0%were confirmed positive by pathological examination. CONCLUSION:The accuracy of pathological examination is the highest. The combined application of fungal smear, fungal culture and pathological examination can improve the diagnostic accuracy of fungal keratitis.

  2. Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study

    Directory of Open Access Journals (Sweden)

    Bharathi Jayahar

    2003-01-01

    Full Text Available Purpose: To study the epidemiological characteristics and laboratory diagnosis of fungal keratitis seen at a tertiary eye care referral centre in South India. Methods: A retrospective review of all culture-proven fungal keratitis seen over a 3-year period, September 1999 through August 2002. Results: Fungal aetiology were confirmed in1095(34.4% of 3183 corneal ulcers. The predominant fungal species isolated was Fusarium spp (471; 42.82% followed by Aspergillus spp (286; 26%. Males (712; 65.08% were more often affected (P< 0.0001. A large proportion of the patients (732; 66.85% were in the younger age group (21 to 50 years. A majority (879; 80.27% came from rural areas (P Conclusion: Agricultural activity and related ocular trauma were principal causes of mycotic keratitis. A potassium hydroxide (KOH wet mount preparation is a simple, and sensitive, method for diagnosis.

  3. Pathogenic spectrum of fungal keratitis and specific identification of Fusarium solani.

    Science.gov (United States)

    He, Dan; Hao, Jilong; Zhang, Bo; Yang, Yanqiu; Song, Wengang; Zhang, Yunfeng; Yokoyama, Koji; Wang, Li

    2011-04-25

    To investigate the predominant causative pathogens and epidemiologic features of fungal keratitis and establish a rapid, specific molecular method to detect fungal keratitis caused by Fusarium solani. A total of 174 patients with presumed fungal keratitis and 174 affected eyes were examined. Isolates from corneal specimens were identified according to morphologic and physiological characteristics. The primers that were designed for F. solani were tested to confirm whether they had species specificity. Multiplex PCR with universal fungal and F. solani-specific primers was performed with fungal and bacterial strains and was used to detect microorganisms in the clinical specimens. A total of 160 patients (92.0%) were diagnosed with fungal infection by either potassium hydroxide wet-mount or microbiologic culture. Fungal cultures were positive in 128 patients (73.6%) with 139 fungal isolates. Fusarium (48.2%) was the most frequently isolated genus, in which F. solani (35.2%) was the most common species, followed by the Aspergillus (18.7%) and Candida (16.6%) genera. The PCR results showed that the designed primers were species specific and suitable for specific identification of F. solani. The multiplex PCR of 3-day broth cultures could identify and distinguish F. solani from other pathogens rapidly and specifically from clinical specimens. Fusarium species, especially F. solani, were found to be the predominant cause of fungal keratitis in northeast China. The established multiplex PCR method could have potential advantages for rapid detection of F. solani. These findings might have significance for early diagnosis and treatment of fungal keratitis.

  4. Synthetic β-sheet forming peptide amphiphiles for treatment of fungal keratitis.

    Science.gov (United States)

    Wu, Hong; Ong, Zhan Yuin; Liu, Shaoqiong; Li, Yan; Wiradharma, Nikken; Yang, Yi Yan; Ying, Jackie Y

    2015-03-01

    Fungal keratitis is a leading cause of ocular morbidity. It is frequently misdiagnosed as bacterial keratitis, causing a delay in proper treatment. Furthermore, due to the lack of safe and effective anti-fungal agents for clinical use, treatment of fugal keratitis remains a challenge. In recent years, antimicrobial peptides (AMPs) have received considerable attention as potent and broad-spectrum antimicrobial agents with the potential to overcome antibiotics resistance. We previously reported the design of short synthetic β-sheet forming peptides (IKIK)2-NH2 and (IRIK)2-NH2 with excellent antimicrobial activities and selectivities against various clinically relevant microorganisms, including Gram-positive Staphylococcus epidermidis and Staphylococcus aureus, Gram-negative Escherichia coli and Pseudomonas aeruginosa, and yeast Candida albicans (C. albicans). In this study, we evaluated the application of the two most promising synthetic β-sheet forming peptide candidates for in vivo fungal keratitis treatment in comparison with the commercially available amphotericin B. It was found that topical solutions of the designed peptides are safe, and as effective as the clinically used amphotericin B. Compared to the costly and unstable amphotericin B, (IKIK)2-NH2 and (IRIK)2-NH2 are water-soluble, less expensive and stable. Thus, the synthetic β-sheet forming peptides are presented as promising candidates for the treatment of fungal keratitis.

  5. Combination of intracameral and intrastromal voriconazole in the treatment of recalcitrant Acremonium fungal keratitis.

    Science.gov (United States)

    Haddad, Randa S; El-Mollayess, Georges M

    2012-01-01

    We present a report of a 28-year-old female with fungal keratitis due to Acremonium that was unresponsive to full medical therapy over 3 weeks. The patient was treated with superficial keratectomy, intrastromal and intracameral voriconazole injections. There was a marked clinical improvement beginning on day 3 post-therapy that was sustained until the last follow-up at 6 months. This is the first case of fungal keratitis due to Acremonium treated by a combination of intrastromal and intracameral voriconazole. This cost-effective treatment modality proved to be significant in impeding the progression of this potentially blinding disease and improving visual prognosis.

  6. Wickerhamomyces anomalus fungal keratitis responds to topical treatment with antifungal micafungin.

    Science.gov (United States)

    Kamoshita, Mamoru; Matsumoto, Yukihiro; Nishimura, Kazuko; Katono, Yasuhiro; Murata, Mitsuru; Ozawa, Yoko; Shimmura, Shigeto; Tsubota, Kazuo

    2015-02-01

    We describe a 91-year-old woman who suffered from fungal keratitis after corneal transplantation. The causative organism was identified as Wickerhamomyces anomalus (formerly Pichia anomala or Hansenula anomala) on the basis of morphological characteristics and the sequence of the internal transcribed spacer region of the ribosomal RNA gene. The patient was successfully treated with topical micafungin (MCFG) only. We present the first report of a case of W. anomalus fungal keratitis that responded to topical treatment with the antifungal MCFG.

  7. [Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey-comment].

    Science.gov (United States)

    Atalay, Mustafa Altay; Koc, Ayşe Nedret

    2014-04-01

    Scedosporium apiospermum is a saprophytic fungus which is isolated worldwide in soil, fertilizers, polluted water, rotten vegetables, and other natural environments. It is the cause of mycetoma, a subcutaneous infection, characterized by granule formation. It may also cause severe local or diffuse infections in immunosuppressive patients. S.apiospermum-induced arthritis, endocarditis, keratitis, scleritis, endophthalmitis, meningitis, osteomyelitis, otomycosis, onychomycosis, chronic prostatitis, peritonitis, esophagitis, renal infection, and hepatosplenic abscess have been previously reported in the literature. Possible risk factors of fungal keratitis, one of the major causes of fungal ocular infection, include ocular injury, long-term therapy with topical or systemic steroids, immunosuppressive agents, and underlying diseases such as pre-existing corneal surface abnormality and diabetes mellitus, and wearing contact lenses. We paid great attention to the case report presented by Kalkan Akçay E et al. titled "Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey", which was published in the October 2013 issue of Bulletin of Microbiology [Mikrobiyol Bul 2013; 47(4): 727-33]. Although it is deemed as the first case report of S.apiospermum-related fungal keratitis in Turkey, there were several previous case reports of ocular infections associated with this type of fungus in Turkey, including those of Yucel A titled "An eye mycosis caused by Scedosporium apiospermum (Monosporium apiospermum)" published in 1989, Kiratli et al. titled "Scedosporium apiospermum chorioretinitis" in 2001, Saracli et al. titled "Scedosporium apiospermum keratitis treated with itraconazole" in 2003 and Erdem et al. titled "Clinical follow up of a keratomycosis case with total corneal melting" in 2005. In conclusion, it should be highlighted that the report of Kalkan Akcay et al. is not the first case report of Scedosporium apiospermum-related fungal keratitis in

  8. Bipolaris oryzae, a novel fungal opportunist causing keratitis.

    Science.gov (United States)

    Wang, Luxia; Al-Hatmi, Abdullah M S; Lai, Xuwen; Peng, Lianghong; Yang, Chuanhong; Lai, Huangwen; Li, Jianxun; Meis, Jacques F; de Hoog, G Sybren; Zhuo, Chao; Chen, Min

    2016-05-01

    We report a case of mycotic keratitis caused by Bipolaris oryzae with predisposing trauma from a foreign body. The fungus was identified by sequencing the internal transcribed spacer region, translation elongation factor 1α (TEF1) gene, and partial glyceraldehyde-3-phosphate dehydrogenase (GPDH) gene, and the species identity was confirmed on the basis of its characteristic conidial phenotype. The patient was treated with surgical intervention and antifungal agents, including intravenous fluconazole (FLC), oral itraconazole, topical 0.15% amphotericin B eye drops, and 0.5% FLC eye drops. To our knowledge, this is the first report of mycotic keratitis caused by B. oryzae worldwide.

  9. Rapid and sensitive diagnosis of fungal keratitis with direct PCR without template DNA extraction.

    Science.gov (United States)

    Zhao, G; Zhai, H; Yuan, Q; Sun, S; Liu, T; Xie, L

    2014-10-01

    This study was aimed at developing a direct PCR assay without template DNA extraction for the rapid and sensitive diagnosis of infectious keratitis. Eighty corneal scrapings from 67 consecutive patients with clinically suspected infectious keratitis were analysed prospectively. Direct PCR was performed with all scrapings, with specific primers for fungi, bacteria, herpes simplex virus-1 (HSV-1) and Acanthamoeba simultaneously. The results were compared with those obtained from culture, smear, and confocal microscopy. Discrepant results were resolved according to the therapeutic effects of the corresponding antimicrobial drugs. The lowest detection limit of direct PCR was ten copies of each pathogen. Sixty-six scrapings yielded positive results with direct PCR, giving a total positive detection rate of 82.5% (66/80). For 34 patients with high suspicion of fungal keratitis, the positive detection rate of direct PCR was 84.8% (39/46). This rate increased to 91.2% (31/34) when repeated scrapings were excluded, and was significantly higher than the rates obtained with culture (35.3%, 12/34) and smear (64.7%, 22/34) (p keratitis with direct PCR and culture were 98.0% and 47.1% (p keratitis, and it is expected to have an impact on the diagnosis and treatment of infectious keratitis in the future.

  10. Bipolaris oryzae, a novel fungal opportunist causing keratitis

    NARCIS (Netherlands)

    Al-Hatmi, Abdullah

    2015-01-01

    We report a case of mycotic keratitis caused by Bipolaris oryzae with predisposing trauma from a foreign body. The fungus was identified by sequencing the internal transcribed spacer (ITS) region, translation elongation factor 1α (TEF1) gene and partial glyceraldehyde-3-phosphate dehydrogenase (GPDH

  11. Efficacy of Antibody to PNAG Against Keratitis Caused by Fungal Pathogens

    Science.gov (United States)

    Zhao, Ge; Zaidi, Tanweer S.; Bozkurt-Guzel, Cagla; Zaidi, Tauqeer H.; Lederer, James A.; Priebe, Gregory P.; Pier, Gerald B.

    2016-01-01

    Purpose Developing immunotherapies for fungal eye infections is a high priority. We analyzed fungal pathogens for expression of the surface polysaccharide, poly-N-acetyl glucosamine (PNAG), and used a mouse model of ocular keratitis caused by Aspergillus flavus, A. fumigatus, or Fusarium solani to determine if PNAG was an immunotherapy target and requirements for ancillary cellular and molecular immune effectors. Methods Enzyme-linked immunosorbent assay (ELISA) or immunofluorescence was used to detect PNAG on fungal cells. Keratitis was induced by scratching corneas of C57BL/6, IL-17R KO, RAG-1 KO, or IL-22 KO mice followed by inoculation with fungal pathogens. Goat antibodies to PNAG, a PNAG-specific human IgG1 monoclonal antibody, or control antibodies were injected either prophylactically plus therapeutically or therapeutically only, and corneal pathology and fungal levels determined in infected eyes at 24 or 48 hours after infection. Results All tested fungal species produced PNAG. Prophylactic or therapeutic treatment by intraperitoneal (IP) injection of antibody to PNAG combined with post-infection topical application of antibody, the latter also used for A. fumigatus, led to reduced fungal levels, corneal pathology, and cytokine expression. Topical administration only of the PNAG monoclonal antibodies (MAb) reduced fungal loads and corneal pathology. There was no antibody protection in IL-17R KO, RAG-1 KO, or IL-22 KO mice. Conclusions Poly-N-acetyl glucosamine is produced by clinically important fungal ocular pathogens. Antibody to PNAG demonstrated protection against Aspergillus and Fusarium keratitis, requiring T cells producing IL-17 and IL-22. These findings indicate the potential to prevent or treat fungal infections by vaccines and immunotherapeutics to PNAG. PMID:28002842

  12. Incidence and clinical characteristics of fungal keratitis in a Danish population from 2000 to 2013

    DEFF Research Database (Denmark)

    Nielsen, Stine E.; Nielsen, Esben; Julian, Hanne Olsen

    2015-01-01

    keratitis were identified. Risk factors, clinical signs and outcome were registered. RESULTS: Twenty-five patients were identified: 52% with Candida, 20% with Fusarium, 16% with Aspergillus and 12% with mixed filamentous fungi. A minimum incidence of fungal keratitis of 0.6 cases per million per year...... was estimated. Prior topical steroid treatment was commonly found in our cases (44%). Trauma including contact lens wear was associated with infection with filamentous fungi, whereas in patients with Candida infection, ocular surface disease was a prominent feature. Median time from onset of symptoms...

  13. Fungal interface keratitis by Candida orthopsilosis following deep anterior lamellar keratoplasty.

    Science.gov (United States)

    Wessel, Julia M; Bachmann, Björn O; Meiller, Ralph; Kruse, Friedrich E

    2013-01-23

    A 39-year-old male patient underwent uncomplicated deep anterior lamellar keratoplasty due to keratoconus. On day 5 after surgery, small whitish infiltrates developed in the corneal interface. The diagnosis of fungal keratitis was made when the culture medium of the graft grew Candida after the surgical intervention. Despite intensive antimycotic treatment and irrigation of the interface, the infiltrates persisted and eventually enlarged. Therefore, revision surgery with penetrating keratoplasty was performed. Microbiological analysis showed Candida orthopsilosis in the culture of the excised graft button. Histopathological staining of the excised graft showed periodic acid-Schiff-positive and Grocott methenamine silver-positive clusters of yeast between Descemet's membrane and the deep corneal stroma with focal perforations through Descemet's membrane. The treatment of mycotic keratitis caused by C orthopsilosis is challenging. Antimycotic treatment was unsuccessful in this case. Progression of the keratitis and perforation of Descemet's membrane suggest that early surgical intervention by penetrating keratoplasty is required.

  14. Fungal Keratitis Due to Beauveria bassiana in a Contact Lenses Wearer and Review of Published Reports.

    Science.gov (United States)

    Lara Oya, Ana; Medialdea Hurtado, María Eloisa; Rojo Martín, María Dolores; Aguilera Pérez, Antonia; Alastruey-Izquierdo, Ana; Miranda Casas, Consuelo; Rubio Prats, Marina; Medialdea Marcos, Santiago; Navarro Marí, José María

    2016-10-01

    Fungal keratitis is a severe ocular infection that primarily affects subjects engaged in outdoor activities. Risk factors include allergic conjunctivitis, previous eye surgery, previous treatment with wide-spectrum antimicrobial agents and corticosteroids and using contact lenses. Corneal infection is usually secondary to trauma involving organic material, which is often the only predisposing factor. Early diagnosis based on clinical examination and microbiological investigation (microscopy, cultures and molecular techniques) is crucial to selecting the appropriate antifungal therapy and prevent progression. We report the case of a patient with keratitis due to Beauveria bassiana, an opportunistic and entomopathogenic filamentous fungus that is used as a biological insecticide and which is a rare cause of corneal infection. We review previous cases reports of B. bassiana keratitis published and its main features to compare with our case, a female occasional agriculture worker who had not suffered any trauma involving organic material. The patient received topical and oral antifungal therapy and debridement surgery, with a satisfactory outcome.

  15. Study of Pathogens of Fungal Keratitis and the Sensitivity of Pathogenic Fungi to Therapeutic Agents with the Disk Diffusion Method.

    Science.gov (United States)

    Wang, Lulu; Wang, Liya; Han, Lei; Yin, Weijing

    2015-01-01

    To identify the causative fungi of fungal keratitis, test their susceptibility to antifungal agents with the disk diffusion method and study the relationship between the organisms, the inhibition zones and the clinical outcomes. 535 patients with fungal keratitis in one eye were included in this study. Pathogenic fungi were isolated by corneal scraping, identified by fungal cultivation and subjected to drug sensitivity tests conducted with the disk diffusion method. The patients were treated initially with voriconazole, terbinafine and natamycin eye drops for one week. Further treatment continued using the most effective drug according to the drug sensitivity results. The patients were followed up every week until three months after cured. The inhibition zones of fungi cultured with voriconazole, terbinafine and natamycin were compared. The relationship between inhibition zones and organism, organism and treatment results measure, and each treatment results measure and inhibition zones were evaluated. Of 535 patients, 53.84%, 19.25% and 26.91% were infected with Aspergillus, Fusarium and other fungi, respectively. Keratitis patients infected with Aspergillus keratitis had the worst outcome. The size of the inhibition zones of Aspergillus spp., Fusarium spp. and other fungal genera differed significantly in response to voriconazole, terbinafine and natamycin. The inhibition zone associated with natamycin correlated significantly with the clinical outcome of fungal keratitis (OR = 0.925), but no other such correlations were found for the other drugs tested. Aspergillus and Fusarium were the predominant pathogenic genera causing fungal keratitis in our patients. Among the causative fungi, infections due to Aspergillus spp. were associated with the worst outcomes. The inhibition zones of fungal isolates in response to natamycin significantly correlated with the treatment outcomes of keratitis. Specifically, the smaller the natamycin inhibition zone, the lower the

  16. Bacterial and fungal keratitis in Upper Egypt: In vitro screening of enzymes, toxins and antifungal activity

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    Abdullah A Gharamah

    2014-01-01

    Full Text Available Purpose: This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents. Materials and Methods: One hundred and fifteen patients clinically diagnosed to have microbial keratitis were investigated. From these cases, 37 bacterial isolates and 25 fungal isolates were screened for their ability to produce extra-cellular enzymes in solid media. In addition, the ability of fungal isolates to produce mycotoxins and their sensitivity to 4 antifungal agents were tested. Results: Protease, lipase, hemolysins, urease, phosphatase, and catalase were detected respectively in 48.65%, 37.84%, 59.46%, 43.24%, 67.57%, and 100% out of 37 bacterial isolates tested. Out of 25 fungal isolates tested during the present study, 80% were positive for protease, 84% for lipase and urease, 28% for blood hemolysis, and 100% for phosphatase and catalase enzymes. Thirteen fungal isolates were able to produce detectable amounts of 7 mycotoxins in culture medium (aflatoxins (B1, B2, G1, and G2, sterigmatocystin, fumagillin, diacetoxyscirpenol, zearalenone, T-2 toxin, and trichodermin. Among the antifungal agents tested in this study, terbinafine showed the highest effect against most isolates in vitro. Conclusion: In conclusion, the ability of bacterial and fungal isolates to produce extracellular enzymes and toxins may be aid in the invasion and destruction of eye tissues, which, in turn, lead to vision loss.

  17. Bacterial and fungal keratitis in Upper Egypt: in vitro screening of enzymes, toxins and antifungal activity.

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    Gharamah, Abdullah A; Moharram, Ahmed M; Ismail, Mady A; Al-Hussaini, Ashraf K

    2014-02-01

    This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents. One hundred and fifteen patients clinically diagnosed to have microbial keratitis were investigated. From these cases, 37 bacterial isolates and 25 fungal isolates were screened for their ability to produce extra-cellular enzymes in solid media. In addition, the ability of fungal isolates to produce mycotoxins and their sensitivity to 4 antifungal agents were tested. Protease, lipase, hemolysins, urease, phosphatase, and catalase were detected respectively in 48.65%, 37.84%, 59.46%, 43.24%, 67.57%, and 100% out of 37 bacterial isolates tested. Out of 25 fungal isolates tested during the present study, 80% were positive for protease, 84% for lipase and urease, 28% for blood hemolysis, and 100% for phosphatase and catalase enzymes. Thirteen fungal isolates were able to produce detectable amounts of 7 mycotoxins in culture medium (aflatoxins (B1, B2, G1, and G2), sterigmatocystin, fumagillin, diacetoxyscirpenol, zearalenone, T-2 toxin, and trichodermin). Among the antifungal agents tested in this study, terbinafine showed the highest effect against most isolates in vitro. In conclusion, the ability of bacterial and fungal isolates to produce extracellular enzymes and toxins may be aid in the invasion and destruction of eye tissues, which, in turn, lead to vision loss.

  18. In vivo confocal microscopy appearance of Fusarium and Aspergillus species in fungal keratitis.

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    Chidambaram, Jaya Devi; Prajna, Namperumalsamy Venkatesh; Larke, Natasha; Macleod, David; Srikanthi, Palepu; Lanjewar, Shruti; Shah, Manisha; Lalitha, Prajna; Elakkiya, Shanmugam; Burton, Matthew J

    2017-08-01

    Clinical outcomes in fungal keratitis vary between Fusarium and Aspergillus spp, therefore distinguishing between species using morphological features such as filament branching angles, sporulation along filaments (adventitious sporulation) or dichotomous branching may be useful. In this study, we assessed these three features within Heidelberg Retina Tomograph 3 in vivo confocal microscopy (IVCM) images from culture-positive Fusarium and Aspergillus spp keratitis participants. Prospective observational cohort study in Aravind Eye Hospital (February 2011-February 2012). Eligibility criteria: age ≥18 years, stromal infiltrate ≥3 mm diameter, Fusarium or Aspergillus spp culture-positive. previous/current herpetic keratitis, visual acuity 80% corneal thinning. IVCM was performed and images analysed for branch angle, presence/absence of adventitious sporulation or dichotomous branching by a grader masked to the microbiological diagnosis. 98 participants were included (106 eligible, 8 excluded as no measurable branch angles); 68 were positive for Fusarium spp, 30 for Aspergillus spp. Mean branch angle for Fusarium spp was 59.7° (95% CI 57.7° to 61.8°), and for Aspergillus spp was 63.3° (95% CI 60.8° to 65.8°), p=0.07. No adventitious sporulation was detected in Fusarium spp ulcers. Dichotomous branching was detected in 11 ulcers (7 Aspergillus spp, 4 Fusarium spp). There was very little difference in the branching angle of Fusarium and Aspergillus spp. Adventitious sporulation was not detected and dichotomous branching was infrequently seen. Although IVCM remains a valuable tool to detect fungal filaments in fungal keratitis, it cannot be used to distinguish Fusarium from Aspergillus spp and culture remains essential to determine fungal species. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Minimal trephination penetrating keratoplasty for severe fungal keratitis complicated with hypopyon.

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    Liu, Yang; Jia, Hui; Shi, Xiaoru; Wang, Jiao; Ning, Yan; He, Bing; Wang, Chunmei; Zheng, Xiaodong

    2013-12-01

    To report outcomes after minimal trephination penetrating keratoplasty (PKP) in the treatment of severe fungal keratitis complicated with hypopyon. Retrospective case series. Series of 19 eyes in 19 patients with severe fungal keratitis complicated with hypopyon that received minimal trephination PKP. The host trephination was made equal to or smaller than the margin of the corneal lesion. Fluconazole (0.2%) was used to irrigate the trephined edge and anterior chamber during surgery, followed by irrigation of the anterior chamber with a 0.02% fluconazole solution after graft transplantation. Postoperative complications, graft rejection, transparency rate, and visual acuity were recorded. Patients were followed postoperatively for 18 to 34 months (mean 28.6 months). At 18 months after PKP, 18 grafts (94.7%) remained clear and 14 eyes (73.7%) had improved visual acuity. Three eyes (15.8%) with secondary glaucoma complications after PKP were treated with subsequent trabeculectomy. Recurrent infection was found in only 1 eye (5.26%) after transplantation and was successfully managed. Immune graft rejections were not observed in any patient during the follow-up period. The minimal trephination technique in combination with antifungal therapy was effective in the treatment of severe fungal keratitis with large corneal lesions and hypopyon. Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  20. Effects of Lamellar Keratectomy and Intrastromal Injection of 0.2% Fluconazole on Fungal Keratitis

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    Xinying You

    2015-01-01

    Full Text Available Purpose. To evaluate effects of lamellar keratectomy and intrastromal injection of 0.2% fluconazole (LKIIF on fungal keratitis. Methods. Data for 54 eyes of consecutive patients with fungal keratitis treated with LKIIF were retrospectively analyzed. The lesions in these eyes did not heal or were aggravated after antifungal chemotherapy for 7 days. The maximum lesion diameters were ≤5 mm and maximum depth was not more than half of full corneal thickness. Cases were followed up for at least 90 days. Results. Forty-six eyes were cured (85.2%. The wound healing times were 3–16 days and were less than 7 days in 28 cases (51.9%. In cured eyes, uncorrected visual acuity (UCVA and best-corrected visual acuity (BCVA were both 20/250–20/20. The UCVA improved in 38 eyes and was unchanged in seven eyes. BCVA improved in 44 eyes and was unchanged in two eyes. When followed up for more than 90 days, 89% (41 of 46 eyes showed improvement in UCVA and 11% were unchanged. Regarding BCVA, 98% improved and one eye was unchanged. No other complications were observed except neovascularization in one eye and thinner corneas. Conclusions. LKIIF was quick and effective for small fungal keratitis confined to half of the corneal thickness.

  1. CLINICAL EVALUATION OF INTRASTROMAL VORICONAZOLE IN RECALCITRANT FUNGAL KERATITIS A PROSPECTIVE STUDY AT SAROJINI DEVI EYE HOSPITAL, HYDERABAD

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    Srinivas Prasad

    2015-07-01

    Full Text Available BACKGROUND: Recalcitrant Fungal keratitis is a common ocular infection leading to visual impairment. OBJECTIVES: To evaluate the efficacy of intrastromal Voriconazole in Recalcitrant Fungal keratitis. MATERIALS AND METHODS: This was an interventional study in department of Cornea, Sarojini Devi Eye Hospital, Osmania Medical College, Hyderabad over a period from Feb.2013 Feb.2014. 30 Patients of Fungal Keratitis not responding to routine topical and syst emic antifungal therapy in 7 to 14 days, which were diagnosed as Recalcitrant fungal keratitis were given 5μgms/0.1ml of voriconazole intrastroml injections around the fungal infiltrates in a grid pattern. Details of patients age and sex, type of causative fungal and traumatic agents, size of corneal ulcer, presence of Hypopyon or not, and time taken for hypopyon absorption, and clinical improvement and resolution of the ulcer and visual acuity were noted. RESULTS: This study group of 30 patients diagnosed as Recalcitrant fungal keratitis showed Causative Fungi as Fusarium in 19(63.0%, Aspergillus in 11(37.0%. Causative Traumatic Agents were vegetative matter i n 19 (63.3%, other agents in 8 (26.7% and not known in 3(10.0. 17(56.7% were Males with 13(43. 3% Females. Age wise distribution was 3(10.0% in>10 - 20yrs, 11(36.7% in 20 – 40 yrs, 15(50.0% in 40 - 60 yrs, and 1(3.3% in >60 yrs . The size of the ulcer showed 1/2 of the cornea in 9(30.0%. 19 (63.3% were with hy popyon and 11(36.7% without hypopyon . After Intrastromal Voriconazole, the absorption of Hypopyon in 12 (63.2% was in 2to 4 wks. and in 2(10.5% in > 4 wks. C linical improvement of the Fungal Corneal Ulcer was seen in no case (0.0% in 4 wks. Time (wks. of healing of the Fungal Corneal Ulcer was in 4 - 6wks in 21 (70.0% and in >6wks in 5(16.7%. Visual Acuity was <3/60 in 2(7.7%, 3/60 - <6/60 in 10(33.3%, 6/60 - <6/18 in 9(30.0% and 6/18 – 6/9 in 5(16.7 %. CONCLUSION: Common causes of fungal keratitis in Recalcitrant Fungal

  2. Is inclusion of Sabouraud dextrose agar essential for the laboratory diagnosis of fungal keratitis?

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    Das Sujata

    2010-01-01

    Full Text Available Purpose: To determine whether the inclusion of Sabouraud dextrose agar (SDA is essential in the diagnosis of fungal keratitis. Materials and Methods: Corneal scrapings of 141 patients with microbial keratitis were smeared and cultured. Sheep blood agar (BA, chocolate agar (CA, SDA, non-nutrient agar (NNA with Escherichia coli overlay, and brain heart infusion broth (BHI were evaluated for time taken for growth and cost. The media were also evaluated experimentally for rate of growth and time taken for identification. Results: Twenty-six of 39 patients positive for fungus in corneal scrapings by microscopy were culture-positive. Fungus grew on BA in 22/39, on CA in 18/39, on SDA in 17/39, on NNA in 17/39, and on BHI in 13/39 cases. Growth on SDA was higher in ulcers with larger infiltrate (6/18 versus 9/13, P = 0.04. Estimated saving with inclusion of only BA/CA was Rs. 600 per patient. Performance of all media was similar in in vitro experiment although the characteristic spores and color were seen earlier on SDA. Conclusion: Fungal keratitis can be reliably confirmed on BA or CA, which support growth of both bacteria and fungus.

  3. Interleukin 17 expression in peripheral blood neutrophils from fungal keratitis patients and healthy cohorts in southern India.

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    Karthikeyan, Rajapandian Sivaganesa; Vareechon, Chairut; Prajna, Namperumalsamy Venkatesh; Dharmalingam, Kuppamuthu; Pearlman, Eric; Lalitha, Prajna

    2015-01-01

    Interleukin 17A (IL-17) production by peripheral blood neutrophils was examined in patients with fungal keratitis and in uninfected individuals in southern India, which has high levels of airborne Aspergillus and Fusarium conidia. Il17a gene expression and intracellular IL-17 were detected in all groups, although levels were significantly elevated in neutrophils from patients with keratitis. There were no significant differences in plasma IL-17 and IL-23 between patients with keratitis and uninfected individuals; however, combined data from all groups showed a correlation between the percentage IL-17 producing neutrophils and plasma IL-23, and between plasma IL-17 and IL-6 and IL-23.

  4. Comparison of reflectance confocal microscopy and two-photon second harmonic generation microscopy in fungal keratitis rabbit model ex vivo

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    Lee, Jun Ho; Lee, Seunghun; Yoon, Calvin J.; Park, Jin Hyoung; Tchah, Hungwon; Kim, Myoung Joon; Kim, Ki Hean

    2016-01-01

    Fungal keratitis is an infection of the cornea by fungal pathogens. Diagnosis methods based on optical microscopy could be beneficial over the conventional microbiology method by allowing rapid and non-invasive examination. Reflectance confocal microscopy (RCM) and two-photon second harmonic generation microscopy (TPSHGM) have been applied to pre-clinical or clinical studies of fungal keratitis. In this report, RCM and TPSHGM were characterized and compared in the imaging of a fungal keratitis rabbit model ex vivo. Fungal infection was induced by using two strains of fungi: aspergillus fumigatus and candida albicans. The infected corneas were imaged in fresh condition by both modalities sequentially and their images were analyzed. Both RCM and TPSHGM could detect both fungal strains within the cornea based on morphology: aspergillus fumigatus had distinctive filamentous structures, and candida albicans had round structures superficially and elongated structures in the corneal stroma. These imaging results were confirmed by histology. Comparison between RCM and TPSHGM showed several characteristics. Although RCM and TPSHGM images had good correlation each other, their images were slightly different due to difference in contrast mechanism. RCM had relatively low image contrast with the infected turbid corneas due to high background signal. TPSHGM visualized cells and collagen in the cornea clearly compared to RCM, but used higher laser power to compensate low autofluorescence. Since these two modalities provide complementary information, combination of RCM and TPSHGM would be useful for fungal keratitis detection by compensating their weaknesses each other. PMID:26977371

  5. MICROBIOLOGICAL PATTERN AND EPIDEMIOLOGIC TRENDS OF FUNGAL KERATITIS IN NORTH INDIA

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    Yusuf Rizvi

    2016-06-01

    Full Text Available CONTEXT Spectrum of fungal keratitis continues to change with geographical location and season. Microbiological and epidemiological data provide guidelines to the treating physician facilitating chances of successful treatment. PURPOSE To report microbiologic and epidemiologic profile of 119 culture-positive cases of fungal keratitis treated at a tertiary centre in North India. SETTINGS AND DESIGN All cases reporting directly or referred to the OPD of Eye Department of Rohilkhand Medical College and Hospital, Bareilly, India, diagnosed and treated as fungal keratitis during a 3-year period between March 2012 and Feb 2015. METHODS Retrospective analysis of clinical and microbiological data of 119 culture-positive cases of fungal keratitis. Demographic features, risk factors, clinical course and laboratory findings were reviewed. RESULTS All patients were residents of 11 adjoining districts of Northern India. Of the 119 patients, 76 (63.8% were males (male: female ratio 1.79:1. 81(68% patients were in young productive age group of 20-45 years. 87 (73% were rural based. Ocular trauma with vegetative material, especially sugarcane leaf or dust falling in eyes were the chief precipitating factors; n = 89 (74.7%. Microbiologically Fusarium was the predominant isolate, 64 cases (53.7%, followed by Aspergillus 34(28.6% and Candida 11(9.2%. 2 cases of Alternaria and Curvularia and solitary cases of Acremonium and Scedosporium were reported. 4 strains remained unidentified. Mode of injury had a causal relation with fungal aetiology. Majority of Fusarium infections were caused by vegetative injuries 39(61%. Of these, 15(23.4% were attributed to sugarcane leaves. Soil/dust fall in eye or Surma application were responsible for bulk of Aspergillus infections; 21(61.7%. Candida infections were sporadic with a higher presenting age (Mean av 51.2 years and a frequent association with topical steroid usage, (8 of 11 cases. Aspergillus infections were predominant

  6. Natamycin in the treatment of fungal keratitis : a systematic review and Meta-analysis

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    Sheng; Qiu; Gui-Qiu; Zhao; Jing; Lin; Xue; Wang; Li-Ting; Hu; Zhao-Dong; Du; Qian; Wang; Cheng-Cheng; Zhu

    2015-01-01

    AIM: To review published clinical studies examining the effect of natamycin in the treatment of fungal keratitis.METHODS: We selected the publications in CENTRAL,MEDLINE, EMBASE, CNKI, and CBM. This study systematically reviewed published randomized controlled trials(RCTs) that compared natamycin to other antifungal agents, and conducted feasible Meta-analysis of efficacy results using Revman 5.2 software.RESULTS: We included seven trials which were mainly carried out in developing countries of Asia, with five trials conducted in India, one each in China and Bangladesh. A total of 804 participants were randomized to following comparisons: 2% econazole versus 5%natamycin showed little difference in the effects of treatment of fungal keratitis [RR =0.99, 95% confidence interval(CI), 0.8 to 1.21]; chlorhexidine gluconate versus5% natamycin indicated that the results on healing of the ulcer at 21 d was less conclusive(RR=0.77, 95% CI, 0.55 to 1.08; I2=0%); 1% voriconazole versus 5% natamycin suggested that natamycin treatment appeared to be significantly better outcomes than voriconazole(regression coefficient =-0.18 log MAR; 95% CI,-0.30 to-0.05; P =0.006), especially in Fusarium cases(regression coefficient=-0.41 log MAR; 95% CI,-0.61 to-0.20; P <0.001);natamycin versus fluconazole showed a significant difference in cure rate(χ2=5.048, P <0.05) and natamycin group was more effective than fluconazole in average period of therapy(t =7.94, P <0.01).CONCLUSION: Natamycin was a preferable choice in the treatment of fungal keratitis, especially in the early period of Fusarium cases.

  7. [Molecular identification and in vitro susceptibility of Fusarium from fungal keratitis in central China].

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    Sun, Shengtao; Lyu, Qixue; Han, Lei; Ma, Qiufei; Hu, Hong; He, Siyu; Tao, Siyu; Zhang, Junjie; Zhang, Hongmin; Wang, Liya

    2015-09-01

    To detect the genotypes and in vitro antifungal susceptibility of Fusarium isolated from patients with fungal keratitis in central China. Partial translation elongation factor (EF) 1-α of 758 strains of Fusarium isolated from patients with fungal keratitis in Henan Eye Institute during 2002 to 2011 were sequenced. Species and genotypes of Fusarium were identified by conducting BLAST searches of the Fusarium ID database with partial EF1-α sequences as the query. The minimum inhibitory concentrations (MIC) of vorionazole, ketoconazole, terbinafine, natamycin, 5-flucytosine, fluconazol, amphotericin B, nystatin, econazole, clotrimazole, miconazole and itraconazole to 145 isolates of Fusarium were determined by microbroth dilution method according to Clinical Laboratory Standards Institute (CLSI) M38-A program. Among the 758 strains of Fusarium isolates, species of 653 strains were identified. 99.69% of the Fusarium strains were identified by EF1-asequences as Fusarium solani species complex (FSSC), Fusarium oxysporum species complex (FOSC) and Gibberella fujikuroi species complex (GFSC), 0.31% as Fusarium sp. Among the 653 isolates from cornea, FSSC was the predominant Fusarium, 386 isolates (59.11%), with 43 genotypes. The most common seen FSSC genotype was FSSC5-d (132/20. 21%), followed by FSSC3+4-eee (58/8.88%), FSSC3+4-ii (37/5.67%) and FSSC3+4-z (31/4.75%). The second complex was GFSC, 254 isolates (38.90%), with 3 species which were F.proliferatum (124 strains/18.99%), F.verticillioides (112 strains/17.15%) and GFSC (18 strains/2.76%) respectively. The third complex was FOSC, 11 (1.68%) strains, with 6 genotypes. The results of in vitro drug sensitivity test showed that Fusarium strains were sensitive to natamycin, vorionazole and amphotericin B, resistant to 5-fluorocytosine, fluconazole, nystatin, clotrimazole, miconazole. More than 50% of Fusarium strains were sensitive to econazole, ketoconazole, itraconazole and terbinafine. The MIC50 of FSSC to

  8. A New Combination Formula for Treatment of Fungal Keratitis: An Experimental Study

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    Hala Mohamed El-Mofty

    2014-01-01

    Full Text Available Objective. To formulate and evaluate slow release ketoconazole and ketorolac to treat fungal keratitis and associated inflammation. Methods. Experimental study with the following outcome measures. Pharmaceutical Evaluation. Mucoadhesive gels containing ketoconazole and ketorolac were used. Microbiological in vitro evaluation was performed using cup method. In vivo evaluation was performed on 24 rabbits divided into 2 groups, 12 rabbits each, group A (fast release formula; 6 times daily and group B (slow release formula; 3 times daily. Each group was divided into two subgroups (6 rabbits each. Both eyes of rabbits were inoculated with Candida albicans. The left eye of all rabbits received the combination formulae. The right eye for one subgroup received ketoconazole as control 1 while the other subgroup received placebo as control 2. Clinical follow-up was done and, finally, the corneas were used for microbiological and pathological evaluation. Results. Gels containing high polymer concentration showed both high viscosity and mucoadhesion properties with slower drug release. The infected eyes treated with slow release formula containing both drugs showed better curing of the cornea and pathologically less inflammation than eyes treated with fast release formula. Conclusion. Slow release formula containing ketoconazole and ketorolac showed higher activity than fast release formula against fungal keratitis and associated inflammation.

  9. Evaluation of nested pcr technique for detection of Pythium insidiosum in pathological specimens from patients with suspected fungal keratitis.

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    Kosrirukvongs, Panida; Chaiprasert, Angkana; Uiprasertkul, Mongkol; Chongcharoen, Metinee; Banyong, Ramrada; Krajaejun, Theerapong; Wanachiwanawin, Wanchai

    2014-01-01

    Diagnosis of Pythium keratitis is problematic due to the difficulty in obtaining a culture report resulting in unnecessarily prolonged usage of antimicrobial medication due to misdiagnosis. This study evaluated and compared nested PCR technique with culture and immunoperoxidase staining assays of Pythium insidiosum in paraffin-embedded corneal tissues from patients with suspected fungal keratitis. Six of 51 pathological reports compatible with fungal infection and 6 of 48 culture-proven fungal keratitis were identified as Pythium. Twenty-seven specimens were PCR-positive for Pythium insidiosum. In comparison with fungal culture for P. insidiosum, PCR had 83% sensitivity and 77% specificity with fair agreement (Kappa score of 0.227, p = 0.001). The mean age of PCR-positive is younger than PCR-negative group and there is a female preponderance in Pythium-infected group (p = 0.002 and p = 0.004, respectively). Nineteen specimens had positive results using immunoperoxidase staining assay with fair agreement to culture method (Kappa 0.340, p keratitis in order to initiate proper management.

  10. Detection of fungi by conventional methods and semi-nested PCR in patients with presumed fungal keratitis

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    Iman Haghani

    2015-03-01

    Conclusion: Due to the increasing incidence of fungal infections in people with weakened immune systems, uninformed using of topical corticosteroids and improper use of contact lens, fast diagnosis and accurate treatment of keratomycosis seems to be essential. Therefore, according to the current study, molecular methods can detect mycotic keratitis early and correctly leading to appropriate treatment.

  11. The clinical characteristics of fungal keratitis in eyes after Descemet’s stripping and automated endothelial keratoplasty

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    Araki-Sasaki K

    2014-09-01

    Full Text Available Kaoru Araki-Sasaki,1,2 Atsuko Fukumoto,1 Yasuhiro Osakabe,3 Hideya Kimura,1 Shinichiro Kuroda1 1Nagata Eye Clinic, Nara, Japan; 2Department of Ophthalmology, Japan Community Health Care Organization, Hoshigaoka Medical Center, Osaka, Japan; 3Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan Abstract: The purpose of this study was to describe the clinical characteristics of fungal keratitis caused by Candida albicans in an eye after Descemet stripping automated endothelial keratoplasty (DSAEK. A 72-year-old male with a history of three trabeculectomies, cataract surgery, and two DSAEK procedures developed a corneal ulcer in his right eye two years after his last DSAEK. Fungal keratitis was most likely related to the immunosuppressive conditions that occurred due to the previous operations, the continuous use of steroid eye drops, and the use of disposable soft contact lenses. A smear and culture from the ulcer detected Candida albicans. Slit-lamp examination showed the characteristic feature was the presence of interface infiltrates located between the host and the graft cornea and in the enlarged area around the ulcer. Two weeks after intense antimycotic treatments with voriconazole, miconazole, and natamycin, perforation of the cornea occurred and further therapeutic penetrating keratoplasty was required. Histological analysis revealed an accumulation of infiltrated cells and fibrotic tissue. The poor prognosis for fungal keratitis that occurs in eyes after undergoing DSAEK may be related to the rapid expansion of inflammatory cells through the interface between the host and the graft. In eyes that develop fungal keratitis after DSAEK, special attention should be paid to the possibility that perforation could occur in these patients. Keywords: DSAEK, Candida albicans, fungal keratitis, keratomycosis, post-operative infection

  12. Excimer Laser Phototherapeutic Keratectomy for the Treatment of Clinically Presumed Fungal Keratitis

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    Liang-Mao Li

    2014-01-01

    Full Text Available This retrospective study was to evaluate treatment outcomes of excimer laser phototherapeutic keratectomy (PTK for clinically presumed fungal keratitis. Forty-seven eyes of 47 consecutive patients underwent manual superficial debridement and PTK. All corneal lesions were located in the anterior stroma and were resistant to medication therapy for at least one week. Data were collected by a retrospective chart review with at least six months of follow-up data available. After PTK, infected corneal lesions were completely removed and the clinical symptoms resolved in 41 cases (87.2%. The mean ablation depth was 114.39±45.51 μm and diameter of ablation was 4.06±1.07 mm. The mean time for healing of the epithelial defect was 8.8±5.6 days. Thirty-four eyes (82.9% showed an improvement in best spectacle-corrected visual acuity of two or more lines. PTK complications included mild to moderate corneal haze, hyperopic shift, irregular astigmatism, and thinning cornea. Six eyes (12.8% still showed progressed infection, and conjunctival flap covering, amniotic membrane transplantation, or penetrating keratoplasty were given. PTK is a valuable therapeutic alternative for superficial infectious keratitis. It can effectively eradicate lesions, hasten reepithelialization, and restore and preserve useful visual function. However, the selection of surgery candidates should be conducted carefully.

  13. Fungal Keratitis

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    ... herpes zoster viruses photokeratitis , due to intense ultraviolet (UV) radiation exposure. Examples include snow blindness or welder’s arc ... 13, 2016 I lost sight from a corneal scar as a child. Now ...

  14. Comparison of continuous versus pulsed photodynamic antimicrobial therapy for inhibition of fungal keratitis isolates in vitro (Conference Presentation)

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    Nolan, Nicholas; Durkee, Heather A.; Aguilar, Mariela C.; Arboleda, Alejandro; Relhan, Nidhi; Martinez, Anna; Rowaan, Cornelis; Gonzalez, Alex; Alawa, Karam A.; Amescua, Guillermo; Flynn, Harry W.; Miller, Darlene; Parel, Jean-Marie A.

    2017-02-01

    Fungal keratitis can lead to pain and impaired vision. Current treatment options include antifungal agents and therapeutic penetrating keratoplasty. An emerging option for the management of keratitis is photodynamic antimicrobial therapy (PDAT) which uses a photosensitizer rose bengal activated with green light. Utilizing a pulsed irradiation, rather than the standard continuous irradiation may have a similar antimicrobial effect with less total energy. This study is to compare pulsed and continuous rose bengal mediated PDAT for inhibition of six fungal isolates on agar plates: Fusarium solani, Fusarium keratoplasticum, Aspergillus fumigatus, Candida albicans, Paecilomyces variotti, and Pseudoallescheria boydii. Isolates were mixed with 0.1% rose bengal and exposed to three irradiation conditions: (1) 30-minute continuous (10.8J/cm2), (2) 15-minute continuous (5.4J/cm2), (3) 30-minute pulsed (5.4J/cm2). Plates were photographed at 72 hours and analyzed with custom software. At 72 hours, 30-minute continuous rose bengal mediated PDAT inhibited all six fungal species. Fungal inhibition was analogous between 30-minute continuous and 30-minute pulsed test groups, with the exception of A. fumigatus. The 15-minute continuous irradiation was less effective when compared to both 30-minute continuous and 30-minute pulsed groups. These in vitro results demonstrate the potential strength of pulsed rose bengal mediated PDAT as an adjunct treatment modality for fungal keratitis.

  15. Effect of voriconazole and ultraviolet-A combination therapy compared to voriconazole single treatment on Fusarium solani fungal keratitis.

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    Choi, Kyoung Sub; Yoon, Sang Chul; Rim, Tyler Hyung Taek; Han, Soo Jung; Kim, Eun-Do; Seo, Kyoung Yul

    2014-06-01

    To demonstrate that ultraviolet-A (UV-A) and voriconazole combination therapy is more effective than voriconazole single treatment for fungal keratitis. The in vitro UV-A (375 nm) fungicidal effect was evaluated on Fusarium solani solutions. Each fungal solution was irradiated with different UV-A irradiation doses. Also, a fungal solution containing voriconazole was also irradiated with UV-A. The in vivo therapeutic effect of UV-A and voriconazole treatment was studied in a rabbit keratitis model. Fungi were injected intrastromally into the cornea of 16 rabbits. Each treatment was initiated 3 days after fungal injection and continued up to 8 days for the following groups: Group 1, control; Group 2, treated with UV-A once a day; Group 3, treated with voriconazole 3 times a day; Group 4, treated with voriconazole 3 times a day and UV-A once a day. On the last day, the sclera-cornea buttons were extracted and microbiological and histological evaluations were performed. The colony-forming units (CFUs) of fungal solutions in culture significantly decreased with UV-A irradiation. The CFUs of fungal solutions containing voriconazole also decreased with UV-A irradiation. In vivo, clinical scores of Group 3 (P=0.03) and Group 4 (P=0.02) 5 days after treatment were significantly lower compared to that of Group 1. The clinical score of Group 4 (P=0.03) 5 days after treatment was significantly lower compared to that of Group 3. The histopathological scores 5 days after treatment were significantly lower in Group 4 compared to those of Group 1 (P<0.01) and Group 3 (P=0.02). Based on our CFU analysis, only Group 4 showed significantly lower CFUs compared to Group 1 (P=0.04). UV-A and voriconazole combination treatment could be a safe and effective alternative to voriconazole single treatment for fungal keratitis.

  16. Colletotrichum truncatum species complex: Treatment considerations and review of the literature for an unusual pathogen causing fungal keratitis and endophthalmitis

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    Victoria Squissato

    2015-09-01

    Full Text Available We present a case of Colletotrichum truncatum species complex fungal keratitis and endophthalmitis in an 87-year-old immunocompetent male in whom oral triazole antifungals were contraindicated. The patient had recently returned from 4 months in Jamaica with a one month history of progressively increasing pain and inflammation in his left eye. Corneal samples grew a filamentous fungus and internal transcribed spacer sequencing polymerase chain reaction confirmed the presence of C. truncatum species complex. Samples showed no microbial growth.

  17. 真菌性角膜炎临床治疗体会%The Clinical Treatment Experience of Fungal Keratitis

    Institute of Scientific and Technical Information of China (English)

    陈桂春; 姚桂芹; 王瑞瑞

    2015-01-01

    目的:探讨真菌性角膜炎患者抗真菌药物治疗和手术治疗方法效果。方法选取临床34例真菌性角膜炎患者临床治疗方法资料进行分析。结果34例真菌性角膜炎患者,经治疗治愈28例,治愈率82.3%,显效3例,显效8.8%,有效1例,无效1例,总有效率97%。结论对真菌性角膜炎的治疗积极控制感染,促进溃疡愈合,减少瘢痕形成,预防和减少并发症。%Objective To investigate the antifungal medicine treatment and the surgical treatment effect to patients with fungal keratitis. Methods Analyzing the clinical treatment data selected from 34 cases of patients with fungal keratitis. Results Of al the 34 cases of patients with fungal keratitis, 28 cases of patients are cured with making up 82.3 percent of the whole, 3 cases of patients show a sign of improvement in their health state with making up 8.8 percent of the whole, and one case is effective and one case is not, the effectiveness incidence reaches to 97 percent in total. Conclusion to treat fungal keratitis, it is necessary to control infection, to facilitate the ulcer healing, and to reduce and prevent from the scar and complications.

  18. Comment on amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    Ahmet; Tas; Abdullah; Ilhan; Umit; Yolcu; Uzeyir; Erdem

    2015-01-01

    <正>Dear Editor,We congratulate Zeng et al[1]for their study entitled"Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis".The authors endeavored to present an alternative method for ophthalmologists in the treatment of a challenging case.We would like to express our reservations and ask for the attitudes of the authors about

  19. A Combination of Intrastromal and Intracameral Injections of Amphotericin B in the Treatment of Severe Fungal Keratitis

    Science.gov (United States)

    Hu, Jianzhang; Zhang, Jingjin; Li, Yanling; Han, Xiaoli; Zheng, Weidong; Yang, Juan

    2016-01-01

    Purpose. To evaluate the efficacy of a combination of intrastromal and intracameral injections of amphotericin B in the treatment of severe recalcitrant fungal keratitis. Methods. Patients with severe fungal keratitis who were resistant to conventional antifungal medical treatments and needed potential surgical intervention were recruited at the First Affiliated Hospital of Fujian Medical University between January 2012 and July 2013. The patients were treated with a combination of intrastromal and intracameral injections of amphotericin B (25 μg/mL and 50 μg/mL, resp.). Selectively repeated injections were performed as necessary. The efficacy, complications, and outcome were evaluated. Results. Nine patients (9 eyes) were involved in this study. All 9 cases responded favorably, and the clinical appearance of serious corneal damage and intraocular extension was resolved after the treatment. Four eyes required only 1 injection, and 5 eyes required repeated injections. Seven corneal ulcers healed with leucoma, and 2 healed with adherent leucoma. All of our cases had a marked increase in the anterior chamber reaction and pain immediately after the injection. There was no obvious clinical evidence of corneal or lenticular toxicity in any patient. Conclusions. A combination of intrastromal and intracameral injections of amphotericin B may be safe and effective for the treatment of severe fungal keratitis that is resistant to conventional therapy. PMID:27721986

  20. 真菌性角膜炎的药物治疗%Drug treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    王千

    2015-01-01

    目的:对治疗真菌性角膜炎的药物应用进行临床分析。方法:选取我院眼科自2013年1月至2015年1月间诊治的160例真菌性角膜炎患者,对其进行抗真菌的药物治疗,同时辅以抗真菌剂滴眼液,加强散瞳的治疗,然后观察记录患者的临床用药效果,并密切关注用药后眼部的变化与不良反应等突发情况。结果:通过对选取的160例真菌性角膜炎患者进行抗真菌性药物的治疗。结论:真菌性角膜炎的治疗关键在于早期做出明确的诊断、以及早期进行抗真菌性药物的有效治疗,一定要在医生的正确的指导下进行合理的用药,改掉不好的生活习惯,坚持持续的用药,如此就可以获得良好的临床治疗效果,其具有非常好的临床推广意义与价值。%Objective:Carry out clinical analysis on drug application of treating fungal keratitis. Methods:Choose 160 patients with fungal keratitis received in our hospital during January 2013 and January 2015, treat them with antifungal drugs and eye drops at the same time, strengthen the mydriasis treatment, then observe patient's clinical drug effect, and pay close attention to eye changes and adverse reactions and other emergency. Results:carry out treatment for 160 cases of fungal keratitis of resistance to fungal drugs. Conclusion:Key of treating fungal keratitis is to make definite diagnosis, and give early effective treatment with anti-fungal drugs, and take them under doctor's guidance, get rid of the bad living habits, insist on continuous medication, so we can obtain good clinical effect, it has good clinical significance and value to widely application.

  1. Update of fungal keratitis diagnosis and treatment%真菌性角膜炎的诊治进展

    Institute of Scientific and Technical Information of China (English)

    何彦; 潘志强

    2009-01-01

    The fungal keratitis is a common ocular disease, and its etiological factor and pathogenesis are definite, but the treatment is difficult and prognosis is poor. It is vital for fungal keratitis to be diagnosed rapidly and treated effectively. This paper had summarized the germ spectrum changes of fungal keratitis, new means of diagnosis adopted both in laboratory and clinical practices, such as improved staining method, confocal biomicroscope, technique of PCR and molecular sequence. There were some details of various new anti-fungal drugs and the available alternatives of surgical treatment for best treating effects.%真菌性角膜炎作为常见眼科疾病,其病因和发病机制比较明确,但是该病治疗棘手、预后差.迅速及时诊断和治疗真菌性角膜溃疡是提高临床治愈率,改善预后的关键.本文分析了近年来有关真菌性角膜炎的菌谱变化、归纳了实验室和临床诊断方法如改良的染色方法、共焦显微镜、聚合酶链式反应及分子序列分析技术等,对近来出现的新型抗真菌药物的实验室研究和临床应用进行了详细叙述,并提出选择合适的手术方式以达到最佳的治疗效果.

  2. A new method to predict the epidemiology of fungal keratitis by monitoring the sales distribution of antifungal eye drops in Brazil.

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    Marlon Moraes Ibrahim

    Full Text Available PURPOSE: Fungi are a major cause of keratitis, although few medications are licensed for their treatment. The aim of this study is to observe the variation in commercialisation of antifungal eye drops, and to predict the seasonal distribution of fungal keratitis in Brazil. METHODS: Data from a retrospective study of antifungal eye drops sales from the only pharmaceutical ophthalmologic laboratory, authorized to dispense them in Brazil (Opthalmos were gathered. These data were correlated with geographic and seasonal distribution of fungal keratitis in Brazil between July 2002 and June 2008. RESULTS: A total of 26,087 antifungal eye drop units were sold, with a mean of 2.3 per patient. There was significant variation in antifungal sales during the year (p<0.01. A linear regression model displayed a significant association between reduced relative humidity and antifungal drug sales (R2 = 0.17,p<0.01. CONCLUSIONS: Antifungal eye drops sales suggest that there is a seasonal distribution of fungal keratitis. A possible interpretation is that the third quarter of the year (a period when the climate is drier, when agricultural activity is more intense in Brazil, suggests a correlation with a higher incidence of fungal keratitis. A similar model could be applied to other diseases, that are managed with unique, or few, and monitorable medications to predict epidemiological aspects.

  3. Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    Bo; Zeng; Ping; Wang; Ling-Juan; Xu; Xin-Yu; Li; Hong; Zhang; Gui-Gang; Li

    2014-01-01

    AIM:To investigate the effect of amniotic membrane covering(AMC) on the healing of cornea epithelium and visual acuity for fungal keratitis after debridement.METHODS:Twenty fungal keratitis patients were divided into two groups randomly, the AMC group and the control group, ten patients each group. Both debridement of the infected cornea tissue and standard anti-fungus drugs treatments were given to every patients, monolayer amniotic membrane were sutured to the surface of the entire cornea and bulbar conjunctiva with 10-0 nylon suture for patients in the AMC group.The diameter of the ulcer was determined with slit lamp microscope and the depth of the infiltration was determined with anterior segment optical coherence tomography. Uncorrected visual acuity(UCVA) was tested before surgery and three month after healing of the epithelial layer. The healing time of the cornea epithelium, visual acuity(VA) was compared between the two groups using t- test.RESULTS:There was no statistical difference of the diameter of the ulcer, depth of the infiltration, height of the hypopyon and VA between the two groups beforesurgery(P >0.05). The average healing time of the AMC group was 6.89 ±2.98 d, which was statistically shorter than that of the control group(10.23±2.78d)(P <0.05).The average UCVA of the AMC group was 0.138 ±0.083,which was statistically better than that of the control group(0.053±0.068)(P <0.05).CONCLUSION:AMC surgery could promote healing of cornea epithelium after debridement for fungal keratitis and lead to better VA outcome.

  4. 念珠菌致真菌性角膜炎3例报告%Three cases of fungal keratitis caused by Candida

    Institute of Scientific and Technical Information of China (English)

    许雪; 黄云丽; 张道军; 李红宾

    2014-01-01

    Fungal keratitis is a serious blinding eye disease. We reported three cases of fungal keratitis caused by Candida in 2011 in our hospital. It gave us a glance at the pathogen and the main features of the disease in our region.%真菌性角膜炎是严重的致盲性眼病,本文报告我院于2011年诊治的3例念珠菌致真菌性角膜炎,这有助于了解在本地区该疾病的致病菌及主要特点。

  5. Zero order delivery of itraconazole via polymeric micelles incorporated in situ ocular gel for the management of fungal keratitis.

    Science.gov (United States)

    Jaiswal, Munmun; Kumar, Manish; Pathak, Kamla

    2015-06-01

    The aim of this article is to investigate the role of amphiphilic block copolymer-based polymeric micelles of itraconazole for the management of fungal keratitis to overcome the limitations of the conventional dosage form. The polymeric micelles were made using pluronics above critical micelle concentration. Itraconazole-loaded polymeric micelles prepared by rotary evaporation method were characterized and the optimized micellar formulation (M5) was selected on the basis of least micelle size (79.99 nm), maximum entrapment efficiency (91.32%±1.73%) and in vitro permeation (90.28%±0.31%) in 8h, that best fitted zero-order kinetics. M5 was developed as pH sensitive in situ gel and characterized for various parameters. The optimized in situ gel (F5) proved to be superior in its ex vivo transcorneal permeation when compared with Itral(®) eye drop and pure drug suspension, exhibiting 41.45%±0.87% permeation with zero-order kinetics (r(2)=0.994) across goat cornea. Transmission electron microscopy revealed spherical polymeric micelles entrapped in the gel matrix. A spectrum of tests revealed hydration capability, non-irritancy, and histologically safe gel formulation that had appropriate handling characteristics. Conclusively, a controlled release pH-sensitive ocular formulation capable of carrying drug to the anterior segment of the eye via topical delivery was successfully developed for the treatment of fungal keratitis.

  6. Advances of the treatment for fungal keratitis%真菌性角膜炎的治疗进展

    Institute of Scientific and Technical Information of China (English)

    姜亚萍; 陈轶卉

    2015-01-01

    真菌性角膜炎( fungal keratitis,FK)是一种由致病真菌引起的、致盲率极高的感染性角膜病,随着现代医学的发展,早期患者或者对药物敏感的真菌感染患者,药物或手术治愈率较前有了明显的提高,但是晚期患者及对药物不敏感的致病真菌感染患者,药物难以控制、溃疡迁延不愈、病情进展恶化,目前仍旧是临床上角膜盲的主要病因之一。在文中我们将就真菌性角膜炎药物及手术治疗的近5a国内外的研究进展作一综述。%Fungal keratitis ( FK ) is an infectious corneal disease caused by pathogenic fungi and has an extremely high rate of blindness. With the development of modern medicine, drugs or surgery treament rate had more obvious enhancement than before for fungal infection in patients at early stage or with drug sensitivity. However, difficulty of being controlled through drugs, resulting the delayed healing of ulcer, deterioration of disease progression are still one of the main clinical causes of corneal blindness at present for fungal infection in patients at advanced stage and without drug sensitivity. In this paper, we reviewed about the drugs and surgical treatment progress of FK according to the studies in the past 5a at home and abroad.

  7. γδ T cells regulate the expression of cytokines but not the manifestation of fungal keratitis.

    Science.gov (United States)

    He, Siyu; Zhang, Hongmin; Liu, Susu; Liu, Hui; Chen, Guoming; Xie, Yanting; Zhang, Junjie; Sun, Shengtao; Li, Zhijie; Wang, Liya

    2015-06-01

    As an important immunoregulatory cell type, the role of γδ T cells in fungal keratitis (FK) is unclear. We observed the distribution of γδ T cells in infected corneas in vivo by two-photon microscopy. The γδ T cells were depleted by neutralizing antibodies. The cytokine expression profile was obtained by protein arrays to determine the cytokines regulated by γδ T cells. ICAM-1, MIP-2 and IL-17A were evaluated by ELISA assays to confirm the role of γδ T cells in FK. We counted the number of neutrophils, evaluated the volume of fungal hyphae and analyzed the manifestation of the disease. The γδ T cells increased significantly at 36 h and 72 h post fungal infection (P fungal hyphae and manifestation of the disease was not affected by the depletion of γδ T cells. Our results demonstrated that γδ T cells have a role in FK via regulation of some cytokines but did not affect the manifestation of this disease, suggesting that γδ T cells are not the key regulator cells in this disease.

  8. Potential role of nuclear receptor ligand all-trans retinoic acids in the treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    Hong-Yan; Zhou; Wei; Zhong; Hong; Zhang; Miao-Miao; Bi; Shuang; Wang; Wen-Song; Zhang

    2015-01-01

    ·Fungal keratitis(FK) is a worldwide visual impairment disease. This infectious fungus initiates the primary innate immune response and, later the adaptive immune response. The inflammatory process is related to a variety of immune cells, including macrophages, helper T cells, neutrophils, dendritic cells, and Treg cells, and is associated with proinflammatory, chemotactic and regulatory cytokines. All-trans retinoic acids(ATRA)have diverse immunomodulatory actions in a number of inflammatory and autoimmune conditions. These retinoids regulate the transcriptional levels of target genes through the activation of nuclear receptors.Retinoic acid receptor α(RAR α), retinoic acid receptor γ(RAR γ), and retinoid X receptor α(RXR α) are expressed in the cornea and immune cells. This paper summarizes new findings regarding ATRA in immune and inflammatory diseases and analyzes the perspective application of ATRA in FK.

  9. Potential role of nuclear receptor ligand all-trans retinoic acids in the treatment of fungal keratitis

    Directory of Open Access Journals (Sweden)

    Hong-Yan Zhou

    2015-08-01

    Full Text Available Fungal keratitis (FK is a worldwide visual impairment disease. This infectious fungus initiates the primary innate immune response and, later the adaptive immune response. The inflammatory process is related to a variety of immune cells, including macrophages, helper T cells, neutrophils, dendritic cells, and Treg cells, and is associated with proinflammatory, chemotactic and regulatory cytokines. All-trans retinoic acids (ATRA have diverse immunomodulatory actions in a number of inflammatory and autoimmune conditions. These retinoids regulate the transcriptional levels of target genes through the activation of nuclear receptors. Retinoic acid receptor α (RAR α, retinoic acid receptor γ (RAR γ, and retinoid X receptor α (RXR α are expressed in the cornea and immune cells. This paper summarizes new findings regarding ATRA in immune and inflammatory diseases and analyzes the perspective application of ATRA in FK.

  10. Use of multiple methods for genotyping Fusarium during an outbreak of contact lens associated fungal keratitis in Singapore

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    Wong Yong W

    2008-07-01

    Full Text Available Abstract Background In Singapore, an outbreak of fungal keratitis caused by members of the Fusarium solani species complex (FSSC was identified in March 2005 to May 2006 involving 66 patients. Epidemiological investigations have indicated that improper contact lens wear and the use of specific contact lens solutions were risk factors. Methods We assessed the genetic diversity of the isolates using AFLP, Rep-PCR, and ERIC-PCR and compared the usefulness of these typing schemes to characterize the isolates. Results AFLP was the most discriminative typing scheme and appears to group FSSC from eye infections and from other infections differently. Conclusion There was a high genomic heterogeneity among the isolates confirming that this was not a point source outbreak.

  11. Design and Evaluation of Voriconazole Eye Drops for the Treatment of Fungal Keratitis

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    Sakshi Malhotra

    2014-01-01

    Full Text Available Voriconazole is a novel antifungal agent with excellent broad spectrum activity commercially available for oral and intravenous administration. The purpose of this study was to prepare ophthalmic formulation of hydroxypropyl beta cyclodextrin (HP-β-CD based voriconazole containing benzalkonium chloride BAK and EDTA with or without viscosity modifiers and study its permeation characteristics through freshly excised goat cornea. The results were observed that viscosity and force of bioadhesion of the voriconazole HP-β-CD solutions containing xanthan gum (XG are more as compared to polyvinyl alcohol. The results revealed that voriconazole drop containing PVA provided least viscosity and higher corneal permeation of drug, while drop formulated with XG had maximum viscosity and least permeation. The HP-β-CD based voriconazole (1.5% ophthalmic formulation containing xanthan gum (1.5, preserved with BAK and EDTA, could provide shelf life of 2 years. The microbiological studies showed that voriconazole ophthalmic solution containing xanthan gum shows better antifungal activity as compared to voriconazole and xanthan gum alone. Thus, it can be concluded that HP-β-CD based voriconazole (1.5%, pH 7.0 ophthalmic solution containing BAK and EDTA with viscosity modifier XG provided maximum precorneal residence time as compared to other viscosity modifiers and polyvinyl alcohol provided less precorneal residence time than other viscosity modifiers.

  12. Fungal Keratitis Caused by Drechslera spp. Treated with Voriconazole: A Case Report

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    Margarita I. Echavez

    2013-01-01

    Full Text Available Objective. To present a case of Drechslera spp. keratitis treated with topical Voriconazole. Method. A case report. Results. A 52-year-old diabetic male presented with a one-week history of foreign body sensation of the left eye, self-medicated with Neomycin, Polymyxin B, and Dexamethasone eye drops, and was diagnosed to have bacterial conjunctivitis, which was treated with Levofloxacin drops. The patient developed a corneal opacity after 2 days and was initially seen with a visual acuity of counting fingers on the left eye, with a 3 mm central corneal ulcer with feathery borders. No hypopyon was noted. The right eye had a visual acuity of 20/20 and had unremarkable findings. Corneal scraping of the ulcer showed no organisms on Gram and Giemsa stain. Cultures were positive for Drechslera spp. and patient was started on Natamycin drops every 15 minutes, Atropine drops 3× a day, and Levofloxacin was continued every 4 hours. The ulcer increased to 4 mm, the infiltrates became deeper involving the midstroma, and there was appearance of a 2 mm hypopyon. Natamycin was shifted to Voriconazole eye drops every 15 minutes. There was note of a decrease in the size of the ulcer and clearing of the infiltrates with the new treatment regimen. Final visual acuity after 29 days of treatment was 20/40 with note of a slight corneal haze in the area of the previous ulcer. Conclusion. Voriconazole may be safe and effective in the treatment of Drechslera keratitis. There was no perforation and there was immediate decrease in the size of the ulcer. This is the first known case of Drechslera keratitis treated with Voriconazole eye drops in the Philippines.

  13. Effectiveness of Posaconazole in Recalcitrant Fungal Keratitis Resistant to Conventional Antifungal Drugs

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    A. Altun

    2014-01-01

    Full Text Available Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA was hand motion. He had 5.0 × 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 × 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs.

  14. Effectiveness of posaconazole in recalcitrant fungal keratitis resistant to conventional antifungal drugs.

    Science.gov (United States)

    Altun, A; Kurna, S A; Sengor, T; Altun, G; Olcaysu, O O; Aki, S F; Simsek, M H

    2014-01-01

    Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA) was hand motion. He had 5.0 × 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 × 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs.

  15. Penetrating keratoplasty in fungal keratitis%穿透性角膜移植治疗真菌性角膜炎

    Institute of Scientific and Technical Information of China (English)

    孙先勇; 黄旭东; 张浩润

    2001-01-01

    Objective:To investigate the therapeutic effect of penetrating keratoplasty (PKP) in fungal keratitis.Method:11 cases with severe fungal keratitis which were uncontrollable with medicine undertook PKP.Results:10 eyes(90.9%) were cured,6 eyes have the vision>0.1;immunological rejection occured in 2 eyes,secondary glaucoma in 2 eyes,hyphema in 1 eye.Conclusion:PKP is an effective treatment for severe fungal keratitis.%目的:观察穿透性角膜移植治疗真菌性角膜炎的疗效。方法:对11眼经抗真菌药物治疗无效的真菌性角膜炎行穿透性角膜移植术。结果:术后10眼治愈,占90.9%,6眼视力在0.1以上。免疫排斥反应2眼,继发青光眼2眼,前房积血1眼。结论:穿透性角膜移植是治疗真菌性角膜炎的有效方法。

  16. 真菌性角膜炎的病原学分析及鉴定%Identification of Fusarium solani as the prevalent strain in fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    贺丹; 万雪; 高嵩; 郝继龙; 横山耕治; 王丽

    2014-01-01

    Objective To investigate the etiological and epidemiological characteristics of fungal keratitis in Jilin province of China and to establish a rapid and specific method for molecular identification of the prevalent fungal pathogens.Methods Corneal scrapings were collected from 225 patients with suspected fungal keratitis.Fungal strains were isolated and identified based on their morphology and physiological characteristics.The epidemiological characteristics of all isolated strains causing fungal keratitis were statistically analyzed.Species-specific primers of Fusarium solani (F.solani) were designed and used together with the universal fungal primers to establish a multiplex PCR assay for identification of F.solani in corneal scrapings.Results 156 out of 225 patients (69.3%) were diagnosed as fungal keratitis by fungal culture followed by the examination of morphological and physiological characteristics.A total of 168 pathogenic fungi strains were isolated,most of which were Fasarium spp.(49.4%),followed by Aspergillus spp.(17.9%) and Candida spp.(14.3%).F.solani was the predominant pathogen accounting for 34.5% in all patients.Most of the patients (87.5%) were farmer and male patients (57.1%) accounted for the majority of 156 patients as well.Corneal trauma (38.5%) was considered as the main predisposing factor.The established multiplex PCR could specifically amplify a 300 bp nucleotide fragment of F.solani.It could be used for a rapid identification of F.solani in corneal scrapings.Conclusion Fusarium genus,particularly the species of F.solani,was the predominant pathogen for fungal keratitis in Jilin province of China.Corneal trauma was the most important predisposing factor.The established multiplex PCR could identify fungal infection from corneal scrapings rapidly and specifically.These findings are very important for the early diagnosis and treatment of fungal keratitis.%目的 掌握真菌性角膜炎在吉林省的病原菌种类和流

  17. 中浅层真菌性角膜炎治疗方式选择分析%Primary study of treatment methods of superficial fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    姜剑; 毕宏生; 王兴荣; 温莹; 张建华

    2012-01-01

    Objective To evaluate the efficiency of drug,amniotic membrane transplantation and lamellar keratoplasty for superficial fungal keratitis. Methods Drug,amniotic membrane transplantation and lamellar keratoplasty was applied to 35 cases of superficial fungal keratitis in our hospital from January 2008 to December 2009. Results Nine cases of fungal keratitis were cured by drug.Amniotic membrane transplantation was performed in 17 cases of fungal keratitis,16 cases were cured and fungal keratitis recurred on 1 case.Ten cases were performed lamellar keratoplasty. Conclusions Fungal keratitis can be cured by drug,amniotic membrane transplantation and lamellar keratoplasty.Amniotic membrane transplantation or lamellar keratoplasty will be an effective method for fungal keratitis if medical therapy failed.%目的 分析研究药物保守治疗、羊膜移植和板层角膜移植(lamellar keratoplasty,LKP)在中浅层真菌性角膜炎治疗中效果.方法 对2008年1月至2009年12月就诊的中浅层真菌性角膜炎病人应用裂隙灯观察感染累及角膜组织的中浅层,未累及角膜全层的35例患者.角膜刮片或角膜病理切片,两者中有一项查见菌丝者确诊为真菌性角膜炎.给予全身局部抗真菌治疗.局部2~3 d角膜溃疡清创一次,碘酊烧灼5 s钟后生理盐水冲洗.病情迁延不愈的患者,在局麻下行角膜清创,如病灶累及角膜厚度1/3以内,行羊膜移植术;如感染灶累及角膜厚度1/3以上且未累及角膜全层,行LKP术.结果 9例患者通过药物保守治疗后治愈.17例患者行角膜清创联合羊膜移植术治疗,其中16例治愈,1例复发后行LKP术治愈.10例患者行LKP术治愈(包括羊膜移植术后复发的1例患者).结论 药物治疗可以有效治愈部分中浅层真菌性角膜炎,对于药物保守治疗持续不愈的患者可以选择羊膜移植和LKP术治疗.

  18. The advances in the treatment of fungal keratitis%真菌性角膜炎治疗进展

    Institute of Scientific and Technical Information of China (English)

    刘欣; 曾庆延

    2015-01-01

    真菌性角膜炎是一种严重的致盲性眼病,近年来治疗真菌性角膜炎新的药物有四代唑类、聚六甲基双胍、钙调磷酸酶抑制剂等,新药物剂型有凝胶缓释剂、克霉唑-β-环糊精等,新的手术方式有角膜胶原交联术、准分子激光治疗性角膜切削术、深板层角膜移植术等.%Fungal keratitis is a serious blindness leading disease.In recent years, new treatment included new medicines such as fourth generation azoles, poly hexamethylene biguanide, calcineurin inhibitors, and new dosage forms such as mucoadhesive gels and Clotrimazole-β-Cyclodextrin, new operation such as corneal collagen cross-linking, excimer laser phototherapeutic keratectomy, deep lamellar keratoplasty,etc.

  19. Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits

    Science.gov (United States)

    Hao, Zhao-Qin; Song, Jin-Xin; Pan, Shi-Yin; Zhang, Lin; Cheng, Yan; Liu, Xian-Ning; Wu, Jie; Xiao, Xiang-Hua; Gao, Wei; Zhu, Hai-Feng

    2016-01-01

    AIM To observe the therapeutic effect of corneal collagen cross-linking (CXL) in combination with liposomal amphotericin B in fungal corneal ulcers. METHODS New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3 groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B (n=5 each). The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28d after treatment. The corneas were examined with transmission electron microscopy (TEM) at 4wk. RESULTS A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d (Pulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease. PMID:27990355

  20. The pathogens of bacterial and fungal keratitis and their resistance to antibiotics%感染性角膜炎病原菌分布特征及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    何梅凤; 吴伟; 周家豪; 唐细兰

    2011-01-01

    Objective To analyze the distribution and shifting trends of pathogens causing bacterial or fungal keratitis and their resistance to commonly used antibiotics in Zhongshan ophthalmic center.Methods Two thousend and forty-six specimens from patients with infective keratitis from January 2004 to December 2010 were collected.Bacterial and fungal culture-positive rate,the genus distribution of isolates and resistance regularity to antibiotics were analyzed retrospectively.Results Out of 2046 specimens,1022 were positive cultures,showing a positive rate of 49.9%.Of those individuals with positive cultures,463 had pure bacterial infection ( including 11 specimens with two bacterial growth),500 had pure fungal infection and 59 had mixed growth.The predominant bacterial pathogens isolated were Gram-positive cocci ( 336 of 533,63.0% ) and Gram-negative bacilli ( 163 of 533,30.6% ),in which Staphylococcus epi(257 of 533,48.2% )was the most common pathogen,followed by Pseudomonas aeruginosa(84 of 533,15.76% ).The predominant fungal pathogens isolated was Fusarium.Spp.( 180 of 559,32.2% ),followed by Aspergillus Spp.(139 of 559,24.9% )and Helminthosporium( 110 of 559,19.7% ).The distribution of pathogens causing bacterial keratitis had no significant change.However,there has been an increase in Helminthosporium and a decrease in Aspergillus Spp.Overall,aminoglycosides showed better sensitivity to Staphylococcus epi,and fluoroquinolones had a better sensitivity to Pseudomonas aeruginosa.Conclusions In the area of Guangdong,the most common pathogens of bacterial keratitis was Staphylococcus epi,which showing highest sensitivity to neomycin,and Fusarium Spp are the predominant pathogens of fungal keratitis.The increased recovery of Helminthosporium and decreased recovery of Aspergillus Spp.from keratitis isolates presents an important challenge to the ophthalmology.%目的 了解我中心感染性角膜炎细菌及真菌分布、变迁及耐药情况,为临床

  1. Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits

    Directory of Open Access Journals (Sweden)

    Zhao-Qin Hao

    2016-11-01

    Full Text Available AIM: To observe the therapeutic effect of corneal collagen cross-linking (CXL in combination with liposomal amphotericin B in fungal corneal ulcers. METHODS: New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3 groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B (n=5 each. The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28d after treatment. The corneas were examined with transmission electron microscopy (TEM at 4wk. RESULTS: A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d (P<0.05. The corneal epithelium defect areas of the combined group was smaller than that of the CXL group (P<0.05 on 7 and 14d, but there were no statistical differences on 3, 21 and 28d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28d. The diameters of the corneal collagen fiber bundles (42.960±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group were thicker than that of the control group (24.900±1.868 nm, but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION: CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.

  2. 氟康唑加冰敷治疗真菌性角膜炎%The therapeutic effect of fluconazol and ice compress treatment for fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    童渝眉; 杨波; 李军

    2011-01-01

    Objective To explore the therapeutic effect of fluconazol and ice compress treatment for fungal keratitis.Methods Twenty-seven cases (27 eyes) with fungal keratitis were divided into two groups.14 cases were treated with fluconazol intravenous drip,subconjunctival injection in control group.Thirteen cases were treated the same as the control group except for additional ice compression in ice treatment group.Results 8 cases cured in control group(57.14% ).10 cases cured in icing group(76.92% ).Icing treatment improved effectiveness of treatment ( P < 0.05 ).Conclusion Fluconazol with ice compress improved therapeutic effect for fungal keratitis.%目的 探讨氟康唑加冰敷治疗真菌性角膜炎的效果.方法 植物性眼外伤后真菌性角膜炎27例(27眼)分为两组:对照组14例,以氯康唑静脉滴注、结膜下注射及滴眼等方法治疗;冰敷组13例,除上述方法外再加冰敷治疗,观察治疗效果.结果 对照组8例有效(57.14%);冰敷组10例有效(76.92%).冰敷组效果好(P<0.05).结论 真菌性角膜炎氟康唑加冰敷治疗效果好.

  3. Molecular mechanism of fungal keratitis%真菌性角膜炎的分子机制研究进展

    Institute of Scientific and Technical Information of China (English)

    徐玲娟; 谢立信

    2010-01-01

    真菌性角膜炎是严重危害视力的感染性角膜病.真菌黏附于角膜后,产生毒素及酶等物质损害角膜组织,而角膜对真菌的入侵产生免疫应答及炎症反应.基质金属蛋白酶存真菌性角膜炎中起着重要的作用.Toll样受体等模式识别受体对真菌的识别介导宿主角膜产生天然免疫和适应性免疫应答.在此过程中,众多的细胞、细胞因子及趋化因子参与了真菌的清除及角膜的损伤和修复.理清细胞之间的相互作用及信号转导,找到炎症反应及免疫反应的关键调控分子,是真菌性角膜炎防治的前提.本文就真菌的黏附及毒素对受侵角膜的影响、角膜对真菌入侵的免疫应答及炎症应答等分子机制的研究进展进行综述.%Fungal keratitis, a common cause of cornea] infectious diseases, is an important contributor to vision loss. Toxins and exoenzymes released from infiltrating fungi led to damage of the comea. Matrix metalloproteinases played an important role in fungal keratitis. Recognition of fungi by pattern-recognition receptors such as Toll-like receptors mediated the host to produce initiate and adaptive immune responses. Immunoprotection and inflammatory reaction which include numerous cells, cytokines and chemokines were involved in the responses of comea versus invading fungi. The cells and cytokines could protect cornea from fungi invasion but also cause some damage. The final outcome was depended upon the balance between impaired factors and repaired factors. A better understanding of molecular mechanism of the immunity and inflammation will provide new ideas for the treatment of fungal keratitis. The molecular mechanism of fungal keratitis was reviewed in this article.

  4. Effectiveness and safety of 0.15% ganciclovir in situ ophthalmic gel for herpes simplex keratitis – a multicenter, randomized, investigator-masked, parallel group study in Chinese patients

    Directory of Open Access Journals (Sweden)

    Lin T

    2013-04-01

    Full Text Available Tong Lin,1 Lan Gong,1 Xing-huai Sun,1 Nai-qing Zhao,2 Wei Chen,3 Hui-ping Yuan,4 Yan Shao,5 Ming-hong Gao,6 Hai Tang71Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, People’s Republic of China; 2Department of Biostatistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People’s Republic of China; 3The School of Ophthalmology and Optometry Affiliated with Wenzhou Medical College, Wenzhou, People’s Republic of China; 4The Second Affiliated Hospital of Haerbin Medical University, Haerbin, People’s Republic of China; 5The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China; 6General hospital of Shenyang Military Command, Shenyang, People’s Republic of China; 7Shenyang SINQI Pharmaceutical Co Ltd, Shenyang, People’s Republic of ChinaObjectives: Parallel comparison with 0.15% ganciclovir (GCV ophthalmic gel to evaluate the effectiveness and safety of 0.15% GCV in situ ophthalmic gel for the treatment of herpes simplex keratitis (HSK.Methods: This was a multicenter, randomized, investigator-masked, parallel group study. HSK patients were randomly divided into two groups, with the corresponding treatment of 0.15% GCV ophthalmic gel or 0.15% GCV in situ ophthalmic gel. Symptoms and signs were observed before administration, and 3 (±1, 7 (±1, 14 (±2, and 21 (±3 days after the administration. The clinical effective rate was considered as the primary outcome. The safety profile was evaluated by AEs, visual acuity, and ocular tolerance.Results: The clinical effective rate in the per-protocol (PP dataset for the treatment group and the control group were 95.10% and 93.00%, respectively (P = 0.5282. The noninferiority test showed significant differences (P = 0.000305, P < 0.025, indicating that the tested drug was noninferior to the control. Patients in the PP dataset of both groups experienced decreases in the total scores of clinical

  5. Molecular characterization, biofilm analysis and experimental biofouling study of Fusarium isolates from recent cases of fungal keratitis in New York State

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    Samsonoff William A

    2007-01-01

    Full Text Available Abstract Background To characterize Fusarium isolates from recent cases of fungal keratitis in contact lens wearers, and to investigate fungal association with MoistureLoc solution. Methods We studied six fungal isolates from recent cases of keratitis in New York State. The isolates were characterized by nucleotide sequencing and phylogenetic analyses of multiple genes, and then typed using minisatellite and microsatellite probes. Experimental fungal biofilm formation was tested by standard methods. MoistureLoc solutions were tested in biofouling studies for their efficacy in elimination of Fusarium contamination. Results Fusarium solani – corneal ulcers (2 isolates, lens case (1 isolate, and F. oxysporum – corneal ulcer (1 isolate, eye (1 isolate, were recovered from five patients. An opened bottle of MoistureLoc solution provided by a patient also yielded F. solani. Two distinct genotypes of F. solani as well as of F. oxysporum were present in the isolated strains. Remarkably, F. solani strains from the lens case and lens solution in one instance were similar, based on phylogenetic analyses and molecular typing. The solution isolate of F. solani formed biofilm on contact lenses in control conditions, but not when co-incubated with MoistureLoc solution. Both freshly opened and 3-month old MoistureLoc solutions effectively killed F. solani and F. oxysporum, when fungal contamination was simulated under recommended lens treatment regimen (4-hr. However, simulation of inappropriate use (15 – 60 min led to the recovery of less than 1% of original inoculum of F. solani or F. oxysporum. Conclusion Temporary survival of F. solani and F. oxysporum in MoistureLoc suggested that improper lens cleaning regimen could be a possible contributing factor in recent infections.

  6. Laboratorial analyses of fungal keratitis in a University Service Análise laboratorial de ceratites fúngicas em Serviço Universitário

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    Alfredo José Muniz de Andrade

    2000-02-01

    Full Text Available Purpose: To present the frequency and type of identified fungi from infectious keratitis. Methods: Retrospective survey of the cases of mycotic keratitis in the period from 1995 to 1998, at the Laboratory of Ocular Microbiology of the Department of Ophthalmology of the Federal University of São Paulo. Description of the fungal isolations, analysis of the causative factors and relation to the number of infectious keratitis in the same period. Results/Conclusion: Mycotic keratitis was diagnosed in 61 (5.48% of the 1,113 patients who presented ulcer of the cornea of infectious etiology, ranging from 3.4 to 9.25%, per year. Filamentous fungi were identified in 47 cases (77.04% and yeasts in 14 (22.95%. Fusarium was the most frequent genus (50.82%, followed by Candida (22.95% and Aspergillus (8.19%. Phaeosiaria sp, Phoma sp, Fonsecaea pedrosoi, Exserohilum rostratum, that are rare etiological fungal agents of keratitis, were also isolated.Objetivo: Apresentar a freqüência e o tipo de fungos identi-ficados de infecções corneanas. Métodos: Levantamento retrospectivo dos casos de ceratites micóticas, no Laboratório de Microbiologia Ocular do Departamento de Oftalmologia da Universidade Federal de São Paulo (UNIFESP no período entre 1995 a 1998. Descrição dos isolamentos de fungos, análise dos fatores desencadeantes e relação com o número de ceratites infecciosas no mesmo período. Resultados/Conclusão: Ceratites micóticas foram diagnos-ticadas em 61 (5,48% dos 1113 pacientes que apresentaram úlcera de córnea de etiologia infecciosa, com variação de 3,46-9,25%, ao ano. Fungos filamentosos foram identificados em 47 casos (77,04% e leveduras em 14 (22,95%. Fusarium foi o gênero mais freqüente (50,82%, seguido de Candida (22,95% e Aspergillus (8,19%. Foram também isolados fungos raros como agentes etiológicos de ceratites como: Phaeosiaria sp; Phoma sp; Fonsecaea pedrosoi e Exserohilum rostratum.

  7. Tacrolimus (FK506 suppresses TREM-1 expression at an early but not at a late stage in a murine model of fungal keratitis.

    Directory of Open Access Journals (Sweden)

    Weilan Huang

    Full Text Available To investigate the efficacy and mechanism of tacrolimus(FK506, which is a novel macrolide immunosuppressant, in inhibiting triggering receptor expressed on myeloid cells-1 (TREM-1 expression in a murine keratitis model induced by Aspergillus fumigatus.TREM-1 was detected in 11 fungus-infected human corneas by quantitative real-time PCR (qRT-PCR. RAW264.7 macrophages were divided into four groups, which received treatment with zymosan (100 µg/ml, zymosan (100 µg/ml + mTREM-1/Fc protein (1 µg/ml, or zymosan (100 µg/ml + FK506 (20 µM or negative-control treatment. After this treatment, the expression of TREM-1, interleukin-1β (IL-1β and tumor necrosis factor α (TNFα was assayed using qRT-PCR and ELISA. The mouse model of fungal keratitis was created by intrastromal injection with Aspergillus fumigatus, and the mice were divided into 2 groups: group A received vehicle eye drops 4 times each day, and group B received 4 doses of FK506 eye drops each day. Corneal damage was evaluated by clinical scoring and histologic examination,and myeloperoxidase (MPO protein levels were also detected by ELISA. The expression of TREM-1, IL-1β and TNFα was then determined at different time points using qRT-PCR and ELISA.TREM-1 expression dramatically increased in the human corneas with fungal keratitis. In contrast, FK506 reduced the expression of TREM-1, IL-1β and TNFα in RAW264.7 macrophages stimulated with zymosan. In the mouse model, at day 1 post-infection, the corneal score of the FK506-treated group was lower than that of the control, and polymorphonuclear neutrophil (PMN infiltration was diminished. TREM-1, IL-1β and TNFα expression was significantly reduced at the same time point. However, the statistically significant differences in cytokine expression, clinical scores and infiltration disappeared at 5 days post-infection.FK506 may inhibit the inflammation induced by fungi and alleviate the severity of corneal damage at an early stage of

  8. Acanthamoeba keratitis after photorefractive keratectomy.

    Science.gov (United States)

    Kaldawy, Roger M; Sutphin, John E; Wagoner, Michael D

    2002-02-01

    A 37-year-old women developed severe suppurative keratitis immediately after having photorefractive keratectomy in her left eye. The keratitis was unresponsive to intensive topical antibiotic agents and topical and systemic steroids. Although the differential diagnosis included nonmicrobial and fungal keratitis, the clinical course and confocal microscopy suggested, and subsequent histopathologic examination confirmed, a diagnosis of Acanthamoeba keratitis. The amebic contamination probably resulted from exposure of the deepithelialized cornea to contaminated freshwater in a northern Wisconsin marsh. This case emphasizes the importance of encouraging patients with epithelial defects and bandage soft contact lenses to avoid exposure to contaminated freshwater until reepithelialization is complete.

  9. Current progression in pharmacotherapeutics of fungal keratitis%真菌性角膜炎的药物治疗进展

    Institute of Scientific and Technical Information of China (English)

    瞿玲辉; 李良毛

    2010-01-01

    Fungal keratitis is the first common infectious corneal disease and has become the main cause of blindness in China.Along with the intensive explore for the pathogenic mechanisms,the significant progress has been achieved in the pharmacotherapeutics.For lowering its blindnessrate,it is imperative to the study on increasing therapeutic option and enhancing therapeutic efficacy.This review summarizes the current advance in clinical use in ophthalmology of novel antifungal agents,including new azoles such as voriconazole and posaconazole,and echinocandins such as caspofungin and micafungin.This article also reviews the progress of administration routes for the management of recalcitrant fungal keratitis,including subconjunctival,interstromal,intracameral and intravitreal injection.%真菌性角膜炎居中国感染性角膜炎的首位,已成为角膜盲的主要病因.随着对发病原因及机制的深入探讨,药物治疗取得了较大进展.为降低该病的致盲率,眼科医师应重视其治疗手段并提高其治疗效果.就抗真菌药物在眼科临床应用的研究进展进行综述.

  10. Retrospective analyse on traumatic fungal keratitis in Enshi Area%恩施地区外伤性真菌性角膜炎回顾性分析

    Institute of Scientific and Technical Information of China (English)

    杨燕宁; 但婧; 宋秀胜; 李霞; 李拓; 李家璋

    2014-01-01

    Objective To study the characteristics of clinical epidemiology of traumatic fungal keratitis in Enshi Area.Methods All cases of traumatic fungal keratitis admitted to the Central Hospital of Enshi Autonomous Prefecture from July 2009 to June 2013 were retrospectively reviewed.Data on patients' demographic characteristics,medical history,occupation,risk factors,presenting time,previous therapies,microbiological examination,treatments,results and follow-up results were recorded and analyzed.Results Based on the history of trauma and the microbiological examination,69 eyes of 69 patients were diagnosed as traumatic fungal keratitis,the follow-up time was 1 month to 14 months.51 patients were male.18 patients were female.The age of patients was 27-71 years old.64 patients were peasants.The number of positive culture by Sabourand culture medium was 67,among which 54 cases (80.6%) were the Fusarium sp.,and 10 cases (14.9%) were Aspergillus sp..59 eyes were cured with antifungal medicine treatment,8 eyes with debridement and lamellar keratectomy,1 eye with penetrating keratoplasty,1 eye had undergone ocular enucleation.Conclusion Fusarium sp.is the dominant pathogen of traumatic fungal keratitis in Enshi Area.Most of the patients are young male peasants and botanic trauma is the most common predisposing factor.Traumatic fungal keratitis can lead to severe visual impairment.%目的 了解恩施地区外伤性真菌性角膜炎临床流行病学特点.方法 回顾性分析2009年7月至2013年6月恩施州中心医院收治的外伤性真菌性角膜炎病例.记录患者人口学特征、病史、职业、致伤原因、病程、先前诊断用药情况,来院后裂隙灯检查、微生物学检查、治疗方法、转归及随访结果,对资料进行分析.结果 4年间,69例(69眼)根据患病诱因、微生物学检查结果诊断为外伤性真菌性角膜炎.随访时间1 ~14个月.男51例,女18例,年龄27 ~71岁.农民64例.主要诱因为植物外伤.

  11. Comparison on the sensitivity of laboratory diagnosis technology in the diagnosis of fungal keratitis%实验室诊断技术在真菌性角膜炎诊断敏感性的对比研究

    Institute of Scientific and Technical Information of China (English)

    陈鹏飞; 秦晓怡; 毛丽萍; 王友沛; 王大选; 郑美琴

    2015-01-01

      结论:病理检查的敏感性最好,真菌涂片、真菌培养及病理检查联合应用能够提高真菌性角膜炎的诊断水平,降低漏诊、误诊。%AIM:To analyze the correlation and clinical significance of fungal smear, fungal culture and pathological examination in the diagnosis of fungalkeratitis. METHODS:One hundred and ten cases (110 eyes) with fungal keratitis from January 2012 to December 2014 were collected. The results of fungal smear, fungal culture and pathological examination results were analyzed retrospectively. Fungal smear was detected by 10% KOH wet microscopy and gram staining microscopy. Fungal culture was used potato dextrose agar ( PDA ) medium. The specimens of pathological examination were from corneal transplantation surgery. paraffin section, HE and hexamine silver and PAS staining was used in the pathological examination. RESULTS:Of the 110 cases of fungal keratitis, fungal smear positive were observed in 50 cases ( 45. 5%), fungal culture positive were observed in 55 cases ( 50.0%); pathological examination positive were observed in 88 cases ( 80. 0%). Fifty cases were both fungal smear and pathological examination positive and 22 cases were both fungal smear and pathological examination negative. The coincidence rate of fungal smear and pathologic examination was 65. 5%. Fifty-five cases were both fungal culture and pathological examination positive and 22 cases were both fungal culture and pathological examination negative. The coincidence rate of fungal culture and pathologic examination was 70. 0%. In the 60 cases of fungal smear negative results, 38 cases ( 63. 3%) were confirmed positive through pathological examination. In the 55 cases of fungus culture negative results, 33 cases (60. 0%) were confirmed positive by pathological examination. CONCLUSION: The accuracy of pathological examination is the highest. The combined application of fungal smear, fungal culture and pathological examination can

  12. Regulation of Toll-like receptors in fungal keratitis%Toll样受体在真菌性角膜炎中的调控作用

    Institute of Scientific and Technical Information of China (English)

    王露萍

    2015-01-01

    真菌性角膜炎(FK)是一种严重的致盲眼病,而Toll样受体(TLRs)在哺乳动物识别真菌的过程中发挥重要作用.大量证据表明,TLRs启动FK的天然免疫,也参与机体针对真菌的获得性免疫反应.本文探讨了TLRs与非TLRs信号通路的相互作用、TLRs信号通路的负性调节因子及TLRs在角膜真菌感染中的作用,以期为角膜真菌感染的治疗提供新的策略.%Fungal keratitis (FK) ,a potential blinding disease,has been difficult to treat due to the limited number of approved antifungal drugs and the taxing dosing regimen.Toll-like receptors (TLRs) function as the pattern recognition receptors (PRRs) in mammals and play an essential role in the recognition of fungal components.There is a great amount of evidence that TLRs initiate the innate immunity in the FK.Furthermore, TLRs also play roles in shaping fungal-specific humoral and cellular adaptive immune responses.This review described the recent advances in interaction between TLRs and non-TLRs signal transduction,negative regulator and function of TLRs in corneal fungal infection.

  13. 那他霉素治疗真菌性角膜炎的临床探析%The Clinical Treatment Analysis of Natamycin in Curing Fungal Keratitis

    Institute of Scientific and Technical Information of China (English)

    王丽华

    2015-01-01

    目的:探析那他霉素治疗真菌性角膜炎的临床效果。方法搜集2013年6月~2014年6月我院接收的真菌性角膜炎74例患者,按照治疗方法不同分为实验组与对照组。对实验组37例进行那他霉素治疗,对照组37例进行氟康唑治疗。观察实验组与对照组的治疗效果,并比较。结果与对照组相比,实验组视力改善情况较好,治疗有效率较高,有明显差异,有统计学意义(P<0.05)。结论那他霉素治疗真菌性角膜炎的临床效果较好,有效率较高,可明显改善患者视力,应予以重视。%Objective The clinical effect of natamycin treatment in fungal keratitis is to be investigated.MethodsChoose 74 patients with fungal keratitis who were treated in hospital from June 2013 to June 2014 and separate them into study group and control group according to different treatment methods. 37 patients in study group were given natamycin treatment,while 37 patients in control group were given Fluconazole treatment,then observe and compare the treatment effects of two groups.Results Compared to control group,the patients’vision condition in study group had been improved better and in addition,treatment efficiency in study group was higher than control group,there was a great differential of treatment effect between two groups with statistic significance(P<0.05).Conclusion Natamycin treatment is clinicaly effective to cure fungal keratitis and improve the patients’vision acuity with high efficiency; therefore,natamycin treatment should be valued.

  14. Acanthamoeba keratitis.

    Directory of Open Access Journals (Sweden)

    Nicholson A

    1995-07-01

    Full Text Available Acanthamoeba keratitis, common in soft lens wearers, is not commonly isolated. The reports of Acanthamoeba keratitis in Indian literature are few. We report here a case of Acanthamoeba Keratitis in a medical student using soft contact lenses, initially diagnosed and treated as a bacterial and later as a viral corneal ulcer, who responded extremely well to medical line of therapy.

  15. Isolation and characterization of a new fungal genus and species, Aphanoascella galapagosensis, from carapace keratitis of a Galapagos tortoise (Chelonoidis nigra microphyes).

    Science.gov (United States)

    Sutton, D A; Marín, Y; Thompson, E H; Wickes, B L; Fu, J; García, D; Swinford, A; de Maar, T; Guarro, J

    2013-02-01

    A new fungal genus and species, Aphanoascella galapagosensis, recovered from carapace keratitis in a Galapagos tortoise residing in a south Texas zoological collection, is characterized and described. The presence of a pale peridium composed of textura epidermoidea surrounded by scarce Hülle cell-like chlamydospores, and the characteristic reticulate ascospores with an equatorial rim separates it from other genera within the Onygenales. The phylogenetic tree inferred from the analysis of D1/D2 sequences demonstrates that this fungus represents a new lineage within that order. As D1/D2 and ITS sequence data also shows a further separation of Aphanoascus spp. into two monophyletic groups, we propose to retain the generic name Keratinophyton for species whose ascospores are pitted and display a conspicuous equatorial rim, and thereby propose new combinations in this genus for four Aphanoascus species.

  16. 真菌及阿米巴混合感染性角膜炎临床分析%Clinical analysis of combined fungal and acanthamoeba keratitis

    Institute of Scientific and Technical Information of China (English)

    胡建章; 许建斌; 黄礼彬; 朱学军; 韩晓丽; 徐国兴

    2010-01-01

    目的 探讨真菌及棘阿米巴混合感染性角膜炎的发病、临床特征、诊断及其治疗.方法 对2007年7月至2008年12月在福建医科大学附属第一医院确诊的19例真菌及棘阿米巴混合感染性角膜炎进行回顾性临床分析,分析其发病诱因、诊断方法及临床特征,采用抗真菌及阿米巴药物或结膜瓣遮盖术或穿透性角膜移植术进行治疗并观察疗效.结果 19例确诊病例中,14例发病与角膜外伤有关,3例与角膜接触镜相关;所有病例通过角膜刮片镜检,或真菌与阿米巴培养确诊;16例表现为角膜局部溃疡型,3例表现为基质环形浸润;5例经药物治愈,11例经结膜瓣遮盖治愈,2例行穿透性角膜移植术(PKP).结论 真菌及棘阿米巴混合感染性角膜炎的发病诱因以角膜外伤为主,角膜刮片镜检是早期诊断的有效方法,综合药物和手术治疗对感染的控制具有重要意义.%Objective To study the etiology, clinical features, diagnosis and treatment of patients with combined fungal and acanthamoeba kerafitis.Methods Nineteen cases of combined fungal and acanthamoeba keratitis at the First Affiliated Hospital of Fujian Medical University between July 2007 and May 2008 were retrospectively reviewed.Predisposing factors, diagnosis, and clinical characteristics of the patients were analyzed. The patients were received medications or conjunctival flap covering or penetrating keratoplasty (PKP).Results Patients in this series, risk factors included corneal trauma (14/19) and contact lens wear (3/19).Patients were confirmed by corneal scraping and microscopic examination, and/or fungal/amoeba culture.Sixteen cases were showed corneal local ulcer, and 3 cases were ring-shaped stromal infiltration. Five cases were cured by combined anti-amoeba and anti-fungal drug therapy, and 11 patients were healed by conjunctival flap covering, and 2 patients performed PKP.Conclusions The main risk factor of combined fungal and

  17. 真菌性角膜炎334例的病原学分析%Aetiology analyses of 334 cases fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    鹿秀海; 高彦; 张莉; 杜满; 李素霞; 王婷; 高华

    2013-01-01

    Objective To analyze the distribution of pathogenic bacterium of the fungal keratitis patients for providing the data of clinical diagnosis and treatment.Methods From July 2005 to December 2010 in Shandong Eye Hospital there were 352 smears of corneal ulcers and corneal tissue exemplar removed in surgery from fungal keratitis patients.The all exemplars were cultured with the Sabouraud dextrose agar culture media in 28 ℃ under the humidor for 7 days.The strains was identified according to the appearance of fungal colonies,mycelium,spore shape,spore arrangement and fungal shape.And there did the retrospective analyses about the positive rate of fungal culture,genus distribution,seasonal distribution and sources of patients,sex ratio,age distribution and occupation.etc.Results There were 334 stock positive fungal culture in 352 cultured specimens from fungal corneal ulcers,the positive rate was 94.9%.There were 187 positive culture from 203 corneal scraping exemplars,the positive rate was 92.1% ; there were 147 positive culture from 149 corneal tissue removed in surgery,the positive rate was 98.7%.The Fusarium strains was most common in all isolated strain,211 (63.2%).The Aspergillus was secondly 47 (14.1%).The character of seasonal distribution of culture positive strain:the 48 strains (14.4%) were cultivated from January to March; the 48 strains (14.4%) were cultivated from April to June; the 64 strains were cultivated (19.2%) from July to September; the 174 strains (52.0%) were cultured from October to December,the ratio were 1∶ 1∶1.3∶3.6 quarterly(x2 =3.360,P =0.339).The incidence of fungal keratitis were higher in the autumn and winter than in spring and summer.The ratio of the male and the female was 2.04∶ 1 in 334 culture-positive patients; the mean age was (48 ± 22) years old.The 217 (65%) came from farmer in the developed group,and the other 117 cases came from other occupations (35%).The 289 (87%) cases came from Shandong

  18. Acanthamoeba Keratitis FAQs

    Science.gov (United States)

    ... Amebic Encephalitis (GAE); Keratitis Parasites Home Share Compartir Acanthamoeba Keratitis FAQs On this Page What is Acanthamoeba ... developing Acanthamoeba keratitis? Infection of the Eye with Acanthamoeba What is Acanthamoeba keratitis? Acanthamoeba keratitis is a ...

  19. 真菌性角膜炎的实验室快速诊断方法分析%Analysis of Laboratory Rapid Diagnostic Method of Fungal Keratitis

    Institute of Scientific and Technical Information of China (English)

    赵志伟; 张蕴莉

    2014-01-01

    目的:探讨真菌性角膜炎快速而有效的临床实验室诊断方法。方法:对2012年6-12月53例临床疑似真菌性角膜炎患者送检的角膜刮片标本,同时进行墨汁-KOH湿片法镜检、荧光染色镜检和真菌培养。以真菌培养为诊断金标准,对墨汁-KOH湿片法与荧光染色法进行方法学比较。结果:32例真菌培养阳性标本,墨汁-KOH湿片法20例阳性,阳性率为62.5%,荧光染色28例阳性,阳性率为87.5%,两者阳性率比较差异有统计学意义(字2=6.125,P=0.025);两种涂片镜检共为阳性的20例,共为阴性的4例。结论:荧光染色法镜检可以提高真菌性角膜炎的阳性诊断率,是真菌性角膜炎快速、简单、有效的临床实验室诊断方法。%Objective:To study the rapid and effective clinical laboratory diagnostic methods of fungal keratitis.Method:Specimens of 53 clinical suspected patients with fungal keratitis from June 2012 to December 2012 were selected,for the ink-KOH wet method microscopy,fluorescence staining microscopy and fungal culture at the same time. Fungus culture as the diagnostic gold standard,the results of ink-KOH wet method microscopy and fluorescent staining microscopy were compared.Result:In 32 cases of positive specimens of fungal culture,20 cases were positive in ink-KOH wet microscopy,the positive rate was 62.5%,28 cases were positive in fluorescent staining microscopy,the positive rate was 87.5%,Two positive rate comparisons difference was statistically significant(X2=6.125,P=6.125). There were 20 cases both kinds of smear microscopy were positive,4 cases were both negative.Conclusion:The fluorescence staining microscopy can improve the positive diagnosis rate of fungal keratitis,it is a kind of rapid, simple and effective method of clinical laboratory diagnosis.

  20. Investigative modalities in infectious keratitis

    Directory of Open Access Journals (Sweden)

    Gupta Noopur

    2008-01-01

    Full Text Available Standard recommended guidelines for diagnosis of infectious keratitis do exist. Based on an extensive Medline literature search, the various investigative modalities available for aiding the diagnosis of microbial keratitis have been reviewed and described briefly. Preferred practice patterns have been outlined and the importance of routine pre-treatment cultures in the primary management of infectious keratitis has been highlighted. Corneal scraping, tear samples and corneal biopsy are few of the specimens needed to carry out the investigative procedures for diagnosis and for initiating therapy in cases of microbial keratitis. In bacterial, fungal and amoebic keratitis, microscopic examination of smears is essential for rapid diagnosis. Potassium hydroxide (KOH wet mount, Gram′s stain and Giemsa stain are widely used and are important for clinicians to start empirical therapy before microbial culture results are available. The usefulness of performing corneal cultures in all cases of suspected infectious keratitis has been well established. In cases of suspected viral keratitis, therapy can be initiated on clinical judgment alone. If a viral culture is needed, scrapings should directly be inoculated into the viral transport media. In vivo confocal microscopy is a useful adjunct to slit lamp bio-microscopy for supplementing diagnosis in most cases and establishing early diagnosis in many cases of non-responding fungal and amoebic keratitis. This is a non-invasive, high resolution technique which allows rapid detection of Acanthamoeba cysts and trophozoites and fungal hyphae in the cornea long before laboratory cultures give conclusive results. Other new modalities for detection of microbial keratitis include molecular diagnostic techniques like polymerase chain reaction, and genetic finger printing by pulsed field gel electrophoresis.

  1. Study on Observing Fungal Keratitis with Laser Corneal Confocal Microscopy%激光角膜共焦显微镜观察真菌性角膜炎的研究

    Institute of Scientific and Technical Information of China (English)

    底煜; 李迅; 聂庆珠; 归东梅; 陈晓隆

    2012-01-01

    目的 探讨激光角膜共焦显微镜在真菌性角膜炎临床诊断中的意义.方法 真菌性角膜炎患者40例40只眼,同时行角膜组织刮片及角膜真菌培养、激光角膜共焦显微镜检查,对三组结果进行比较.结果 根据病史、临床表现确诊的真菌性角膜炎患者40例40只眼,激光角膜共焦显微镜的确诊率为90%,角膜刮片的确诊率为30%,培养查真菌菌落确诊率为25%.激光角膜共焦显微镜检查检出率高于角膜组织刮片(P<0.01)及真菌培养(P<0.01)检查.结论 激光角膜共焦显微镜对真菌性角膜炎的检出具有及时、无创和高阳性率的特点,对真菌性角膜炎的早期诊断、治疗和研究具有重要的临床意义.%Objective To investigate the significance of laser corneal confocal microscopy in clinical diagnosis of fungal keratitis. Methods Altogether 40 patients(40 eyes)clinically diagnosed with suspected fungal keratitis were given examinations based on come-al tissue smear, comeal fungus cultivation and corneal confocal microscope simultaneously and the results were analysed. Results For the 40 patients diagnosed with fungal keratitis according to medical history and clinical signs, the positive rates of the examinations based on comeal confocal microscopy, corneal tissue smear and fungal cultivation were 90% , 30% and 25% respectively. Laser comeal confocal microscopic check had a higher detection rate than corneal tissue smear method (P < 0. 01) and fungal cultivation check (P<0. 01). Conclusions Detection of fungal keratitis with laser corneal confocal microscopy, featuring rapidness, noninvasiveness and high positive rate, is of great significance to early-stage diagnosis, treatment and study of fungal keratitis.

  2. Keratitis due to Aspergillus flavus: Clinical profile, molecular identification of fungal strains and detection of aflatoxin production

    Science.gov (United States)

    Leema, George; Kaliamurthy, Jayaraman; Thomas, Philip A.

    2010-01-01

    Purpose To document the clinical profile of patients with keratitis due to Aspergillus flavus and to elaborate on differences in the aflatoxin-producing potential of keratitis strains versus environmental strains of A. flavus. Methods Over a 6-month period, strains of Aspergillus flavus were isolated in culture from corneal scrape or biopsy material of patients who presented with suppurative keratitis (clinical isolates). The strains were confirmed to be A. flavus by molecular methods (amplification of the internal transcribed spacer 2 [ITS 2] region and direct sequencing followed by comparative GenBank analysis). The aflatoxin-producing potential of each strain was determined by thin-layer chromatography. The ability of each strain to form sclerotia in Czapek-Dox agar (CDA) after 7 days incubation at 30 °C in the dark and to produce a beige ring in yeast extract sucrose agar supplemented with methyl β-cyclodextrin and sodium desoxycholate (YESD medium) after 3 days incubation at 30 °C was also assessed. For comparison, the tests were also run on 10 strains of A. flavus (identity confirmed by molecular methods) collected from local farming areas (environmental isolates). Results Aflatoxin B1 was detected in 16 (80%) of 20 culture filtrate or mycelial homogenate samples of the clinical isolates (mean concentration: 366.7±125.4 parts per billion [ppb]) but in only eight (40%) of 20 samples of environmental isolates (mean concentration: 306.6±125.4 ppb). Seven of the eight aflatoxin-producing clinical isolates and two of the four aflatoxin-producing environmental isolates formed sclerotia (>400 μm) and a beige ring in culture. Conclusions Aflatoxin B1 was detected in a significantly higher percentage of growth samples of clinical isolates (80%) than growth samples of environmental isolates (40%) (χ2=6.667; p=0.0098); the therapeutic implications of this finding require further study. The production of sclerotia and a beige ring in culture appear to be useful

  3. The efficacy of silver nitrate in treatment of post-traumatic fungal keratitis%角膜外伤后真菌性角膜炎应用硝酸银烧灼的效果

    Institute of Scientific and Technical Information of China (English)

    薄玉霞; 李长瑞; 马淑玲; 王朝峰; 容占其; 林莉丽

    2012-01-01

    Objective To discuss the efficacy of silver nitrate in treatment of post-traumatic fungal keratitis.Methods 21 cases (21 eyes) with fungal keratitis were burned by 2% nitric acid silver and application of conventional drug.Results 19 cases cured in 10 -60 days,2 cases of corneal perforation heald with cicatrisation.Conclusion Fungal keratitis treating with silver nitrate can shorten the course.%目的 探讨角膜外伤后真菌感染应用硝酸银烧灼的效果.方法 对21例(21眼)真菌性角膜炎在应用常规药物治疗的同时,溃疡面以2%硝酸银烧灼,等治疗.结果 19例在10 ~60 d治愈,2例角膜穿孔瘢痕愈合.结论 硝酸银烧灼辅助治疗真菌性角膜炎具有缩短病程,效果.

  4. 真菌性角膜炎患者手术治疗效果分析%Clinical effect of surgery on treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    周玲芬; 程凯尧; 陈虹

    2014-01-01

    目的:观察采用不同手术方法治疗真菌性角膜炎的临床效果,为临床治疗提供参考。方法选择2008年12月-2012年12月眼科收治的真菌性角膜炎患者共186例,患眼186眼,根据不同的手术方式分为4组,A组行单纯板层角膜切削,B组行板层角膜切削联合羊膜覆盖,C组行单纯穿透性角膜移植,D组行穿透性角膜移植联合羊膜覆盖,各组患者随访时间均>1年,观察各组术后效果。结果186例患眼中184眼保留了眼球,其中179例患者在术后随访中视力明显与术前相比有明显提高:A组治疗有效44例有效率93.62%;B组治疗有效47例有效率94.00%;C组治疗有效47例有效率95.92%;D组治疗有效38例有效率95.00%。结论当药物治疗不能控制真菌性角膜炎病程发展时要及时改行手术治疗,彻底将病灶组织清除是保证手术治疗效果的首要条件,术中应用羊膜和结膜瓣覆盖有利于保护创面,利于愈合。%OBJECTIVE To observe the clinical effects of different surgeries on treatment of fungal keratitis so as to provide guidance for clinical treatment .METHODS A total of 186 patients with fungal keratitis (186 eyes ) ,who were treated in the department of ophthalmology from Dec 2008 to Dec 2012 ,were enrolled in the study and divid-ed into four groups according to the types of surgery ;the group A underwent the simple lamellar keratectomy ,the group B underwent the lamellar keratectomy combined with amnion covering ,the group C received the simple pen-etrating keratoplasty ,and the group D received the penetrating keratoplasty combined with amnion covering ;one-year follow-up was conducted for the patients ,and the clinical effects were observed .RESULTS Totally 184 of the 186 eyes had the eyeballs reserved ,and the postoperative follow-up showed that the visual acuities of 179 patients have been significantly improved .The effective rate of treatment was 93 .62

  5. Comparison of Mycotic Keratitis with Nonmycotic Keratitis: An Epidemiological Study

    Directory of Open Access Journals (Sweden)

    Mohammad M. Khater

    2014-01-01

    Full Text Available Purpose. This work aims to study the problems encountered with and the different epidemiological features of patients with fungal keratitis. Patients and Methods. All cases with keratitis attending the Outpatient Clinic of Ophthalmology Department at Tanta University Hospital during three years from the first of January 2011 to the end of December 2013 were selected and carefully examined and cases with mycotic keratitis were further examined and investigated. Results. From 66303 attendants during this period with different complaints, there were 361 cases (0.54% with mycotic keratitis and 473 cases (0.71% of nonmycotic origin. Mycotic keratitis is common between 40 and 60 years, more in farmers (64%, families with large number and large crowding index, rural than urban residence, and patients with outdoor water sources and insanitary sewage disposal. Positive fungal cultures were obtained in 84.5% and were negative in 15.5% of cases in spite of their typical clinical findings for diagnosis and their improvement with antifungal therapy. Conclusion. Mycotic keratitis is more frequent in farmers, rural areas, outdoor water supply, insanitary sewage disposal, and patients preceded with organic trauma. Atypical clinical findings were found in some cases and not all cases improved with specific antifungal therapy.

  6. Establishment and pathological observation of rabbit model with fungal keratitis%兔眼真菌性角膜炎模型的病理学观察

    Institute of Scientific and Technical Information of China (English)

    董贤慧; 钱涛; 高维娟; 贺小平; 侯淑敏; 韦素春; 杨国兴

    2012-01-01

    目的 观察兔眼真菌性角膜炎(FK)动物模型的病理学改变.方法 新西兰白兔15只(30只眼),随机分为模型组、生理盐水组和正常对照组,每组10只兔眼.采用角膜基质注射法建立茄病镰刀菌性角膜炎模型,接种后2d角膜刮片行真菌培养;接种后1、2、6、8、l4、20 d和30 d,对兔眼溃疡评分;接种后3、8、15、30 d于裂隙灯下观察兔眼病理变化并拍照;接种后30 d处死家兔,取角膜,HE染色,光镜下观察组织病理学改变,PAS染色观察角膜基质层间的真菌菌丝,电镜观察角膜超微结构改变.结果 模型组角膜刮片真菌培养均可见典型真菌菌落生长;与正常对照组相比,模型组在接种1、2、6、8、14、20d和30 d后,角膜溃疡评分均有显著性差异(P<0.05).模型组接种3、8、15、30 d后,分别可见角膜溃疡、穿孔、前房积脓、新生血管、角膜白斑等并发症.HE染色、PAS染色、电镜观察均显示模型组角膜感染样改变.生理盐水组和正常对照组未见明显病理改变.结论 角膜基质注射法可以成功建立兔眼的真菌性角膜炎模型,出现典型的形态学改变.%Objective To observe the histopathological changes of animal models with fungal keratitis. Methods 15 New Zealand white rabbits (30 eyes) were divided into 3 groups, fungal keratitis model, saline and control groups. Fusarium Solani was injected into the corneal stroma of the eyes to establish fungal keratitis. Saline was injected into the corneal stroma of the eye8 of saline group. Noting was done in the control group. Lesion of cornea was taken and cultured after inoculated fungus for 2 days. The eyes of each group were examined clinically and respectively by slit lamp with a scoring system on day 1,2, 6, 8, 14, 20 and day 30. Photograph through the slit lamp on day 3, 8, 15 and day 30 after the inoculation. The rabbits were sacrificed with ear vein of air embolism at 30 day to observe the histological

  7. By Laser Confocal Microscopy Observed Clinical Efficacy of Fungal Keratitis%共焦显微镜对真菌性角膜炎药物治疗后转归的临床观察

    Institute of Scientific and Technical Information of China (English)

    张秀娟; 李雪丽; 勾晓梅; 周丽霞; 谷万章

    2015-01-01

    Objective To investigate the clinical observation of fungal keratitis after drug treatment outcomes with confocal microscopy.Methods 32 patients (32 eyes) with fungal keratitis hospitalized patients given anti -drug treat-ment of fungal keratitis in treated 2 w, 4 w, 8 w, respectively , for patients confocal microscopy , depending on the num-ber of fungal hyphae , size, clinical signs adjust medication.Results All of patients were cured 28 cases, varying de-grees of visual acuity improved after treatment in 8w to review confocal microscopy , the patient′s condition is stable , only see a small amount of fungal hyphae or fungal hyphae completely subsided , visible scar -like changes , 4 cases of the disease after treatment 2 w deterioration, corneal perforation, final enucleation after treatment , the total effective rate was 87.5%, with statistical significance (P<0.05).Conclusions Confocal microscopy as a non -invasive treatment meth-ods, can be used as medication guide fungal keratitis an objective examination tool .%目的:探讨共焦显微镜对真菌性角膜炎药物治疗后转归的临床观察。方法32例(32只眼)真菌性角膜炎的住院患者给予抗真菌性角膜炎药物治疗,在接受治疗的2w、4w、8w分别对患者进行共焦显微镜检查,根据真菌菌丝的数量、大小,临床体征调整用药。结果32例患者中28例治愈,视力不同程度提高,在治疗2月后复查共焦显微,患者病情稳定,仅见少量真菌菌丝或真菌菌丝完全消退,可见疤痕样改变,4例治疗2周后病情恶化,角膜穿孔,最终眼球摘除,治疗后总有效率为87.5%,有统计学意义( P<0.05)。结论共焦显微镜作为一种无创伤性诊疗手段,可作为指导真菌性角膜炎药物治疗的一种客观检查工具。

  8. Post intrastromal corneal ring segments insertion complicated by Candida parapsilosis keratitis

    Directory of Open Access Journals (Sweden)

    Mitchell BM

    2013-02-01

    Full Text Available Bradley M Mitchell,1 A John Kanellopoulos,2 Ramon L Font31Eclipse IS Consulting, Rosenberg, TX, 2Department of Ophthalmology, New York University Medical School, New York City, NY, 3Department of Ophthalmology, Ophthalmic Pathology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USAAbstract: This case report describes the clinical and histopathologic features, including molecular confirmation, of fungal keratitis after intrastromal corneal ring segments placement for keratoconus. A 52-year-old woman underwent insertion of Intacs® corneal implants for treatment of keratoconus. Extrusion of the implants was noted 5 months post insertion and replaced. Three months later, monocular infiltrates and an epithelial defect were observed. The Intacs were removed and the infiltrates were treated with ofloxacin and prednisolone acetate. Microbial cultures and stains were negative. The patient demonstrated flares and exacerbation one month later. Mycoplasma and/or fungus were suspected and treated without improvement. Therapeutic keratoplasty was performed 10 months following initial placement of the corneal ring implants. The keratectomy specimen was analyzed by light microscopy and a panfungal polymerase chain reaction assay. A histopathologic diagnosis of Candida parapsilosis keratitis was made and confirmed by polymerase chain reaction. One year postoperatively, a systemic workup of the patient was done with no signs of recurrence. This rare report of fungal keratitis following Intacs insertion is the first reported case of C. parapsilosis complicating Intacs implantation.Keywords: keratoconus, Intacs®, polymerase chain reaction, PCR, molecular diagnosis, histopathology

  9. Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis.

    Science.gov (United States)

    Chen, Yingxin; Gao, Minghong; Duncan, Joshua K; Ran, Di; Roe, Denise J; Belin, Michael W; Wang, Mingwu

    2016-11-01

    The aim of the present study was to investigate the efficacy of a novel surgical intervention, excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay (EKCAI), for the treatment of recalcitrant filamentary fungal keratitis. A retrospective analysis was performed of patients who underwent excisional keratectomy combined with conjunctival flap inlay (EKCFI), EKCAI or therapeutic penetrating keratoplasty (TPK) from January 2006 to January 2011. Recalcitrance was determined as being unresponsive to standard medical antifungal therapy for at ≥1 week. Outcome measures among the three intervention modalities were compared. A total of 128 patients had a follow-up of ≥1 year after the primary intervention. The success rates of interventions at 1-year follow-up were 58.33% in the EKCFI group, 88.37% in the EKCAI group and 93.44% in the TPK group (P<0.0002). The preoperative visual acuity of the three groups were similar (P=0.6458), while the postoperative best-corrected visual acuity (BCVA) of patients without recurrence was significantly different among the three groups 3 months after surgery. The best postoperative BCVA was found in the TPK group, while the worst was in the EKCFI group. In conclusion, EKCAI does not require donor cornea, is straightforward surgically, and has a favorable success rate compared with EKCFI.

  10. Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

    Science.gov (United States)

    Chen, Yingxin; Gao, Minghong; Duncan, Joshua K.; Ran, Di; Roe, Denise J.; Belin, Michael W.; Wang, Mingwu

    2016-01-01

    The aim of the present study was to investigate the efficacy of a novel surgical intervention, excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay (EKCAI), for the treatment of recalcitrant filamentary fungal keratitis. A retrospective analysis was performed of patients who underwent excisional keratectomy combined with conjunctival flap inlay (EKCFI), EKCAI or therapeutic penetrating keratoplasty (TPK) from January 2006 to January 2011. Recalcitrance was determined as being unresponsive to standard medical antifungal therapy for at ≥1 week. Outcome measures among the three intervention modalities were compared. A total of 128 patients had a follow-up of ≥1 year after the primary intervention. The success rates of interventions at 1-year follow-up were 58.33% in the EKCFI group, 88.37% in the EKCAI group and 93.44% in the TPK group (P<0.0002). The preoperative visual acuity of the three groups were similar (P=0.6458), while the postoperative best-corrected visual acuity (BCVA) of patients without recurrence was significantly different among the three groups 3 months after surgery. The best postoperative BCVA was found in the TPK group, while the worst was in the EKCFI group. In conclusion, EKCAI does not require donor cornea, is straightforward surgically, and has a favorable success rate compared with EKCFI. PMID:27882109

  11. 穿透性角膜移植术治疗真菌性角膜炎的临床观察%Clinical study on effect of penetrating keratoplasty in treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    蔡志刚; 夏泽梅

    2012-01-01

    Objective To evaluale the therapeutic effect of penetrating keratoplasty in treatment of patients with fungal keratitis. Methods Forty nine eyes of 49 patients with fungal keratitis were treated with penetrating keratoplasty, and their clinical characteristics and effect of operation were observed. Results Among them, 4 cases were treated with enucleation, three cases give up for treatment, the vision in remaining patients were improved after the operation. Visual acuity of patients after operation reached 0.01 to 0. 3, 15 cases were suffered from postoperative fungal recurrence, 5 patients with transient increase in IOP at 3 days after operation, and rejection occurred in 27 cases. Conclusion Penetrating keratoplasty is an effective procedure in treatment of patients with fungal keratitis, and visual acuity is significantly increased after keratoplasty.%目的 观察穿透性角膜移植术治疗真菌性角膜炎的临床疗效.方法 对真菌性角膜炎49例49眼进行穿透性角膜移植术,观察其临床特点及手术效果.结果 术后49例患者中除4例眼球摘除、3例放弃治疗外,其余视力均较术前提高.术后视力0.01~0.3.15例术后出现真菌复发,5例患者在术后3 d内眼压暂时升高,27例出现排斥反应.结论 穿透性角膜移植术是治疗真菌性角膜炎的有效方法.

  12. 我国真菌性角膜炎诊断和治疗中的几个问题%Several problems of diagnosis and treatment in fungal keratitis in China

    Institute of Scientific and Technical Information of China (English)

    史伟云; 王婷

    2013-01-01

    Fungal keratitis is one of major blindness disease in corneal infection.At present,mistake and missed diagnosis were often happened in Fungal keratitis.Initial doctor was insufficient knowledge of diagnosis.There were not to do etiology examination in corneal fungal infection,and lead to some case getting worse during medicinal treated.Highly ratio patients need controlled infection by corneal transplantation due to severe lack antifungal eye drops,and poor understood the way of antifungal medicine in clinic.Finally,Fungal keratitis is still one of major intractable disease in corneal infection,because some doctor were short of experience to hold surgical opportunity and indication,and corneal donor severe shortage in China.%真菌性角膜炎是致盲率极高的感染性角膜病,目前,在真菌性角膜炎的诊断方面,误诊和漏诊病例不少,主要是首诊医师对本病认识不足,对病原学检测意识不够,往往在药物治疗无效时才想起行病原学检查.治疗方面,目前临床严重缺少抗真菌眼用药物,同时医师对正确应用药物的方式和途径理解不深,致真菌角膜炎需行角膜移植来控制感染的比例很高.另外,医师缺乏把握手术时机及适应证经验,加上角膜供体的短缺,使真菌性角膜炎仍是感染性角膜病中最棘手的眼病之一.

  13. Effects of immunocyte on the process of fungal keratitis%小鼠真菌性角膜炎中主要免疫细胞的作用

    Institute of Scientific and Technical Information of China (English)

    张红敏; 刘素素; 许中中; 马聪慧; 谢艳亭; 吴细丕; 王丽娅

    2012-01-01

    0.001),但造模后9 h、120h与造模后6h比较差异均无统计学意义(P=0.772、0.323).真菌接种后72 h和120 h角膜T淋巴细胞数与造模后6h比较差异均有统计学意义(P=0.000、0.000).造模后模型组中性粒细胞数目与炎症临床评分呈明显正相关(r=0.593,P=0.000),T淋巴细胞浸润数目与炎症临床评分间无明显相关性(r=0.315,P=0.062). 结论 真菌性角膜炎的免疫反应过程中,病变早期主要是中性粒细胞发挥关键作用.%Background Infective keratopathy is a key cause of corneal blindness in China,and fungal keratitis is proved to have a higher incidence and bigger threats in infective keratitis.Researches showed that topical immunology plays an important effect during the development of fungal keratitis,but its mechanism is still studying.Objective This experiment was to explore the critical immunocyte during the process of fungal keratitis.Methods Forty-eight SPF 12-week-old male C57BL/6J mice were included and randomized into the control group and model group.The fungal keratitis model closely mimicking human cornea infections was established in the mouse using scratch followed by incubation of fusarium solani on the cornea,and the mice in the control group scratched on the cornea only.Cornea was examined under the slit lamp at 0,6,9,12,24,72 and 120 hours after operation.The severity of keratomycosis was clinically scored based on the literature criteria.The inflammatory cells were identified using immnofluorescence label,and the number of the inflammatory cells was calculated and compared among different groups and time points.This study complied with the Statement of ARVO in the use of experimental animal.Both Experimental Animal Ethic Commission in Zhengzhou University and Life Science Management Commission approved this study proposal.Results After inoculation of fusarium solani,typical fungul keratitis signs were seen on the cornea.Severe corneal opacifieation occurred within 24 hours

  14. 真菌性角膜炎的病原菌鉴定和药物敏感性分析%The identification and drug susceptibility of pathogens isolated from fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    贺丹; 张晓威; 郝继龙; 万雪; 单秋实; 王丽

    2014-01-01

    Objective To investigate the pathogen species,drug susceptibility and epidemiological characteristics of fungal keratitis in Jilin province,which provide evidence for diagnosis and treatment of clinical infections.Methods Corneal scrapings from 256 patients of suspected fungal infections were collected.Pathogenic fungi were isolated and i-dentified,the drug susceptibility and epidemiological characteristics were analyzed.Results 182 cases were diagnosed as fungal keratitis.Positive rate of fungal culture was 71.1%.A total of 194 fungal strains were isolated.Fusarium spp. (47.0%)was the predominant pathogen,among them,Fusarium solani (32.0%)was the most common isolate.The infections tended to occur in autumn.The majority of patients were male,middle-aged and farmer.Most of them had corneal trauma and treated with medicine before.The main pathogens were sensitive to natamycin.Conclusion Fusari-um spp.,especially Fusarium solani was the predominant pathogen of fungal keratitis in Jilin province.Corneal trauma will increase during the harvest season in autumn,which easily cause the occurrence of fungal keratitis.And natamycin can be used as the preferred drug for the prevention and treatment of fungal keratitis.%目的:了解吉林省真菌性角膜炎的病原菌种类、药物敏感性及流行病学特征,为感染的诊治提供参考依据。方法收集256例疑似真菌感染患者的角膜刮片标本,进行病原真菌的分离、鉴定及药物敏感性检测,并分析流行病学信息。结果有182例患者被诊断为真菌性角膜炎,真菌培养阳性率为71.1%,共分离获得194株真菌菌株。病原菌以镰刀菌属(47.0%)为主,其中茄病镰刀菌最常见(32.0%)。该病多发生在秋季,以男性、中老年、农民居多。多数患者有外伤史和局部用药史。主要病原真菌对纳他霉素均敏感。结论吉林省真菌性角膜炎病原菌以镰刀菌,特别是茄病镰刀菌为主。

  15. 那他霉素滴眼液治疗角膜外伤后真菌性角膜炎%The treatment of traumatic fungal keratitis with natamycin eye drops

    Institute of Scientific and Technical Information of China (English)

    皮百木; 穆红梅; 张婉婷; 申飞; 黄明可

    2014-01-01

    Objective To observe clinical effects and safeness of 5% domestic Natamycin eye drops for the treatment of traumatic fungal keratitis.Methods From July 2013 to November 2013,thirty-seven eyes of 37cases of fungal keratitis diagnosed by corneal smear examination were treated by local debridement,iodine cauterization,and application of 5% natamycin eye drops.The therapeutic effect was observed.Results Of thirty-seven cases,30 cases were cured,7 cases were improved.Conclusion Combined with local debridement and iodine cauterization,the 5 % domestic Natamycin eye drop is safe and effective for mild to moderate traumatic fungal keratitis.%目的 观察5%那他霉素滴眼液治疗角膜外伤后真菌性角膜炎的临床疗效.方法 经角膜刮片确诊的真菌性角膜炎的37例(37眼)进行病灶刮除并碘酊烧灼联合国产5%那他霉素滴眼液滴眼,观察疗效.结果 37例中30例痊愈,7例好转.结论 病灶刮除并碘酊烧灼联合国产5%那他霉素滴眼液治疗轻中度外伤性真菌性角膜炎有效.

  16. Clinical effect of high quality nursing service for patients with fungal keratitis%真菌性角膜炎患者应用优质护理服务临床效果观察

    Institute of Scientific and Technical Information of China (English)

    李晶

    2015-01-01

    Objective To investigate the clinical effect of high quality nursing service for patients with fungal keratitis.Methods 100 cases of fungal keratitis were divided into two groups, the experimental group to implement quality care, the control group implemented conventional care.Results the effective rate of the experimental group was 94%, the satisfaction rate was 96%, the control group was 84%, the satisfaction rate was 80%.Conclusion the implementation of high quality nursing care in patients with fungal keratitis can significantly improve the clinical treatment effect, promote the patient's condition as soon as possible, it is worth to be widely used.%目的:探讨真菌性角膜炎患者应用优质护理服务的临床效果。方法选取100例真菌性角膜炎患者分为两组,实验组实施优质护理,对照组实施常规护理。结果实验组有效率为96%,满意率为94%;对照组有效率为84%,满意率为80%。结论对真菌性角膜炎患者实施优质的护理服务可显著提高临床治疗效果,促进患者病情尽早康复,值得广泛应用。

  17. 激光共焦显微镜在真菌性角膜炎诊断中的应用%The application of laser corneal microscopy in diagnosis of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    常青; 王峰

    2013-01-01

    AIM: To evaluate the value of Heidelberg retina tomograph 3-RCM (HRT3-RCM) in clinical diagnosis of fungal keratitis.METHODS: Thirty-two eyes with clinical determined fungal keratitis were observed with HRT3 - RCM examination. In the same time, the corneal scraping was performed for all cases.RESULTS: In 32 patients, the positive rate of corneal scraping was 75% (24/32) and the positive rate of HRT3-RCM was 94% (30/32).CONCLUSION: HRT3-RCM, which is using laser as light source, is a new generation of confocal microscopy. It is a rapid, effective and noninvasive technique that can be used in the early diagnosis, treatment of fungal keratitis.%目的:探讨激光共焦显微镜HRT3-RCM在真菌性角膜炎诊断中的应用价值.方法:对临床拟诊真菌性角膜炎患者32例32眼行HRT3-RCM检查,同时进行角膜刮片细胞学检查.结果:在32例患者中,24例在角膜组织刮片中查到了菌丝,阳性率为75%;30例在激光共焦显微镜下观察到真菌菌丝,阳性率为94%.结论:HRT3-RCM是利用激光作为光源的新一代共焦显微镜,是一种快速、有效、无创的检查方法,可用于真菌性角膜炎的早期病原学诊断以及治疗观察.

  18. Analysis of the Effect of Comprehensive Nursing for 48 Cases of Fungal Keratitis%48例真菌性角膜炎的综合护理效果分析

    Institute of Scientific and Technical Information of China (English)

    林小兰; 杜翠芬

    2016-01-01

    目的:探究对96例真菌性角膜炎进行综合护理的效果。方法随机选取我院治疗的真菌性角膜炎患者96例分成两组,各48例,观察组给与综合护理,对照组给予一般护理,观察两组治疗后的护理效果。结果观察组患者的护理总有效率优于对照组,差异有统计学意义(P<0.05)。结论真菌性角膜炎治疗中实施综合护理,有效改善患者的病情,提高患者的治愈率。%Objective To explore the effect of comprehensive nursing for 96 cases of fungal keratitis.MethodsRandomly selected patients with fungal keratitis hospitalized 96 patients,were divided into two groups,each of 48 cases.Observation group given comprehensive care,control group was given general nursing care,then to observe the effect of the two groups after treatment.ResultsThe total effective rate of the observation group was better than that of the control group,the difference was statisticaly significant(P<0.05).ConclusionThe implementation of comprehensive nursing in the treatment of fungal keratitis,effectively improve the patient's condition,improve the patient's cure rate.

  19. Genus Distribution of Bacteria and Fungi Associated with Keratitis in a Large Eye Center Located in Southern China.

    Science.gov (United States)

    Lin, Lixia; Lan, Weizhong; Lou, Bingsheng; Ke, Hongmin; Yang, Yuanzhe; Lin, Xiaofeng; Liang, Lingyi

    2017-04-01

    To investigate the genus distribution of bacteria and fungi associated with keratitis in a large eye center located in Southern China and to compare the results with existing data from other areas in China. All results of corneal microbiological examinations from 2009 to 2013 of patients who had been clinically diagnosed with bacterial or fungal keratitis were obtained chronologically and anonymously from the microbiology database at Zhongshan Ophthalmic Center. Smear/culture data were reviewed and analyzed. Antibiotic resistance of the harvested bacteria was also evaluated. Of 2973 samples, the microbial detection rate was 46.05%; in which 759 eyes (25.5%) were positive for bacteria, 796 eyes (26.8%) were positive for fungi, and 186 eyes (6.3%) were co-infected with both fungi and bacteria. The most common type of bacteria isolated was Staphylococcus epidermidis (31.9%), followed by Pseudomonas aeruginosa (12.4%). The most common type of fungus was Fusarium species (29.3%), followed by Aspergillus species (24.1%). For the bacteria harvested, mean antibiotic resistance was chloromycetin (34.6%), cephalosporins (20.0%), fluoroquinolones (18.6%), and aminoglycosides (10.5%). The genus distribution of organisms detected in keratitis cases in the largest eye center located in Southern China differs from those in other areas in China. In Southern China during the time period studied, S. epidermidis and Fusarium sp. were the most common pathogens of infectious keratitis. Monitoring the changing trend of pathogens as well as antibiotic resistance are warranted.

  20. 巴基斯坦南部84例真菌性角膜炎的研究%Fungal keratitis:84 cases report in Southern Pakistan

    Institute of Scientific and Technical Information of China (English)

    Ashok Kumar Narsani; Siddiqa Gul; sved Asher Dabir; Shafi Muhammad Jatoi; Mahtab Alam Khanzada; Mahesh Kumar

    2008-01-01

    AIM:To identify the predisposing factors,causative fungi and to improve the facilities for the laboratory diagnosis of fungal keratitis.METHODS:Two hundred and forty eyes of 240 patients of clinically suspected microbial corneal ulcer were included in the study.Data was collected through history and slit lamp examination.Using standard techniques,corneal scraping was performed.A portion of each scraping was examined by direct microscopy for the presence of fungi,bacteria and acanthamoeba by using 10% potassium hydroxide and also by Gram and Giemsa stainings.Another portion was inoculated directly on the surface of solid media such as Blood agar,Mac-Conkey agar,chocolate agar and Sabouraud agar in C-shaped streaks for culture.RESULTS:A total of 240 patients with suppurative corneaI ulcer were enrolled in the study,out of which fungi were identified in 84(35%)patients.Of these,48(57.1%)were males and 36(42.9%)females.The age ranged between 22-80 years.Sixty patients(71.4%)belonged to rural population and twenty four(28.6%)to urban population.Trauma with vegetative material was the most frequent cause noted in eighteen(21.4%)patients.Peak incidence was in the months of October-Nevember.Out of 84 eyes with fungal keratitis,fungi alone were the etiologic agents in 74(80.10%)cases and bacteria with fungi were identified in 10(11.90%).The most frequently isolated organism was Candida albicans which was found in 66(78.6%)patients.CONCLUSION:Fungal keratitis is the leading cause of infective corneal ulcer and Candida albicans being the most commonly isolated pathogen in the patients belonging to Southern Pakistan.The direct microscopic examination with potassium hydroxide 100mL/L method is a simple,rapid,inexpensive and reliable method in the diagnosis of this infection.%目的:确定真菌性角膜炎的易感因素、致病真菌,以及提高相应的实验室诊断能力.方法:240例240眼临床疑似微生物感染的角膜溃疡患者进入本研究.通过病史回

  1. Seasonal trends of microbial keratitis in south India

    Science.gov (United States)

    Lin, Charles C.; Prajna, Lalitha; Srinivasan, Muthiah; Prajna, N. Venkatesh; McLeod, Stephen D.; Acharya, Nisha R.; Lietman, Thomas M.; Porco, Travis C.

    2016-01-01

    Purpose Prior studies suggest that fungal keratitis is more common in hot, humid climates while bacterial keratitis is independent of seasonal variation. This study analyzes seasonal trends in the incidence of fungal and bacterial keratitis at the Aravind Eye Hospital in southeast India. Methods Using microbiology records from August 2006 to July 2009, retrospective analyses of infectious keratitis were performed. Bacterial and fungal keratitis incidence data were analyzed for seasonal patterns. Results Among the 6,967 infectious keratitis cases, cultures were performed in 5,221 (74.9%) and positive in 3,028 (58%). Of the positive cultures cases, 1,908 (63%) and 1,081 (35.7%) were of fungal and bacterial etiology, respectively. The predominant fungal organism was Fusarium spp (42.3%) and the predominant bacterial organisms were Streptococcus pneumoniae (35.1%), Pseudomonas aeruginosa (24.3%), and Nocardia spp (8.1%). Analyses revealed an uneven distribution of fungal keratitis throughout the year (pinfection from vegetative corneal injury may be more likely. Robust screening efforts during these periods may mitigate visually debilitating sequelae from infectious keratitis. PMID:22868629

  2. 真菌性角膜炎的流行病学特征及病原学研究%Epidemiologic feature and etiological analysis on patients with fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    李慧; 刘梦阳; 郑红英; 万胜平; 孟旭霞

    2012-01-01

    目的 对真菌性角膜炎的流行病学特征和常见致病原因进行分析,为临床早期诊断和防治提供依据.方法 对2008年1月~ 2010年12月收治的278例真菌性角膜炎患者的性别、季节性特征、致病原因及角膜刮片、真菌培养结果进行回顾性分析.结果 278例真菌性角膜炎患者中男172例(61.9%),女106例(38.1%);146例(52.5%)发病集中在9~11月;有明确致病原因144例,其中植物性外伤65例(23.4%)、异物外伤51例(18.3%);251例(90.3%)角膜刮片检查发现真菌菌丝或孢子;225例真菌培养分离出真菌197株(87.6%),其中镰刀菌属131例(66.5%)、链格孢属41例(20.8%)、曲霉菌属12例(6.1%)、酵母菌属4例(2.0%)、毛霉菌属3例(1.5%)、其他菌属6例(3.0%).结论 本地区真菌性角膜炎的发病呈显著季节性,植物性外伤和异物损伤是主要致病原因,镰刀菌属是最为常见的病原菌;角膜溃疡组织刮片直接显微镜检查是早期确诊的有效方法.%Objective To analyze the epidemiologic feature and common cause of fungal keratitis, so to provide evidence for the prevention and treatment of fungal keratitis. Methods The patients'sex, seasonal characteristics, the results of cornea smears and fungal culture between January 2008 and December 2010 were analyzed retrospectively. Results A total of 278 fungal keratitis cases were investigated in this study, which included 172 (61.9% ) male and 106 (38. 1% ) female patients; The onset of the disease was mainly from September to November, which accounted for 52. 5% of total patients; 144 patients have determined etiology for ocular infection, among whom 65 (23.4% ) had injury history related to plant hindings and 51 ( 18. 3% ) had injury history related to eyewinker removal; The positive rate was 90. 3% (251/278) by microscopic analysis of KOH wet mounts; The number of positive culture was 197, in which the main fungal isolates were Fusarium species 131cases

  3. A new pyrenochaeta species causing keratitis

    NARCIS (Netherlands)

    Ferrer, C.; Perez-Santonja, J.J.; Rodriguez, A.E.; Colom, M.F.; Gene, J.; Alio, J.L.; Verkley, G.J.M.; Guarro, J.

    2009-01-01

    We report a new fungus as an agent of fungal keratitis in a diabetic woman. The fungal etiology was established by classic microbiology and PCR following 3 months of antibacterial therapy. The morphological features of the isolate and sequence analysis of the internal transcribed spacer region indic

  4. Clinical study of confocal laser microscopy in fungal keratitis%应用激光共焦显微镜诊断真菌性角膜炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    李昂; 范忠义

    2013-01-01

    目的:应用激光共焦显微镜观察真菌性角膜炎患者图像特点及菌丝和孢子检出率,探讨激光共焦显微镜检查在真菌性角膜炎临床诊断中的意义.方法:对41例41眼经门诊确诊为真菌性角膜炎的患者行角膜激光共焦显微镜检查,观察不同治疗期真菌性角膜炎患者活体角膜各层图像特点.结果:共焦显微镜下真菌性角膜炎患者图像有如下特点:(1)病变部位角膜各层形态结构破坏明显;角膜上皮至基质不同程度水肿;炎细胞浸润;神经结构破坏;基质层结构紊乱,透过度降低;(2)真菌菌丝是本病的特异性诊断依据,不同菌种感染在镜下菌丝有不同的影像学特点;(3)不同病变时期和治疗阶段,图像有很大差异,真菌菌丝的检出并不是诊断本病的唯一依据.结论:激光共焦显微镜检查具有无创、及时等优点,在临床诊断真菌性角膜炎中有重要参考意义,尤其是指导临床早期诊断、合理治疗及评价预后.%AIM: To examine the configuration of fungal keratitis and the detection rate of hypha and spore under confocal laser microscopy and investigate the value of confocal microscopy in the clinical diagnosis of fungal keratitis.METHODS: We conducted laserconfocal microscopy on 41 patients of 41 eyes diagnosed as fungal keratitis and compared the configuration of different layers of cornea in different stages.RESULTS: The fungal infected corneas histologically showed disordered layers, edema, infiltration of inflammatory cells, damaged sub-epithelial nerves and disordered stroma with reduced transparence. Hypha showed a specific base on the diagnosis of the disease, but not the only, it may appeared different configuration in different types of fungal keratitis and at different stages of the disease.CONCLUSION: Confocal laser microscopy is a noninvasive and rapid intuitive technique, and can offer helpful analysis in the early diagnosis, reasonable treatment and prognosis

  5. 糖尿病真菌性角膜炎患者临床特征、病原学特点及预后的回顾性分析%A retrospective analysis of the clinical characteristics, etiology and prognosis of fungal keratitis with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    黄晓明; 赵桂秋; 林静; 葛程; 胡丽婷; 姜楠; 徐强; 王谦

    2014-01-01

    了该病的人口学特征、临床症状、病原菌类型及预后.%Background The incidence of fungal keratitis is increasing and it is one of the leading causes of infectious corneal blindness.Fungal keratitis with diabetes mellitus (DM)also has an increasing trend,but the study on the disease is still relatively scarce.Objective This study was to analyze the clinical characteristics,etiology and prognosis of fungal keratitis with DM.Methods The clinical data of 87 cases of fungal keratitis with DM and 40 cases of fungal keratitis without systemic disease were retrospectively reviewed,and the demographic characteristics,clinical symptoms,pathologic examination and the prognosis of the patients were analyzed and compared.Results Poor glycemic control and trauma were more likely precipitating factors of fungal keratitis with DM.The proportion of vegetable injury was 36.8% in the fungal keratitis with DM group,and it was lower than 57.5% in the fungal keratitis without systemic disease group(x2 =6.06,P<0.05).The age at onset for fungal keratitis in the fungal keratitis with DM group was higher than that in the fungal keratitis without systemic disease group.The majority of patients in the fungal keratitis with DM group was farmers (34.5%)and physical workers (26.4%),with a mean history of DM for (13.0±4.9) years.Laboratory examination showed that Fusarium was the primary pathogenic fungi for the fungal keratitis with a proportion of 60.0% and next was Aspergillus (20.0%) and Candida (20.0%).The proportion of Candida infection was higher in the fungal keratitis with DM group than that in the fungal keratitis without systemic disease group(20.0% versus 10.0%) (x2 =3.92,P<0.05).The cure rate for fungal keratitis with DM patients was 46.0%,and that for fungal keratitis without systemic disease patients was 62.5%,showing a significant difference between them (x2 =5.48,P<0.05).In addition,the ineffective rate of treatment for fungal keratitis

  6. 中西医结合治疗真菌性角膜炎疗效观察%Clinical observation on the treatment of fungal keratitis with combination of TCM and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    齐峰瑞

    2014-01-01

    目的:观察中西医治疗真菌性角膜炎的临床疗效。方法:收治真菌性角膜炎患者60例,采用氟康唑注射液和那他霉素滴眼液点眼结合中药内服治疗。结果:治愈48例,显效10例,无效2例,总有效率96.76%。结论:规范有效的治疗方案能显著改善患者的症状和体征,提高疗效,促使患者早日康复。%Objective:To explore the clinical effect on the treatment of fungal keratitis with combination of TCM and Western Medicine.Methods:60 cases with fungal keratitis were selected.They were treated with Fluconazole Injection and natamycin eye drops combined with traditional Chinese medicine.Results:48 cases were cured;10 cases were effective;2 cases were ineffective;the total efficiency was 96.76% .Conclusion:Effective treatment can significantly improve the symptoms and signs of patients, improve the curative effect,and promote early rehabilitation of patients.

  7. Ciprofloxacin Ophthalmic

    Science.gov (United States)

    Ciprofloxacin ophthalmic solution is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection of ... in the clear front part of the eye). Ciprofloxacin ophthalmic ointment is used to treat conjunctivitis. Ciprofloxacin ...

  8. Expression of substance P in experimental fungal keratitis%实验性大鼠镰刀菌性角膜溃疡中P物质的表达

    Institute of Scientific and Technical Information of China (English)

    赵桂秋; 汪鑫; 胡丽婷; 林静; 车成业; 姜楠

    2011-01-01

    P<0.01.mRNA表达比较:茄病镰刀菌组F=658.60,q值分别为18.9941、9.5132、27.4719、42.0007、9.4809、46.4661、60.9948、36.9852、51.5139、14.5287,均P<0.01;金黄色葡萄球菌组F=335.13,q值分别为16.9266、4.1677、7.1081、32.4724、12.7589、24.0347、49.3990、11.2759、36.6402、25.3643.均P<0.01=.相同时间点上两实验组间比较,茄病镰刀菌组SP表达低于金黄色葡萄球菌组,差异有统计学意义(SP吸光度值t=6.5493、7.3867、16.0505、14.5479、6.5360,均P<0.05;mRNA表达比较t=7.2878、9.5232、8.8149、43.6256、11.1269,均P<0.05=.实验组左眼SP表达1 d达到最高(吸光度值为0.2840±0.0212,mRNA为0.3950±0.0129),5 d降至正常水平(吸光度值为0.2125±0.0174,mRNA为0.3321±0.0041),与实验组比较差异有统计学意义(SP吸光度值比较:与茄病镰刀菌组比较t=4.2261、18.3314、35.5163、5.3609、13.4826;与金黄色葡萄球菌组比较t=9.0508、25.6639、63.4924、7.4828、7.1301;均P<0.05.mRNA表达比较:与茄病镰刀菌组比较t=6.0249、31.9158、26.0413、9.1550、19.1741;与金黄色葡萄球菌组比较t=12.2636、53.4404、36.8727、15.8687、8.2939;均P<0.05=.结论 SP可能参与了真菌性角膜溃疡早期损伤和晚期修复过程,在真菌性角膜溃疡组表达低于细菌性角膜溃疡组可能参与了真菌性角膜溃疡疼痛较轻的机制.%Objective To detect the change process of substance P ( SP) expression and the difference between fungus and bacterial keratitis and explore effects of SP on the damage and repair process of keratitis model of Wistar rats. Methods Wistar rats were divided randomly as blank controlled group, fungal keratitis group and bacterial keratitis group. Inoculate fusarium and staphylococcus into cornea of Wistar rats to make animal keratitis model. Choose the right eye as experimental eye and the left eye as control. After the model was created successfully,25 rats were executed randomly at 1,5,8,10 and 14 days

  9. 角膜共焦显微镜在真菌性角膜炎诊断中的优势%Corneal confocal microscopy in diagnosis of fungal keratitis advantage

    Institute of Scientific and Technical Information of China (English)

    王荃; 李凯军; 高东鸿; 路晖

    2014-01-01

    Objective To explore the advantages of corneal confocal microscope in the diagnosis of fungal keratitis. Methods 32casesoffungalkeratitisunderwentcornealtissuelesionscraping,fungalcultureandcornealconfocalmi-croscopy.Results The detection rate was 94.3% in 32 cases of keratitis by confocal microscopy;hyphae or spores were found by smears,the detection rate of 42.8%;fungal culture found fungal colonies,the detection rate of 54.3%. Conclusion In diagnosis of fungal keratitis,corneal confocal microscopy is a simple method with direct and clear view in vivo,high repeatability and noninvasion.%目的:研究角膜共焦显微镜在真菌性角膜炎诊断中的优势。方法门诊诊断为真菌性角膜炎的患者32例均行病灶角膜组织刮片、真菌培养及角膜共焦显微镜检查,比较结果。结果32例角膜炎患者,共焦显微镜检查检出率为94.3%;刮片查到菌丝或孢子,检出率为42.8%;真菌培养发现真菌菌落,检出率为54.3%,共焦显微镜检出率明显高于刮片及真菌培养。结论在真菌性角膜炎的诊断中,角膜共焦显微镜具有操作简便,检查快捷,可在活体直接进行检查,可重复性高,扫描结果可直接同步显示到电脑屏幕,图像清晰,直观、无创等优势,对临床诊治真菌性角膜炎有极大的帮助。

  10. Pathogenic analysis of fungal keratitis: a report of 94 cases.%94例真菌性角膜炎患者的病原菌临床分析

    Institute of Scientific and Technical Information of China (English)

    陈英; 廖敏华

    2012-01-01

    Objective To learn the pathogenic features of fungal keratins in Hainan province and analyzed its epidemiological characters, thus provide guidance for individualized treatment. Methods A retrospective study was carried out in 94 patients diagnosed as having fungal keratitis in the Department of Ophthalmology from March 2010 to February 2011. The strains were identified by bacterial culture. Results Fungal keratitis highly occurred from Sep. to Dec. Sixty-one cases were detected with Fusarium (64.9%), 28 with Aspergillus fumigatus (29.8%), 2 cases with Alternaria alternate (2.1%), and 3 cases needed further identification (3.2%). Conclusion Fusarium is a dominant pathogen of fungal keratitis in Hainan province.%目的 了解海南地区真菌性角膜炎病原菌的种类和构成情况,分析真菌性角膜炎患者的流行病学特征,并指导临床个体化治疗.方法 对2010年3月至2011年2月在我院眼科门诊就诊的94例刮片镜检阳性的真菌性角膜炎患者的病例进行回顾性分析,细菌培养鉴定菌种.结果 海南地区真菌性角膜炎在10~12月份为高发季节,以镰刀菌感染(61例,64.9%)为主,除此之外还有烟曲霉菌(28例,29.8%)、链格孢霉菌(2例,2.1%)、待鉴定菌种(3例,3.2%).结论 真菌性角膜炎是严重的致盲性眼病,应提高对该病的认识和诊断水平,镰刀菌为目前海南地区真菌性角膜炎的主要致病菌.

  11. Fusarium sp in severe contact lens related fungal keratitis%镰孢菌属镰刀菌致与接触镜有关的真菌性角膜炎1例

    Institute of Scientific and Technical Information of China (English)

    Shawarinin Jusoh; Effat Omar; Manickam Ravichandran; Mohtar Ibrahim

    2008-01-01

    目的:报道1例罕见的被确诊为由镰孢菌属镰刀菌引起的与接触镜有关的严重的真菌性角膜炎,该病例最后通过治疗性穿透性角膜移植术成功治疗.方法:病例报告.结果:一位39岁的马来西亚女士,私企职员,配戴长戴性软性接触镜18a.感右眼剧痛、眼红10d.眼部检查见多个长有伪足的圆形旁中心角膜溃疡,前房少许积脓,临床诊断为真菌性角膜炎.经重复角膜刮片检查真菌和细菌结果均阴性后给予局部广谱抗生素和抗真菌治疗,但患者右眼角膜炎病情进一步加重,又给予其他的局部和全身抗真菌药物治疗,患者右眼角膜溃疡进一步加深.最后,为保留眼球,限制感染,在发病1.5mo后,给予患者治疗性的穿透性角膜移植术.术后,角膜组织病理学检查和PCR检查证实为镰孢菌属镰刀菌感染所致.结论:这是1例罕见的由镰孢菌属镰刀菌感染引起的严重的与接触镜有关的真菌性角膜炎.这也说明了在真菌性角膜炎的治疗上存在挑战性.为控制真菌性角膜炎进一步发展,并保护眼球,治疗性的穿透性角膜移植术应该是最后的选择.%AIM: To report a rare case of severe contact lens related fungal keratitis due to fusarium sp, which not only was successfully treated with therapeutic penetrating keratoplasty but also aided in the confirmation of diagnosis. METHODS:Case report.RESULTS: A 39-year-old private clerk Malay lady who wore extended wear soft contact lens for the past 18 years, presented with acute right eye pain and redness for 10 days duration. Ocular examination showed multiple round feathery paracentral corneal ulcers with presence of minimal hypopyon. Clinical diagnosis of presumed fungal keratitis was made. She was treated with broad spectrum topical antibiotics and antifungal agents after repeated corneal scrapping was negative either for fungi or for the bacteria. However, she developed deterioration of the right eye

  12. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents.

    Science.gov (United States)

    Tsatsos, Michael; MacGregor, Cheryl; Athanasiadis, Ioannis; Moschos, Marilita M; Hossain, Parwez; Anderson, David

    2016-12-01

    Ophthalmic herpes simplex viral keratitis is responsible for a range of ocular manifestations from superficial epithelial disease to stromal keratitis and endotheliitis. The Herpetic Eye Disease Study has guided the management of herpetic eye disease for almost twenty years, but newer medications such as valacyclovir are now available and are considered to have better bioavailability than acyclovir. In this review, we examine the existing evidence on the pathogenesis of different ophthalmic herpes simplex viral keratitis disease modalities and the role of oral and topically administered antiviral drugs in the treatment of herpes simplex viral keratitis.

  13. Acanthamoeba keratitis with Curvularia co-infection

    Directory of Open Access Journals (Sweden)

    Gupta N

    2010-01-01

    Full Text Available We report a case of Acanthamoeba keratitis with Curvularia co-infection. Acanthamoeba and fungal co-infection have been uncommonly reported in literature, worldwide. A classical history with a strong clinical suspicion and experienced laboratory personnel with systematic examination of corneal scrapings for bacterial, viral, parasitic and fungal causes are imperative for accurate diagnosis. Early diagnosis of Acanthamoeba keratitis or fungal infection followed by aggressive and appropriate treatment with effective agents is critical for the retention of good vision. Acanthamoeba keratitis is difficult to diagnose and, despite improvement in treatment options, may culminate in prolonged morbidity and significant loss of visual acuity. This case emphasizes the important role played by clinical microbiologists in making prompt diagnosis which can ultimately reduce visual morbidity.

  14. HELMENTHOSPORIUM – KERATITIS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vepa

    2015-01-01

    Full Text Available The incidence of fungal keratitis has shown a dramatic increase in the recent years. This was a patient who following fall of insect presented with pain , redness and watering in right eye. Examination revealed an 4x5mm oval ulcer with slough. Laboratory evaluation showed Helminthosporium sp. , Though Helminthos porium sp. , of fungus rarely cause disease in humans it should be kept in mind in immunocompromised individuals and patients using the over the counter drugs.

  15. Lacrimal Duct Occlusion Is Associated with Infectious Keratitis

    Science.gov (United States)

    Li, Guigang; Guo, Jingmin; Liu, Rong; Hu, Weikun; Xu, Lingjuan; Wang, Juan; Cai, Subo; Zhang, Hong; Zhu, Yingting

    2016-01-01

    Background: To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human infectious keratitis. Methodology/Principle Findings: The design is prospective, non-control case series. Thirty-one eyes from twenty-eight continuous patients with infectious keratitis were included in this study. The presence/absence of lacrimal duct obstruction was determined by the lacrimal duct irrigation test. The diagnosis of infectious keratitis was made based on clinical manifestations, cornea scraping microscopic examination and bacterial/fungus culture. Diagnosis of viral keratitis was set up based on the recurrent history, deep neovascularization and typical outlook of the cornea scar. The treatment of keratitis included drugs, eye drops or surgery, while treatment of chronic dacryocystitis was lacrimal duct dredging with supporting tube implantation surgery. In the thirty-one eyes with infectious keratitis, fifteen suffered from fungal keratitis (48%), two bacterial keratitis (6%), and fourteen viral keratitis (45%). Eleven eyes (35%) from ten patients with infectious keratitis also suffered from lacrimal duct obstruction. In those cases, six eyes also suffered from lower canalicular obstruction, three nasolacrimal duct obstruction and chronic dacryocystitis, one a combination of upper and lower canalicular obstruction, one upper canalicular obstruction. After local and systemic applications of anti-bacterial, anti-viral, anti-fungal and anti-inflammatory drugs, twenty-eight eyes (90%) recovered within three weeks, while the ulceration of three patients required the lacrimal duct dredging and supporting tube implantation surgery for the healing. Conclusions: Herein, we first report that the prevalence of infectious keratitis is closely correlated to the occurrence of lacrimal duct obstruction. When both confirmed, simultaneous treatment of keratitis and lacrimal duct obstruction

  16. Traditional Chinese Medicine Combined with Antifungal Agents for Treating Fungal Keratitis in 53 Cases%中药联合抗真菌药物治疗真菌性角膜炎53例

    Institute of Scientific and Technical Information of China (English)

    邓显峰

    2015-01-01

    Objective To observe the clinical effect of traditional Chinese medicine combined with antifungal agents in treating fungal keratitis. Methods Totally 106 patients with fungal keratitis in the hospital were selected and divided into the experimental group and the control group,53 cases each. The control group adopted 5% Natamycin Eye Drops and 0. 2% Fluconazole Eye Drops for treatment, while on this basis the experimental group adopted oral Yupingfeng Powder and Yinhuatufuling Decoction,and traditional Chinese medicine fumigation eye treatment. The curative effect,vision,adverse reactions and cure time after 15 d treatment were evaluat-ed. Results The experimental group was significantly better than the control group in the curative effect,visual acuity and cure time ( P ﹤ 0. 05);the adverse reactions had no statistically significant difference between the two groups. Conclusion The integrated tradi-tional Chinese and Western medicine for treating fungal keratitis can obtain better curative effect,shorten the cure time and deserves to be promoted in clinic.%目的:观察中药联合抗真菌药物治疗真菌性角膜炎的临床疗效。方法选取医院诊治的真菌性角膜炎患者106例,按就诊先后顺序将其分为试验组和对照组,各53例。对照组患者采用5%那他霉素滴眼液和0.2%氟康唑滴眼液滴眼治疗,试验组患者在对照组基础上采用玉屏风散合银花土茯苓汤内服和中药熏蒸患眼治疗。治疗15 d后进行疗效、视力、不良反应、痊愈时间等评估。结果试验组的疗效、视力和痊愈时间均明显优于对照组( P﹤0.05),两组患者不良反应发生情况无显著性差异。结论中西医结合治疗真菌性角膜炎可取得较好疗效,能缩短痊愈时间,值得临床推广。

  17. 那他霉素联合氟康唑治疗真菌性角膜炎的疗效评比%Curative Effect Comparation of Fungal Keratitis Treated with Natamycin and Fluconazole

    Institute of Scientific and Technical Information of China (English)

    祝彩英

    2015-01-01

    Objective:To study the curative effect of fungal keratitis treated with Natamycin and Fluconazole.Method:145 patients with fungal keratitis admitted in our hospital from April 2013 to August 2014 were selected,in accordance with the random number table they were randomly divided into the experimental group(n=75) and the control group(n=70),the control group was treated with Natamycin Eye Drops,the experimental group was treated with Natamycin combined with Fluconazole Eye Drops,the ulcer,pain,empyema and curative effect of two groups were observed and compared. Result:The total effective rate of the experimental group(80.00%) was significantly higher than that of the control group(52.86%),the difference had statistically significant(P<0.05).Conclusion:The curative effect of fungal keratitis treated with Natamycin and Fluconazole is more significantly than Natamycin alone,is suitable for clinical application for a long time.%目的:研究那他霉素联合氟康唑治疗真菌性角膜炎的疗效,探讨其临床适用性。方法:选取2013年4月-2014年8月在笔者所在医院就诊的145例真菌性角膜炎患者,按照随机数字表法分为试验组75例和对照组70例,对照组给予那他霉素滴眼液点眼,试验组给予氟康唑滴眼液和那他霉素滴眼液联合点眼,观察两组患者溃疡、疼痛、积脓等症状,评比其疗效。结果:试验组治疗总有效率(80.00%)明显高于对照组(52.86%),差异有统计学意义(P<0.05)。结论:那他霉素联合氟康唑治疗真菌性角膜炎疗效比单独使用那他霉素疗效更为显著,适合临床长期推广应用。

  18. 探究角膜移植治疗真菌性角膜炎的围手术期护理对策%Explore the Treatment of Fungal Keratitis Corneal Transplant Perioperative Nursing Strategy

    Institute of Scientific and Technical Information of China (English)

    李娟

    2015-01-01

    目的:探究与分析角膜移植治疗真菌性角膜炎的围手术期护理对策。方法回顾性分析我院自2012年10月至2014年10月收治的60例真菌性角膜炎患者的临床资料。总结其围手术期护理对策及治疗效果。结果该组患者共60例,其中有56例患者感染得到控制,控制率为93.33%,术后矫正视力在0.05至0.5之间。全部患者治疗结束后出现3例感染复发,复发率为5.00%,后给予穿透性角膜移植术后治愈。结论为患者采用角膜移植治疗真菌性角膜炎时配合积极有效的围手术护理对策可确保临床治愈率,患者的视力也随之得到矫正,复发率较低,值得推广。%Objective To investigate and analyze corneal transplantation in the treatment of fungal keratitis perioperative nursing.MethodsA retrospective analysis of the clinical data in our hospital since October 2012 to October 2014 were treated 60 cases of fungal keratitis patients. Summarize the perioperative nursing measures and treatment.Results This group of patients a total of 60 cases, including 56 cases of patients with infection control, control rate was 93.33%, corrected visual acuity between 0.05 and 0.5. After al the patients appeared three cases of infection recurrence rate was 5.00%, after giving penetrating keratoplasty cure.Conclusion Patients with corneal transplantation in the treatment of fungal keratitis with positive and effective perioperative nursing strategies to ensure that the clinical cure rate, the patient's vision also wil be corrected, low recurrence rate, it is worth promoting.

  19. Pathogen distribution of traumatic fungal keratitis in south Zhejiang%浙南地区角膜外伤后真菌性角膜炎病原分布

    Institute of Scientific and Technical Information of China (English)

    陈鹏飞; 王大选; 毛丽萍; 顾云峰; 郑美琴

    2015-01-01

    Objective To analyze the pathogen distribution and characteristics of traumatic fungal keratitis in south Zhejiang in last two years.Methods One hundred and twenty-three cases with fungal keratitis from January 2013 to December 2014 were collected.The positive rate of fungal culture, strain distribution, seasonal distribution, sources of patients, gender distribution, profession, and etiology were retrospectively analysed.Results Among the 123 cases, the number of positive culture was 90 and the positive rate was 73.2%.The main pathogenic bacterium was Fusarium which was detected in 44 cases (48.9%), the next was Aspergillums which was detected in 17 cases (18.9%), 11 cases (12.2%) were Alternaria, 10 cases (11.1%) were Candida, 6 cases (6.7%) were Penicillium and 2 case (2.2%) were Filamentous fungi (undifferentiated).Profession distribution: About 82 cases (67%) were farmer, 13 cases (10.6%) were urban residents, 10 cases (8.1%) were rural migrant workers, 8 cases (6.5%) were culturist and 10 cases (8.1%) were other professions.Seasonal distribution: The number of the fungal keratitis patients in the second half of the year was significantly more than that in the first half of the year.Etiology distribution: 96 patients had history of coneal abrasion, 20 cases were caused by foreign bodies splashing, 7 cases were chemical injury and 28 cases were caused by other reasons.Conclusion The Fusarium is the predominant pathogen of ocular fungal infection in the south of Zhejiang followed by Aspergillums.Farmers are susceptible to fungal keratitis.The second half of the year is the peak time of fungal keratitis.And trauma is the most common inducing factor of fungal keratitis[1].%目的 分析最近两年浙南地区角膜外伤后真菌性角膜炎患者的病原分布及其特点.方法 收集2013年1月至2014年12月123例真菌性角膜炎病例.对真菌培养的阳性率、菌株分布、季节分布、患者来源、性别分布、职业

  20. Pharmacologic Action of Natamycin for Treatment of Experimental Fungal Keratitis in Rabbits%纳他霉素滴眼剂治疗兔眼真菌性角膜炎的药效研究

    Institute of Scientific and Technical Information of China (English)

    董贤慧; 高维娟; 钱涛; 贺小平; 侯淑敏; 郭银; 韦素春; 杨国兴

    2011-01-01

    目的:探讨国产纳他霉素滴眼剂对真菌性角膜炎的治疗作用,为其临床应用提供实验基础.方法:成年健康新西兰白兔30只,随机分为6组,真菌性角膜炎(FK)模型组、生理盐水组、纳他霉素滴眼剂赋形剂组、Natacyn组、纳他霉素组和正常对照组,每组10只兔眼.除正常对照组外其余各组角膜基质注射法建立真菌性角膜炎模型.各组动物于造模后第4、10、15和21天于裂隙灯下观察兔眼溃疡情况并评分,第10和21天观察兔眼治愈情况,并记录各组角膜发生新生血管、虹膜炎、前房积脓、斑翳等发生情况.结果:(1)第10、15和21天Natacyn组和纳他霉素组兔眼溃疡评分低于FK模型组(均P< 0.001);纳他霉素组和Natacyn组差别无统计学意义.(2) Natacyn组和纳他霉素组较FK模型组兔眼治愈率升高(均P< 0.001),而前2组治愈率差别无统计学意义.(3)纳他霉素和Natacyn组较FK模型组兔眼真菌性炎症并发症发生率低(均P< 0.001),而前2组真菌性炎症合并症发生率差别无统计学意义(P>0.05).结论:纳他霉素滴眼剂可降低真菌性角膜炎兔眼溃疡评分、提高治愈率、有效预防并发症.%Objective: To evaluate the efficacy of topical natamycin in an experimental rabbit model of fusarium solani, and provide the experimental basis for the clinical safety thereof. Methods:Thirty New Zealand rabbits were randomly divided into 6 groups,fungal keratitis model group(FK) .normal saline eye drop group,vehicle eye drop group,natacyn group,natamycin group and normal control group (10 rabbit eyes in each group). The rabbit model of fungal keratitis was induced by injection in into the central comeal stroma of eyes. After 4 d, 10 d, 15 d, and 21 d of treatment, the eyes of each group were examined clinically by slit lamp with a scoring system. The treatment results of rabbit eyes were observed on the 10 d and 21 d of treatment. The corner vascularisation, iritis

  1. Primary study of treatment of fungal keratitis by amniotic membrane transplantation and amniotic membrane cover%羊膜移植联合羊膜覆盖治疗真菌性角膜炎分析

    Institute of Scientific and Technical Information of China (English)

    姜剑; 毕宏生; 王兴荣; 窦冉; 左振刚; 许静

    2010-01-01

    目的 探讨角膜清创联合羊膜移植羊膜覆盖治疗真菌性角膜炎的手术适应证的选择和临床效果.方法 2008年3月至2009年11月就诊的17例真菌性角膜炎患者,视力为FC/50cm~0.2,经角膜刮片法10%KOH溶液处理后查见菌丝,常规全身、局部抗真菌治疗3周至2个月后,患者病情迁延不愈,角膜涂片仍见菌丝.手术适应证为感染深度小于1/3角膜厚度,感染范围小于1/3角膜面积.手术方式:在局麻下行角膜清创,至角膜植床无明显感染迹象.溃疡面行羊膜小植片移植,角膜表面行羊膜大植片覆盖.术后结膜下注射0.2%氟康唑注射液0.5ml.结果 16例患者术后视力为0.5~1.0,感染得到控制.羊膜小植片与角膜融合,可见角膜组织内云翳形成.1例患者术后感染灶融解,改行板层角膜移植术后治愈.结论 角膜清创联合羊膜移植羊膜覆盖可以有效治疗药物难以治愈的表浅真菌性角膜炎.良好的手术适应证的选择不仅可以治愈真菌性角膜炎,而且可以获得良好的术后视力.真菌复发和角膜融解是手术后的危险因素.%Objective To evaluate the efficiency ofamniotic membrane transplantation and amniotic membrane cover for fungal keratitis. Methods Amniotic membrane transplantation and amniotc membrane cover was done on 17 cases of fungal keratitis after infected tissue had been completely cleared in our hospital fiom March 2008 to November 2009. Results Amniotic membrane graft grown well. Sixteen cases of fungal keratitis were cured and visual acuity were 0.5-1.0, and one recurring case was performed lamellar keratoplasty and visual acuity was 0.2. Conclusions Amniotic membrane transplantation and amniotic membrane cover is an effective method for fungal keratitis.

  2. 波氏假阿利什菌(尖端赛多孢子菌)引起的真菌性角膜炎1例%Fungal keratitis caused by Pseudallescheria boydii(Scedosporium apiospermum)

    Institute of Scientific and Technical Information of China (English)

    Moharmnad Nasser Hashemian; Mehrdad Shamshiri; Firoozeh Rahimi; Mohammad Taher Rajabi; Seyed Ali Tabatabaee; Mohammad Reza Salari

    2008-01-01

    我们报道成功治疗波氏假阿利什菌引发的真菌性角膜炎1例,患者只留有很小的角膜瘢痕.一位71岁女性患者,有疼痛、红肿和异物感病史,来到我们第三眼科中心就诊.最初角膜刮片显示有真菌成分,2d后真菌培养为阳性,5d后显示生长物为波氏假阿利什菌.患者仅用药物疗法取得临床治愈,留下微小的角膜瘢痕,最终视力为3/10.%· We report successful treatment of a case of fungal keratitis caused by Pseudallescheria boydii with minimal corneal scar. A 71-year-old woman with history of pain, redness and foreign body sensation presented to our tertiary eye center. Initial corneal scraping revealed fungal elements. After two days fungal culture became positive, and after five days it was shown to be growth of Pseudallescheria boydii. The patient achieved clinical cures with medical therapy alone with minimal corneal scar and good visual outcome of 3/10.

  3. 环孢素A联合氟康唑治疗真菌性角膜炎的临床观察%Clinical observation about the treatment of fungal keratitis by cydosporine A (CsA) and fluconazole

    Institute of Scientific and Technical Information of China (English)

    王涌

    2011-01-01

    Objective To study the therapy reaction to fungal keratitis with cyclosporine A ( CsA) and fluconazole. Methods 127 patients (127 eyes) were divided into 2 groups (A or B). The groups A (63 eyes) was treated by fluconazole, the groups B (64 eyes) was treated by fluconazole and cyclosporine A (CsA). Results The groups B was obviously higher than the groups A in vision restoration, obviously effective rate and total effective rate ,and obviously lower than the groups A in ineffective rate. There was statistical difference. Conclusion Cyclosporine A ( CsA) and fluconazole can significantly enhance trenting results of fungal keratitis,and cyclosporine A (CsA) can be used as the leading locally used drug.%目的 探讨环孢索A( cyclosporine A,CsA)联合氟康唑治疗真菌性角膜炎的临床效果.方法 将127例真菌性角膜炎患者随机分为两组,A组为常规组采取氟康唑药物治疗,B组为治疗组在A组氟康唑治疗基础上加用CsA治疗.结果 B组在视力恢复、显效率及总有效率上明显优于A组,无效率也明显低于A组,差异有统计学意义.结论 CsA联合氟康唑能明显提高真菌性角膜炎的治疗效果,可作为一线局部抗真菌药物使用.

  4. Current Situation of Lamellar Keratoplasty for Fungal Keratitis%板层角膜移植术治疗真菌性角膜炎的研究进展

    Institute of Scientific and Technical Information of China (English)

    黄迪(综述); 吴敏; 胡竹林(审校)

    2015-01-01

    Fungal keratitis is a commonly encountered disease of ophthalmology with very high blinding rate and its incidence has been increasing year by year. Partial or systemic use of effective antifungal drugs combined with appropriate surgical methods are the consensus of treatment for fungal keratitis. The common surgical ways include traditional penetrating lamellar keratoplasty, lamellar keratoplasty and deep lamellar keratoplasty. The latter two surgeries are becoming more and more popular due to the advantages of having less adverse reactions such as corneal endothelial failure,rejections,and the clinical application is becoming more and more prominent.%真菌性角膜炎是一种致盲率极高且发病率逐年上升的眼科常见病。局部或全身使用有效的抗真菌药物,并选择恰当的手术方式已成为治疗真菌性角膜炎的共识,手术方式包括传统穿透性角膜移植术、板层角膜移植术和深板层角膜移植术。其中,板层角膜移植术和深板层角膜移植术因能显著减少角膜移植术后的角膜内皮功能衰竭、排斥等不良反应的发生,在临床上的应用日益突出。

  5. Clinical study on the recurrence of fungal keratitis after lamellar keratoplasty%真菌性角膜炎板层角膜移植术后复发的临床研究

    Institute of Scientific and Technical Information of China (English)

    胡建章; 谢立信

    2008-01-01

    Objective To study the characters,diagnosis,treatment and risk factors of the recurrence of fungal keratitis after lamellar keratoplasty(LKP). Methods In this nonrandomized retrospective case series,two hundred and eighteen cases of fungal keratitis were undertaken partial LKP from January 1998 to July 2005.The case history was inquired in detail preoperatively.A trephine with diameter 0.5 mm larger than the area of fungal infeetion was used to incise the lamellar corneal ulcer,and the hyphae of some cases were inspected with microscope during the operation. The recurrence of fungal keratitis was observed after the surgery. Medical treatment and/or operation were used in the management of recurrent cases. The risk factors for the recurrence of fungal keratitis after LKP,such as fungal species,glucocorticoid or immunosuppressant therapy,hypopyon or endothelial plague,were also analyzed. Results Seventeen cases(7.80%)recurred within 2 weeks after surgery and mainly(15 cases)within 1 week.The recurrence displayed with increased local irritation and hypha infihration on recipient LKP bed. All recurrent fungal infections were controlled by performing penetrating keratoplasty(PKP). Risk factor analysis:(1)The recurrent rate of Aspergillus infection(19.23 %)was higher than that in Fusarium infection(5.63%)(P=0.0323). (2)The recurrence rate of cases treated with glueocorticoid or immunosuppressant preoperatively(21.70%)was much higher than that in non-treated cases(6.15%)(P=0.0219).(3)The recurrence rate of cases with hypopyon or endothelial plague preoperatively(17.02%)was much higher than that without these signs(5.26%)(P=0.0134).Conclusions The recurrence of fungal keratitis after LKP OCCUrs mainly within the 1 st week. Aspergillus infection, glucocortieoid or immunosuppressant therapy,hypopyon or endothelial plague are the risk factors for LKP.%目的 探讨板层角膜移植术(LKP)治疗真菌性角膜炎术后真菌复发的特点、诊

  6. Clinical and epidemiological characteristics of infectious keratitis in Paraguay.

    Science.gov (United States)

    Nentwich, Martin M; Bordón, M; di Martino, D Sánchez; Campuzano, A Ruiz; Torres, W Martínez; Laspina, F; Lichi, S; Samudio, M; Farina, N; Sanabria, Rosa R; de Kaspar, Herminia Mino

    2015-06-01

    To describe the clinical and epidemiological characteristics of patients with severe infectious keratitis in Asunción, Paraguay between April 2009 and September 2011. All patients with the clinical diagnosis of severe keratitis (ulcer ≥2 mm in size and/or central location) were included. Empiric treatment consisted of topical antibiotics and antimycotics; in cases of advanced keratitis, fortified antibiotics were used. After microbiological analysis, treatment was changed if indicated. In total 48 patients (62.5 % males, 25 % farmers) were included in the analysis. A central ulcer was found in 81.3 % (n = 39). The median delay between onset of symptoms and time of first presentation at our institution was 7 days (range 1-30 days). Fungal keratitis was diagnosed in 64.5 % (n = 31) of patients, of which Fusarium sp. (n = 17) was the most common. Twenty-one patients (43.8 %) reported previous trauma to the eye. The globe could be preserved in all cases. While topical therapy only was sufficient in most patients, a conjunctival flap was necessary in six patients suffering from fungal keratitis. The high rate of fungal keratitis in this series is remarkable, and microbiological analysis provided valuable information for the appropriate treatment. In this setting, one has to be highly suspicious of fungal causes of infectious keratitis.

  7. Corneal edema and keratitis following selective laser trabeculoplasty

    Directory of Open Access Journals (Sweden)

    Erica Tan Liu

    2017-06-01

    Conclusions and importance: With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent damage to the cornea.

  8. Mycotic keratitis due to Aspergillus nomius

    NARCIS (Netherlands)

    Manikandan, P.; Varga, J.; Kocsube, S.; Samson, R.A.; Anita, R.; Revathi, R.; Doczi, I.; Nemeth, T.M.; Narendran, V.; Vagvolgyi, C.; Manoharan, C.; Kredics, L.

    2009-01-01

    We report the first known case of fungal keratitis caused by Aspergillus nomius. Ocular injury was known as a predisposing factor. The patient was treated with natamycin and econazole eye drops, itraconazole eye ointment, and oral ketoconazole. A therapeutic penetrating keratoplasty was performed 16

  9. Infectious keratitis caused by Aspergillus tubingensis

    NARCIS (Netherlands)

    Kredics, L.; Varga, J.; Kocsube, S.; Rajaraman, R.; Raghavan, A.; Doczi, I.; Bhaskar, M.; Nemeth, T.M.; Antal, Z.; Venkatapathy, N.; Vagvolgyi, C.; Samson, R.A.; Chockaiya, M.; Palanisamy, M.

    2009-01-01

    PURPOSE: To report 2 cases of keratomycosis caused by Aspergillus tubingensis. METHODS: The therapeutic courses were recorded for 2 male patients, 52 and 78 years old, with fungal keratitis caused by black Aspergillus strains. Morphological examination of the isolates was carried out on malt extract

  10. [Acanthamoeba keratitis].

    Science.gov (United States)

    Bouheraoua, N; Labbé, A; Chaumeil, C; Liang, Q; Laroche, L; Borderie, V

    2014-10-01

    Early diagnosis and appropriate therapy are key elements for a good prognosis in Acanthamoeba keratitis (AK). AK should be considered in any case of corneal trauma complicated by exposure to soil or contaminated water, and in all contact lens (CL) wearers. A presumptive diagnosis of AK can be made clinically and with in vivo confocal microscopy, although a definitive diagnosis requires identification of Acanthamoeba on direct scraping, histology, or identification of Acanthamoeba DNA by polymerase chain reaction (PCR). We use cysticidal drugs for treating AK because encysted forms are more resistant than trophozoites to treatment. The treatment protocol used a biguanide (PHMB 0.02% or chlorhexidine 0.02%) and a diamidine (propamidine 0.1% or hexamidine 0.1%). New diagnostic modalities and more specific topical anti-amoebic treatments would substantially benefit patients with AK.

  11. Advances in corneal intrastromal injection for treatment of fungal keratitis%角膜基质注射治疗真菌性角膜炎的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘桑田(综述); 毕燕龙(审校)

    2015-01-01

    真菌性角膜炎(fungal keratitis,FK)作为一种严重的致盲性眼病,其病变常易侵犯角膜深层,目前国内外治疗FK的方法主要为口服或静脉注射全身抗真菌药,联合局部使用抗真菌滴眼剂,这些途径的治疗对于某些难治性FK病例往往效果欠佳。近年来,国内外学者发现通过往角膜基质病灶区内直接注射抗真菌药对FK的治疗有良好的疗效。本文就角膜基质注射治疗FK作一综述。%As a serious blinding eye disease,fungal keratitis(FK)often tends to invade into deep corneal stroma. Clinically,the main therapy for FK includes oral or intravenous systemic administration of antifungal drugs,with local antifungal eyedrops. However,these treatments often have poor effects on some intractable FK patients. Recently,it is revealed that direct corneal intrastromal injection of antifungal drugs has a good clinical effect,even on intractable cases. In this paper,the advances in corneal intrastromal injection for treatment of FK are reviewed.

  12. A comparative study on clinical outcomes of penetrating keratoplasty for diabetes versus non-diabetes fungal keratitis patients%糖尿病和非糖尿病真菌性角膜炎穿透角膜移植术治疗临床效果的对照研究

    Institute of Scientific and Technical Information of China (English)

    朱铖铖; 赵桂秋; 刘园园; 林静; 彭旭东; 胡丽婷; 姜楠; 王雪; 仇胜

    2016-01-01

    Background Fungal keratitis is one of the main leading cause of blindness in China,the incidence of which is increasing year by year,while fungal keratitis with diabetes mellitus (DM) also has an increasing trend.Penetrating keratoplasty (PKP) is an effective treatnent for fungal keratitis with high risks,but the study on clinical effect of diabetes mellitus on PKP is still relatively scarce.Objective The clinical data of 92 cases of fungal keratitis with DM and 106 cases of fungal keratitis without systemic disease who underwent PKP were retrospectively reviewed,and the postoperative best corrected visual acuity (BCVA),implant rejection,fungus recurrence,complicated cataract and secondary glaucoma were analyzed and compared.Results Moderate and severe infection were obtained in corneas of the two groups,the eye number distributions of different infection degree and Eurotium infection were not significantly different between the two groups (x2=0.166,P =0.684).The eye number distributions of Eurotium infection had no statistical significance between the two groups (x2 =0.340,P =0.854).The eye number distributions of Fusarium and Candida infection were significantly different between the two groups (x2=2.068,P =0.010;x2 =3.874,P =0.049) The BCVA of the 2 groups from 1 week to 2 years postoperative were all higher than preoperative.The numbers of patients whose BCVA>0.3 in fungal keratitis with DM group were significantly lower than those in the fungal keratitis without DM group in different time intervals after surgery (all at P<0.05).The implant rejection rate was 42.39% in the fungal keratitis with DM group,which was significantly higher than 28.30% in the fungal keratitis without DM group (x2 =4.306,P =0.038).The fungus recurrence rate was 17.39% in the fungal keratitis with DM group,which was significantly higher than 9.43% in the fungal keratitis without DM group (x2 =3.941,P =0.047).In addition,the proportion of complicated cataract patients in

  13. Bimatoprost Ophthalmic

    Science.gov (United States)

    Bimatoprost ophthalmic is used to treat glaucoma (a condition in which increased pressure in the eye can ... condition which causes increased pressure in the eye). Bimatoprost is in a class of medications called prostaglandin ...

  14. An epidemiological investigation of onion growers with Fungal Keratitis%洋葱种植者与真菌性角膜炎的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    王文和; 刘辉

    2012-01-01

    目的 探讨民勤县洋葱种植者与真菌性角膜炎的发病关系.方法 通过对甘肃民勤县52例真菌性角膜炎的临床观察及微生物培养及对洋葱采挖现场的土壤、腐烂洋葱及采挖者手指采样的微生物培养分析.结果 52例患者真菌培养,25例培养出真菌,菌种以尖孢镰刀菌最多(48%);洋葱采挖现场调查发现,洋葱刺激气味造成60%的作业者角膜上皮糜烂;现场采样真菌培养,3类标本中均培养出多种真菌,腐烂洋葱中尖孢镰刀菌最多,土壤中黄曲霉菌、茄病镰刀菌居多,作业者手指尖孢镰刀菌最多.结论 采挖洋葱的农民因洋葱刺激性气味造成角膜上皮糜烂,为真菌感染创造有利条件;农民接触腐烂的洋葱及土壤,手上污染了大量真菌,在擦拭眼泪时将真菌带入结膜囊造成感染.大多数致病菌是尖孢镰刀菌,主要来源于腐烂的洋葱.%Objective To probe into the causes for the onion farmers of Minqin County who vulnerable to fungal keratitis with the main pathogenic fungi and sources. Method Through the 52cases with clinical observation of fungal keratitis and microorganism cultivation,the clinical features and main pathogenic Fungi were analyzed on site investigation of onion excavation at the scene,and found out it's etiology.Examination on the spot of the onion excavating places to search for the etiological agent,sample the scene soil,rotten onion and workers' fingers,to discover the pathogenic bacteria origins. Results Retrospectively analyzed fungal culture in the 52 cases of the patients.The most strains were Fusarium oxysporum (48%).Sixty percent excavators suffered from erosion of corneal epithelium caused by stimulating taste of onions.With Scene sampling fungal culture,a variety of fungal species were raised from three kinds of samples,what the content were most of Fusarium oxysporums in rotten onions,Aspergillus flavus and Fusarium solan in soil,and Fusarium oxysporums

  15. Mycotic keratitis : A study in coastal Karnataka

    Directory of Open Access Journals (Sweden)

    Kotigadde Subbannayya

    1992-01-01

    Full Text Available Fungi were isolated from 67 cases out of the 295 cases of corneal ulcers investigated. Aspergillus species and species of Candida were the major fungal members isolated. Allescheria boydii was isolated from 3 cases, having no previous history of injury to the eye or infection with bacterial or viral agents. A boydii corneal infection is a rare occurrence. Higher incidence of mystic keratitis was seen among females than males. No relationship to seasonal changes could be established. Bacterial infection was associated in 46. 27% of the cases of mycotic keratitis and Staphylococcus was the predominant bacterial pathogen observed.

  16. Successful treatment of a refractory stromal fungal keratitis by intrastromal injection of amphotericin B%两性霉素B角膜基质内注射成功治疗真菌性角膜炎1例

    Institute of Scientific and Technical Information of China (English)

    Yanti Muslikhan; Nor Sharina Yusuf; Khairy Shamel Sonny Teo; Azhany Y aakob; Mohtar Ibrahim

    2010-01-01

    目的:报告1例使用5mg/L两性霉素成功治疗难治性真菌性角膜炎的病例.方法:病例报告.结果:女性患者1例,48岁,以右眼红1wk,伴视力下降和角膜混浊2d入院.否认有外伤或异物史.检查发现:右眼视力:6/12,针孔视力:6/18.注射结膜前使眼分泌物保持最少.角膜旁中央区有一全层基质脓肿-形态不规则且伴有卫星病灶及羽状边缘,不伴有上皮缺损,有前房积脓液平.左眼正常.诊断为真菌性角膜炎.尽管在此前患者经历了3wk的局部两性霉素B点眼(1次/2h),那他霉素眼液点眼(1次/4h),但并无病情恢复的迹象.相反12点出现了一个新的更大的基质脓肿病灶.我们应用5mg/L两性霉素B角膜基质注射联合穿透性角膜移植术治疗后溃疡面积明显减少,前房积脓完全消失,没有毒性反应发生.患者干预后2mo视力恢复了正常视力(6/6).结论:使用两性霉素B 5mg/L基质内注射,使用过程安全有效,是一种治疗难治性真菌性角膜炎的理想方法.%AIM: To report a successful intrastromal injection of amphotericin B 5mg/L in a refractory fungal keratitis.METHODS: An interventional case report RESULTS: A 48-year-old lady presented with history of redness of the right eye for one week duration followed by decrease in vision and corneal opacity for two days. There was no histow of trauma or foreign body. Examination revealed visual acuity of 6/16 with pinhole of 6/12 of the right eye. The conjunctiva was injected with minimal eye discharge. There was a full thickness stromal abscess at the paracentral area of the cornea. It was irregular,feathery margin with few satellite lesions. There was no epithelial defect noted. Hypopyon level was also seen.The left eye was normal. A presumptive diagnosis of fungal keratitis was entertained. Despite three weeks of intensive treatment with topical amphotericin B every 2 hours and natamycin every 4 hours and antibiotic cover,the lesion showed no sign of

  17. Observation of effect of itraconazole applied in treatment of fungal keratitis%伊曲康唑治疗真菌性角膜炎的临床效果研究

    Institute of Scientific and Technical Information of China (English)

    徐苏云; 严琴梅; 王美华; 姜方义

    2015-01-01

    目的:研究伊曲康唑治疗真菌性角膜炎临床效果,为合理用药提供参考依据。方法选择2011年3月-2014年2月收治的36例真菌性角膜炎患者为观察组,采用伊曲康唑+两性霉素B+氟康唑滴眼液治疗,回顾性调查2005年3月-2011年3月收治的36例真菌性角膜炎患者临床资料为对照组,给予两性霉素B+氟康唑滴眼液治疗,连续治疗1个月后对两组治疗效果进行评估并记录。结果治疗有效率观察组为97.2%、对照组为88.9%,治疗有效率观察组高于对照组,差异有统计学意义( P<0.05);观察组患者的角膜溃疡、前房积脓、畏光流泪恢复时间均明显短于对照组,差异有统计学意义(P<0.05);两组患者在治疗过程中均无明显不良反应发生。结论在两性霉素B和氟康唑的基础上加用伊曲康唑治疗真菌性角膜炎效果,优于仅应用两性霉素B和氟康唑,且可缩短治疗所需时间,治疗安全性较好,值得临床推广。%OBJECTIVE To observe the effect of itraconazole applied in treatment of fungal keratitis so as to provide reference of rational administration .METHODS Totally 36 cases of patients diagnosed as fungal keratitis from Mar .2011 to Feb .2014 were selected as the observation group ,and itraconazole ,amphotericin B and fluconazole eye drops were applied .Another 36 cases of patients diagnosed as fungal keratitis during Mar .2005 to Mar .2011 were selected as the control group ,and only amphotericin B and fluconazole eye drops were applied .The effect was assessed and recorded after treating for a month .RESULTS The efficient rate in the observation group was 97 .2% ,higher than 88 .9% in the control group ,with statistical significance (P<0 .05) .The recovery time of corneal ulcers ,hypopyon ,photophobia and tearing in the observation group was shorter than that in the control group ,with statistical significance (P<0 .05) .No

  18. The imaging investigation of the treatment of fungal keratitis by laser confocal microscopy%激光共焦显微镜观察真菌性角膜炎治疗效果的研究

    Institute of Scientific and Technical Information of China (English)

    吴艳; 石尧; 薛春燕

    2012-01-01

    目的 研究激光共焦显微镜对观察真菌性角膜炎治疗过程中病情转归的意义.方法 对42例(42眼)经门诊诊断为真菌性角膜炎的患眼,临床使用那他霉素眼用混悬液抗真菌治疗,治疗前及治疗后l周、1月分别行患眼的激光共焦显微镜检查,观察真菌菌丝生长情况.并根据临床反应判断治疗结果.结果 治疗后病灶处菌丝密度明显减少,甚至消失,周边炎性细胞浸润减少,基质透亮度增加,胶原纤维增生,组织呈瘢痕化增生.治疗前,激光共焦显微镜下42例中37例见菌丝分布(88.1%),抗真菌治疗l周后42例菌丝阳性为26例(61.9%),1月后患眼菌丝阳性为9例(21.4%),结果差异具有统计学意义(P<0.05).最终治愈28例(66.7%),好转9例(21.4%),无效5例(11.9%).最终有效率达88.1%.其中无效5例中均为菌丝阳性,好转中菌丝阳性为4例,但密度较治疗前明显减少.结论 激光共焦显微镜对观察真菌性角膜炎病情的转归具有临床意义.%Objective To observe the treatment of the fungal keratitis by laser confocal microscope. Methods Fourty-two cases (42 eyes)suffered with fungal keratitis were treated with natamycin eyedrop. Laser confocal microscope scanning was given before and after the treatment 1 week and 1 month for observation of the existence of the hypha. Results The hypha and the inflammatory cells were decreased,the stroma was lighten, and the corneas became scarring after the treatment. The hypha was found in 37 out of 42 cases before the treatment. There were 26 cases had hypha 1 week after treatment, and 9 cases had hypha 1 month after treatment, which showed the statistical significance (P <0.05). The final effective power rate was 88. 1% , which curing 28 cases, improving 9 cases and no-effective 5 cases. The hypha was found in all the no effective cases and 4 of improving cases,but the latter showed a decreasing density. Conclusion The laser confocal microscope can be used

  19. Clinical features and confocal microscopic imaging characteristics of 466 cases with infectious keratitis

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    Hui Xiao

    2014-10-01

    Full Text Available AIM: To observe the role of confocal microscopy in infectious keratitis management. METHODS:Totally 466 patients(467 eyesdiagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized.RESULTS:All patients were recorded, the average age was 54.4±13.0 years, in which 264 cases(56.7%were male, and 202 cases(43.3%were female. In the 466 patients, 190(40.8%were fungal keratitis, 148(31.8%were viral keratitis, 125(26.8%were bacterial keratitis and 3(0.6%were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis. CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.

  20. Perfil das ceratites fúngicas no Hospital São Geraldo Belo Horizonte - MG Spectrum of fungal keratitis at the São Geraldo Hospital - Belo Horizonte - MG

    Directory of Open Access Journals (Sweden)

    Cristina Moreira Salera

    2002-01-01

    Full Text Available Objetivos: Apresentar 20 casos de ceratite fúngica do Hospital São Geraldo, Belo Horizonte, Minas Gerais, Brasil e analisá-los quanto aos fatores associados, fungos identificados e tratamento instituído. Métodos: Foi realizada uma análise retrospectiva dos prontuários de 20 pacientes (20 olhos com ceratite fúngica, confirmada pela cultura, durante o período de janeiro de 1994 a dezembro de 1999 no Hospital São Geraldo. Resultados: Quinze pacientes (75% eram do sexo masculino. A idade variou de 9 a 67 anos (média de 35,7 anos. Um dos fatores associados analisado foi o trauma ocular (60%. O fungo mais freqüentemente isolado foi o Fusarium sp (60%, seguido pelo Aspergillus sp (30%. Natamicina foi o antifúngico tópico mais freqüentemente utilizado. No que diz respeito ao tratamento sistêmico, a droga mais utilizada foi o cetoconazol. Quatorze pacientes (70% necessitaram de ceratoplastia penetrante durante a fase aguda da infecção. Conclusões: Fusarium sp foi o fungo mais isolado em nosso Serviço e a história de trauma ocular foi freqüente (60%. Nossa experiência mostrou um número maior de indicações de ceratoplastia penetrante terapêutica.Purpose: To present 20 cases of fungal keratitis at the São Geraldo Hospital, Belo Horizonte, Minas Gerais, Brazil and to analyze them regarding associated factors, type of identified fungi and treatment. Methods: The authors retrospectively analyzed the charts of 20 patients (20 eyes of culture positive fungal keratitis treated from January 1994 to December 1999 at the São Geraldo Hospital. Results: Fifteen patients (75% were male. The average was 35.7 years (range 9 to 67 years. One of the associeted factors analyzed was ocular trauma (60%. Fusarium sp was the most commonly isolated organism (60%, followed by Aspergillus sp (30%. Natamycin was the topical antifungals most frequently used, while systemic treatment commonly used was cetoconazol. Fourteen patients (70% had penetrating

  1. 病灶清创联合羊膜移植治疗迁延性真菌性角膜炎的疗效观察%Lesion debridement combined with amniotic membrane transplantation treating persistent fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    张军; 王丽娅; 刘森玉; 伟伟

    2012-01-01

    目的 探讨病灶清创联合羊膜移植治疗迁延性真菌性角膜炎疗效的有效性和安全性.方法 回顾性研究.共收集2007年3月至2008年3月河南省眼科研究所确诊的迁延性真菌性角膜炎患者16例(16只眼).临床确诊的真菌性角膜炎患者(角膜刮片或真菌培养阳性者)经及时,规范的抗真菌药物治疗4~6周,角膜溃疡病灶仍存,荧光素染色上皮缺损至少2 mm角膜浸润病灶未累及角膜深层(裂隙灯检查浸润病灶深度<1/3角膜厚度,无内皮斑、前房积脓)者,行病灶清创联合羊膜移植术治疗.结果 16例患者中11例(68.8%)病变处于活动期(术前共焦显微镜检查及10%氢氧化钾涂片检查:阳性),5例(31.2%)病变处于非活动期(术前共焦显微镜检查及10%氢氧化钾涂片检查:阴性)术后平均愈合时间(13.21±6.35)d(7~26)d;其中活动期病变组平均上皮愈合时间(14.22±7.05)d;非活动期病变组平均上皮愈合时间(11.40±5.03)d.两组上皮愈合时间差异无统计学意义(P>0.05).所有病例随访期间未见严重的并发症.结论 病灶清创联合羊膜移植对治疗迁延性真菌性角膜炎有着良好的疗效,是治疗迁延性真菌性角膜炎的又一方法.%Objective To investigate the therapeutic effect and complication of amniotic membrane transplantation (AMT) combined with debridement in persistent fungal keratitis. Methods Diagnosis of fungal keratitis was confirmed by corneal scraping examination or fungal cultures in 16eyes of 16 patients.The indications to perform AMT combined with debridement were to promote reepithelialization in non-healing ulcers.Antifungal agents were administered throughout the whole course of hospitalization.Repeated cultures were performed immediately before AMT combined debridement.The main outcome measurements were epithelial healing rate,necessity therapeutic penetrating keratoplasty (TPK),and persistence of infection. Results During follow

  2. Clinical analysis 0f 83 cases plant ocular trauma cause fungal keratitis%83例植物性角膜外伤致真菌性角膜炎的临床探讨

    Institute of Scientific and Technical Information of China (English)

    周世宏

    2012-01-01

    Objectiveo To investigate the means and clinical efficacy of cornea plant trauma cause fungal keratitis. Methods Cornea for 83 cases (83 eyes) plant trauma , cause infectivity keratitis cases reported , Make use of directly microscopy or through a form of the corneal ulcer or through epiphyte culture in laboratory, the choice of treatment.83 cases among the amnion transplantation combined clean out ulcer 22 cases, Tyro transplantation of corneal 8 cases, All patients iodized to cauterize combined clean out ulcer. Partial and full body conventional use to resist fungi drug treatment. Results 83 cases of 81 cases of cure , To cure rate 97.5%, Eyesight are increased .2 cases of reatment when corneal has extensive damage, To close to punch. The front room is thick with pus, Finally illness got worse and had to choose their eyeballs removal. Conclusions In Fungal keratitis reasonable drug treatment , applications , the innovation of surgical techniques and surgical methods the correct choice , is the key to effective infection control and prevent recurrence of infection.%目的探讨植物性角膜外伤致真菌性角膜炎的治疗方法和效果.方法对83例(83只眼)有角膜植物伤史的感染性角膜炎病例,通过直接镜检或根据角膜溃疡的表现或通过实验室真菌培养等方式予以确诊后,选择治疗方案.83例中行溃疡面清除联合羊膜移植术的22例,行板层角膜移植术的8只眼,所有病人行溃疡面清除加碘酊烧灼,局部和全身常规使用抗真菌药物治疗.结果83例病例中81例治愈,治愈率97.5%,视力均较前增加.2例就诊时角膜已大面积毁坏,接近穿孔,前房大量积脓,最终病情恶化而不得不选择眼球内容摘除术.结论在真菌性角膜炎的治疗中,药物的合理应用,手术技巧的革新和手术方式的正确选择,是有效控制感染并防止感染复发的关键.

  3. Contact lens associated microbial keratitis: practical considerations for the optometrist

    Directory of Open Access Journals (Sweden)

    Zimmerman AB

    2016-01-01

    Full Text Available Aaron B Zimmerman, Alex D Nixon, Erin M Rueff College of Optometry, The Ohio State University, Columbus, OH, USAAbstract: Microbial keratitis (MK is a corneal condition that encompasses several different pathogens and etiologies. While contact lens associated MK is most often associated with bacterial infections, other pathogens (fungi, Acanthamoeba species, etc may be responsible. This review summarizes the risk factors, microbiology, diagnostic characteristics, and treatment options for all forms of contact lens-related MK.Keywords: corneal ulcer, fungal keratitis, bacterial keratitis, Acanthamoeba, Fusarium, Pseudomonas

  4. 病灶清创及结膜瓣遮盖术治疗真菌性角膜溃疡%Debridement combined with conjunctival flap covering for the treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    张进

    2015-01-01

    目的 探讨病灶清创联合结膜瓣遮盖术治疗真菌性角膜溃疡的手术效果.方法 我院真菌性角膜溃疡28例(28眼),抗真菌药物治疗5 ~7d后,无明显好转或加重,行病灶清创联合结膜瓣遮盖术.局部麻醉下从浸润的边缘外1 mm开始剥除板层坏死组织,显露正常角膜组织,将溃疡灶的堤状隆起的边缘修平,使清创后的创面较平整;根据溃疡面的大小和位置制作结膜瓣,位于周边者选择单蒂舌形结膜瓣;位于中央或旁中央者选用桥形双蒂结膜瓣;接近全角膜感染选用全角膜结膜瓣遮盖.结果 随访1月至半年,27(96.43%)例结膜瓣与角膜形成良好愈合,无溃疡复发;1例(3.57%)病情严重者2周后向深层浸润并波及眼内,最终丧失眼球.结论 此手术操作简单,取材方便,费用低,尤其适合基层医院,能有效降低真菌性角膜溃疡的危害和致盲率.%Objective To investigate the effect of focal cleaning combined with conjunctival flap covering on the treatment of fungal keratitis.Methods Twenty-eight eyes of 28 cases diagnosed with fungal keratitis were retrospectively analysed.After using anti-fungal drugs for 5 to 7 days,all cases did not get better or grew worse.Then focal debridement combined with conjunctival flap covering were performed.Under local anesthesia,necrotic tissues were excised from l mm away from the infiltrative edge,to where normal corneal tissue exposed.The upwarping zone around the ulcer lesion was removed to make the surface smooth.The size and shape of conjunctival flap were dicided by the area and location of corneal ulcer.Tongue-shape flaps were used for peripheral ulcer,bridge-shape flaps were choosed if ulcer located in the corneal centre,and the whole cornea should be covered if ulcer infiltrated all around the cornea.Results The follow-up period was from 1 month to 6 months.Ulcer of 27 cases(96.43%) were healed and did not recur.The remaining one (3.57%) was under serious

  5. Microscopia confocal in vivo no diagnóstico de ceratite fúngica: relato de caso In vivo confocal microscopy in the diagnosis of fungal keratitis: case report

    Directory of Open Access Journals (Sweden)

    Gustavo Victor

    2006-06-01

    Full Text Available Os autores relatam um caso em que a microscopia confocal in vivo ajudou no diagnóstico e acompanhamento de ceratite fúngica. Realizou-se a microscopia confocal in vivo em paciente com úlcera corneana, que há 30 dias estava sendo tratada, sem obter melhora com uso de diversos medicamentos tópicos. O paciente também tinha se submetido à coleta de material corneano para análise laboratorial, com resultado negativo e inconclusivo. Foi observado à microscopia confocal, hifas e coleções infecciosas fúngicas. Dez dias após o diagnóstico confocal, o resultado de nova coleta de material corneano revelou crescimento de Fusarium sp.The authors describe a case of fungal keratitis that the in vivo confocal microscopy helped in the diagnosis and follow-up. Confocal microscopy was done in a patient's ulcer that did not improve with several topical medicines. Corneal scrapings were obtained and culture results were without conclusion. We observed hyphae and infectious collections on confocal microscopy. New corneal culture showed Fusarium sp ten days after confocal diagnosis.

  6. Ophthalmic Lenses

    CERN Document Server

    Bhootra, Ajay Kumar

    2009-01-01

    This book is uniquely meant for the ophthalmologists, optometrists and opticians to help the world see better by excellent vision through the services of technicians and clinical principle based ophthalmology so that the management of ocular problems can be done for a better vision . Informs that a wide range of material and design of ophthalmic lenses with innovative developments is available. This book presents comprehensively rich information about the ophthalmic lenses and their dispensing tips . It will be highly useful mainly for the students of optometry and opticians, ophthalmologists,

  7. [Lacrimal and salivatory glycoproteins in ophthalmic herpes].

    Science.gov (United States)

    Reuk, S E; Terekhina, N A

    2016-01-01

    to compare tear, saliva, and plasma levels of acute phase proteins (APPs) of inflammation in patients with herpes keratitis and to use the RESULTS in treatment evaluation. APPs were measured in tears, oral fluid, and blood plasma from 22 adults and 34 children with ophthalmic herpes as well as 68 healthy controls using immunoturbidimetric and spectrophotometric methods of detection. High levels of C-reactive protein and orosomucoid, low levels of ceruloplasmin, α1-antitrypsin, and transferrin in tears from patients with herpes keratitis as well as abnormal tear, saliva, and plasma APPs levels at discharge are poor prognostic signs. They all indicate that corneal inflammation is still intense and that the treatment should not be ceased yet. Severity of APPs concentration changes in tear from patients with herpes keratitis correlates with the depth of corneal lesions, recurrence rate, and disease dynamics. Quantitative determination of acute phase proteins in tear and oral fluid is an early and sensitive inflammation test and may be also used for non-invasive monitoring and antiviral treatment evaluation. Oral fluid allows to extend the capabilities of non-invasive diagnostics of ophthalmic herpes.

  8. Childhood microbial keratitis

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    Abdullah G Al Otaibi

    2012-01-01

    Conclusion: Children with suspected microbial keratitis require comprehensive evaluation and management. Early recognition, identifying the predisposing factors and etiological microbial organisms, and instituting appropriate treatment measures have a crucial role in outcome. Ocular trauma was the leading cause of childhood microbial keratitis in our study.

  9. MICROBIAL KERATITIS IN KANNAUJ DISTRICT: AN EPIDEMIOLOGICAL AND MICROBIOLOGICAL EVALUATION

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    Sanjeev

    2014-03-01

    Full Text Available The aim of the present study was to identify the prevalence of non-viral etiological agents, their geographic, climatic and occupational risk factors associated with microbial keratitis in patients of Kannauj district of Uttar Pradesh, India. Microbial keratitis is a leading cause of monocular blindness world-wide. This study was conducted to find out the epidemiological factors associated with this disease in our set up. METHOD: A prospective analysis of 250 clinically diagnosed cases coming to OPD of Govt. Medical College, Kannauj were examined over a period of one year, from 1st January 2013 to 31st December 2013. Age, Sex, Occupation, Agents leading to the ulcer were some of the parameters included in our study. Corneal scrapes were collected and subjected to microscopy, culture and sensitivity. RESULTS: In 250 patients of clinically diagnosed microbial keratitis, 153(61.2% were Males and 97(38.8% Females. Most common Age group was 41-60 yrs. (40.8% followed by 21-40 yrs. (39.2%. Most common cause of Microbial keratitis was Ocular Trauma. Among the microbial keratitis fungal ulcer were more frequent due to trauma by Organic Vegetative matter and as Kannauj is rural area, so Farmers were mostly affected (54%. CONCLUSION: Microbial keratitis is mostly seen in Farmers in this part of India. Males are affected more than Females. Aspergillus and staphylococcus aureus were the most common causative agents. Increased prevalence of Microbial keratitis was seen during harvest and post-harvest seasons.

  10. Chronic Ocular Hypertension after Treated Multifocal Bacterial Keratitis

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    Theodoros Athanassios Papadopoulos

    2013-02-01

    Full Text Available Purpose: To report an unusual case of multifocal bacterial keratitis that despite success-ful treatment caused chronic ocular hypertension. Methods: A 67-year-old woman with unilateral multifocal keratitis and no previous ocular pathology was admitted to our hospital. Corneal scrapings and conjunctival samples were obtained for culture and the patient received intensive therapy with fortified vancomycin and tobramycin eye drops. Results: The cultures demonstrated two strains of Staphylococcus epidermidis, one resistant to ciprofloxacin and both sensitive to vancomycin. Treatment was effective and gradually discontinued after total cessation of the inflammatory activity. During the follow-up period, the patient developed late and persistent ocular hypertension of unknown etiology, in absence of any detectable inflammation or complication, and received permanent antiglaucoma therapy. Conclusion: Differential diagnosis between fungal and bacterial infection is critical in cases of multifocal keratitis. Patients with multifocal bacterial keratitis may need intraocular pressure monitoring, even after complete infection healing.

  11. Epidemiology and clinical characteristics of fungal keratitis in Fujian province%福建地区真菌性角膜炎的流行病学和临床特点研究

    Institute of Scientific and Technical Information of China (English)

    刘昭升; 吴护平; 许芬芳; 谢素贞; 闫蕾

    2009-01-01

    目的 研究福建地区真菌性角膜炎(fungal keratitis,FK)的流行病学和临床表现特点.方法 回顾性分析2006年7月至2008年7月住院确诊的FK患者176例,分析其流行病学和临床表现方面的特点.结果 10~12月发病率最高,农村居民106例(60.2%),男女患病率比为1.5:1,41~60岁为发病集中年龄,仅39.8%有明确外伤史,在153例先于外院就诊的患者中,仅有28例(18.3%)接受过角膜刮片和(或)真菌培养检查;菌丝苔被、伪足、前房积脓发生率分别为94%、65%和55%;菌属鉴定结果:前两位分别为:镰刀菌属(60.4%)和曲霉菌属(25.4%);保守治疗治愈率80.9%,眼球保存率为97.5%;镰刀菌属菌丝在角膜中的生长方式表现为水平、斜行和垂直生长,曲霉菌属全部表现为斜行和垂直生长.结论 福建地区FK在10~12月为高发期,多发于中老年的农村居民,多数无明显诱因发病,菌丝苔被、伪足和前房积脓依次为前三位临床体征,致病菌属以镰刀菌属和曲霉菌属为主,它们在角膜内地生长方式有所不同,大多数药物保守治疗有效,加上手术治疗绝大多数能保住眼球.基层医院对本病的诊治有待加强.%Objective To study the epidemiology and clinical characteristics of fungal keratitis(FK)in Fujian province.Methods A total of 176 hospitalized cases of fungal keratitis from July 2006 to July 2008 were retrospectively reviewed for epidemiology and clinical characteristics.Results The peak of FK occurred in Oct.to Dec.One hundred and six(60.2%)patients were rural resident.The ratio between the male and female patients was 1.5:1.Most patients were 41~60 years old.The history of trauma was present in 70 patients(39.8%).Only 28 patients(18.3%)received etiological examination in the 153 patients hospitalized in other hospital first.The incidence rate of mycelium lawn,pseudopodium and hypopyon was 94%,65% and 55% respectively.Fusarium species were isolated the most frequently(60

  12. 角膜清创联合羊膜移植治疗表浅真菌性角膜炎临床观察%Clinical observation of corneal debridement combined with amniotic membrane transplantation for treatment of superfic fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    赵庆亮

    2011-01-01

    目的 观察角膜清创联合羊膜移植治疗表浅真菌性角膜炎的临床疗效.方法 选择2007年9月至2010年9月在我院确诊的表浅真菌性角膜炎患者经眼局部抗真菌药物治疗无效或病程长、迁延不愈者36例(36只眼),采用角膜清创联合羊膜移植手术治疗.术后随访3~6个月,裂隙灯观察角膜与羊膜愈合情况、共焦显微镜观察羊膜转归等.结果 术后2例真菌感染复发,经板层角膜移植治愈.34例术后1~2周角膜上皮愈合,角膜水肿、炎症反应消退,羊膜与角膜融为一体,3个月逐渐吸收,残留轻重不等角膜云翳或斑翳,眼表稳定,视力较术前明显提高.结论 角膜清创联合羊膜移植手术简单易行,是治疗表浅真菌性角膜炎的一种有效方法.%Objective To evaluate the efficacy of corneal debridement combined with amniotic membrane transplantation for the treatment of superfic fungal keratitis. Methods 36 patients ( 36 eyes ) with superfic fungal keratitis were referred to our hospital fiom September 2007 to September 2010. The patients with persistent cornea ulcer after treatment of topical antifungal drug over 3 ~ 7 days underwent corneal debridement combined with amniotic membrane transplantation.We investigated the healing of corneal ulcer and amniotic membrane with slit biomicroscope, and the transformation of amniotic membrane with confocal microscopy. Results Corneal epithelium in 34 cases healed. Corneal inflammation and edema disappeared within two weeks postoperatively, except in two cases with fungal keratitis who had been cured by lamellar keratoplasty relapse. Amniotic membranes that adhered with the cornea dissolved and different degree corneal nebula or macula was observed 3 months after operation. Visual acuity was improved obviously. Conclusion Corneal debridement combined with amniotic membrane transplantation was effective and easy for treatment of superfic fungal keratitis.

  13. Neutrophil as double-edged swords in fungal keratitis%中性粒细胞在角膜真菌感染病程中的双相作用

    Institute of Scientific and Technical Information of China (English)

    杨彪

    2015-01-01

    Fungal keratitis is a corneal disease caused by fungal infection with high possibility of blindness,and the morbidity is being higher year by year.Both native immune and adaptive immune are included during antifungi process in which the fungi is killed by native immune especially by neutrophil.The neutrophil kill the fungi not only by oxygen-dependent and oxygen-independent way but also by the neutrophil extracellular traps which is discovered in recent years.The enzyme and reactive oxygen species(ROS) released by the neutrophil are included in the process of fungi killing.But those materials can cause tissue damage which may cause the scar or even corneal perforation.This review mainly focused on the mechanism how the neutrophil kill fungi and cause tissue damage.%真菌性角膜炎是由真菌引起的角膜感染性疾病,致盲率高,且近几年其发病率逐年升高.机体对真菌的免疫包括特异性免疫和非特异性免疫,其中中性粒细胞介导的非特异性免疫对真菌的杀伤起着关键性的作用,其中不仅包括氧依赖型和非氧依赖型的杀菌方式,还包括近些年发现的中性粒细胞胞外捕获的杀菌方式.中性粒细胞通过释放酶以及活性氧簇(ROS)起到杀灭真菌的作用,但这些物质在杀伤真菌的同时也会造成组织损伤、瘢痕形成甚至角膜穿孔.本文主要介绍中性粒细胞杀伤真菌以及造成组织破坏的机制.

  14. Successful medical management of recalcitrant Fusarium solani keratitis: molecular identification and susceptibility patterns.

    Science.gov (United States)

    Taylan Sekeroglu, Hande; Erdem, Elif; Yagmur, Meltem; Gumral, Ramazan; Ersoz, Reha; Ilkit, Macit; Harbiyeli, Ibrahim Inan

    2012-09-01

    Fungal keratitis is a rare but sight-threatening infection of the cornea that may be caused by several fungal pathogens. A delay in diagnosis and inadequate treatment may even lead to loss of the affected eye. Fungal keratitis is often misdiagnosed as bacterial keratitis because isolation and identification of the fungal pathogen is difficult and requires experience, and fungal growth in culture requires time. In this report, a 14-year-old boy with recalcitrant Fusarium solani keratitis, unresponsive to initial therapy, is presented. CLSI M38-A2 in vitro antifungal susceptibility tests demonstrated that only amphotericin B (0.5 μg/ml) had potent activity against F. solani; however, fluconazole (>64 μg/ml), itraconazole (>16 μg/ml), voriconazole (8 μg/ml), and posaconazole (>16 μg/ml) had high minimum inhibitory concentrations. In addition, caspofungin (>16 μg/ml) and anidulafungin (>16 μg/ml) exhibited high minimum effective concentrations. Repeated intrastromal voriconazole injections, topical voriconazole, and caspofungin combined with systemic antifungal agents improved of the corneal lesion with a significant increase in visual acuity. Intrastromal voriconazole injection may be used as an adjunctive treatment method for recalcitrant fungal keratitis with no prominent complications. The intrastromal route could be an effective route of administration of antifungal agents, especially for F. solani keratitis, as in this case. A combination of various antifungal agents administered by different routes prevented loss of the eye.

  15. Diagnosis and management of neurotrophic keratitis

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    Sacchetti M

    2014-03-01

    Full Text Available Marta Sacchetti,1 Alessandro Lambiase2 1Cornea and Ocular Surface Unit, Ospedale San Raffaele di Milano-IRCCS, Milan, 2Ophthalmology, University La Sapienza of Rome, Italy Abstract: Neurotrophic keratitis (NK is a degenerative disease characterized by corneal sensitivity reduction, spontaneous epithelium breakdown, and impairment of corneal healing. Several causes of NK, including herpetic keratitis, diabetes, and ophthalmic and neurosurgical procedures, share the common mechanism of trigeminal damage. Diagnosis of NK requires accurate investigation of clinical ocular and systemic history, complete eye examination, and assessment of corneal sensitivity. All diagnostic procedures to achieve correct diagnosis and classification of NK, including additional examinations such as in vivo confocal microscopy, are reviewed. NK can be classified according to severity of corneal damage, ie, epithelial alterations (stage 1, persistent epithelial defect (stage 2, and corneal ulcer (stage 3. Management of NK should be based on clinical severity, and aimed at promoting corneal healing and preventing progression of the disease to stromal melting and perforation. Concomitant ocular diseases, such as exposure keratitis, dry eye, and limbal stem cell deficiency, negatively influence the outcome of NK and should be treated. Currently, no specific medical treatment exists, and surgical approaches, such as amniotic membrane transplantation and conjunctival flap, are effective in preserving eye integrity, without ameliorating corneal sensitivity or visual function. This review describes experimental and clinical reports showing several novel and potential therapies for NK, including growth factors and metalloprotease inhibitors, as well as three ongoing Phase II clinical trials. Keywords: neurotrophic keratitis, cornea sensitivity, cornea innervation, persistent epithelial defect

  16. Non-traumatic keratitis due to Colletotrichum truncatum

    Science.gov (United States)

    Llamos, Reina; Al-Hatmi, Abdullah M. S.; Martínez, Gerardo; Hagen, Ferry; Velar, Rosario; de la Caridad Castillo Pérez, Alexeide; Illnait-Zaragozí, María T.

    2016-01-01

    Introduction: The fungal genus Colletotrichum is an uncommon cause of human infections. It has been implicated in cutaneous phaeohyphomycosis, artritis and keratitis secondary to traumatic implantation. Case presentation: We report two cases of keratitis due Colletotrichum truncatum in middle-aged, immunocompetent persons without history of trauma. The aetiological agents were identified based on DNA sequencing. Azoles and echinocandins showed high minimal inhibitory concentrations while amphotericin B was ≤ 0.25  mg l−1. Both patients failed topical antifungal treatment and needed penetrating keratoplasty with a favourable outcome. Conclusion: C. truncatum caused keratomycosis which did not respond to topical antifungal agents. To the best of our knowledge these are the first reported cases of keratitis due to this fungus in Cuba and Latin-America and highlights the expanding spectrum of fungal agents causing eye infections. PMID:28348770

  17. 5%那他霉素联合0.2%氟康唑治疗真菌性角膜炎65例疗效观察%Combined use of 5% natamycin and 0.2% fluconazole for the treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    龚桦; 龚向明; 钟兴武

    2013-01-01

    目的 观察联合应用5%那他霉素与0.2%氟康唑治疗真菌性角膜炎的疗效.方法 收集2010年1月至2013年1月经角膜病灶取材直接湿片镜检或真菌培养阳性者共65例,根据角膜炎浸润的不同程度将病例分为非严重的中轻度组与严重的重度组,联合应用5%那他霉素与0.2%氟康唑滴眼,每小时各一次,经规范治疗7~10d,视病情继续药物治疗或手术治疗,疗程共7~50 d不等.临床检查及疗效判断标准两组相同.结果 非严重组24例,治愈23例(95.8%),1例有效(4.2%);严重组41例,治愈12例(29.3%),有效11例(26.8%),无效18例(43.9%).两组间总的有效率差异具有显著统计学意义(P<0.01).结论 5%那他霉素联合0.2%氟康唑治疗真菌性角膜炎,特别是对非严重的中轻度者有非常满意的疗效,对严重的真菌性角膜炎也有较为满意的效果.%Objective To observe the clinical effects of combined use of 5% natamycin and 0.2% fluconazole for the treatment of fungal keratitis.Methods Sixty-five patients with fungal keratitis were collected from Jan.2010 to Jan.2013 in the study.The patients were divided into the non-severe group and the severe group base on the degree of corneal inflammation,which were treated with topical 5% natamycin and 0.2% fluconazole hourly,for 7~10 d.According to the disease status,medication or surgery were applied,for 7~50 d.Clinical examination and clinical criteria were identical in the two groups.Results Twenty-three (95.8%) of 24 patients with non-severe keratitis were healed,and 1 (4.2%)showed effective response to treatment,while 12 (29.3%) of 41 patients with severe keratitis were healed,11 (26.8%)showed response to treatment,and 18 (43.9%) failed.The total effective rate showed statistically significant difference between the two groups (P<0.01).Conclusion Combined use of 5% natamycin and 0.2% fluconazole for the treatment of fungal keratitis has

  18. OPHTHALMIC MANIFESTATIONS OF LEUKEMIA

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    E. E. Grishina

    2016-01-01

    Full Text Available Ophthalmic manifestations of leukemia are variable and are predominantly represented by leukemic infiltration of the eye and hemodynamic abnormalities in the retinal vasculature. Leukemic infiltration of the retina should be differentiated from an inflammatory process, such as retinitis, chorioretinitis of viral or fungal origin that are not uncommon in patients with hematological malignancies. Retinal involvement is mainly seen in adult patients with acute myeloid leukemia and is less common in patients with acute lymphoblastic leukemia. Retinopathy is more frequent during relapses of the underlying disease. Also, retinopathy can be the first sign of the disease. Leukemia should be included into the list for differential diagnosis with disorders that can be associated with optical nerve edema and retinal hemorrhages. Fundus abnormalities correlate with peripheral blood parameters. Retinopathy and leukemic optic neuropathy are predictors of unfavorable prognosis. Early diagnostics and timely and adequate treatment may fully eliminate ocular symptoms and improve quality of life in patients with hemoblastoses.

  19. Peripheral Ulcerative Keratitis

    Science.gov (United States)

    ... of a foreign object trapped in the eye. The ulcer is located in the margin of the cornea ... the cause of peripheral ulcerative keratitis, they scrape the ulcer and eyelid margins for a sample. The sample ...

  20. Freshwater Fungal Infections

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    Dennis J. Baumgardner

    2017-01-01

    Full Text Available Fungal infections as a result of freshwater exposure or trauma are fortunately rare. Etiologic agents are varied, but commonly include filamentous fungi and Candida. This narrative review describes various sources of potential freshwater fungal exposure and the diseases that may result, including fungal keratitis, acute otitis externa and tinea pedis, as well as rare deep soft tissue or bone infections and pulmonary or central nervous system infections following traumatic freshwater exposure during natural disasters or near-drowning episodes. Fungal etiology should be suspected in appropriate scenarios when bacterial cultures or molecular tests are normal or when the infection worsens or fails to resolve with appropriate antibacterial therapy.

  1. Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: Experience of over a decade

    Directory of Open Access Journals (Sweden)

    Gopinathan Usha

    2009-01-01

    Full Text Available Purpose : To review the epidemiological characteristics, microbiological profile, and treatment outcome of patients with suspected microbial keratitis. Materials and Methods : Retrospective analysis of a non-comparative series from the database was done. All the patients presenting with corneal stromal infiltrate underwent standard microbiologic evaluation of their corneal scrapings, and smear and culture-guided antimicrobial therapy. Results : Out of 5897 suspected cases of microbial keratitis 3563 (60.4% were culture-proven (bacterial - 1849, 51.9%; fungal - 1360, 38.2%; Acanthamoeba - 86, 2.4%; mixed - 268, 7.5%. Patients with agriculture-based activities were at 1.33 times (CI 1.16-1.51 greater risk of developing microbial keratitis and patients with ocular trauma were 5.33 times (CI 6.41-6.44 more likely to develop microbial keratitis. Potassium hydroxide with calcofluor white was most sensitive for detecting fungi (90.6% and Acanthamoeba (84.0% in corneal scrapings, however, Gram stain had a low sensitivity of 56.6% in detection of bacteria. Majority of the bacterial infections were caused by Staphylococcus epidermidis (42.3% and Fusarium species (36.6% was the leading cause of fungal infections. A significantly larger number of patients (691/1360, 50.8% with fungal keratitis required surgical intervention compared to bacterial (799/1849, 43.2% and Acanthamoeba (15/86, 17.4% keratitis. Corneal healed scar was achieved in 75.5%, 64.8%, and 90.0% of patients with bacterial, fungal, and Acanthamoeba keratitis respectively. Conclusions : While diagnostic and treatment modalities are well in place the final outcome is suboptimal in fungal keratitis. With more effective treatment available for bacterial and Acanthamoeba keratitis, the treatment of fungal keratitis is truly a challenge.

  2. The observation of clinical application of confocal microscopy in the diagnosis and treatment of fungal keratitis%共聚焦显微镜在真菌性角膜炎诊治中应用观察

    Institute of Scientific and Technical Information of China (English)

    郝兆芹; 宋金鑫; 吴洁

    2013-01-01

    目的 观察共聚焦显微镜在真菌性角膜炎的诊断及治疗中的作用.方法 (1)收集2011年9月至2012年9月在西安市第一医院眼科就诊的真菌性角膜炎患者54例,入院时即行共聚焦显微镜及角膜刮片检查.(2)在对共聚焦显微镜确诊病例的治疗过程中,分别在第1、2、3、4周再对这些病例进行共聚焦显微镜检查,监测角膜病灶变化.结果 54例患者中共聚焦显微镜检出52例,诊断率为96.3%,角膜刮片检出49例,诊断率为90.7%,二者差异无统计学意义(P>0.05).54例患者中22例伴有前房积脓;49例有植物性外伤或异物进入史,约为90.74%;有1例患者因感染未控制致角膜全溶解、眼内炎行根治性手术治疗.共聚焦显微镜下可见真菌性角膜炎的抗感染治疗一般2周时起效,2~3周时病情好转,第4周时感染基本得到控制.此时可根据角膜病灶情况选择结膜瓣遮盖或羊膜移植手术,以促进角膜修复.结论 共聚焦显微镜检查安全无创伤,可重复性强,对真菌性角膜炎的诊断快速,可监测角膜病情变化,指导临床治疗,提高治愈率.%Objective To observe the effect of confocal microscopy in the diagnosis and treatments of fungal keratitis.Methods Fifty-four patients of fungal keratitis were selected from our hospital from 2011.9 to 2012.9,checked by confocal microscopy and cornea scraping.The changes of corneal lesion by confocal microscopy were examined,respectively in the lth,2th,3th,4th week.Results Fifty-two patients were diagnosed by confocal microscopy,diagnosis rate was 96.3%,49 patients were diagnosed by cornea scraping,diagnosis rate was 90.7%.The two diagnosis rate had no statistics difference (P >0.05).Among the patients,22 had hypopyum,49 had the history of trauma or foreign body,about 90.74%,the infection of 1 patient was not controlled and then cured by radical operation.By confocal microscopy,the anti-infective therapy effected at 2th week

  3. [Peripheral ulcerative keratitis].

    Science.gov (United States)

    Stamate, Alina-cristina; Avram, Corina Ioana; Malciolu, R; Oprea, S; Zemba, M

    2014-01-01

    Ulcerative keratitis is frequently associated with collagen vascular diseases and presents a predilection for peripheral corneal localization, due to the distinct morphologic and immunologic features of the limbal conjunctiva, which provides access for the circulating immune complexes to the peripheral cornea via the capillary network. Deposition of immune complexes in the terminal ends of limbal vessels initiates an immune-mediated vasculitis process, with inflammatory cells and mediators involvement by alteration of the vascular permeability. Peripheral ulcerative keratitis generally correlates with exacerbations of the background autoimmune systemic disease. Associated sceritis, specially the necrotizing form, is usually observed in severe cases, which may evolve in corneal perforation and loss of vision. Although the first-line of treatment in acute phases is represented by systemic administration of corticosteroids, immunosuppressive and cytotoxic agents are necessary for the treatment of peripheral ulcerative keratitis associated with systemic diseases.

  4. Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern india

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    Rautaraya Bibhudutta

    2011-12-01

    Full Text Available Abstract Background Mycotic keratitis is an important cause of corneal blindness world over including India. Geographical location and climate are known to influence the profile of fungal diseases. While there are several reports on mycotic keratitis from southern India, comprehensive clinico-microbiological reports from eastern India are few. The reported prevalence of mycotic keratitis are 36.7%,36.3%,25.6%,7.3% in southern, western, north- eastern and northern India respectively. This study reports the epidemiological characteristics, microbiological diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern India. Methods A retrospective review of medical and microbiology records was done for all patients with laboratory proven fungal keratitis. Results Between July 2006 and December 2009, 997 patients were clinically diagnosed as microbial keratitis. While no organisms were found in 25.4% (253/997 corneal samples, 23.4% (233/997 were bacterial, 26.4% (264/997 were fungal (45 cases mixed with bacteria, 1.4% (14/997 were Acanthamoeba with or without bacteria and 23.4% (233/997 were microsporidial with or without bacteria. Two hundred fifteen of 264 (81.4%, 215/264 samples grew fungus in culture while 49 corneal scrapings were positive for fungal elements only in direct microscopy. Clinical diagnosis of fungal keratitis was made in 186 of 264 (70.5% cases. The microscopic detection of fungal elements was achieved by 10% potassium hydroxide with 0.1% calcoflour white stain in 94.8%(238/251 cases. Aspergillus species (27.9%, 60/215 and Fusarium species (23.2%, 50/215 were the major fungal isolates. Concomitant bacterial infection was seen in 45 (17.1%, 45/264 cases of mycotic keratitis. Clinical outcome of healed scar was achieved in 94 (35.6%, 94/264 cases. Fifty two patients (19.7%, 52/264 required therapeutic PK, 9 (3.4%, 9/264 went for evisceration, 18.9% (50/264 received glue application with bandage

  5. A novel rat contact lens model for Fusarium keratitis

    Science.gov (United States)

    Abou Shousha, Mohamed; Santos, Andrea Rachelle C.; Oechsler, Rafael A.; Iovieno, Alfonso; Maestre-Mesa, Jorge; Ruggeri, Marco; Echegaray, Jose J.; Dubovy, Sander R.; Perez, Victor L.; Miller, Darlene; Alfonso, Eduardo C.

    2013-01-01

    Purpose The aim of this study was to develop and characterize a new contact lens–associated fungal keratitis rat model and to assess the ability of non-invasive spectral-domain optical coherence tomography (SD-OCT) to detect pathological changes in vivo in fungal keratitis. Methods We used SD-OCT to image and measure the cornea of Sprague Dawley rats. Fusarium infection was initiated in the rat eye by fitting Fusarium solani–soaked contact lenses on the experimental eye, while the control animals received contact lenses soaked in sterile saline. The fungal infection was monitored with periodic slit-lamp examination and in vivo SD-OCT imaging of the rat eye, and confirmed by histology, counting of viable fungi in the infected rat cornea, and PCR with specific primers for Fusarium sp. Results We imaged and measured the rat cornea with SD-OCT. Custom-made contact lenses were developed based on the OCT measurements. Incubation of contact lenses in a F. solani suspension resulted in biofilm formation. We induced contact lens–associated Fusarium keratitis by fitting the rat eyes for 4 h with the Fusarium-contaminated contact lenses. The SD-OCT images of the cornea correlated well with the slit-lamp and histopathological results and clearly defined clinical signs of infection, namely, increased corneal thickening, loss of epithelial continuity, hyper-reflective areas representing infiltrates, and endothelial plaques characteristic of fungal infection. Moreover, in three cases, SD-OCT detected the infection without any clear findings on slit-lamp examination. Infection was confirmed with histological fungal staining, PCR, and microbiological culture positivity. Conclusions We developed a highly reproducible rat contact lens model and successfully induced contact lens–associated Fusarium keratitis in this model. The clinical presentation of contact lens–associated Fusarium keratitis in the rat model is similar to the human condition. SD-OCT is a valuable tool that

  6. Microbial keratitis in children.

    Science.gov (United States)

    Kunimoto, D Y; Sharma, S; Reddy, M K; Gopinathan, U; Jyothi, J; Miller, D; Rao, G N

    1998-02-01

    Microbial keratitis is a major cause of corneal blindness worldwide. This problem is particularly relevant to children, because most of their visual life is ahead of them, and they are uniquely at risk for irreversible ocular deficits, such as those resulting from amblyopia. The objective of this study was to determine the etiologic agents and predisposing factors in childhood infectious keratitis and to examine the outcome of treatment in terms of structure and visual acuity. The study design was a retrospective cases series. The authors studied 113 eyes in 107 children 16 years of age and younger who were treated for (nonviral) microbial keratitis at the LV Prasad Eye Institute in Hyderabad, India, during the 4.5-year period between February 1, 1991, and June 30, 1995. The patients who met the following criteria were included in the study: (1) corneal stromal infiltrate was present on slit-lamp examination; and (2) a corneal scraping was taken at the time of examination for suspected microbial keratitis. Etiologic micro-organisms, predisposing factors, treatment method, structural treatment outcome, and visual acuity treatment outcome of the infectious keratitis episode were measured. The principal predisposing factors identified in this study were trauma (21.2%), ocular disease (17.7%), systemic disease (15.9%), and prior penetrating keratoplasty in the same eye (8.8%). Vitamin A deficiency was an important factor within the category of severe systemic disease, and contact lens wear was not involved in any of the cases. A total of 85 organisms were isolated in cultures of corneal scrapings from 64 (56.6%) of the 113 cases. Staphylococcus species (43.7%), Streptococcus pneumoniae (18.8%), and fungi (17.2%) were the most common isolates. Eighteen eyes (15.9%) required surgery, and 28 (36.4%) of the 77 patients on whom visual acuity was assessed at last follow-up achieved an unaided visual acuity of 20/60 or better at last follow-up. This work represents the

  7. Study on treating fungal keratitis of rabbit eyes using collagen shield delivering fluconazole eye drops made by centrifugal method HAN%离心法制备胶原膜载释氟康唑治疗兔眼真菌性角膜炎的研究

    Institute of Scientific and Technical Information of China (English)

    韩晓梅; 王巾; 祝玉玲

    2009-01-01

    目的 研究用离心法制得的角膜胶原膜载释氟康唑(普芬)眼液在兔眼真菌性角膜炎治疗中的应用.方法 从猪巩膜中提取、纯化胶原,采用离心法制备角膜胶原膜,在普芬眼液内浸泡用于治疗兔眼真菌性角膜炎.结果 胶原膜载释普芬眼液治疗组病灶愈合平均时间11 d,局部滴用普芬眼液组病灶愈合平均时间18 d,两组治愈率和有效率分别为78.94%、63.15%和92.10%、78.94%,差异有统计学意义(P<0.05).结论 应用离心法制得的胶原膜载释普芬眼液是治疗真菌性角膜炎给药途径的创新,具有广阔的发展前景.%Objective To evaluate the effect of collagen shield delivering fluconazole eye drops made by centrifugal method on treating fungal keratitis of rabbit eyes.Methods Using centrifugal method to make corneal collagen shield,after soaked with fluconazole eye drops,the collagen shields were used to treat fungal keratitis of rabbit eyes.Results The healing focus time of collagen shield delivering fluconazole eye drops group was average 11 days,the healing focus time of only delivering fluconazole eye drops group was average 18 days.The cure rate and effective rate of 2 groups were 78.94%,63.15% and 92.10%,78.94%,there were significance between 2 groups(P<0.05).Conclusion It was innovation for corneal collagen shield delivering fluconazole eye drops made by centrifugal method to cure fungal keratitis,which had broad development foreground.

  8. 碘酊烧灼联合氟康唑、斯皮仁诺治疗真菌性角膜炎的临床分析%Clinical Analysis of Tincture of Iodine Cauterization Combined with Fluconazole and Linnemann in the Treatment of Fungal Keratitis

    Institute of Scientific and Technical Information of China (English)

    李梅

    2015-01-01

    目的:探讨碘酊烧灼联合氟康唑、斯皮仁诺治疗真菌性角膜炎的临床效果,以为临床治疗提供参考依据。方法选取2012年8月至2013年8月前往我院接受诊疗的40例真菌性角膜炎患者为研究对象,回顾性分析其临床诊疗资料。结果治疗效果:40例患者中,总有效率为92.50%;不良反应:4例患者临床出现厌食、食欲不振、恶心、腹部不适等不适症状,经对症治疗后均症状好转,经血常规复检,无异样。结论碘酊烧灼联合氟康唑、斯皮仁诺应用于真菌性角膜炎病症的临床治疗,疗效较佳,且不良反应较小,具有临床推广应用的价值。%Objective To investigate the effectiveness of clinical analysis of tincture of iodine cauterization combined with lfuconazole and linnemann in the treatment of fungal keratitis, provide a reference basis for clinical treatment.Methods Retrospectively analyze the clinical data of 60 patients with fungal keratitis in our hospital from August 2012 to August 2013.Results Treatment effect: Nineteen cases of 40 patients, The total efifciency is 92.50%; Adverse reactions: Four patients clinical appear anorexia, loss of appetite, nausea, abdominal discomfort and other symptoms, improved after symptomatic treatment, afther check routine blood test, Results show that the normal.Conclusions Tincture of iodine cauterization combined with lfuconazole and linnemann in the treatment of fungal keratitis, curative effect is better and with no obvious poisonousside effect, and possess the important value of clinical application.

  9. Colletotrichum graminicola keratitis: first case report from India.

    Science.gov (United States)

    Yegneswaran, Prakash P; Pai, Vijaya; Bairy, Indira; Bhandary, Sulatha

    2010-01-01

    Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum graminicola is rare. We diagnosed Colletotrichum graminicola keratitis in a 44-year-old man who presented with a non-healing corneal ulcer since three weeks. Positive smears and cultures from the corneal scrapings established the causative organism as C. graminicola. The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin. Infection resolved over 10 weeks and antimicrobials were stopped. We describe the clinical presentation and treatment outcome of Colletotrichum graminicola keratitis.

  10. Colletotrichum graminicola keratitis: First case report from India

    Directory of Open Access Journals (Sweden)

    Yegneswaran Prakash

    2010-01-01

    Full Text Available Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants. In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum graminicola is rare. We diagnosed Colletotrichum graminicola keratitis in a 44-year-old man who presented with a non-healing corneal ulcer since three weeks. Positive smears and cultures from the corneal scrapings established the causative organism as C. graminicola. The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin. Infection resolved over 10 weeks and antimicrobials were stopped. We describe the clinical presentation and treatment outcome of Colletotrichum graminicola keratitis.

  11. Calotropis procera -induced keratitis

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    Pandey Nidhi

    2009-01-01

    Full Text Available Calotropis procera produces copious amounts of latex, which has been shown to possess several pharmacological properities. Its local application produces intense inflammatory response. In the 10 cases of Calotropis procera -induced keratitis reported here, the clinical picture showed corneal edema with striate keratopathy without any evidence of intraocular inflammation. The inflammation was reversed by the local application of steroid drops.

  12. [Bilateral neurotrophic keratitis secondary to encephalic trunk metastasis].

    Science.gov (United States)

    Ibáñez Flores, N; Sanz Moreno, S

    2002-12-01

    We report the case of a 69-year-old man with a lung carcinoma history. The patient showed signs of conjuntival hyperemia, painless bilateral corneal edema, persistent epitelial defects and reported to have decreasing visual acuity for a week. The clinical examination revealed a bilateral neurotrophyc keratitis with both a decreased frequency of blinking and a bilateral atrophy mandibular muscles. Local ocular patology was excluded. Systemic exploration showed a meningeal neoplasic infiltration and metastasis on the initial trigeminal nerve stretch. In our knowledge, this is the first case reported in the literature. Ophthalmic signs should be considered in the diagnosis of systemic pathology.

  13. Keratitis by Fusarium temperatum, a novel opportunist.

    Science.gov (United States)

    Al-Hatmi, Abdullah M S; Bonifaz, Alexandro; de Hoog, G Sybren; Vazquez-Maya, Leticia; Garcia-Carmona, Karla; Meis, Jacques F; van Diepeningen, Anne D

    2014-11-12

    Fusarium species are among the most common fungi present in the environment and some species have emerged as major opportunistic fungal infection in human. However, in immunocompromised hosts they can be virulent pathogens and can cause death. The pathogenesis of this infection relies on three factors: colonization, tissue damage, and immunosuppression. A novel Fusarium species is reported for the first time from keratitis in an agriculture worker who acquired the infection from plant material of maize. Maize plants are the natural host of this fungus where it causes stalk rot and seeding malformation under temperate and humid climatic conditions. The clinical manifestation, microbiological morphology, physiological features and molecular data are described. Diagnosis was established by using polymerase chain reaction of fungal DNA followed by sequencing portions of translation elongation factor 1 alpha (TEF1 α) and beta-tubulin (BT2) genes. Susceptibility profiles of this fungus were evaluated using CLSI broth microdilution method. The analyses of these two genes sequences support a novel opportunist with the designation Fusarium temperatum. Phylogenetic analyses showed that the reported clinical isolate was nested within the Fusarium fujikuroi species complex. Antifungal susceptibility testing demonstrated that the fungus had low MICs of micafungin (0.031 μg/ml), posaconazole (0.25 μg/ml) and amphotericin B (0.5 μg/ml). The present case extends the significance of the genus Fusarium as agents of keratitis and underscores the utility of molecular verification of these emerging fungi in the human host.

  14. Epidemiological, clinical and microbiological characteristics of fungal keratitis%单唾液酸四己糖神经节苷脂与视神经病变预后的相关性

    Institute of Scientific and Technical Information of China (English)

    皮百木; 齐坤英; 穆红梅; 张千帆

    2013-01-01

    目的评估单唾液酸四己糖神经节苷脂(Monosialotetera-hexosyl ganglioside GM1)与视神经病变预后的相关性。方法采用回顾性病例对照研究,收集首次发病的视神经病变患者143例196眼的临床资料,将可能影响研究对象视力预后的因素:性别、年龄、疾病类别、治疗前(矫正)视力、治疗前发病时间、是否接受GM1治疗为协变量;疗效、首次视力提高的时间、治疗2周后(矫正)视力为因变量,用多元Logistic回归分析探讨GM 1对视神经病变视力预后的影响。结果单因素分析:GM1与视神经病变的疗效、首次视力提高时间、治疗2周后(矫正)视力关联有统计学意义,其 P 值、OR、95% CI 分别为(P =00.00,OR =03.13,95% CI :01.70-05.78;P =00.01, OR =03.91,95% CI :02.19-06.98;P =00.00,OR =03.50,95% CI :01.96-06.25)。多因素分析:调整其他混杂因素后,GM1与视神经病变的疗效、首次视力提高时间、治疗2周后(矫正)视力显示有明显的促进作用。其调整OR 值,95% CI 分别为(OR =03.11,95% CI :01.59-06.06;OR =04.24,95% CI :02.24,08.05;OR =03.08,95% CI :01.41-06.71)。结论 GM1对视神经疾病的视力恢复有明显促进作用,有助于获得较好的视力预后。%Objective To explore the features of clinic-epidemiological and laboratory diagnosis of fungal keratitis . Methods Three hundred and fifteen patients of different ages having provisional diagnosis of suppurative corneal ulceration were registered for the study . Data were collected through history and slit lamp xamination . Corneal scraping was performed . A portion of each scraping were examined by direct microscopy . Another portion were inoculated directly on to solid culture media . Results Among corneal scraping from 315 patients , the fungus grew in 116 (36 .8% ) . The

  15. Sterile Keratitis following Collagen Crosslinking

    Science.gov (United States)

    Javadi, Mohammad-Ali; Feizi, Sepehr

    2014-01-01

    Purpose: To report a keratoconic eye that developed severe sterile keratitis and corneal scar after collagen crosslinking necessitating corneal transplantation. Case Report: A 26-year-old man with progressive keratoconus underwent collagen crosslinking and presented with severe keratitis 72 hours after the procedure. The initial impression was infectious corneal ulcer and a fortified antibiotic regimen was administered. However, the clinical course and confocal microscopy results prompted a diagnosis of sterile keratitis. The eye developed severe corneal scars leading to reduced visual acuity and necessitating corneal transplantation. Conclusion: Sterile keratitis may develop after collagen crosslinking resulting in profound visual loss leading to corneal transplantation. PMID:25709779

  16. COLLOIDON BABY WITH OPHTHALMIC INVOLVEMENT

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    Shrinivas M

    2014-12-01

    Full Text Available Collodion baby is a rare, genetic heterogeneous skin disorder. It refers to a clinicentity used for newborns who are encased by a translucent, tight and parchment paper like skin sheets so called collodion membrane, on the entire body surface. 1 Collodion baby is a phenotype which broadly describes the above condition which includes a number of phenotypes. The two most common phenotypes are lamellar ichthyosis and non-bullous congenital erythroderma which account for 75% of cases and others like Sjögren-Larsson syndrome, Netherton syndrome, Gaucher disease etc account for 15% of the cases. 2 Lamellar ichthyosis which is more common, is an autosomal recessive condition caused by mutations in the transglutaminase-1 gene, defect on chromosome 14q11.Lid ectropion and ocular complications like exposure keratitis are seen commonly in colloidon babies. 3 15 day old male baby, first issue of a second degree consanguineously married couple, born at a gestation age of 36 weeks (normal vaginal delivery was referred to ophthalmic institute for management of ectropion. Child was diagnosed to have lamellar ichthyosis at the paediatric referral institute. At birth baby weighed 2500 grams, length 48 cm, head circumference of 34 cm.

  17. Colletotrichum graminicola keratitis: First case report from India

    OpenAIRE

    Yegneswaran, Prakash P.; Pai, Vijaya; Bairy,Indira; Bhandary, Sulatha

    2010-01-01

    Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum grami...

  18. Necrotizing Keratitis Caused by Acyclovir-Resistant Herpes Simplex Virus

    Directory of Open Access Journals (Sweden)

    Koji Toriyama

    2014-10-01

    Full Text Available Background: We report a case of necrotizing keratitis caused by acyclovir (ACV-resistant herpes simplex virus (HSV with a clinical appearance similar to a previous fungal keratitis infection. Methods: Observational case report. Results: Penetrating keratoplasty was performed in the left eye with a history of herpetic keratitis that resolved with periodic treatment with ACV ointment and a topical steroid. The left eye was painful and red with an abscess and corneal erosion in the peripheral donor cornea. Examination of the scraped corneal epithelium by light microscopy and culturing identified Candida albicans; polymerase chain reaction (PCR was negative for human herpes viruses. After antifungal treatment, the ocular pain gradually decreased and the lesions slowly improved but recurred with a similar clinical appearance. A second light microscopy examination and cultures were negative for pathogens including C. albicans. PCR was positive for HSV-1 DNA; treatment with 3% topical ACV ointment was unsuccessful. A third examination showed only HSV-1 DNA. Despite antiviral ACV ointment, no clinical improvement occurred based on the HSV DNA copy numbers, which were the same before and after treatment, indicating a possible ACV-resistant strain. When topical trifluorothymidine was substituted for ACV, clinical improvement occurred and the HSV DNA copy numbers decreased. Conclusion: Necrotizing keratitis induced by ACV-resistant HSV occurred independently after fungal keratitis, with a similar clinical appearance in this case, making diagnosis and treatment difficult. Monitoring the HSV DNA load by real-time PCR could be useful for refractory cases even with atypical clinical appearances.

  19. Change of (1,3)-β-D-glucan in tear before and after penetrating keratoplasty for fungal keratitis%真菌性角膜溃疡患者穿透角膜移植术前后泪液(1,3)-β-D-葡聚糖的变化

    Institute of Scientific and Technical Information of China (English)

    喻文倩; 梁涛; 刘珂凤; 王婷

    2014-01-01

    背景 穿透角膜移植术(PKP)近年来已成为治疗真菌性角膜溃疡的有效方法,但是术后糖皮质激素的使用时机目前暂无定论.研究发现真菌性角膜溃疡患者泪液中(1,3)-β-D-葡聚糖的质量浓度明显高于正常. 目的 检测真菌性角膜溃疡患者行PKP术前及术后泪液中(1,3)-β-D-葡聚糖的质量浓度变化,探讨其对术后应用抗真菌药物的持续时间和糖皮质激素类药物应用的时机. 方法 采用病例观察研究设计,收集2011年8月至2012年12月在青岛大学附属医院就诊的真菌性角膜溃疡行PKP的患者20例20眼,以患者的自身对侧眼作为对照组,分别于术前ld及术后1、7、14、21、28 d收集患者泪液各50μl,用G实验法检测泪液中(1,3)-β-D-葡聚糖质量浓度. 结果 对照组,实验组术前ld,术后1、7、14、21和28 d泪液中(1,3)-β-D-葡聚糖的质量浓度分别为(14.67±3.84)、(1 861.66±196.17)、(927.71±155.82)、(392.30±71.22)、(179.60±40.47)、(40.20±12.46)、(15.12± 1.80) mg/L,组间总体比较差异有统计学意义(F=883.45,P=0.00).随着术后时间的延长,术眼泪液中(1,3)-β-D-葡聚糖质量浓度逐渐下降,各时间点与前一时间点间比较差异均有统计学意义(t'=13.84、t=16.67、t'=11.02、t'=13.97、t'=-8.45,均P=0.00),术后28 d泪液中(1,3)-β-D-葡聚糖质量浓度接近对照组,差异无统计学意义(P=0.64).术后28 d内18例患眼感染无复发,2例患眼分别于术后第5天和第6天感染复发,泪液中(1,3)-β-D-葡聚糖质量浓度分别为2 350.24 mg/L和1 992.82 mg/L.结论 真菌性角膜溃疡患者PKP术后泪液中(1,3)-β-D-葡聚糖的质量浓度于术后28 d降至正常范围,提示真菌性角膜溃疡患者PKP术后抗真菌治疗至少需维持28 d,此时局部使用糖皮质激素抗排斥反应较为安全.%Background Penetrating keratoplasty (PKP) has become an effective method of treatment for fungal keratitis in recent years,but the application

  20. Is blood agar an alternative to sabouraud dextrose agar for the isolation of fungi in patients with mycotic keratitis.

    Science.gov (United States)

    Reddy, Ashok Kumar; Brahmaiah, Upputuri; Narayen, Nitesh; Reddy, Ravi Kumar; Reddy, Rupak Kumar; Chitta, Meghraj; Prasad, Srinivas; Swarup, Rishi; Mohiuddin, Syed Maaz; Reddy, Madhukar; Aasuri, Murali K; Murthy, B S R; Bhide, Milind; Ahmed, Sajid

    2013-06-01

    To compare the blood agar (BA), sabouraud dextrose agar (SDA) and chocolate agar (CA) for the isolation of fungi in patients with mycotic keratitis. Corneal Scrapings of 229 patients with clinically diagnosed microbial keratitis were inoculated on BA, SDA, CA. The culture media were evaluated for the rate and time taken for the fungal growth. Seventy six of 229 patients had fungal keratitis. Fungus grew on BA in 60/76(78.9 %), on SDA in 76/76 (100 %), on CA in 40/76(52.6 %) patients. The fungi which grew on BA (60/76) also grown on SDA at the same time. The colony morphologies of different fungi were better on SDA than BA/CA. Among the different culture media, SDA is essential for the isolation fungi in patients with mycotic keratitis.

  1. The effectiveness of corneal ulcer debridement and antifungal agents in the treatment of patients with fungal keratitis%角膜溃疡清创术与抗真菌药物联用治疗真菌性角膜炎的有效性评价

    Institute of Scientific and Technical Information of China (English)

    廖敏

    2016-01-01

    目的探究角膜溃疡清创术与抗真菌药物联用治疗真菌性角膜炎的有效性。方法选取从2011年7月至2015年7月进行治疗的真菌性角膜炎患者184例。对照组88例患者进行角膜溃疡清创术治疗,观察组96例患者进行角膜溃疡清创术与抗真菌药物联用治疗。治疗结束后对两组患者的治疗效果进行对比分析。结果在治疗结束后,观察组患者总有效率为92例(95.8%),对照组患者总有效率为60例(68.2%)。观察组患者视力>0.5比率为54.2%,明显高于对照组患者0.5比率36.62%,差异有统计学意义( P <0.05)。观察组患者的愈合时间、眼前指数、手动-光感、手术次数均优于对照组,差异有统计学意义( P <0.05)。结论在治疗真菌性角膜炎时,采用角膜溃疡清创术与抗真菌药物联用的方法效果良好,能明显改善患者视力,值得临床推广使用。%Objective To explore the effectiveness of corneal ulcer debridement combined with antifungal agents in the treatment of pa-tients with fungal keratitis. Methods Select 184 patients with fungal keratitis treatment in our hospital from July 2011 to July 2015,the 88 cases of control group with treatment of corneal ulcer debridement,the 96 cases of observation group with treatment of corneal ulcer debridement and an-tifungal agents. The clinical parameters and effect of 2 groupspatients were compared. Results After treatment,the total effective rate in the ob-servation group was 95. 8% ,and the total effective rate was 68. 2% in the control group. The observation group of patients with visual > 0. 5 ratio was 54. 2% ,significantly higher than the control group(36. 62% ),the difference was statistically significant( P < 0. 05). The observation group,the healing time,immediate index,manual light perception,and number of operations were superior to the control group,the difference was statistically significant( P < 0. 05). Conclusion

  2. 碘酊烧灼联合氟康唑和二性霉素B治疗真菌性角膜炎的效果观察%Effect observation of iodine burning combined with fluconazole and am-photericin B treating fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    徐雅萍; 张敏; 陈欢; 董科

    2015-01-01

    目的:探讨碘酊烧灼联合氟康唑和二性霉素B治疗真菌性角膜炎的临床效果。方法选取2014年3~10月我院收治的真菌性角膜炎患者84例,随机分为三联组和二联组,二联组采用氟康唑联合二性霉素B治疗,三联组采用碘酊烧灼联合氟康唑和二性霉素B治疗,比较两组患者的症状消失时间和治疗效果。结果三联组患者角膜溃疡、前房脓肿、异物感、畏光流泪的临床症状消失时间均短于二联组[(20.5±2.6)d vs(24.8±2.9)d,(18.8±2.4)d vs(23.4±2.7)d,(15.4±2.0)d vs(17.8±2.2)d,(21.2±2.8)d vs(26.6±2.9)d](P<0.05)。三联组的治疗效果显著优于二联组(总有效率:97.62%v s 83.33%)(P<0.05)。结论碘酊烧灼联合氟康唑和二性霉素B治疗真菌性角膜炎可缩短患者的症状消失时间,提高治疗效果。%Objective To evaluate the clinical effect of iodine burning combined with fluconazole and amphotericin B treating fungal keratitis. Methods 84 cases with fungal keratitis treated in our hospital from March to October 2014 were selected and they were randomly divided into triple group and bivalent group,bivalent group was given fluconazole combined with amphotericin B,and triple group was given iodine burning combined with fluconazole and amphotericin B.The disappearing time of symptom and treatment effect in patients between two groups was compared respectively. Results The disappearing time of clinical symptom of corneal ulcer,anterior abscess,foreign body sensation,photophobia, tearing in bivalent group was shorter than that of bivalent group respectively [(20.5±2.6)d vs (24.8±2.9)d,(18.8±2.4)d vs (23.4±2.7)d,(15.4±2.0)d vs (17.8±2.2)d,(21.2±2.8)d vs (26.6±2.9)d) (P<0.05].Treatment effect of triple group was obvi-ously better than that of bivalent group (the total effective rate:97.62% vs 83.33%) (P<0.05). Conclusion Iodine burn-ing combined with fluconazole and

  3. Pathogenic analysis and diagnosis of dungal keratitis inTangshan Region%唐山地区真菌性角膜炎的病原学分析及诊断

    Institute of Scientific and Technical Information of China (English)

    刘素媛; 张岸平; 单秀水; 岳丽

    2013-01-01

    Objective To analyze the macroscopical shifting trends and laboratory diagnosis of pathogenic bacteria in fungal keratitis,to provide a dependable basis for the diagnosis and treatment of the disease.Methods This study retrospectively reviewed 530 cases that diagnosed as fungal keratitis in Tangshan ophthalmic hospital between 2008 and 2012,and statistic analyzed their smear Giemsa stain cytology,fungal culture.These data was compared by using chi-square test and percentages,and compared those with data in the period of 1999-2003.Its seasonal distribution of the disease was analyzed.Results Of 233 cases of fungal hyphae from the 530 samples were revealed,through Giemsa stained smear cytology examination,and the positive rate was 43.97%,and 296 cases of fungal culture was positive,the positive rate 55.84%.And the season of incidence focused on the 9-12 month,accounted for 60.6%.In 2008-2012 Fusarium species,No-spore species,Aspergillus,Altemaria species were the top four pathogens,respectively,accounted for 67.24%,19.26%,7.43% and 5.07% respectively.Conclusions Fungal keratitis cases need treatment in our hospital is increasing in recent 10 years.Smear staining method is a rapid diagnosis method of suspected fungal keratitis.Fusarium species is the major fungal pathogens in our area,accounting for 67.24% and is always the first pathogen.Aspergillus species and no-spore species are uptrend,however Alternaria species decline.%目的 对真菌性角膜炎的病原菌变化及实验室诊断进行总结,为该病的诊断治疗提供可靠的依据.方法 分析2008~2012年5年间在唐山市眼科医院拟诊为真菌性角膜炎的病例530份,统计其涂片Giemsa染色细胞学检查及真菌培养阳性率,应用卡方检验和百分比统计方法,将这些资料与1999~2003年的材料进行比较,并分析其发病的季节性分布规律.结果 在530份标本中涂片Giemsa染色细胞学检查发现真菌菌丝233例,阳性率43.97

  4. Acanthamoeba keratitis in Pondicherry.

    Science.gov (United States)

    Parija, S C; Prakash, M R; Rao, V A; Vellaniparambil, R J

    2001-06-01

    Acanthamoeba keratitis is a potentially devastating infection of the cornea caused by the free-living amoebae, Acanthamoeba species. During the period from 1997 to 2000, a total of 136 corneal scrapings from clinically suspected cases were screened and examined for the presence of the Acanthamoeba. On examination of the direct smear by microscopy, 11 out of 136 cases were positive for Acanthamoeba. Eight patients were males and 3 were females. The age of these patients ranged from 15 to 57 years. All of these cases were agricultural workers who did not use contact lens. Four cases gave a history of injury to the eye and 1 patient gave a history of applying cow dung on the eye after the injury. Rest of the patients did not give any history of trauma or wearing contact lenses. The patients were treated with topical application of neosporin ointment. Many of our cases had complications such as poor vision (all 11 cases had 6/60 or less), scar formation (3 cases), opacity (5 cases) and corneal perforation (2 cases). This report documents for the first time the cases of Acanthamoeba keratitis in Pondicherry.

  5. Treatment of Acanthamoeba keratitis.

    Science.gov (United States)

    Seal, David

    2003-08-01

    The treatment of Acanthamoeba keratitis has now been possible since the first successful therapy developed in the mid 1980s with a combination of propamidine 0.1% (Brolene) and neomycin 1%. However, only half the patients responded to this regimen as the cysts were often resistant to neomycin and relatively insensitive to propamidine. This led to research for better therapy, culminating in the mid 1990s with research in Glasgow demonstrating much increased effectiveness with use of the biguanide chlorhexidine 0.02% and in London and Bristol for similar effectiveness with the polymeric polyhexamethylene biguanide (PHMB) 0.02%. Both biguanides were combined with propamidine for enhanced effectiveness but were also shown to be effective as monotherapy. While this therapy inactivates the trophozoites and cysts in Acanthamoeba keratitis in the majority of patients (approximately 90%), there have been notable failures particularly when presentation is late with deep stromal infection. Additional highly acanthamoebicidal drugs are needed that can penetrate the stroma for synergistic action. This role may be taken up by certain antineoplastic drugs, such as alkylphosphocholine-1 (Miltefosine), that also have antiprotozoal activity.

  6. HERPETIC KERATITIS OUTCOMES DEPENDING ON IMMUNE STATUS OF PATIENTS

    Directory of Open Access Journals (Sweden)

    Svetlana V. Aksenova

    2016-06-01

    Full Text Available Introduction. Herpetic keratitis with the formation frequency of several million patients a year occupy an important place in infectious pathology of the eye and remain one of actual problems of ophthalmology. The lack of reliable ways of dealing with ophthalmic herpes dictates the necessity of finding optimal ways to treat patients, what prompted us to conduct this research. Purpose of the study. To evaluate the effect of the standard treatment regimen herpetic keratitis on the parameters of the immune status of the patient. Materials and Methods. We examined and treated 15 patients (15 eyes with herpetic keratouveitis. The control group consisted of 20 healthy people of similar age (20 eyes. Comparative evaluation of clinical and immunological status of patients conducted before and after standard therapy. Results. In the study of these immunological parameters of examinees were detected increase in the number leucocytes, lymphocytes, neutrophils absorbency, HCT-activity of neutrophils, the CIC in patients with herpetic keratitis during exacerbation of the disease, however, a decrease amount of TFR and TFS cells with helper and suppressor activity. During treat-ment immunological parameters have normalized somewhat, but were higher than the reference value. Discussion and Conclusions. The research showed that the base therapy does not provide normalization of cellular immune status even when clinical recovery, with the result that retained the ability of cells to maintain local inflammatory focus, complicate the regeneration process, promote chronicity and recurrence of the herpetic keratitis. These facts make it necessary to change the program of treatment of patients with this pathology and introduce the recommended range of products such as antioxidant and immunomodulatory activities.

  7. Fluorometholone acetate. A new ophthalmic derivative of fluorometholone.

    Science.gov (United States)

    Kupferman, A; Berrospi, A R; Leibowitz, H M

    1982-04-01

    Hourly topical administration of 0.1% fluorometholone acetate ophthalmic suspension produced, on the average, a 47% reduction in the polymorphonuclear leukocytes invading the cornea during an experimentally induced inflammatory keratitis. This is a significantly greater anti-inflammatory effect than we have previously reported for the alcohol derivative of fluorometholone and is not significantly different from the therapeutic effect of 1.0% prednisolone acetate ophthalmic suspension, the most effective corneal anti-inflammatory agent that we have studied to date. Fluorometholone acetate (0.1%) formulated as a high-viscosity carbomer gel and applied at three-hour intervals reduced invading leukocytes in the cornea an average of 48%, an effect not significantly different from hourly administration of the suspension.

  8. Neutrophil extracellular traps involvement in corneal fungal infection

    Science.gov (United States)

    Zhao, Yingying; Zhang, Fan; Wan, Ting; Fan, Fangli; Xie, Xin; Lin, Zhenyun

    2016-01-01

    Purpose Neutrophils release neutrophil extracellular traps (NETs) when defending against invading microorganisms. We investigated the existence of NETs in fungal keratitis. Methods Fourteen patients with unilateral fungal keratitis were included. Detailed information about each patient was recorded, including (1) patient history (onset of symptoms and previous therapy), (2) ocular examination findings by slit-lamp biomicroscopy, (3) laboratory findings from direct smear examination and culture of corneal scrapings, (4) NET formation, and (5) treatment strategy and prognosis. Immunofluorescence staining was used to evaluate the existence of NETs on corneal scrapings. The relationship between the quantification of NETs and the clinical character of the fungal keratitis was identified. Results NETs were identified in all 14 patients. Patients with a higher grade of NET formation and fewer fungal hyphae always showed a good treatment response and a short course of infection. NETs were consistently found mixed with fungal hyphae in the corneal scrapings from infected patients. No statistical significance was found between the grade of NETs formed and the course of infection before presentation, and no relationship between the quantification of NETs and the size of the ulcer was found. Conclusions The results suggest that NETs are involved in fungal keratitis. The number of NETs in infected corneas may provide a tool for evaluating the prognosis for fungal keratitis. PMID:27559290

  9. 角膜板层清创联合无缝线羊膜移植术治疗表浅真菌性角膜炎%Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    张皇; 艾明

    2014-01-01

    To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis. ●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. ●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty. ●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union

  10. Distinguishing infective versus noninfective keratitis

    Directory of Open Access Journals (Sweden)

    Srinivasan M

    2008-01-01

    Full Text Available For the purpose of this symposium, the term "keratitis" implies suppurative nonviral and viral keratitis. Corneal ulcers have been described in ancient literature. But even today, despite the availability of a wide range of newer antimicrobials and new diagnostic techniques, infective keratitis continues to pose a diagnostic and therapeutic challenge. This article focuses on the key diagnostic clinical features of the most common organisms causing infective keratitis - bacteria, fungi, viruses, nocardia and acanthamoeba - in India. While the clinical features in some cases are fairly straightforward, most cases challenge the clinician. We describe the salient clinical features which can help arrive at a diagnosis to begin appropriate treatment immediately, prior to the laboratory report.

  11. [Keratitis by Lasiodiplodia theobromae: a case report and literature review].

    Science.gov (United States)

    Samudio, Margarita; Laspina, Florentina; Fariña, Norma; Franco, Alicia; Mino de Kaspar, Herminia; Giusiano, Gustavo

    2014-12-01

    We report a case of mycotic keratitis caused by Lasiodiplodia theobromae in a 60-year-old man with a history of ocular trauma with vegetable matter. Ophthalmological assessment with slit-lamp and microbiological evaluation of the corneal ulcer by conventional microbiological techniques were performed. Mycology study of the corneal scraping showed the presence of fungal filaments and the isolate was identified as Lasiodiplodia theobromae. Patient was treated with natamycin 5% and fluconazole 0.2% for 37 days. The infection was controlled but the corneal scars required a cornea transplant. This is the first case of keratitis by Lasiodiplodia theobromae in Paraguay. Difficulties in the management of these cases, which often requires surgical procedures, are discussed.

  12. A Murine Model of Contact Lens–Associated Fusarium Keratitis

    Science.gov (United States)

    Sun, Yan; Chandra, Jyotsna; Mukherjee, Pranab; Szczotka-Flynn, Loretta; Ghannoum, Mahmoud A.

    2010-01-01

    Purpose. Fusarium solani and F. oxysporum were the causative organisms of the 2005/2006 outbreak of contact lens–associated fungal keratitis in the United States. The present study was an investigation of the ability of F. oxysporum grown as a biofilm on silicone hydrogel contact lenses to induce keratitis. Methods. A clinical isolate of F. oxysporum was grown as a biofilm on lotrafilcon A contact lenses, and a 2-mm diameter punch was placed on the abraded corneal epithelium of either untreated or cyclophosphamide-treated C57BL/6 mice or of IL-1R1−/−, MyD88−/−, TLR2−/−, or TLR4−/− mice. After 2 hours, the lens was removed, and corneal opacification, colony forming units (CFUs), and histopathology were evaluated. Results. C57BL/6 mice developed severe corneal opacification within 24 hours and resolved after four days. In contrast, corneal opacification progressed in cyclophosphamide-treated mice, and was associated with unimpaired fungal growth in the cornea, and with hyphae penetrating into the anterior chamber. The phenotype of MyD88−/− and IL-1R−/− mice was similar to that of cyclophosphamide-treated animals, with significantly impaired cellular infiltration and fungal clearance. Although TLR4−/− mice developed a cellular infiltrate and corneal opacification similar to C57BL/6 mice, the CFU count was significantly and consistently higher. Conclusions. Fusarium grown as a biofilm on silicone hydrogel contact lenses can induce keratitis on injured corneas, with disease severity and fungal killing dependent on the innate immune response, including IL-1R1, MyD88, and TLR4. PMID:19875664

  13. Filamentous fungal infections of the cornea: a global overview of epidemiology and drug sensitivity.

    Science.gov (United States)

    Kredics, László; Narendran, Venkatapathy; Shobana, Coimbatore Subramanian; Vágvölgyi, Csaba; Manikandan, Palanisamy

    2015-04-01

    Fungal keratitis is a serious suppurative, usually ulcerative corneal infection which may result in blindness or reduced vision. Epidemiological studies indicate that the occurrence of fungal keratitis is higher in warm, humid regions with agricultural economy. The most frequent filamentous fungal genera among the causal agents are Fusarium, Aspergillus and Curvularia. A more successful therapy of fungal keratitis relies on precise identification of the pathogen to the species level using molecular tools. As the sequence analysis of the internal transcribed spacer (ITS) region of the ribosomal RNA gene cluster (rDNA) is not discriminative enough to reveal a species-level diagnosis for several filamentous fungal species highly relevant in keratitis infections, analysis of other loci is also required for an exact diagnosis. Molecular identifications may also reveal the involvement of fungal species which were not previously reported from corneal infections. The routinely applied chemotherapy of fungal keratitis is based on the topical and systemic administration of polyenes and azole compounds. Antifungal susceptibility testing of the causal agents is of special importance due to the emergence and spread of resistance. Testing the applicability of further available antifungals and screening for new, potential compounds for the therapy of fungal keratitis are of highlighted interest.

  14. Role of activated macrophages in experimental Fusarium solani keratitis.

    Science.gov (United States)

    Hu, Jianzhang; Hu, Yingfeng; Chen, Shikun; Dong, Chenhuan; Zhang, Jingjin; Li, Yanling; Yang, Juan; Han, Xiaoli; Zhu, Xuejun; Xu, Guoxing

    2014-12-01

    Macrophages under the conjunctival tissue are the first line defender cells of the corneas. Elimination of these cells would lead to aggravation of fungal keratitis. To determine how the course of fungal keratitis would be altered after the activation of these macrophages, a murine model was achieved by intrastromal instillation of latex beads before the corneas were infected with Fusarium solani. The keratitis was observed and clinically scored daily. Infected corneas were homogenized for colony counts. The levels of the IL-12, IL-4, MPO, MIF and iNOS cytokines were measured in the corneas using real-time polymerase chain reactions and enzyme-linked immunosorbent assays. CD3+, CD4+ and CD8+ lymphocytes in the corneas, submaxillary lymph nodes and peripheral blood were detected using immunohistochemistry and flow cytometry, respectively. The latex bead-treated mice exhibited aggravated keratitis. Substantially increased macrophage and polymorphonuclear leukocyte infiltration was detected in the corneas, although few colonies were observed. There was a marked increase in the IL-12, IL-4, MPO, MIF and iNOS expression in the corneas. The numbers of CD3+, CD4+ and CD8+ lymphocytes and the CD4+/CD8+ ratio were significantly enhanced in the corneas and submaxillary lymph nodes. However, the number of CD4+ lymphocytes was decreased in the peripheral blood, while the number of CD8+ lymphocytes increased. Collectively, our data demonstrate that the activation of macrophages in the cornea may cause an excessive immune response. Macrophages appear to play a critical role in regulating the immune response to corneal infections with F. solani. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Rapid and sensitive diagnosis of Acanthamoeba keratitis by loop-mediated isothermal amplification.

    Science.gov (United States)

    Ge, Z; Qing, Y; Zicheng, S; Shiying, S

    2013-11-01

    A loop-mediated isothermal amplification (LAMP) assay was developed for the detection of Acanthamoeba. The sensitivity of the LAMP assay was tested using different copies of positive DNA. The specificity of the assay was tested using DNA extracted from Acanthamoeba, Pseudomonas aeruginosa, Candida albicans, herpes simplex virus-1 and human corneal epithelial cells. Its effectiveness was evaluated and compared with culture, corneal smear examination and real-time PCR in corneal samples from mice with Acanthamoeba keratitis. We also tested three corneal samples from patients with suspected Acanthamoeba or fungal infection using LAMP. Loop-mediated isothermal amplification was confirmed to be very sensitive, with the lowest detection limit being ten copies/tube of Acanthamoeba DNA. The LAMP primers only amplified Acanthamoeba DNA. During the development of Acanthamoeba keratitis in mice, almost all of the positive rates of LAMP at each time post-infection were higher than those of culture or corneal smear examination. The total positive rate of LAMP was significantly higher than those of culture and corneal smear examination (p Acanthamoeba keratitis tested positive for Acanthamoeba using LAMP along with culture or corneal smear examination, whereas the other suspected fungal keratitis tested negative. The LAMP assay is a simple, rapid, highly specific and sensitive method for the diagnosis of keratitis caused by Acanthamoeba.

  16. Microbial keratitis: a community eye health approach

    Directory of Open Access Journals (Sweden)

    Kieran S O’Brien

    2015-06-01

    Full Text Available Microbial keratitis is an infection of the cornea. Corneal opacities, which are frequently due to microbial keratitis, remain among the top five causes of blindness worldwide. Microbial keratitis disproportionately affects low- and middle-income countries. Studies indicate that the incidence of microbial keratitis may be up to 10 times higher in countries like Nepal and India compared to the United States.

  17. TEAR SUBSTITUTES PREVENT OPHTHALMIC COMPLICATIONS IN INTENSIVE CARE UNIT PATIENTS

    Directory of Open Access Journals (Sweden)

    S. A. Kochergin

    2015-01-01

    Full Text Available Aim. To study the effects of Cationorm for the prevention of ophthalmic complications in intensive care unit (ICU patients and to compare the efficacy of ocular surface lubricants used in ICU. Patients and methods. 50 ICU patients (100 eyes with bilateral lagophthalmos (2 mm or more were enrolled in the study. Study group and control group each included 25 patients (50 eyes who were on deep sedation and ventilator. Before and after the treatment, general examination, biomicroscopy, tonometry, ophthalmoscopy, Schirmer’s test and Norn’s test (with fluorescein were performed. Results. Cationorm significantly improves tear film stability without any corneal epithelial defects (100 % of patients. In 7 controls (14 eyes, 28 %, initial signs of corneal xerosis and exposure keratitis were revealed. Conclusions. ICU patients are at high risk of complications due to hypodynamia and reduced innervation of the eye and its appendages. Bilateral lagophthalmos develops in 16.67 % of ICU patients who are on deep sedation and ventilator (up to 3 days. In the abscence of preventive therapy, lagophthalmos results in complications, i.e., keratitis and, occasionally, corneal ulceration and perforation. ICU patients require ophthalmological examination and tear substitutes. Regular instillations of Cationorm minimize ophthalmic complications due to intensive therapy. Cationorm restores tear firm architectonics and may be considered as a first-line choice for such disorders. 

  18. Immune-mediated canine and feline keratitis.

    Science.gov (United States)

    Andrew, Stacy E

    2008-03-01

    Although the normal cornea is devoid of vasculature and lymphatics, there are still several immune-mediated corneal conditions that can occur in dogs and cats. An overview of corneal immunology is presented. Diseases of dogs, including chronic superficial keratitis, superficial punctate keratitis, and canine adenovirus endotheliitis, as well as feline diseases, including eosinophilic keratitis and herpesvirus-related conditions, are discussed.

  19. A novel murine model of Fusarium solani keratitis utilizing fluorescent labeled fungi.

    Science.gov (United States)

    Zhang, Hongmin; Wang, Liya; Li, Zhijie; Liu, Susu; Xie, Yanting; He, Siyu; Deng, Xianming; Yang, Biao; Liu, Hui; Chen, Guoming; Zhao, Huiwen; Zhang, Junjie

    2013-05-01

    Fungal keratitis is a common disease that causes blindness. An effective animal model for fungal keratitis is essential for advancing research on this disease. Our objective is to develop a novel mouse model of Fusarium solani keratitis through the inoculation of fluorescent-labeled fungi into the cornea to facilitate the accurate and early identification and screening of fungal infections. F. solani was used as the model fungus in this study. In in vitro experiment, the effects of Calcofluor White (CFW) staining concentration and duration on the fluorescence intensity of F. solani were determined through the mean fluorescence intensity (MFI); the effects of CFW staining on the growth of F. solani were determined by the colony diameter. In in vivo experiment, the F. solani keratitis mice were induced and divided into a CFW-unlabeled and CFW-labeled groups. The positive rate, corneal lesion score and several positive rate determination methods were measured. The MFIs of F. solani in the 30 μg/ml CFW-30 min, 90 μg/ml CFW-10 min and 90 μg/ml CFW-30 min groups were higher than that in the 10 μg/ml CFW-10 min group (P  0.05). No significant differences (P > 0.05) were observed for the positive rate or the corneal lesion scores between the CFW-unlabeled and the CFW-labeled group. On day 1 and 2, the positive rates of the infected corneas in the scraping group were lower than those in the fluorescence microscopy group (P  0.05). Thus, these experiments established a novel murine model of F. solani keratitis utilizing fluorescent labeled fungi. This model facilitates the accurate identification and screening of fungal infections during the early stages of fungal keratitis and provides a novel and reliable technology to study the fungal keratitis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Microscopic Evaluation, Molecular Identification, Antifungal Susceptibility, and Clinical Outcomes in Fusarium, Aspergillus and, Dematiaceous Keratitis

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    Devarshi U. Gajjar

    2013-01-01

    Full Text Available Purpose. Fusarium, Aspergillus, and Dematiaceous are the most common fungal species causing keratitis in tropical countries. Herein we report a prospective study on fungal keratitis caused by these three fungal species. Methodology. A prospective investigation was undertaken to evaluate eyes with presumed fungal keratitis. All the fungal isolates (n=73 obtained from keratitis infections were identified using morphological and microscopic characters. Molecular identification using sequencing of the ITS region and antifungal susceptibility tests using microdilution method were done. The final clinical outcome was evaluated in terms of the time taken for resolution of keratitis and the final visual outcome. The results were analyzed after segregating the cases into three groups, namely, Fusarium, Aspergillus, and Dematiaceous keratitis. Results. Diagnosis of fungal keratitis was established in 73 (35.9% cases out of 208 cases. The spectra of fungi isolated were Fusarium spp. (26.6%, Aspergillus spp. (21.6%, and Dematiaceous fungi (11.6%. The sequence of the ITS region could identify the Fusarium and Aspergillus species at the species complex level, and the Dematiaceous isolates were accurately identified. Using antifungal agents such as fluconazole, natamycin, amphotericin B, and itraconazole, the minimum inhibitory concentrations (MICs for Fusarium spp. were >32 μg/mL, 4–8 μg/mL, 0.5–1 μg/mL, and >32 μg/mL, respectively. Antifungal susceptibility data showed that Curvularia spp. was highly resistant to all the antifungal agents. Overall, natamycin and amphotericin B were found to be the most effective antifungal agents. The comparative clinical outcomes in all cases showed that the healing response in terms of visual acuity of the Dematiaceous group was significantly good when compared with the Fusarium and Aspergillus groups (P<0.05. The time required for healing in the Fusarium group was statistically significantly less when

  1. New Treatments for Bacterial Keratitis

    Directory of Open Access Journals (Sweden)

    Raymond L. M. Wong

    2012-01-01

    Full Text Available Purpose. To review the newer treatments for bacterial keratitis. Data Sources. PubMed literature search up to April 2012. Study Selection. Key words used for literature search: “infectious keratitis”, “microbial keratitis”, “infective keratitis”, “new treatments for infectious keratitis”, “fourth generation fluoroquinolones”, “moxifloxacin”, “gatifloxacin”, “collagen cross-linking”, and “photodynamic therapy”. Data Extraction. Over 2400 articles were retrieved. Large scale studies or publications at more recent dates were selected. Data Synthesis. Broad spectrum antibiotics have been the main stay of treatment for bacterial keratitis but with the emergence of bacterial resistance; there is a need for newer antimicrobial agents and treatment methods. Fourth-generation fluoroquinolones and corneal collagen cross-linking are amongst the new treatments. In vitro studies and prospective clinical trials have shown that fourth-generation fluoroquinolones are better than the older generation fluoroquinolones and are as potent as combined fortified antibiotics against common pathogens that cause bacterial keratitis. Collagen cross-linking was shown to improve healing of infectious corneal ulcer in treatment-resistant cases or as an adjunct to antibiotics treatment. Conclusion. Fourth-generation fluoroquinolones are good alternatives to standard treatment of bacterial keratitis using combined fortified topical antibiotics. Collagen cross-linking may be considered in treatment-resistant infectious keratitis or as an adjunct to antibiotics therapy.

  2. Infectious keratitis in patients undergoing Boston Type 1 keratoprosthesis (Boston KPro procedure: case series

    Directory of Open Access Journals (Sweden)

    Heloisa Moraes do Nascimento

    2011-04-01

    Full Text Available Description of two cases of infectious keratitis in patients after Boston Type 1 keratoprosthesis (Boston KPro implantation. The first case refers to a patient that had the device indicated due to limbal deficiency secondary to severe dry eye who presented a fungal infection by Aerobasidium pullulans that was successfully treated with amphotericin B eye drops. The second case reports a patient with Boston KPro implantation due to previous corneal transplant rejection showing bacterial keratitis in the fourth postoperative month. The etiologic agent was identified asStreptococcus sp and topical treatment with vancomycin was effective. The importance of postoperative surveillance in Boston KPro eyes is discussed.

  3. A comparative, retrospective, observational study of the clinical and microbiological profiles of post-penetrating keratoplasty keratitis

    Science.gov (United States)

    Lin, I.-Huang; Chang, Yi-Sheng; Tseng, Sung-Huei; Huang, Yi-Hsun

    2016-09-01

    Infectious keratitis after penetrating keratoplasty (PK) is a devastating condition that may result in graft failure and poor visual outcome. In this study, we retrospectively reviewed the medical records of patients who underwent PK between 2009 and 2014, and recorded those who developed infectious keratitis. We compared the predisposing factors and organisms isolated to those identified in our previous study, conducted between 1989 and 1994. The incidence of post-PK infectious keratitis decreased from 11.6% (41 out of 354 cases, 1989-1994) to 6.5% (9 out of 138 cases, 2009-2014). Graft epithelial defect and suture-related problems remained the leading two risk factors of infectious keratitis after PK. Gram-positive and Gram-negative bacterial infection decreased from 58.5% and 46.3% to 11.1% and 22.2%, respectively (P = 0.023 and P = 0.271). In contrast, fungus infection increased from 9.8% to 66.7% (P = 0.001) fungi have become the major pathogen for post-PK infectious keratitis. In conclusion, while the incidence of post-PK infectious keratitis has decreased over time, the number and frequency of fungal infections have significantly increased in the recent study period. Clinicians should be aware of the shifting trend in pathogens involved in post-PK infectious keratitis.

  4. Updates in ophthalmic pathology.

    Science.gov (United States)

    Mendoza, Pia R; Grossniklaus, Hans E

    2017-05-01

    Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  5. Aspergillus keratitis: A cause of blindness in Tropical India

    Directory of Open Access Journals (Sweden)

    Kafil Akhtar

    2012-01-01

    Full Text Available Mycotic keratitis is a fungal infection of the cornea, which constitute an important eye problem in outdoor workers. This infection is difficult to treat, and it can lead to severe visual impairment or blindness. Trauma is the major predisposing factor, followed by ocular and systemic defects, prior application of corticosteroids and prolonged use of antibiotic eye-drops. We report this case because of the rarity of endogenous Aspergillosis presenting as blindness in tropical India and review of the relevant literature.

  6. Rhodotorula mucilaginosa Keratitis: A rare fungus from Eastern India

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    Suman Saha

    2014-01-01

    Full Text Available Rhodotorula mucilaginosa rarely cause keratitis in immunocompromised individuals. A 30 year old male with history of minor trauma presented with cotton wool like stromal infiltration and hypopyon in left eye. Microbiological examination of corneal scraping showed fungal hyphae and yeast cells in direct smear. Molecular identification of the organism was performed which showed 100% homology with Rhodotorula mucilaginosa. Management of these cases is difficult often necessitating surgical procedures. However further reports are necessary to understand the disease and establish a treatment protocol.

  7. A case of Beauveria bassiana keratitis confirmed by internal transcribed spacer and LSU rDNA D1–D2 sequencing

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    M. Ligozzi

    2014-05-01

    Full Text Available We describe a case of fungal keratitis due to Beauveria bassiana in a farmer with Fuchs' dystrophy, treated with amphotericin B. Surgery with penetrating keratoplasty was necessary to resolve the lesions. Susceptibility testing and molecular sequencing permitted the identification and treatment of this rare aetiological agent of invasive fungal disease.

  8. A case of Beauveria bassiana keratitis confirmed by internal transcribed spacer and LSU rDNA D1-D2 sequencing.

    Science.gov (United States)

    Ligozzi, M; Maccacaro, L; Passilongo, M; Pedrotti, E; Marchini, G; Koncan, R; Cornaglia, G; Centonze, A R; Lo Cascio, G

    2014-05-01

    We describe a case of fungal keratitis due to Beauveria bassiana in a farmer with Fuchs' dystrophy, treated with amphotericin B. Surgery with penetrating keratoplasty was necessary to resolve the lesions. Susceptibility testing and molecular sequencing permitted the identification and treatment of this rare aetiological agent of invasive fungal disease.

  9. [Confocal microscopy as an early relapse marker after keratoplasty due to Fusarium solani keratitis].

    Science.gov (United States)

    Daas, L; Bischoff-Jung, M; Viestenz, A; Seitz, B; Viestenz, A

    2017-01-01

    In the case of therapy-resistant keratitis an infection with Fusarium solani should be taken into consideration as a rare but very severe eye disease. In the majority of cases Fusarium solani keratitis will result in a protracted clinical course despite aggressive medicinal and surgical interventions. We describe the case of a referred patient after intensive topical, intracameral and systemic antibacterial and antimycotic therapy as well as surgical treatment with emergency keratoplasty à chaud because of Fusarium solani keratitis. The patient presented to our department with persistent discomfort for further therapeutic interventions. Using confocal microscopy we were able to demonstrate the presence of fungal hyphae in the host cornea and the graft, which was important for making further surgical decisions. Furthermore, this emphasizes the role of confocal microscopy as an early relapse marker during the clinical monitoring.

  10. 碘酊烧灼联合氟康唑和两性霉素B治疗真菌性角膜炎疗效观察%Curative effects of iodine tincture cauterization combined with fluconazol, amphotericin Bin treatment of fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    张茂菊; 李拓; 李家璋; 吴青松; 李红艳

    2009-01-01

    Objective To investigate the clinical curative effects of iodine tincture cauterization combined with fluconazol, amphotericin B in treatment of fungal keratitis(FK), Methods According to severity of patients' condition, different approaches were taken to treat 25 FK patients(25 eyes). About mild patients,2.5 g · L-1 iodine tincture cauterized ulcer surface. Fluconazol eye drops and amphotericin B eye drops were used to drop the eye every 30 minutes one time;Fluconazol injection 100 mL was used through intravenous infusion one time daily;About moderate or severe patients,fragile necrotic tissues and their secretion were removed as far as possible. Then the treatments were taken as those for mild patients. Results In all 25 cases (25 eyes) ,16 cases were cured,6 cases improved,3 cases without effective change,22 cases with utility(cured and improved),accounting for 88.00%. Two cases were found with gastrointestinal reaction at different grades, 1 case with slight transaminase increase, and other complications were not found during treatment. Conclusions Iodine tincture cauterization combined with systemic and topical applications of fluconazol and amphotericin B is an effective method to treat FK without obvious side effects, and it can be popularized in clinical application.%目的 观察碘酊烧灼联合氟康唑、两性霉素B治疗真菌性角膜炎(fungal keratitis,FK)的临床疗效.方法 选择FK患者25例(25眼),根据病情轻重采用不同的治疗方法.轻度:用2.5 g·L-1碘酊烧灼溃疡面,氟康唑滴眼液及两性霉素B滴艰液滴眼,每30 min 1次,氟康唑注射液100 mL每天1次静脉滴注;中、重度:先将易碎的坏死组织及其分泌物尽可能清除,余方法基本同轻度.结果 25例(25眼)患者治愈16例,好转6例,无效3例,有效(治愈+好转)22例,占88.00%.2例患者治疗过程中出现程度不等的胃肠道反应,1例出现轻度转氨酶升高,余未见其他不良反应发生.结论 碘酊烧灼联合氟

  11. Keratitis due to Shigella flexneri.

    NARCIS (Netherlands)

    Muytjens, H.L.; Eggink, C.A.; Dijkman, F.C.A.P.; Bakkers, J.M.J.E.; Melchers, W.J.G.

    2006-01-01

    Multiresistant Shigella flexneri isolates were cultured from the cornea and stool of a girl. Genetic analysis showed the isolates were identical. Shigella spp. are rare causes of ulcerative keratitis; there have only been 14 published cases since 1943. Although prognosis after local treatment is goo

  12. AMNIOTIC MEMBRANE TRANSPLANTATION FOR KERATITIS.

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    Snezhana Murgova

    2015-06-01

    Full Text Available Keratitis without proper management tends to perforate the cornea, resulting in severe adverse consequences. In recent studies, amniotic membrane is reported to have anti-inflammatory effect and promote wound healing of corneal ulcer. Purpose: To report on the efficacy of permanent amniotic membrane transplantation (AMT in the treatment of keratitis. Case report: A 58-year-old man with severe keratitis in both eyes caused by long term administration of topical anesthetic (alcaine for electric ophthalmia. Single layer of amniotic membrane (AM was placed on the defect and secured to the limbus with interrupted 10-0 nylon sutures. A bandage contact lens was applied on the AM. Postoperative medication included topical antibiotic, artificial tears and mydriatic. Three months later corticosteroid was included. There was an immediate decrease of patient’s pain after surgery. Complete epithelialization was noted after 1 month. Conclusion: AMT is an alternative adjunctive method of treatment of keratitis; it promotes epithelialization process, decreased inflammation, corneal haze and neovascularization.

  13. Keratitis due to Shigella flexneri.

    NARCIS (Netherlands)

    Muytjens, H.L.; Eggink, C.A.; Dijkman, F.C.A.P.; Bakkers, J.M.J.E.; Melchers, W.J.G.

    2006-01-01

    Multiresistant Shigella flexneri isolates were cultured from the cornea and stool of a girl. Genetic analysis showed the isolates were identical. Shigella spp. are rare causes of ulcerative keratitis; there have only been 14 published cases since 1943. Although prognosis after local treatment is

  14. Treatment with intrastromal and intracameral voriconazole in 2 eyes with Lasiodiplodia theobromae keratitis: case reports.

    Science.gov (United States)

    Lekhanont, Kaevalin; Nonpassopon, Manachai; Nimvorapun, Nutthida; Santanirand, Pitak

    2015-02-01

    To report the clinical presentation and the role of intrastromal and intracameral voriconazole injection in the management of rare cases of fungal keratitis caused by Lasiodiplodia theobromae.Two eyes of 2 patients with Lasiodiplodia keratitis unresponsive to topical and oral antifungal medications were included in this study. Diagnosis of Lasiodiplodia keratitis was confirmed by microbiological analysis, including culture-based (case 1 and 2) and DNA sequencing techniques (case 2 only).The first patient presented with multiple satellite lesions and one of these infiltrates spread deeply into the cornea, forming a stromal abscess. Another patient had a large full-thickness corneal infiltrates with several fungal balls in the anterior chamber, requiring a limbus-to-limbus therapeutic penetrating keratoplasty. Despite aggressive topical therapy, the stromal abscess continued to worsen in the first case and recurrent keratitis was observed postoperatively in the second case. Voriconazole 50 μg/0.1 mL was administered intracamerally and intrastromally around the fungal abscess as adjuncts to topical antimycotics in the first case. The second patient who needed therapeutic keratoplasty was treated with an intracameral injection of 50 μg/0.1 mL voriconazole at the end of surgery. Postoperatively, 100 μg/0.1 mL voriconazole was also injected intracamerally after the recurrence of infection was noted in the graft. Reinjections were given 48 hours apart in both cases. After the injections, all corneal and anterior chamber lesions were reduced in size and density and completely resolved within 4 weeks.Intrastromal and intracameral voriconazole injections may offer safe and effective treatment options for L theobromae keratitis.

  15. Topical voriconazole therapy of Purpureocillium lilacinum keratitis that occurred in disposable soft contact lens wearers.

    Science.gov (United States)

    Todokoro, Daisuke; Yamada, Norihiro; Fukuchi, Mariko; Kishi, Shoji

    2014-10-01

    The objective of this study was to describe 2 cases of keratitis caused by Purpureocillium lilacinum (formerly Paecilomyces lilacinus) that occurred in disposable contact lens users, which were successfully treated with topical voriconazole. Case 1 was a healthy 44-year-old woman, who wore weekly disposable contact lenses and had developed a superficial corneal infection in her right eye. For diagnosis, corneal scraping and molecular identification of the cultured pathogen were performed. A corneal smear revealed the presence of fungi. The pathogen was identified as P. lilacinum by traditional morphological identification of fungal culture, and this identification was confirmed by DNA sequencing of the ribosomal internal transcribed spacer (ITS) sequence. Therapy with topical fluconazole, topical pimaricin (natamycin), and oral itraconazole were ineffective. Topical voriconazole showed a significant effect, and the keratitis was successfully treated. Case 2 was a 43-year-old woman with bilateral recurrent peripheral corneal ulcers by meibomian gland dysfunction, who used therapeutic bandage contact lenses on her left eye. However, a corneal abscess with hypopyon occurred in the eye after 3 months. The microbial smear examination showed the presence of fungi and the fungal culture, and the DNA sequence of ITS region revealed that the causative agent was P. lilacinum. The susceptibility testing against antifungal agents showed that voriconazole was effective. The lesion improved gradually by topical voriconazole. As a conclusion, P. lilacinum keratitis can occur in disposable soft contact lens wearer. Early and accurate detection of the pathogenic organism is essential. Topical voriconazole was effective against P. lilacinum keratitis.

  16. Identification problems with sterile fungi, illustrated by a keratitis due to a non-sporulating Chaetomium-like species

    NARCIS (Netherlands)

    Vinod Mootha, V.; Shahinpoor, P.; Sutton, D.A.; Xin, L.; Najafzadeh, M.J.; de Hoog, G.S.

    2012-01-01

    A 39-year-old farm worker was injured in her right eye by a piece of wire, which resulted in a corneal ulcer unresponsive to antibiotic treatment. The clinical appearance was that of a corneal infiltrate with feathery borders resembling fungal keratitis. Corneal scrapings were collected and the

  17. Identification problems with sterile fungi, illustrated by a keratitis due to a non-sporulating Chaetomium-like species

    NARCIS (Netherlands)

    Vinod Mootha, V.; Shahinpoor, P.; Sutton, D.A.; Xin, L.; Najafzadeh, M.J.; de Hoog, G.S.

    2012-01-01

    A 39-year-old farm worker was injured in her right eye by a piece of wire, which resulted in a corneal ulcer unresponsive to antibiotic treatment. The clinical appearance was that of a corneal infiltrate with feathery borders resembling fungal keratitis. Corneal scrapings were collected and the pati

  18. Neuro-ophthalmic sarcoidosis

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    Baughman RP

    2012-03-01

    Full Text Available Robert P Baughman1, Kenneth L Weiss2, Karl C Golnik31Department of Medicine, 2Department of Radiology, 3Department of Ophthalmology, University of Cincinnati Medical Center, Cincinnati, Ohio, USAAbstract: Neuro-ophthalmic disease occurs in about a third of patients with neurosarcoidosis. Optic nerve involvement is the most common manifestation, but other cranial nerves and the optic chiasm can be involved. However, there are several other common diseases that cause optic neuropathy, including multiple sclerosis. The diagnosis of sarcoidosis can often be made based on the multi-organ nature of the disease and ancillary testing. Most patients with neuro-ophthalmic sarcoidosis require systemic therapy. While corticosteroids are usually the first step in therapy, cytotoxic agents such as methotrexate and azathioprine have been useful as steroid-sparing agents for chronic disease. The monoclonal antibodies directed against tumor necrosis factor have been reported as effective in refractory cases of neuro-ophthalmic disease.Keywords: sarcoidosis, methotrexate, infliximab, multiple sclerosis, optic neuritis, prednisone

  19. Effect of topical 0.5% povidone-iodine compared to 5% natamycin in fungal keratitis caused by Fusarium solani in a rabbit model: a pilot study Efeito tópico de iodo-povidona 0,5% comparado com natamicina 5% em ceratites fúngicas causadas por Fusarium solani em um modelo animal de coelhos: estudo piloto

    Directory of Open Access Journals (Sweden)

    Lauro Augusto de Oliveira

    2008-12-01

    Full Text Available PURPOSE: To evaluate the efficacy of topical administration of 0.5% povidone-iodine in experimental Fusarium solani keratitis in rabbits. METHODS: Fungal keratitis caused by Fusarium solani was induced in the right eye of 24 New Zealand rabbits. The rabbits were randomly divided into 3 different treatment groups: Group I (povidone-iodine - treated with topical 0.5% povidone-iodine; Group II (natamycin - treated with topical 5% natamycin; and Group III (control - treated with topical saline solution. In all groups the rabbits were treated for three days and then sacrificed. The corneas were excised, macerated and immersed in 10 mL BHI. Culture samples were plated daily on Sabouraud's agar for 7 days, and the number of colony-forming units (CFU was counted. The rabbits were clinically evaluated during the treatment period. RESULTS: The povidone-iodine and natamycin groups demonstrated better efficacy than the control group based on the number of rabbits with no colonies growing. However, there were no statistically significant differences between the three groups when the number of CFU was analyzed (p>0.05. CONCLUSIONS: Our study demonstrates important methodological considerations in the use of in vivo animal models for the testing of antifungal agents. Using this sample size and methodology of counting CFU, topical 0.5% povidone-iodine demonstrated no benefit in the treatment of experimental Fusarium solani when compared with topical 5% natamycin.OBJETIVO: Avaliar a eficácia do uso tópico de iodo-povidona 0,5% em ceratite experimental por Fusarium solani em coelhos. MÉTODOS: Ceratite fúngica por Fusarium solani foi induzida no olho direito de 24 coelhos da raça New Zealand. Os coelhos foram divididos aleatoriamente em 3 diferentes grupos de tratamento: Grupo I (iodo-povidona - tratados com iodo-povidona 0,5%; Grupo II (natamicina - tratados com natamicina 5%; Grupo III (controle - tratados com solução salina. Os coelhos dos 3 grupos foram

  20. Diagnostic Ophthalmic Ultrasound for Radiologists.

    Science.gov (United States)

    Kendall, Cynthia J; Prager, Thomas C; Cheng, Han; Gombos, Dan; Tang, Rosa A; Schiffman, Jade S

    2015-08-01

    Ophthalmic ultrasound is an invaluable tool that provides quick and noninvasive evaluation of the eye and the orbit. It not only allows the clinicians to view structures that may not be visible with routine ophthalmic equipment or neuroimaging techniques but also provides unique diagnostic information in various ophthalmic conditions. In this article, the basic principles of ophthalmic ultrasound and examination techniques are discussed. Its clinical application is illustrated through a variety of ocular pathologic abnormalities (eg, narrow angles, ciliary body tumor, detached retina, choroidal melanoma, and papilledema).

  1. Scleritis and Peripheral Ulcerative Keratitis

    OpenAIRE

    Galor, Anat; Thorne, Jennifer E.

    2007-01-01

    Scleritis and peripheral ulcerative keratitis (PUK) can present as isolated conditions or as part of a systemic inflammatory or infectious disorder. Both are serious ocular conditions that can result in vision loss and therefore require early diagnosis and treatment. Nearly two-thirds of patients with non-infectious scleritis require systemic glucocorticoid therapy, and one fourth need a glucocorticoid-sparing agent, as well. Essentially all patients with non-infectious PUK require systemic g...

  2. Colletotrichum graminicola keratitis: First case report from India

    OpenAIRE

    Yegneswaran Prakash; Pai Vijaya; Bairy Indira; Bhandary Sulatha

    2010-01-01

    Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum grami...

  3. [Herpetic keratitis: clinical-virological correlation].

    Science.gov (United States)

    Martínez, M J; Vogel, M; Stoppel, J; Charlin, R; Squella, O; Srur, M; Traipe, L; Verdaguer, J; Suárez, M

    1997-06-01

    Herpetic keratitis is the main infectious cause of corneal opacity. The existence of effective antiviral agents underscores the need of an early diagnosis. To correlate clinical features of herpetic keratitis with virological studies. Forty one patients with a clinical diagnosis of herpetic keratitis were studied. Viral isolation, polymerase chain reaction (PCR) and typification were done in a sample taken by swabbing the ocular lesion. Twenty six patients (31% female) had epithelial keratitis, that was mild or moderate in 88% of cases and acute in 77% of them. In 20 patients (77%), viral isolation and PCR were positive (HSV-2 in one case). Fifteen patients (67% female) had stromal keratitis, 93% of cases were moderate or severe and 53% were acute. Viral isolation was negative in all cases and in 20% PCR was positive. Viral isolation and PCR were equally sensitive in epithelial keratitis, but in stromal keratitis only PCR could detect the virus. Moderate acute dendrite was the predominant clinical manifestation. The higher proportion of women with stromal keratitis supports its possibly autoimmune etiology. HSV-2 is seldomly isolated and possibly associated to vertical transmission.

  4. Early diagnosis of mycotic keratitis : Predictive value of potassium hydroxide preparation

    Directory of Open Access Journals (Sweden)

    Sharma Savitri

    1998-01-01

    Full Text Available Potassium hydroxide (KOH preparation is an underutilized modality in the diagnosis of mycotic keratitis. We have earlier shown its utility in the diagnosis of Nocardia and Acanthamoeba keratitis. The aim of this study was (i to evaluate the sensitivity, specificity and predictive value of KOH preparation, and (ii to compare its efficacy with other methods of corneal scraping examination, for the diagnosis of mycotic keratitis. The study was conducted in two phases. In phase I, randomized corneal scrapings were examined by KOH, Gram′s stain, and lactophenol cotton blue (LPCB in 91 infectious keratitis subjects. In phase II, 53 corneal scrapings were stained with KOH and calcofluor white (CFW, and viewed with bright field (KOH and fluorescence (CFW microscopy. The KOH and CFW readings were recorded by an observer masked to the clinical findings and culture results. Nineteen scrapings were examined by two masked observers. In 22 culture positive fungal keratitis patients in phase I, the sensitivity of KOH, Gram′s stain, and LPCB methods was 100%, 86.4%, and 77.3%, respectively. In phase II, the specificities of KOH and CFW were identical (83.8%, while the sensitivities were 81.2% and 93.7%, respectively (p = 0.59, in 16 culture positive mycotic keratitis patients. There was no significant difference between the negative and positive predictive values of KOH and CFW. Furthermore, no significant interobserver variability was found in the specificity and sensitivity. The KOH method compares well with other microscopy methods in the diagnosis of keratomycosis and has a definite place in the armamentarium of diagnostic techniques.

  5. Fungal Sinusitis

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    ... Marketplace Find an ENT Doctor Near You Fungal Sinusitis Fungal Sinusitis Patient Health Information News media interested ... sinusitis results. There Are Four Types Of Fungal Sinusitis: Mycetoma Fungal Sinusitis produces clumps of spores, a " ...

  6. 21 CFR 886.4390 - Ophthalmic laser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding...

  7. 21 CFR 886.4790 - Ophthalmic sponge.

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    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic sponge. 886.4790 Section 886.4790 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4790 Ophthalmic sponge. (a) Identification. An ophthalmic sponge is a device that is an absorbant sponge, pad, or spear made of folded gauze,...

  8. Diagnosing and managing microbial keratitis

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    Madan P Upadhyay

    2015-06-01

    Full Text Available Infections of the cornea can lead to corneal opacity and blindness if not identified quickly and managed appropriately. The terms ‘microbial keratitis’, ‘infective keratitis’ and ‘suppurative keratitis’ are all used to describe suppurative infections of the cornea. In this issue we use the term microbial keratitis. These infections are characterised by the presence of white or yellowish infiltrates in the corneal stroma, with or without an overlaying corneal epithelial defect, and associated with signs of inflammation.

  9. PROSPECTIVE STUDY OF EFFECTIVENESS OF INTRASTROMAL VORICONAZOLE INJECTION IN THE MANAGEMENT OF DEEP NON HEALING FUNGAL CORNEAL ULCER AS AN ADJUNCTIVE THERAPY

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    Yalaka Jayapal

    2015-08-01

    Full Text Available INTRODUCTION : Fungal infections of the cornea usually are difficult to treat. Contemporary antifungal drugs in the treatment of mycotic keratitis are less effective than contemporary antibacterial drugs in the treatment of bacterial keratitis. Moreover, the penetratio n of many antifungal drugs into the cornea is suboptimal, which makes it difficult to treat cases of deep mycotic keratitis. In this present case study we report a series of thirty patients in which intrastromal voriconazole was used in conjunction with to pical treatment to treat successfully deep seated recalcitrant fungal keratitis . AIM AND OBJECTIVE: To evaluate the role of intrastromal injection of voriconazole in the management of deep recalcitrant fungal keratitis as an adjunctive therapy . METHODS AND MA TERIALS: In this interventional case series, thirty eyes of thirty patients with deep stromal recalcitrant fungal keratitis that were unresponsive to topical antifungal therapy underwent intrastromal injection of voriconazole 50μgms/0.1ml. Duration of s tudy was 6 weeks per patient. RESULTS : Before the intracorneal injections, all thirty eyes had gradually worsening lesions on topical medications. After the intervention, a faster reduction in the size of corneal infiltration was documented and complete re solution of the ulcers was seen within 6 weeks of time. CONCLUSION : Targeted delivery of voriconazole by intrastromal injection may be a safe and effective way to treat cases of deep - seated recalcitrant fungal keratitis responding poorly to conventional tr eatment modalities

  10. Use of 18S rRNA gene-based PCR assay for diagnosis of acanthamoeba keratitis in non-contact lens wearers in India.

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    Pasricha, Gunisha; Sharma, Savitri; Garg, Prashant; Aggarwal, Ramesh K

    2003-07-01

    Identification of Acanthamoeba cysts and trophozoites in ocular tissues requires considerable expertise and is often time-consuming. An 18S rRNA gene-based PCR test, highly specific for the genus Acanthamoeba, has recently been reported in the molecular diagnosis of Acanthamoeba keratitis. This PCR assay was compared with conventional microbiological tests for the diagnosis of Acanthamoeba keratitis. In a pilot study, the PCR conditions with modifications were first tested on corneal scrapings from patients with culture-proven non-contact lens-related Acanthamoeba, bacterial, and fungal keratitis. This was followed by testing of corneal scrapings from 53 consecutive cases of microbial keratitis to determine sensitivity, specificity, and predictive values of the assay. All corneal scrapings from patients with proven Acanthamoeba keratitis showed a 463-bp amplicon, while no amplicon was obtained from patients with bacterial or fungal keratitis. Some of these amplified products were sequenced and compared with EMBL database reference sequences to validate these to be of Acanthamoeba origin. Out of 53 consecutive cases of microbial keratitis included for evaluating the PCR, 10 (18.9%) cases were diagnosed as Acanthamoeba keratitis on the basis of combined results of culture, smear, and PCR of corneal scrapings. Based on culture results as the "gold standard," the sensitivity of PCR was the same as that of the smear (87.5%); however, the specificity and the positive and negative predictive values of PCR were marginally higher than the smear examination (97.8 versus 95.6%, 87.5 versus 77.8%, and 97.8 versus 97.7%) although the difference was not significant. This study confirms the efficacy of the PCR assay and is the first study to evaluate a PCR-based assay against conventional methods of diagnosis in a clinical setting.

  11. Beauveria bassiana keratitis in bullous keratopathy: antifungal sensitivity testing and management.

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    Figueira, Luís; Pinheiro, Dolores; Moreira, Raul; Pinto, Eugénia; Simões, Joana; Camisa, Elisa; Torrão, Luís; Palmares, Jorge; Falcão-Reis, Fernando

    2012-01-01

    Beauveria bassiana is a ubiquitous fungus available as an insecticide. In humans, it has limited virulence; to our knowledge, only 3 cases of invasive disease and 10 cases of keratitis have been documented. We report the first case of B bassiana keratitis in a patient with aphakic bullous keratopathy. The fungal keratitis proved to be highly resistant to topical clotrimazole. Molecular identification was based on DNA sequence analysis. The minimal inhibitory concentrations (MIC) obtained were 2 µg/mL for voriconazole, 0.250 µg/mL for posaconazole, and >128 µg/mL for fluconazole; amphotericin B MIC was >16 µg/mL. In the absence of clinical improvement, a penetrating keratoplasty (PK) was performed. The patient was discharged on topical and systemic voriconazole and prednisolone 40 mg PO/day. The eye remained calm with a transparent cornea and clear anterior chamber. B bassiana keratitis is extremely rare, with only a few cases reported. Its risk factors are unknown. We report the first case in a patient with aphakic bullous keratopathy, which proved highly resistant to antifungal therapy (antifungal susceptibility results are presented). A PK was necessary for clinical improvement. A review of the literature is performed in an effort to define therapeutic strategies.

  12. Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

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    Stephen Tak-lun Li

    2016-10-01

    Full Text Available Purpose: The aim of this paper is to report the successful management of the first case of Lasiodiplodia theobromae keratitis in Hong Kong. Methods: We conducted a case report. Results: A 43-year-old Chinese male with a history of diabetes developed left eye keratitis after a trauma during tree felling. Fungal keratitis was diagnosed using a confocal microscope on day 1, and L. theobromae was confirmed from the culture. He was given oral voriconazole, topical natamycin, and topical and intracameral amphotericin B. The patient’s condition improved after the initial treatment. However, there was a slow progression to descemetocele formation and impending perforation due to corneal melting. Penetrating keratoplasty was performed at 8 weeks after presentation. Final visual recovery was good with no recurrence of infection. The cornea remained clear. Conclusions: We report the first case of L. theobromae keratitis in Hong Kong, and it is the only case so far that involved the use of oral voriconazole in the combination therapy. Early recognition with the aid of confocal microscopy allowed the early start of treatment. The use of newer antifungal voriconazole topically and orally combined with topical amphotericin B appeared to be useful in the eradication of the fungus and prevention of recurrence. Intracameral antifungals might have improved the clinical management.

  13. Successful Treatment of Lasiodiplodia theobromae Keratitis – Assessing the Role of Voriconazole

    Science.gov (United States)

    Li, Stephen Tak-lun; Yiu, Evan Po-fat; Wong, Angela Hiu-yan; Yeung, John Chun-Ting; Yu, Lester Wang-hon

    2016-01-01

    Purpose The aim of this paper is to report the successful management of the first case of Lasiodiplodia theobromae keratitis in Hong Kong. Methods We conducted a case report. Results A 43-year-old Chinese male with a history of diabetes developed left eye keratitis after a trauma during tree felling. Fungal keratitis was diagnosed using a confocal microscope on day 1, and L. theobromae was confirmed from the culture. He was given oral voriconazole, topical natamycin, and topical and intracameral amphotericin B. The patient's condition improved after the initial treatment. However, there was a slow progression to descemetocele formation and impending perforation due to corneal melting. Penetrating keratoplasty was performed at 8 weeks after presentation. Final visual recovery was good with no recurrence of infection. The cornea remained clear. Conclusions We report the first case of L. theobromae keratitis in Hong Kong, and it is the only case so far that involved the use of oral voriconazole in the combination therapy. Early recognition with the aid of confocal microscopy allowed the early start of treatment. The use of newer antifungal voriconazole topically and orally combined with topical amphotericin B appeared to be useful in the eradication of the fungus and prevention of recurrence. Intracameral antifungals might have improved the clinical management. PMID:27843433

  14. Trends of Bacterial Keratitis Culture Isolates in Jerusalem; a 13- Years Analysis

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    Politis, Michael; Wajnsztajn, Denise; Rosin, Boris; Block, Colin; Solomon, Abraham

    2016-01-01

    Purpose To describe the trends in pathogens and antibacterial resistance of corneal culture isolates in infectious keratitis during a period of 13 years at Hadassah-Hebrew University Medical Center. Methods A Retrospective analysis of bacterial corneal isolates was performed during the months of January 2002 to December 2014 at Hadassah Hebrew University Medical Center. Demographics, microbiological data and antibiotic resistance and sensitivity were collected. Results A total of 943 corneal isolates were analyzed during a 13 year period. A total of 415 positive bacterial cultures and 37 positive fungal cultures were recovered, representing 48% of the total cultures. The Annual incidence was 34.78 ± 6.54 cases. The most common isolate was coagulase-negative staphylococcus (32%), which had a significant decrease in trend throughout the study period (APC = -8.1, p = 0.002). Methicillin-resistant Staphylococcus aureus (MRSA) appears to have a decrease trend (APC = -31.2, P = 0.5). There was an increase in the resistance trend of coagulase-negative staphylococci to penicillin (APC = 5.0, P = keratitis. There was no significant change in the annual incidence of cases of bacterial keratitis seen over the past 13 years. Keratitis caused by MRSA appeared to decrease in contrast to the reported literature. PMID:27893743

  15. Allovahlkampfia spelaea Causing Keratitis in Humans

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    Tolba, Mohammed Essa Marghany; Huseein, Enas Abdelhameed Mahmoud; Farrag, Haiam Mohamed Mahmoud; Mohamed, Hanan El Deek; Kobayashi, Seiki; Suzuki, Jun; Ali, Tarek Ahmed Mohamed; Sugano, Sumio

    2016-01-01

    Background Free-living amoebae are present worldwide. They can survive in different environment causing human diseases in some instances. Acanthamoeba sp. is known for causing sight-threatening keratitis in humans. Free-living amoeba keratitis is more common in developing countries. Amoebae of family Vahlkampfiidae are rarely reported to cause such affections. A new genus, Allovahlkampfia spelaea was recently identified from caves with no data about pathogenicity in humans. We tried to identify the causative free-living amoeba in a case of keratitis in an Egyptian patient using morphological and molecular techniques. Methods Pathogenic amoebae were culture using monoxenic culture system. Identification through morphological features and 18S ribosomal RNA subunit DNA amplification and sequencing was done. Pathogenicity to laboratory rabbits and ability to produce keratitis were assessed experimentally. Results Allovahlkampfia spelaea was identified as a cause of human keratitis. Whole sequence of 18S ribosomal subunit DNA was sequenced and assembled. The Egyptian strain was closely related to SK1 strain isolated in Slovenia. The ability to induce keratitis was confirmed using animal model. Conclusions This the first time to report Allovahlkampfia spelaea as a human pathogen. Combining both molecular and morphological identification is critical to correctly diagnose amoebae causing keratitis in humans. Use of different pairs of primers and sequencing amplified DNA is needed to prevent misdiagnosis. PMID:27415799

  16. Allovahlkampfia spelaea Causing Keratitis in Humans.

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    Mohammed Essa Marghany Tolba

    2016-07-01

    Full Text Available Free-living amoebae are present worldwide. They can survive in different environment causing human diseases in some instances. Acanthamoeba sp. is known for causing sight-threatening keratitis in humans. Free-living amoeba keratitis is more common in developing countries. Amoebae of family Vahlkampfiidae are rarely reported to cause such affections. A new genus, Allovahlkampfia spelaea was recently identified from caves with no data about pathogenicity in humans. We tried to identify the causative free-living amoeba in a case of keratitis in an Egyptian patient using morphological and molecular techniques.Pathogenic amoebae were culture using monoxenic culture system. Identification through morphological features and 18S ribosomal RNA subunit DNA amplification and sequencing was done. Pathogenicity to laboratory rabbits and ability to produce keratitis were assessed experimentally.Allovahlkampfia spelaea was identified as a cause of human keratitis. Whole sequence of 18S ribosomal subunit DNA was sequenced and assembled. The Egyptian strain was closely related to SK1 strain isolated in Slovenia. The ability to induce keratitis was confirmed using animal model.This the first time to report Allovahlkampfia spelaea as a human pathogen. Combining both molecular and morphological identification is critical to correctly diagnose amoebae causing keratitis in humans. Use of different pairs of primers and sequencing amplified DNA is needed to prevent misdiagnosis.

  17. Epidemiological and Microbiological Diagnosis of Suppurative Keratitis in Gangetic West Bengal, Eastern India

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    Basak Samar

    2005-03-01

    Full Text Available PURPOSE: To determine the epidemiologcial pattern and risk factors involved in suppurative corneal ulceration in Gangetic West Bengal, eastern India, and to identify the specific microbial agents responsible for corneal infections. METHODS: All patients with suspected microbial keratitis presenting to the corneal clinic at Disha Eye Hospital, Barrackpore, West Bengal, India, from January 2001 to December 2003 were evaluated. Sociodemographic data and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping and cultures were performed. RESULTS: Over a three-year period, 1198 patients with suppurative keratitis were evaluated. Ocular trauma was the most common predisposing factor in 994 (82.9% patients (P< 0.0001, followed by use of topical corticosteroids in 231 (19.28% patients. Cultures were positive in 811 (67.7% patients. Among these culture positive cases, 509 (62.7% patients had pure fungal infections (P< 0.001, 184 (22.7% patients had pure bacterial infections and 114 (14.1% had mixed fungal with bacterial infections. Acanthamoeba was detected in 4 (0.49% patients. The most common fungal pathogen was Aspergillus spp representing 373 (59.8% of all positive fungal cultures (P< 0.0001, followed by Fusarium spp in 132 (21.2% instances. Most common bacterial isolate was Staphylococcus aureus, representing 127 (42.6% of all the bacterial culture (P< 0.0001 followed by Pseudomonas spp 63 (21.1%. CONCLUSION: Suppurative keratitis in Gangetic West Bengal, most often occurs after a superficial corneal trauma with vegetative or organic materials. Fungal ulcers are more common than bacterial ulcers. Aspergillus spp and Staphylococcus aureus were the most common fungus and bacteria respectively. These ′regional′ findings have important public health implications for the treatment and prevention of suppurative corneal ulceration in this region of India.

  18. Amniotic Membrane Transplantation in Herpetic Keratitis and Bacterial Keratitis

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    Elif Eraslan Yusufoğlu

    2013-08-01

    Full Text Available Purpose: To evaluate the effect of amniotic membrane transplantation (AMT in the treatment of corneal ulcers resulting from herpetic keratitis (HK and bacterial keratitis (BK. Material and Method: Forty-six patients (25 HK, 21 BK treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Results: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33 months and 10.2±6.8 (3-27 months, respectively. The ulcers were mostly central in HK (72% and paracentral in BK (52.4% (p=0.03. Ulcer depth was deeper than 1/2 of the cornea in 14 (56% HK and in 7 (33.3% BK (p=0.290. Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50 days in HK and 22.1±10.9 (8-45 days in BK (p=0.488. While epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic penetrating keratoplasty in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was more evident in BK cases (p=0.018 for HK and p<0.001 for BK. Discussion: Amniotic membrane transplantation is an effective and safe treatment for bacterial and herpetic corneal ulcers. The reason for the lower final visual acuities in the herpetic group was thought to be related to a more central location, deeper involvement and scars due to previous attacks.(Turk J Ophthalmol 2013; 43: 229-35

  19. Successful treatment of Fusarium keratitis after photo refractive keratectomy

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    Gian Maria Cavallini

    2013-01-01

    Full Text Available A 39-year-old woman presented to our hospital with a history of photorefractive keratectomy (PRK, performed two weeks prior; slit-lamp examination revealed diffuse conjunctival congestion, corneal ulcer and stromal infiltration. After 5 days of antifungal and antibacteric treatment, the infiltrate progressively increased so that a therapeutic penetrating keratoplasty was necessary. The microbiological analyses revealed the presence of fungal filaments. Twenty days after surgery the patient had recurrent fungal infiltrate in the donor cornea with wound dehiscence. We performed a second penetrating keratoplasty. With the matrix-assisted-laser-desorption-ionization-time-of-flight analysis (MALDI-TOF we identified a Fusarium solani.Intravenous amphothericine B, a combination of intracameral and intrastromal voriconazole and intracameral amphotericine B were administered. After 6 months from the last surgery the infection was eradicated. The management of fungal keratitis after PRK depends on many factors: In our experience, a prompt keratoplasty and the use of intracameral antifungal medication proved to be very effective.

  20. Polymyxin B and Trimethoprim Ophthalmic

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    ... and trimethoprim ophthalmic combination is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection ... follow these steps: Wash your hands thoroughly with soap and water. While tilting your head back, pull ...

  1. Fusarium sacchari, a cause of mycotic keratitis among sugarcane farmers - a series of four cases from North India.

    Science.gov (United States)

    Bansal, Yashik; Chander, Jagdish; Kaistha, Neelam; Singla, Nidhi; Sood, Sunandan; van Diepeningen, Anne D

    2016-11-01

    The two most common filamentous fungi causing mycotic keratitis are Aspergillus and Fusarium spp. Around 70 Fusarium spp. are involved in causing human infections. In this study, four cases of keratitis in sugarcane farmers in India are being reported, caused by the sugar cane pathogen Fusarium sacchari, a species of the Fusarium fujikuroi species complex. Fusarial keratitis was established by potassium hydroxide/Calcofluor white wet mounts and fungal culture of corneal scrapings on conventional media. Final identification was done by genetic sequencing at CBS-KNAW, Utrecht, The Netherlands. The antifungal susceptibility testing was done using broth microdilution method as per CLSI document M38-A2. Four cases of F. sacchari keratitis were identified. Three of them had trauma with sugarcane leaves, whereas one sugarcane farmer reported trauma by vegetative matter. The morphological similarities among various Fusarium species warrant use of molecular methods for identification of cryptic species. A wide distribution of sugarcane farming could be the possible explanation for emergence of F. sacchari keratitis in India. © 2016 Blackwell Verlag GmbH.

  2. Evaluation of loop-mediated isothermal amplification assay for rapid diagnosis of Acanthamoeba keratitis

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    Abhishek Mewara

    2017-01-01

    Full Text Available Background: The clinical features of Acanthamoeba keratitis (AK are non-specific and closely resemble bacterial, viral and fungal keratitis. Materials and Methods: We compared loop-mediated isothermal amplification (LAMP with microscopy, non-nutrient agar (NNA culture and polymerase chain reaction (PCR in clinical suspects of AK. Results: Of 52 clinical samples (42 AK suspects and 10 proven bacterial, viral or fungal keratitis, 3 were positive by direct microscopy (sensitivity 60%, confidence interval [CI]: 17%–92.7%, and 5 by NNA culture, 18S rDNA PCR and LAMP (sensitivity 100%, CI: 46.3%–100%. The limit of detection of Acanthamoeba DNA was 1 pg/μl by both LAMP and PCR. Conclusion: PCR and LAMP assays targeting 18S rDNA gene were found particularly suitable for a rapid and accurate diagnosis of AK. LAMP assay takes 2–3 h lesser than PCR, and thus offers a rapid, highly sensitive and specific, simple and affordable diagnostic modality for patients suspected of AK, especially in resource limited settings

  3. Keratitis caused by the recently described new species Aspergillus brasiliensis: two case reports

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    Vágvölgyi Csaba

    2010-02-01

    Full Text Available Abstract Introduction Human infections caused by Aspergillus brasiliensis have not yet been reported. We describe the first two known cases of fungal keratitis caused by Aspergillus brasiliensis. Case presentations A 49-year-old Indian Tamil woman agricultural worker came with pain and defective vision in the right eye for one month. Meanwhile, a 35-year-old Indian Tamil woman presented with a history of a corneal ulcer involving the left eye for 15 days. The fungal strains isolated from these two cases were originally suspected to belong to Aspergillus section Nigri based on macro- and micromorphological characteristics. Molecular identification revealed that both isolates represent A. brasiliensis. Conclusion The two A. brasiliensis strains examined in this study were part of six keratitis isolates from Aspergillus section Nigri, suggesting that this recently described species may be responsible for a significant proportion of corneal infections caused by black Aspergilli. The presented cases also indicate that significant differences may occur between the severities of keratitis caused by individual isolates of A. brasiliensis.

  4. Post intrastromal corneal ring segments insertion complicated by Candida parapsilosis keratitis

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    Mitchell, Bradley M; Kanellopoulos, A John; Font, Ramon L

    2013-01-01

    This case report describes the clinical and histopathologic features, including molecular confirmation, of fungal keratitis after intrastromal corneal ring segments placement for keratoconus. A 52-year-old woman underwent insertion of Intacs® corneal implants for treatment of keratoconus. Extrusion of the implants was noted 5 months post insertion and replaced. Three months later, monocular infiltrates and an epithelial defect were observed. The Intacs were removed and the infiltrates were treated with ofloxacin and prednisolone acetate. Microbial cultures and stains were negative. The patient demonstrated flares and exacerbation one month later. Mycoplasma and/or fungus were suspected and treated without improvement. Therapeutic keratoplasty was performed 10 months following initial placement of the corneal ring implants. The keratectomy specimen was analyzed by light microscopy and a panfungal polymerase chain reaction assay. A histopathologic diagnosis of Candida parapsilosis keratitis was made and confirmed by polymerase chain reaction. One year postoperatively, a systemic workup of the patient was done with no signs of recurrence. This rare report of fungal keratitis following Intacs insertion is the first reported case of C. parapsilosis complicating Intacs implantation. PMID:23467516

  5. Persistent corneal epithelial defect responding to rebamipide ophthalmic solution in a patient with diabetes

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    Hayashi Y

    2016-05-01

    Full Text Available Yusuke Hayashi, Hiroshi Toshida, Yusuke Matsuzaki, Asaki Matsui, Toshihiko Ohta Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan Objective: Rebamipide ophthalmic suspension was developed for the treatment of dry eyes and for other corneal diseases, promoting the secretion of both mucin in tear fluid and membrane-associated mucin, increasing the number of goblet cells, and restoring the barrier function of the corneal epithelium. We report a case of a persistent corneal epithelial defect in a patient with diabetes treated with topical application of rebamipide ophthalmic suspension. Case presentation: A 73-year-old woman had a history of type 2 diabetes for 35 years and nonproliferative diabetic retinopathy for 23 years. She presented to our department with discharge and ophthalmalgia in the left eye. A corneal ulcer was detected, and culture of corneal scrapings was performed, with Staphylococcus aureus and Streptococcus canis being isolated. The infection was treated with levofloxacin eye drops and ofloxacin ophthalmic ointment based on the sensitivity profile of the isolate. However, a corneal epithelial defect persisted for approximately 2 months despite continuing treatment with 0.1% hyaluronic acid ophthalmic suspension and 0.3% ofloxacin eye ointment. Her hemoglobin A1c was 7.3%. The persistent corneal epithelial defect showed improvement at 2 weeks after treatment with rebamipide unit dose 2% ophthalmic suspension, and it did not recur even when vitrectomy was subsequently performed for vitreous hemorrhage due to progression of diabetic retinopathy. Conclusion: This is the first report about efficacy of rebamipide unit dose 2% ophthalmic suspension for presenting persistent corneal epithelial defect in a patient with diabetes. In the present case, the suggested mechanisms are the following: improving the corneal barrier function, stabilization of mucin on the keratoconjunctival epithelium, and

  6. Acanthamoeba keratitis: report of three cases.

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    Maudgal, P C

    1989-01-01

    During the last year we diagnosed three patients to have Acanthamoeba keratitis. In one patient, who wore soft contact lenses, keratitis had developed after swimming in a contaminated heated swimming pool. Neither a history of trauma was present in two other patients nor did they wear contact lenses. Diagnosis of Acanthamoeba was established by Calcofluor White (cellufluor) staining of the scraped corneal material. Patients were treated with Flagyl (metronidazole) 0.5% eyedrops, Brolene (propamidine isethionate) 0.1% eyedrops, Neomycin eyedrops, topical corticosteroids (including sustain-release corticosteroid subconjunctival injections) and mydriatics. Keratitis in one patient healed within one month with full visual recovery, whereas the disease nearly ameliorated in the second patient. Corneal inflammation subsided markedly in the third patient with medical therapy, but a keratoplasty had to be performed because of a central opaque and ectatic cornea. This patient had already developed severe keratitis with necrosis of the cornea at the time of diagnosis.

  7. Successful salvage therapy of Fusarium endophthalmitis secondary to keratitis: an interventional case series

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    Comer GM

    2012-05-01

    Full Text Available Grant M Comer, Maxwell S Stem, Stephen J SaxeUniversity of Michigan, Department of Ophthalmology and Visual Sciences, Ann Arbor, MI, USAPurpose: To describe a combination of treatment modalities used for the successful eradication of Fusarium endophthalmitis.Design: Interventional case series.Participants: Three consecutive patients with keratitis-associated Fusarium endophthalmitis.Methods: After failure of traditional management options, a combination of intravitreal and long-term, high-dose systemic voriconazole, topical antifungal medications, and surgical intervention, with penetrating keratoplasty, lensectomy, and endoscopic-guided pars plana vitrectomy, was administered to each patient.Results: All three cases achieved full resolution of the infection, with a final Snellen visual acuity score of 20/50 to 20/70.Conclusions: An aggressive combination of therapeutic modalities, including the removal of subiris abscesses, might be needed for the successful resolution of Fusarium endophthalmitis.Keywords: endophthalmitis, fungal, Fusarium, keratitis, keratoplasty, voriconazole 

  8. Imported pythium insidiosum keratitis after a swim in Thailand by a contact lens-wearing traveler.

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    Lelievre, Lucie; Borderie, Vincent; Garcia-Hermoso, Dea; Brignier, Anne C; Sterkers, Margaret; Chaumeil, Christine; Lortholary, Olivier; Lanternier, Fanny

    2015-02-01

    A 30-year-old woman with a history of contact lens wear and exposure to swimming pool water in Thailand presented with a non-responsive, progressive corneal ulcer of the right eye. Confocal microscopy evidenced septate linear branching structures, raising suspicion of fungal keratitis. She was promptly treated with topical antibiotics and both topical and intravenous caspofungin plus voriconazole. Worsening of the clinical picture after 1 month of intensive medical therapy led to a large therapeutic penetrating keratoplasty being performed. Corneal cultures grew a mold-like organism, which was identified by sequencing as Pythium insidiosum, an aquatic oomycete. After 4 years of follow-up, the graft exhibits no infection relapse, but graft transparency has been lost after two rejection episodes. Keratoplasty combined with antifungal treatment may offer a cure to P. insidiosum keratitis, although long-term preservation of corneal transparency is difficult to obtain. © The American Society of Tropical Medicine and Hygiene.

  9. Acanthamoeba keratitis presenting as dendritic keratitis in a soft contact lens wearer.

    Science.gov (United States)

    Yeung, Edward Yip; Huang, Samuel Chao-Ming; Tsai, Ray Jui-Fang

    2002-03-01

    Acanthamoeba keratitis is a rare cause of corneal infection in Taiwan, which can result in devastating visual outcomes. A 37-year-old woman, who wore soft contact lenses, suffered from severe pain in her left eye. Biomicroscopy revealed dendritic keratitis, radial keratoneuritis, and fine keratic precipitates on her cornea. Culture, using non-nutrient agar plate seeded with Escherichia coli, resulted in heavy growth of Acanthamoeba. The inpatient treatment, including topical neomycin-polymyxin B and metronidazole (0.5%) eyedrops, oral ketoconazole, and then oral prednisolone, successfully controlled the corneal infection. The best-corrected visual acuity was 0.9 without any evidence of recurrence of infection after 21 months of follow up. Acanthamoeba keratitis can present as dendritic keratitis, which mimics herpes simplex infection, thus, delays appropriate treatment. Early diagnosis and judicious treatment are essential for restoring the vision and avoiding the subsequent need of penetrating keratoplasty.

  10. First cases of Acanthamoeba keratitis in Slovakia.

    Science.gov (United States)

    Ondriska, Frantisek; Mrva, Martin; Lichvár, Martin; Ziak, Peter; Murgasová, Zuzana; Nohýnková, Eva

    2004-01-01

    We present the case report of the first identification of Acanthamoeba as a causative agent of keratitis in the Slovak Republic. For the first time, Acanthamoeba sp. Group III was isolated from a 53-year-old patient with keratitis, which was manifested after an injury of the right eye. A delayed visit to a physician as well as a late diagnosis of the illness led to the advanced stage of eye disease. As the treatment with itraconazol and cornea transplantation showed no result, enucleation of the eye was decided. Acanthamoeba ludgunensis was also the causative agent of keratitis in a 39-year-old patient wearing contact lenses. His complaints occurred a month after bathing in a thermal swimming pool. The symptoms presented in the left eye were those of herpetic keratitis, and led to a cloudy cornea with circular infliltrate and poor vision. A prompt clinical and laboratory diagnosis, along with treatment with propamidine-isetionate resulted in a significant improvement of the eye condition. Contact lenses were probably related to another case of Acanthamoeba keratitis. The patient, a 15-year-old girl, kept wearing contact lenses during bathing in various swimming pools and in the sea; her contact lenses were also regularly washed under tap water. Due to the fact that cysts of Acanthamoeba sp. group II were found in the contact lens solution, this is presumed to be the source of the eye infection.

  11. Clinical and microbiological study of paediatric infectious keratitis in South India: a 3-year study (2011-2013).

    Science.gov (United States)

    Aruljyothi, Lokeshwari; Radhakrishnan, Naveen; Prajna, Venkatesh N; Lalitha, Prajna

    2016-12-01

    To study the risk factors, microbiological profile and clinical outcomes of infectious keratitis affecting paediatric patients. Retrospective case series. Review of case records of paediatric patients (0-16 years) diagnosed with infectious keratitis who presented to Aravind Eye Hospital, Madurai, India during January 2011 to December 2013. Demographic details, predisposing factors, microbiological investigations, clinical course and visual outcome were analysed. In this time period, 240 eyes of 234 children had a diagnosis of infectious keratitis. One hundred and twenty-five (53.4%) children had a history of trauma. Smears were obtained in 220 eyes, while culture was performed in 191 eyes. The culture results were positive in 142 (74.3%) eyes. Fungi was the most common infectious agent isolated in culture (54.2%) followed by bacteria (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical therapy occurred in 223 (92.9%) eyes, while 17 (7.1%) eyes required therapeutic keratoplasty. Of the 151 patients with preliminary and final visual acuity, vision improved by 2 lines in 68 eyes (45%), stayed the same in 75 eyes (49.6%) and worsened in 8 eyes (5.3%). Contrary to previous reports, fungi are the most common aetiological organism in the causation of infectious keratitis in children in our study population. Fusarium was the most common fungal species isolated. These data are similar to the data obtained from adult patients with infectious keratitis in this region. While microbiological investigations are important to initiate appropriate antimicrobial therapy, the findings from our study need to be kept in mind, especially while initiating empirical therapy in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Besifloxacin ophthalmic suspension, 0.6%: a novel topical fluoroquinolone for bacterial conjunctivitis.

    Science.gov (United States)

    O'Brien, Terrence P

    2012-06-01

    Acute bacterial conjunctivitis, the most common cause of conjunctivitis, is responsible for approximately 1% of all primary-care consultations. Of the topical ophthalmic antibiotics used to treat acute bacterial conjunctivitis, fluoroquinolones are especially useful because they possess a broad antibacterial spectrum, are bactericidal in action, are generally well tolerated, and have been less prone to development of bacterial resistance. Besifloxacin, the latest advanced fluoroquinolone approved for treating bacterial conjunctivitis, is the first fluoroquinolone developed specifically for topical ophthalmic use. It has a C-8 chlorine substituent and is known as a chloro-fluoroquinolone. Besifloxacin possesses relatively balanced dual-targeting activity against bacterial topoisomerase IV and DNA gyrase (topoisomerse II), two essential enzymes involved in bacterial DNA replication, leading to increased potency and decreased likelihood of bacterial resistance developing to besifloxacin. Microbiological data suggest a relatively high potency and rapid bactericidal activity for besifloxacin against common ocular pathogens, including bacteria resistant to other fluoroquinolones, especially resistant staphylococcal species. Randomized, double-masked, controlled clinical studies demonstrated the clinical efficacy of besifloxacin ophthalmic suspension 0.6% administered three-times daily for 5 days to be superior to the vehicle alone and similar to moxifloxacin ophthalmic solution 0.5% for bacterial conjunctivitis. In addition, besifloxacin ophthalmic suspension 0.6% administered two-times daily for 3 days was clinically more effective than the vehicle alone for bacterial conjunctivitis. Besifloxacin has also been shown in preclinical animal studies to be potentially effective for the "off-label" treatment of infections following ocular surgery, prophylaxis of endophthalmitis, and the treatment of bacterial keratitis. Taken together, clinical and preclinical animal studies

  13. In vitro susceptibility of filamentous fungi from mycotic keratitis to azole drugs.

    Science.gov (United States)

    Shobana, C S; Mythili, A; Homa, M; Galgóczy, L; Priya, R; Babu Singh, Y R; Panneerselvam, K; Vágvölgyi, C; Kredics, L; Narendran, V; Manikandan, P

    2015-03-01

    The in vitro antifungal activities of azole drugs viz., itraconazole, voriconazole, ketoconazole, econazole and clotrimazole were investigated in order to evaluate their efficacy against filamentous fungi isolated from mycotic keratitis. The specimen collection was carried out from fungal keratitis patients attending Aravind eye hospital and Post-graduate institute of ophthalmology, Coimbatore, India and was subsequently processed for the isolation of fungi. The dilutions of antifungal drugs were prepared in RPMI 1640 medium. Minimum inhibitory concentrations (MICs) were determined and MIC50 and MIC90 were calculated for each drug tested. A total of 60 fungal isolates were identified as Fusarium spp. (n=30), non-sporulating moulds (n=9), Aspergillus flavus (n=6), Bipolaris spp. (n=6), Exserohilum spp. (n=4), Curvularia spp. (n=3), Alternaria spp. (n=1) and Exophiala spp. (n=1). The MICs of ketoconazole, clotrimazole, voriconazole, econazole and itraconazole for all the fungal isolates ranged between 16 μg/mL and 0.03 μg/mL, 4 μg/mL and 0.015 μg/mL, 8 μg/mL and 0.015 μg/mL, 8 μg/mL and 0.015 μg/mL and 32 μg/mL and 0.06 μg/mL respectively. From the MIC50 and MIC90 values, it could be deciphered that in the present study, clotrimazole was more active against the test isolates at lower concentrations (0.12-5 μg/mL) when compared to other drugs tested. The results suggest that amongst the tested azole drugs, clotrimazole followed by voriconazole and econazole had lower MICs against moulds isolated from mycotic keratitis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Nosocomial keratitis caused by methicillin-resistant Staphylococcus aureus: case report and preventative measures

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    Puneet S. Braich

    2015-10-01

    Full Text Available A 47-year-old African-American woman was admitted to the intensive care unit of our community hospital for respiratory failure secondary to severe decompensated heart failure, requiring intubation. In the ensuing days, she developed a methicillin-resistant Staphylococcus aureus (MRSA infection of the cornea, despite no growth of MRSA in multiple blood, sputum, and urine cultures. This unexpected corneal infection complicated her hospital stay, and increased morbidity and disease-related cost. Risk factors, warning signs, and preventative measures for MRSA keratitis secondary to lagophthalmos (inability to completely close one's eyelids are outlined in this case report. Implementing simple precautions such as taping eyelids shut or using artificial lubrication may reduce patient morbidity and disease-related costs. These recommendations are directed to non-ophthalmic clinicians who provide care to patients in settings where MRSA colonization is widespread.

  15. Amoebic keratitis in Iran (1997-2007

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    F Rahimi

    2007-07-01

    Full Text Available Background: Amoebic keratitis introduced as a painful corneal infection which sometimes lead to poor vision and blind-ness. The main goal of this study was to report amoebic keratitis during ten years from 1997-2007 in patients who was sus-pected to have amoebic keratitis and referred to Parasitology laboratory, School of Public Health, Tehran Univer¬sity of Medical Sciences, Iran. Other aim was to assess the major risk factor for developing this sight-threatening disease. Comparison of lens culture and corneal scrapes culture also was performed. "nMethods: During 1997-2007, 142 patients referred to Dept. of Medical Parasitology, School of Public Health, Tehran Uni-versity of Medical Sciences, Iran. Details of each patient such as age, sex, history of contact lens wear, type of contact lens, clinical symptoms were recorded in questioners. Keratitis was diagnosed on the basis of culture of lenses and/or corneal scrapes on non-nutrient agar overlaid with Escherichia coli and direct microscopy of lenses and/or corneal scrapes. "nResults: Among 142 patients, 49 (34.5% had amoebic keratitis. 73.46% of these patients were from Tehran but there were a few cases from other cities. The commonest age was between 15-25 yr (75.5% and more female (37:12 were identified then male. It is worth to mention that 44 patients (89.79% were contact lens wearers who among them 41 patients (93.18% wore soft contact lens and only three patients suffer from amoebic keratitis because of wearing hard contact lens. Other finding of this study demonstrated that the most common sign of the patients was severe pain combined with photophobia. "nConclusion: This study indicates that Acanthamoeba keratitis continue to rise in Iran. This is due to increase frequency of lens wearers as well as consideration of ophthalmologist to Acanthamoeba as an agent of keratitis and improvement of labo¬ratory methods. Another finding of this research was the confirmation of soft contact lens

  16. Ophthalmic Disorders in Adults with Down Syndrome

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    Sharon J. Krinsky-McHale

    2012-01-01

    Full Text Available A myriad of ophthalmic disorders is associated with the phenotype of Down syndrome including strabismus, cataracts, and refractive errors potentially resulting in significant visual impairment. Ophthalmic sequelae have been extensively studied in children and adolescents with Down syndrome but less often in older adults. In-depth review of medical records of older adults with Down syndrome indicated that ophthalmic disorders were common. Cataracts were the most frequent ophthalmic disorder reported, followed by refractive errors, strabismus, and presbyopia. Severity of intellectual disability was unrelated to the presence of ophthalmic disorders. Also, ophthalmic disorders were associated with lower vision-dependent functional and cognitive abilities, although not to the extent that was expected. The high prevalence of ophthalmic disorders highlights the need for periodic evaluations and individualized treatment plans for adults with Down syndrome, in general, but especially when concerns are identified.

  17. Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole

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    Mohd-Tahir Fadzillah

    2013-01-01

    Full Text Available Aim. To report a case of refractory fungal keratitis caused by Scedosporium apiospermum. Methods. Interventional case report. Results. A 47-year-old Malay housewife presented with left eye cornea ulcer as her first presentation of diabetes mellitus. There was no history of ocular trauma, contact lens used, or cornea foreign body. Scedosporium apiospermum was isolated from the cornea scrapping. Her cornea ulcer initially responded well to topical Amphotericin B within 3 days but subsequently worsened. Repeat cornea scrapping also yields Scedosporium apiospermum. This refractory keratitis was successfully treated with a combination of topical Amphotericin B and Voriconazole over 6 weeks. Conclusion. Scedosporium apiospermum keratitis is an opportunistic infection, which is difficult to treat despite tight control of diabetes mellitus and intensive antifungal treatment. The infection appeared to have very quick onset but needed long duration of treatment to completely heal. Surgical debridement always plays an important role as a therapeutic procedure as well as establishes the diagnosis through repeat scrapping.

  18. Multiphoton microscopy for imaging infectious keratitis: demonstration of the pattern of microbial spread in an experimental model

    Science.gov (United States)

    Sun, Yen; Lo, Wen; Wu, Ruei-Jhih; Lin, Sung-Jan; Lin, Wei-Chou; Jee, Shiou-Hwa; Tan, Hsin-Yuan; Dong, Chen-Yuan

    2006-02-01

    The purpose of this study is to assess the application of multiphoton fluorescence and second harmonic generation (SHG) microscopy for imaging and monitoring the disease progress of infectious keratitis in an experimental model, and to investigate the possible correlation of tissue architecture with spreading patterns of pathogens in an experimental model. Porcine eyes are to be obtained from slaughter house and processed and placed in organ culture system. Fungal infections by common pathogens of infectious keratitis are to be induced in porcine cornea buttons. Multiphoton fluorescence and SHG microscopy will be used for imaging and for monitoring the progression and extension of tissue destruction and possibly the pattern of pathogen spreading. We found that SHG imaging is useful in identifying alterations to collagen architecture while autofluorescence microscopy can be used to visualize the fungi and cells within the stroma. In summary, multiphoton fluorescence and second harmonic generation microscopy can non-invasively demonstrate and monitor tissue destruction associated with infectious keratitis. The pattern of pathogen spreading and its correlation with the tissue architecture can also be shown, which can be useful for future studies of the tissue-microbial interactions for infectious keratitis.

  19. Fungal arthritis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000444.htm Fungal arthritis To use the sharing features on this page, please enable JavaScript. Fungal arthritis is swelling and irritation (inflammation) of a joint ...

  20. Fungal Meningitis

    Science.gov (United States)

    ... Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis Fungal Meningitis Language: English Español (Spanish) Recommend on Facebook Tweet ... the brain or spinal cord. Investigation of Fungal Meningitis, 2012 In September 2012, the Centers for Disease ...

  1. Achromobacter xylosoxidans keratitis after contact lens usage.

    Science.gov (United States)

    Park, Jung Hyun; Song, Nang Hee; Koh, Jae Woong

    2012-02-01

    To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.

  2. A case of trauma related Acanthamoeba keratitis.

    Science.gov (United States)

    Kamel, A G M; Faridah, H; Yusof, S; Norazah, A; Nakisah, M A

    2004-12-01

    Acanthamoeba is an uncommon cause of keratitis but one of the most severe because of the prolonged and painful course of the disease and poor visual outcome. Although contact lens use is the principal risk factor, about 10% of cases occur following trauma and exposure to contaminated soil or water. Two cases of Acanthamoeba keratitis involving women contact lens wearers have previously been reported in Malaysia but this is the first time, a non contact lens related Acanthamoeba keratitis is reported. The case involved a 28 year old Indonesian male construction worker who had a trauma of the right eye during work. His eye was struck by sand and dust particles after which he quickly washed with water from an open tank at the construction site. He experienced pain, redness, glaring and blurring of vision of the right eye three days later. The diagnosis was missed at initial presentation but culture of the corneal scraping had proven Acanthamoeba as the aetiological agent. The history and clinical findings of this trauma related Acanthamoeba keratitis are briefly discussed.

  3. Targeting Herpetic Keratitis by Gene Therapy

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    Hossein Mostafa Elbadawy

    2012-01-01

    Full Text Available Ocular gene therapy is rapidly becoming a reality. By November 2012, approximately 28 clinical trials were approved to assess novel gene therapy agents. Viral infections such as herpetic keratitis caused by herpes simplex virus 1 (HSV-1 can cause serious complications that may lead to blindness. Recurrence of the disease is likely and cornea transplantation, therefore, might not be the ideal therapeutic solution. This paper will focus on the current situation of ocular gene therapy research against herpetic keratitis, including the use of viral and nonviral vectors, routes of delivery of therapeutic genes, new techniques, and key research strategies. Whereas the correction of inherited diseases was the initial goal of the field of gene therapy, here we discuss transgene expression, gene replacement, silencing, or clipping. Gene therapy of herpetic keratitis previously reported in the literature is screened emphasizing candidate gene therapy targets. Commonly adopted strategies are discussed to assess the relative advantages of the protective therapy using antiviral drugs and the common gene therapy against long-term HSV-1 ocular infections signs, inflammation and neovascularization. Successful gene therapy can provide innovative physiological and pharmaceutical solutions against herpetic keratitis.

  4. Standardization of the Diagnosis and Treatment in Infectious Keratitis%感染性角膜炎的规范化诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    刘群义

    2015-01-01

    Objective To study the standardization of diagnosis and treatment of infectious keratitis.Methods The hospital treated 82 patients with infectious keratitis,standardization of diagnosis and treatment,observation of diagnosis and treatment of the results.Results 82 cases of patients with infectious keratitis,viral keratitis in 47 cases,bacterial keratitis 29 cases,6 cases of fungal keratitis. After symptomatic treatment,77 patients were improved,5 cases patients was invalid.ConclusionThe clinical treatment of infectious keratitis patients,through the standardization of diagnosis,symptomatic treatment can improve therapeutic effect.%目的:探讨感染性角膜炎的规范化诊断及治疗。方法选择医院收治的感染性角膜炎患者82例,给予规范化诊断及治疗,观察诊断及治疗结果。结果82例感染性角膜炎患者中,病毒性角膜炎47例,细菌性角膜炎29例,真菌性角膜炎6例。经过对症治疗后,77例患者好转出院,5例患者治疗无效。结论临床治疗感染性角膜炎患者时,通过规范化诊断,给予对症治疗,提升治疗效果。

  5. Human Microbiota and Ophthalmic Disease.

    Science.gov (United States)

    Lu, Louise J; Liu, Ji

    2016-09-01

    The human ocular surface, consisting of the cornea and conjunctiva, is colonized by an expansive, diverse microbial community. Molecular-based methods, such as 16S rRNA sequencing, has allowed for more comprehensive and precise identification of the species composition of the ocular surface microbiota compared to traditional culture-based methods. Evidence suggests that the normal microbiota plays a protective immunological role in preventing the proliferation of pathogenic species and thus, alterations in the homeostatic microbiome may be linked to ophthalmic pathologies. Further investigation of the ocular surface microbiome, as well as the microbiome of other areas of the body such as the oral mucosa and gut, and their role in the pathophysiology of diseases is a significant, emerging field of research, and may someday enable the development of novel probiotic approaches for the treatment and prevention of ophthalmic diseases.

  6. Fine needle aspiration biopsy of ophthalmic tumors☆

    Science.gov (United States)

    Singh, Arun D.; Biscotti, Charles V.

    2012-01-01

    A majority of intraocular tumors can be diagnosed based on clinical examination and ocular imaging studies, which obviate the need for diagnostic ophthalmic fine needle aspiration biopsy (FNAB). Overall, diagnostic accuracy of ophthalmic FNAB is high but limited cellularity can compromise the diagnostic potential of ophthalmic aspirate samples. The role of ophthalmic FNAB is limited in retinal tumors. Orbital FNAB should be considered in the evaluation of lacrimal gland tumors, orbital metastasis, and lymphoproliferative lesions. Negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. With improved understanding of genetic prognostic factors of uveal melanoma, ophthalmic FNAB is gaining popularity for prognostic purposes in combination with eye conserving treatment of the primary tumor. In special clinical indications, ancillary studies such as immunohistochemistry and FISH can be performed on ophthalmic FNAB samples. Assistance of an experienced cytopathologist cannot be overemphasized. PMID:23960981

  7. Molecular characterization of drug-resistant and drug-sensitive Aspergillus isolates causing infectious keratitis

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    Niranjan Nayak

    2011-01-01

    Full Text Available Purpose: To study the susceptibilities of Aspergillus species against amphotericin B in infectious keratitis and to find out if drug resistance had any association with the molecular characteristics of the fungi. Materials and Methods: One hundred and sixty Aspergillus isolates from the corneal scrapings of patients with keratitis were tested for susceptibilities to amphotericin B by broth microdilution method. These included Aspergillus flavus (64 isolates, A. fumigatus (43 and A. niger (53. Fungal DNA was extracted by glass bead vertexing technique. Polymerase chain reaction (PCR assay was standardized and used to amplify the 28S rRNA gene. Single-stranded conformational polymorphism (SSCP of the PCR product was performed by the standard protocol. Results: Of the 160 isolates, 84 (52.5% showed low minimum inhibitory concentration (MIC values (≤ 1.56 μg/ml and were designated as amphotercin B-sensitive. Similarly, 76 (47.5% had high MICs (≥ 3.12 μg/ml and were categorized as amphotericin B-resistant. MIC 50 and MIC 90 values ranged between 3.12-6.25 μg/ml and 3.12-12.5 μg/ml respectively. A. flavus and A. niger showed higher MIC 50 and MIC 90 values than A. fumigatus. The SSCP pattern exhibited three extra bands (150 bp, 200 bp and 250 bp each in addition to the 260 bp amplicon. Strains (lanes 1 and 7 lacking the 150 bp band showed low MIC values (≤ 1.56 μg/ml. Conclusion: A. niger and A. flavus isolates had higher MICs compared to A. fumigatus, suggesting a high index of suspicion for amphotericin B resistance. PCR-SSCP was a good molecular tool to characterize Aspergillus phenotypes in fungal keratitis.

  8. Aetiological diagnosis of microbial keratitis in South India - A study of 1618 cases

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    Bharathi M

    2002-01-01

    Full Text Available PURPOSE: To identify the specific microbial pathogens responsible for corneal ulceration in South India and compare these profiles with other series. METHODS: All patients with infectious keratitis who presented between 20th September 1999 and 31st March 2001 were evaluated. They were examined by slit-lamp biomicroscopy and corneal scrapings were performed for cultures and smears by using standard protocols. RESULTS: In the 18 months period, 1618 patients with corneal ulcerations were evaluated. Corneal cultures were found to be positive in 1126(69.59% patients. Of the 1618 patients, 566(34.98% had bacterial growth, 522(32.26% had fungal growth, 30(1.85% had mixed bacterial and fungal growth, 8(0.49% had Acanthamoeba species growth and the remaining 492(30.41% were found to be culture negative. The predominant bacterial pathogen isolated was Streptococcus pneumoniae representing 41.85%, followed by Pseudomonas aeruginosa 21.25%. The predominant fungal pathogens isolated were Fusarium species (45.85% followed by Aspergillus species (24.37%. CONCLUSIONS: Bacterial and fungal infections occurred almost with equal frequency, the predominant bacterial and fungal species isolated being Streptococcus pneumoniae and Fusarium species respectively. The findings of our study show that there is a region wise variation in the predominance of corneal pathogens. This has an important public health implication for the initiation of therapy.

  9. Ophthalmic lymphoma: epidemiology and pathogenesis.

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    Sjö, Lene Dissing

    2009-02-01

    With a lifetime risk of 1% and 700 new cases per year, Non-Hodgkin lymphoma (NHL) is the seventh most frequent type of cancer in Denmark. The incidence of NHL has increased considerably in Western countries over the last decades; consequently, NHL is an increasing clinical problem. Ophthalmic lymphoma, (lymphoma localized in the ocular region, i.e. eyelid, conjunctiva, lacrimal sac, lacrimal gland, orbit, or intraocularly) is relatively uncommon, accounting for 5%-10% of all extranodal lymphomas. It is, however, the most common orbital malignancy. The purpose of this thesis was to review specimens from all Danish patients with a diagnosis of ophthalmic lymphoma during the period 1980-2005, in order to determine the distribution of lymphoma subtypes, and the incidence- and time trends in incidence for ophthalmic lymphoma. Furthermore, an extended analysis of the most frequent subtype, extranodal marginal zone lymphoma (MALT lymphoma), was done to analyse clinical factors and cytogenetic changes with influence on prognosis. A total of 228 Danish patients with a biopsy-reviewed verified diagnosis of ocular adnexal-, orbital-, or intraocular lymphoma were identified. We found that more than 50% of orbital- and ocular adnexal lymphomas were of the MALT lymphoma subtype, whereas diffuse large B-cell lymphoma (DLBCL) predominated intraocularly (Sjo et al. 2008a). Furthermore, lymphoma arising in the lacrimal sac was surprisingly predominantly DLBCL (Sjo et al. 2006). Incidence rates were highly dependent on patient age. There was an increase in incidence rates for the whole population from 1980 to 2005, corresponding to an annual average increase of 3.4% (Sjo et al. 2008a). MALT lymphoma arising in the ocular region was found in 116 patients (Sjo et al. 2008b). One third of patients had a relapse or progression of disease after initial therapy and relapses were frequently found at extra-ocular sites. Overall survival, however, was not significantly poorer for patients

  10. Bilateral herpetic keratitis presenting with unilateral neurotrophic keratitis in pemphigus foliaceus: a case report

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    Yang Hee K

    2011-07-01

    Full Text Available Abstract Introduction We report a case of bilateral herpetic keratitis developing after rapid oral corticosteroid tapering in a patient with pemphigus foliaceus, which was followed by unilateral neurotrophic keratitis that was treated with amniotic membrane transplantation. Case presentation A 71-year-old Korean man developed bilateral herpetic keratitis one week after rapid tapering of systemic corticosteroid. He had been on high-dose oral corticosteroid and azathioprine therapy for six months for treatment of pemphigus foliaceus. Topical acyclovir ointment was prescribed. A week later, our patient's right eye had healed, but his left eye showed increased stromal edema with enlarged epithelial defects. He was prescribed oral acyclovir with topical broad-spectrum antibiotics applied to his left eye. The stromal edema cleared within a week but the epithelial defect remained unchanged. An amniotic membrane transplantation was performed on our patient's left eye, and his epithelial defect had totally healed three weeks later. Conclusions Patients with autoimmune disease or who are on immunosuppressive therapy have a higher chance of developing bilateral herpetic keratitis. Although rare, the condition may be followed by unilateral neurotrophic keratitis. Rapid corticosteroid tapering may act as a triggering factor for viral infection or reactivation of herpes.

  11. Burden of fungal infections in Senegal.

    Science.gov (United States)

    Badiane, Aida S; Ndiaye, Daouda; Denning, David W

    2015-10-01

    Senegal has a high rate of tuberculosis and a low HIV seropositivity rate and aspergilloma, life-threatening fungal infections, dermatophytosis and mycetoma have been reported in this study. All published epidemiology papers reporting fungal infection rates from Senegal were identified. Where no data existed, we used specific populations at risk and fungal infection frequencies in each to estimate national incidence or prevalence. The results show that tinea capitis is common being found in 25% of children, ~1.5 million. About 191,000 Senegalese women get recurrent vaginal thrush, ≥4 times annually. We estimate 685 incident cases of chronic pulmonary aspergillosis (CPA) following TB and prevalence of 2160 cases. Asthma prevalence in adults varies from 3.2% to 8.2% (mean 5%); 9976 adults have allergic bronchopulmonary aspergillosis (ABPA) and 13,168 have severe asthma with fungal sensitisation (SAFS). Of the 59,000 estimated HIV-positive patients, 366 develop cryptococcal meningitis; 1149 develop Pneumocystis pneumonia and 1946 develop oesophageal candidiasis, in which oral candidiasis (53%) and dermatophytosis (16%) are common. Since 2008-2010, 113 cases of mycetoma were diagnosed. In conclusion, we estimate that 1,743,507 (12.5%) people in Senegal suffer from a fungal infection, excluding oral candidiasis, fungal keratitis, invasive candidiasis or aspergillosis. Diagnostic and treatment deficiencies should be rectified to allow epidemiological studies.

  12. Persistence of acanthamoeba antigen following acanthamoeba keratitis

    OpenAIRE

    Yang, Y; Matheson, M; Dart, J; Cree, I.

    2001-01-01

    AIM—To investigate the hypothesis that persistent corneal and scleral inflammation following acanthamoeba keratitis is not always caused by active amoebic infection but can be due to persisting acanthamoebic antigens
METHODS—24 lamellar corneal biopsy and penetrating keratoplasty specimens were obtained from 14 consecutive patients at various stages of their disease and divided for microscopy and culture. Histological sections were immunostained and screened for the presence of Acanthamoeba c...

  13. Eosinofil keratitis hos en dansk hest

    DEFF Research Database (Denmark)

    Olsen, Emil; Henriksen, Michala de Linde; Andersen, Pia Haubro

    2009-01-01

    Eosinofil keratitis (EK) er en relativt sjælden øjenlidelse hos hest, som især ses i tempererede områder. Klinisk er lidelsen karakteriseret ved én eller multiple corneaulcerationer dækket med hvidt eller gelatinøst proliferativt subepithelialt plaque. Denne casereport, som omhandler en 20-årig p...

  14. Contact lens-related acanthamoeba keratitis.

    Science.gov (United States)

    Stapleton, Fiona; Ozkan, Jerome; Jalbert, Isabelle; Holden, Brien A; Petsoglou, Con; McClellan, Kathy

    2009-10-01

    Acanthamoeba keratitis is a rare but severe disease, with more than 95% of cases occurring in contact lens wearers. With a worldwide resurgence of contact lens-related disease, this report illustrates the clinical characteristics and treatment challenges representative of this disease. This report describes Acanthamoeba keratitis in a 47-year-old female using extended wear silicone hydrogel contact lenses, with a history of swimming in a home pool and failure to subsequently disinfect the contact lenses. The diagnosis was based on clinical signs, disease course, and confocal microscopy results despite a negative result for corneal smear and culture. The corneal signs included an epithelial defect, epithelial irregularities, anterior stromal infiltrates, perineural infiltrates, an anterior stromal ring infiltrate, and hypopyon. The case was diagnosed as an infective keratitis and treated promptly using intensive topical administration of fortified gentamicin and cephalothin. The high likelihood Acanthamoeba prompted immediate use of polyhexamethylbiguanide and chlorhexidine, with propamide and adjunct treatment using atropine and oral diclofenac. Steroids were added on day 3, and the frequency of administration of antibacterial treatment was gradually reduced and ceased by day 10. The analgesia was stopped at 3 months. The frequency of administration of antiamoeba therapy and steroid treatment was slowly reduced and all treatment was ceased after 18 months. Despite considerable morbidity in terms of the treatment duration, hospitalization, outpatient appointments, and associated disease costs, the final visual outcome (6/6) was excellent.

  15. Pattern recognition receptors in microbial keratitis.

    Science.gov (United States)

    Taube, M-A; del Mar Cendra, M; Elsahn, A; Christodoulides, M; Hossain, P

    2015-11-01

    Microbial keratitis is a significant cause of global visual impairment and blindness. Corneal infection can be caused by a wide variety of pathogens, each of which exhibits a range of mechanisms by which the immune system is activated. The complexity of the immune response to corneal infection is only now beginning to be elucidated. Crucial to the cornea's defences are the pattern-recognition receptors: Toll-like and Nod-like receptors and the subsequent activation of inflammatory pathways. These inflammatory pathways include the inflammasome and can lead to significant tissue destruction and corneal damage, with the potential for resultant blindness. Understanding the immune mechanisms behind this tissue destruction may enable improved identification of therapeutic targets to aid development of more specific therapies for reducing corneal damage in infectious keratitis. This review summarises current knowledge of pattern-recognition receptors and their downstream pathways in response to the major keratitis-causing organisms and alludes to potential therapeutic approaches that could alleviate corneal blindness.

  16. Alternative methods of ophthalmic treatment in Russia.

    Science.gov (United States)

    Vader, L

    1994-04-01

    Russian ophthalmic nurses and physicians are using alternative methods of treatment to supplement traditional eye care. As acupuncture and iridology become more popular in the United States, ophthalmic nurses need to be more knowledgeable about these treatments and the implications for patients.

  17. Effects of ophthalmic disease on concentrations of plasma fibrinogen and serum amyloid A in the horse.

    Science.gov (United States)

    Labelle, A L; Hamor, R E; Macneill, A L; Lascola, K M; Breaux, C B; Tolar, E L

    2011-07-01

    There is little scientific information available about the ability of ocular disease to cause a systemic inflammatory response. Horses are frequently affected with ocular disease and ensuring their systemic health prior to performing vision saving surgery under anaesthesia is essential for the successful treatment of ophthalmic disease. Ocular disease will cause elevations in the concentration of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. Whole blood and serum samples were obtained from 38 mature horses with ulcerative keratitis or uveitis and no evidence of systemic disease, 9 mature horses with no evidence of ocular or systemic disease (negative controls) and 10 mature horses with systemic inflammatory disease and no evidence of ocular disease (positive controls). Blood samples were assayed for concentrations of the acute phase proteins fibrinogen and serum amyloid A. Fibrinogen and serum amyloid A were significantly different in the positive control group compared to the negative control, corneal disease and uveitis groups (P<0.126). There was no significant difference between the negative control, corneal disease and uveitis groups (P<0.001). Ulcerative keratitis and anterior uveitis are not associated with elevated concentrations of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. When the clinician is presented with a patient with ocular disease and elevated plasma fibrinogen or serum amyloid A concentrations, a nonocular inflammatory focus should be suspected. © 2011 EVJ Ltd.

  18. An Insight into Ophthalmic Drug Delivery System

    Directory of Open Access Journals (Sweden)

    Rathore K. S.

    2009-04-01

    Full Text Available Promising management of eye ailments take off effective concentration of drug at the eye for sufficient period of time. Dosage forms are administered directly to eye for localized ophthalmic therapy. Most of the treatments call for the topical administration of ophthalmic active drugs to the tissues around the ocular cavity. Conventional ophthalmic drug delivery systems including eye drops, ophthalmic ointments, are no longer sufficient to encounter eye diseases. This article reviews the constraints with conventional ocular therapy and explores various novel approaches like in-situ gel, ocular films or ocuserts, nanosuspension, collagen shields, latex systems, nanoparticles, liposomes, niosomes, iontophorosis, eye implants, etc to improve the ophthalmic bioavailability of drugs to the anterior chamber of the eye.

  19. Recurrence of bilateral herpes simplex virus keratitis following bimatoprost use

    Directory of Open Access Journals (Sweden)

    Kothari Mihir

    2006-01-01

    Full Text Available A 76-year-old man presented with features of bilateral herpes simplex virus (HSV keratitis. It was found to be recurrence of bilateral HSV keratitis following the use of Bimatoprost eye drops for uncontrolled intraocular pressure in a case of bilateral primary open-angle glaucoma.

  20. The use of antimicrobial peptides in ophthalmology: an experimental study in corneal preservation and the management of bacterial keratitis.

    Science.gov (United States)

    Mannis, Mark J

    2002-01-01

    Bacterial keratitis is an ocular infection with the potential to cause significant visual impairment. Increasing patterns of antibiotic resistance have necessitated the development of new antimicrobial agents for use in bacterial keratitis and other serious ocular infections. With a view to exploring the use of novel antimicrobial peptides in the management of ocular infection, we performed a series of experiments using synthetic antimicrobial peptides designed for the eradication of common and serious ophthalmic pathogens. Experiments were performed with three clinical ocular isolates--Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis--in three experimental settings: (1) in vitro in a controlled system of 10 mM sodium phosphate buffer, (2) in vitro in modified chondroitin sulfate-based corneal preservation media (Optisol), and (3) in an in vivo animal model (rabbit) simulating bacterial keratitis. In all cases, outcomes were measured by quantitative microbiological techniques. The candidate peptides (CCI A, B, and C and COL-1) produced a total reduction of the test pathogens in phosphate buffered saline. In modified Optisol, the peptides were effective against S epidermidis at all temperatures, demonstrated augmented activity at 23 degrees C against the gram-positive organisms, but were ineffective against P aeruginosa. The addition of EDTA to the medium augmented the killing of P aeruginosa but made no difference in the reduction of gram-positive organisms. In an in vivo rabbit model of Pseudomonas keratitis, COL-1 demonstrated neither clinical nor microbicidal efficacy and appeared to have a very narrow dosage range, outside of which it appeared to be toxic to the ocular surface. Our data indicate that the antimicrobial peptides we tested were effective in vitro but not in vivo. In an age of increasing antibiotic resistance, antimicrobial peptides, developed over millions of years as innate defense mechanisms by plants and animals

  1. Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study

    Directory of Open Access Journals (Sweden)

    Varsha Tukaram Kalshetti

    2015-09-01

    Full Text Available Objective: Corneal blindness is a major public health problem worldwide and mycotic keratitis is one of the predominant causes. Infection is difficult to treat and can lead to severe visual impairment or blindness. It is worldwide in distribution but is more common in tropics and subtropical region. Trauma is the major predisposing factor, followed by ocular or systemic defects, prior application of corticosteroids, and prolonged use of antibiotic eye drops. The purpose of this study was to document the clinical and epidemiological features and laboratory diagnosis of fungal corneal ulcer. Methods:Patients who presented with clinically suspected orneal ulcer to ophthalmology department registered for the study. Data were collected through history and slit lamp examination. Corneal scrapping was performed. A portion of each scrapping was examined by direct microscopy. Another portion was inoculated directly on to solid culture media. Results: This study included 40 subjects with corneal ulcer based on clinical suspicion, of whom 14 cases were diagnosed with mycotic keratitis in the laboratory. Among these 14 cases, culture showed fungal growth only in 12 cases where the remaining cases were positive only by Potassium hydroxide (KOH preparation. Males were more commonly affected and were mostly in the age group of 21 to 50 years. Aspergillus species and Fusarium species were the major isolates. Conclusion: Rapid diagnosis and early institution of anti-fungal therapy is necessary to prevent ocular morbidity and blindness. The direct microscopy method by KOH is rapid, inexpensive and reliable method and culture helps in definite diagnosis and identification. J Microbiol Infect Dis 2015;5(3: 99-102

  2. 21 CFR 886.4350 - Manual ophthalmic surgical instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4350 Manual ophthalmic surgical instrument. (a) Identification. A manual ophthalmic surgical instrument is a nonpowered, handheld...

  3. 21 CFR 886.5800 - Ophthalmic bar reader.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic bar reader. 886.5800 Section 886.5800...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5800 Ophthalmic bar reader. (a) Identification. An ophthalmic bar reader is a device that consists of a magnifying lens intended for use by a...

  4. 21 CFR 886.5810 - Ophthalmic prism reader.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...

  5. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to...

  6. 21 CFR 886.1860 - Ophthalmic instrument stand.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic instrument stand. 886.1860 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1860 Ophthalmic instrument stand. (a) Identification. An ophthalmic instrument stand is an AC-powered or nonpowered device intended to store...

  7. Management and treatment of contact lens-related Pseudomonas keratitis

    Directory of Open Access Journals (Sweden)

    Willcox MD

    2012-06-01

    Full Text Available Mark DP WillcoxSchool of Optometry and Vision Science, University of New South Wales, Sydney, AustraliaAbstract: Pubmed and Medline were searched for articles referring to Pseudomonas keratitis between the years 2007 and 2012 to obtain an overview of the current state of this disease. Keyword searches used the terms "Pseudomonas" + "Keratitis" limit to "2007–2012", and ["Ulcerative" or "Microbial"] + "Keratitis" + "Contact lenses" limit to "2007–2012". These articles were then reviewed for information on the percentage of microbial keratitis cases associated with contact lens wear, the frequency of Pseudomonas sp. as a causative agent of microbial keratitis around the world, the most common therapies to treat Pseudomonas keratitis, and the sensitivity of isolates of Pseudomonas to commonly prescribed antibiotics. The percentage of microbial keratitis associated with contact lens wear ranged from 0% in a study from Nepal to 54.5% from Japan. These differences may be due in part to different frequencies of contact lens wear. The frequency of Pseudomonas sp. as a causative agent of keratitis ranged from 1% in Japan to over 50% in studies from India, Malaysia, and Thailand. The most commonly reported agents used to treat Pseudomonas keratitis were either aminoglycoside (usually gentamicin fortified with a cephalosporin, or monotherapy with a fluoroquinolone (usually ciprofloxacin. In most geographical areas, most strains of Pseudomonas sp. (≥95% were sensitive to ciprofloxacin, but reports from India, Nigeria, and Thailand reported sensitivity to this antibiotic and similar fluoroquinolones of between 76% and 90%.Keywords: Pseudomonas, keratitis, contact lens

  8. Fungal rhinosinusitis.

    Science.gov (United States)

    Netkovski, J; Shirgoska, B

    2012-01-01

    Fungi are a major part of the ecosystem. In fact, over 250 fungal species have been reported to produce human infections. More than ever, fungal diseases have emerged as major challenges for physicians and clinical microbiologists. The aim of this study was to summarize the diagnostic procedures and endoscopic surgical treatment of patients with fungal rhinosinusitis. Eleven patients, i.e. 10% of all cases with chronic inflammation of paranasal sinuses, were diagnosed with fungal rhinosinusitis. Ten of them were patients with a noninvasive form, fungus ball, while only one patient was classified in the group of chronic invasive fungal rhinosinusitis which was accompanied with diabetes mellitus. All patients underwent nasal endoscopic examination, skin allergy test and had preoperative computed tomography (CT) scans of the sinuses in axial and coronal plane. Functional endoscopic sinus surgery was performed in 10 patients with fungus ball, while a combined approach, endoscopic and external, was done in the immunocompromised patient with the chronic invasive form of fungal rhinosinusitis. Most cases (9/11) had unilateral infection. In 9 cases infection was restricted to a single sinus, and here the maxillary sinus was most commonly affected (8/9) with infections in other patients being restricted to the sphenoid sinus (1/9). Two patients had infections affecting two or more sinuses. In patients with an invasive form of the fungal disease there was involvement of the periorbital and orbital tissues. In patients with fungus ball the mycelia masses were completely removed from the sinus cavities. Long-term outcome was positive in all the operated patients and no recurrence was detected. The most frequent fungal agent that caused rhinosinusitis was Aspergillus. Mucor was identified in the patient with the invasive form. Endoscopic examination of the nasal cavity and CT scanning of paranasal sinuses followed by endoscopic sinus surgery were represented as valuable

  9. Big data and ophthalmic research.

    Science.gov (United States)

    Clark, Antony; Ng, Jonathon Q; Morlet, Nigel; Semmens, James B

    2016-01-01

    Large population-based health administrative databases, clinical registries, and data linkage systems are a rapidly expanding resource for health research. Ophthalmic research has benefited from the use of these databases in expanding the breadth of knowledge in areas such as disease surveillance, disease etiology, health services utilization, and health outcomes. Furthermore, the quantity of data available for research has increased exponentially in recent times, particularly as e-health initiatives come online in health systems across the globe. We review some big data concepts, the databases and data linkage systems used in eye research-including their advantages and limitations, the types of studies previously undertaken, and the future direction for big data in eye research.

  10. Natamycin in the treatment of keratomycosis: Correlation of treatment outcome and in vitro susceptibility of fungal isolates

    Directory of Open Access Journals (Sweden)

    Linu Pradhan

    2011-01-01

    Full Text Available In this study, 60 fungal isolates from 60 patients with fungal keratitis were tested in vitro for their susceptibility to natamycin and the mean minimum inhibitory concentrations of natamycin (MICn were correlated with clinical outcome. The mean MICn for various groups of fungi from patients with either early (16 μg/ml. While the clinical response in all patients with early A. flavus keratitis was good it was poor in late cases (5/8 patients, 62.5%. Fusarium species, Acremonium species and dematiaceous fungi were sensitive with low mean MICn (Fusarium: 5.7-7.2 μg/ml, Acremonium: 5.7-6.8 μg/ml, dematiaceous: (1.6-4 μg/ml. However, 46.6% (7/15 patients in Fusarium and 57.1% (4/7 in Acremonium group needed keratoplasty. We conclude that despite susceptibility of most fungal species causing keratitis to natamycin, the treatment outcome is poor in advanced fungal keratitis.

  11. Fungal allergens.

    OpenAIRE

    1995-01-01

    Airborne fungal spores occur widely and often in far greater concentrations than pollen grains. Immunoglobulin E-specific antigens (allergens) on airborne fungal spores induce type I hypersensitivity (allergic) respiratory reactions in sensitized atopic subjects, causing rhinitis and/or asthma. The prevalence of respiratory allergy to fungi is imprecisely known but is estimated at 20 to 30% of atopic (allergy-predisposed) individuals or up to 6% of the general population. Diagnosis and immuno...

  12. Ochrobactrum anthropi Keratitis with Focal Descemet’s Membrane Detachment and Intracorneal Hypopyon

    Directory of Open Access Journals (Sweden)

    Nandini Venkateswaran

    2016-01-01

    Full Text Available Purpose. To describe a unique case of O. anthropi keratitis associated with a rare manifestation of Descemet’s membrane detachment and intracorneal hypopyon and to discuss challenges in diagnosis and management. Methods. Best-corrected visual acuity was measured with Snellen letters. Corneal scrapings were performed and aerobic, viral, herpetic, acid-fast bacilli, Acanthamoeba, and fungal stains and cultures were obtained. Following evisceration, tissue was evaluated for histologic features and again stained for bacteria, mycobacteria, Acanthamoeba, fungi, and viral particles. Results. Initial presentation to our institute was notable for a corneal ulcer, focal Descemet’s membrane detachment, and intracorneal hypopyon. Speciation of initial corneal scrapes revealed Ochrobactrum anthropi and initial management included fortified tobramycin. Despite medical therapy, the patient developed a corneal perforation and required subsequent evisceration. Conclusion. O. anthropi is an emerging ocular pathogen that has not been previously reported in cases of keratitis. As this pathogen becomes increasingly recognized as a source of ocular infections, it is important to identify and treat aggressively to avoid vision-threatening disease.

  13. Ochrobactrum anthropi Keratitis with Focal Descemet's Membrane Detachment and Intracorneal Hypopyon

    Science.gov (United States)

    Venkateswaran, Nandini; Wozniak, Rachel A. F.

    2016-01-01

    Purpose. To describe a unique case of O. anthropi keratitis associated with a rare manifestation of Descemet's membrane detachment and intracorneal hypopyon and to discuss challenges in diagnosis and management. Methods. Best-corrected visual acuity was measured with Snellen letters. Corneal scrapings were performed and aerobic, viral, herpetic, acid-fast bacilli, Acanthamoeba, and fungal stains and cultures were obtained. Following evisceration, tissue was evaluated for histologic features and again stained for bacteria, mycobacteria, Acanthamoeba, fungi, and viral particles. Results. Initial presentation to our institute was notable for a corneal ulcer, focal Descemet's membrane detachment, and intracorneal hypopyon. Speciation of initial corneal scrapes revealed Ochrobactrum anthropi and initial management included fortified tobramycin. Despite medical therapy, the patient developed a corneal perforation and required subsequent evisceration. Conclusion. O. anthropi is an emerging ocular pathogen that has not been previously reported in cases of keratitis. As this pathogen becomes increasingly recognized as a source of ocular infections, it is important to identify and treat aggressively to avoid vision-threatening disease. PMID:27777806

  14. 角膜病灶刮片检查在角膜炎中的应用评价%Evaluation of Corneal Scraping Test in Keratitis

    Institute of Scientific and Technical Information of China (English)

    李连洲

    2013-01-01

    Objective:To evaluate the application value of corneal scraping test for keratitis.Method:Corneal scraping test was used in 22 cases(22 eyes) of keratitis patients.Result:In 22 cases the diagnosis of 14 cases of patients with fungal keratitis,6 cases were detected fungi(42.8%);he diagnosis of 8 cases of patients with bacterial keratitis,2 cases were detected bacteria(25%).Conclusion:The use of corneal scraping test has higher practical value.%目的:评价角膜病灶刮片检查在角膜炎中的应用价值。方法:对22例(22眼)角膜炎患者做角膜病灶刮片检查。结果:22例患者中14例诊断为真菌性角膜炎,6例检出真菌,检查率42.8%;8例诊断为细菌性角膜炎,2例检出细菌,检查率25.0%。结论:角膜病灶刮片检查有较高的实用价值。

  15. Expression of IL-8, IL-6 and IL-1β in tears as a main characteristic of the immune response in human microbial keratitis.

    Science.gov (United States)

    Santacruz, Concepcion; Linares, Marisela; Garfias, Yonathan; Loustaunau, Luisa M; Pavon, Lenin; Perez-Tapia, Sonia Mayra; Jimenez-Martinez, Maria C

    2015-03-03

    Corneal infections are frequent and potentially vision-threatening diseases, and despite the significance of the immunological response in animal models of microbial keratitis (MK), it remains unclear in humans. The aim of this study was to describe the cytokine profile of tears in patients with MK. Characteristics of ocular lesions such as size of the epithelial defect, stromal infiltration, and hypopyon were analyzed. Immunological evaluation included determination of interleukine (IL)-1β, IL-6, IL-8, IL-10, IL-12 and tumor necrosis factor (TNF)-α in tear samples obtained from infected eyes of 28 patients with MK and compared with their contralateral non-infected eyes. Additionally, frequency of CD4+, CD8+, CD19+ and CD3-CD56+ cells was also determined in peripheral blood mononuclear cells in patients with MK, and compared with 48 healthy controls. Non-significant differences were observed in the size of the epithelial defect, stromal infiltration, and hypopyon. Nevertheless, we found an immunological profile apparently related to MK etiology. IL-8 > IL-6 in patients with bacterial keratitis; IL-8 > IL-6 > IL-1β and increased frequency of circulating CD3-CD56+ NK cells in patients with gram-negative keratitis; and IL-8 = IL-6 > IL-1β in patients with fungal keratitis. Characterization of tear cytokines from patients with MK could aid our understanding of the immune pathophysiological mechanisms underlying corneal damage in humans.

  16. Anaesthesia for Ophthalmic Surgical Procedures | Onakpoya | East ...

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Ophthalmic surgical procedures are performed under anaesthesia to enhance ... Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was ...

  17. Contact lens wear and microbial keratitis.

    Science.gov (United States)

    Ahuja, Markanday

    2002-11-01

    Common types of contact lens are hard, rigid gas-permeable or soft lenses. Most lenses are worn on a daily basis. Cosmetic lenses are worn for non-medical indications. Microbial keratitis, a rare but most significant complication is discussed in this article. Pseudomonas aeruginosa and staphylococci are the most common organisms cause infective keratitis. Fungi and acanthamoeba are also responsible. The causes of increased susceptibility to infection are poor lens hygiene, adhesion of bacteria to lens surface and hypoxia. Preventing measures to be taken while wearing contact lens are discussed in a nutshell. Ocular pain, conjunctival infection, photophobia, epiphora and reduced vision are some of the symptoms of corneal infection. Diagnostic laboratory investigations are to be carried out immediately when a microbial corneal ulcer is suspected. Acanthamoeba can be cultured from corneal scrapes. Immunologically based fluorescein labelling techniques appear to be more sensitive than simple staining. The treatment consists of medical and surgical intervention. Corneal thinning, descemetocele formation and perforation are possible complications.

  18. Fungal nail infection

    Science.gov (United States)

    Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium ... hair, nails, and outer skin layers. Common fungal infections include: Athlete's foot Jock itch Ringworm on the ...

  19. Contact Lens-Associated Acanthamoeba Keratitis in Iran

    Directory of Open Access Journals (Sweden)

    AH Maghsood

    2005-07-01

    Full Text Available Acanthamoeba keratitis is a vision-threatening infection caused by pathogenic species of the genus Acanthamoeba. In this study, 13 Acanthamoeba keratitis cases were diagnosed among 52 keratitis patients. To confirm the identity of Acanthamoeba at the genus level, a PCR-based method was used, and their pathogenic potential was determined using in vitro cytotoxicity assays on human corneal epithelial cells. Twelve (92.3% of Acanthamoeba keratitis patients were contact lens wearers; among them eleven (91.7% wore soft contact lenses. 11/13 (84.6% isolates were axenised in liquid culture medium, of which 10 (90.9% isolates disrupted corneal cells. Nine (69.2% isolates showed Acanthamoeba sp. group II, and four (30.8% showed group III morphology. To our knowledge this is the first report of determination of Acanthamoeba pathogenicity in Iran. This study confirms the importance of determination of pathogenic potential of Acanthamoeba isolates for clinical purposes.

  20. Advances in the Diagnosis and Treatment of Acanthamoeba Keratitis

    Directory of Open Access Journals (Sweden)

    Benjamin Clarke

    2012-01-01

    Full Text Available This paper aims to review the recent literature describing Acanthamoeba keratitis and outline current thoughts on pathogenesis, diagnosis, and treatment as well as currently emerging diagnostic and treatment modalities.

  1. The Value of Cytology Smears for Acanthamoeba Keratitis

    Directory of Open Access Journals (Sweden)

    Sangita P. Patel

    2016-01-01

    Full Text Available Purpose. Acanthamoeba keratitis remains a difficult diagnosis despite advances in genetic and imaging technologies. The purpose of this paper is to highlight the utility of cytology smears for diagnosis of Acanthamoeba keratitis. Methods. This is a case study of the diagnostic course for a patient with suspected Acanthamoeba keratitis. Results. A 40-year-old male with poor contact lens hygiene presented with severe left eye pain. Slit lamp examination showed two peripheral ring infiltrates without an epithelial defect. The epithelium over both infiltrates was removed with a Kimura spatula. Half of the sample was smeared on a dry microscope slide and the other half was submitted for Acanthamoeba culture and PCR. Both culture and PCR were negative for Acanthamoeba, but hematoxylin and eosin stain of the smear revealed double-walled cysts. Conclusion. H&E staining of corneal cytology specimens is an efficient and readily available test for diagnosis of Acanthamoeba keratitis.

  2. Challenges in the management of Neisseria gonorrhoeae keratitis.

    Science.gov (United States)

    McElnea, Elizabeth; Stapleton, Patrick; Khan, Sheryar; Stokes, John; Higgins, Gareth

    2015-02-01

    We describe the presentation and subsequent management of a case of keratitis caused by Neisseria gonorrhoeae. A thirty-nine year old gentleman presented with a purulent ocular discharge. Corneal melt with corneal perforation occurred. Neisseria gonorrhoeae was cultured. Systemic and topical antibiotics were given. Deep lamellar keratoplasty was performed for corneal perforation. At three months post treatment no recurrence of infection was noted. The possibility of Neisseria gonorrhoeaea keratitis should always be considered in patients with a purulent ocular discharge even if the case history is not immediately suggestive of the same. Severe gonococcal keratitis may be unilateral. Deep lamellar keratoplasty can be considered as a therapeutic option in patients with severe gonococcal keratitis.

  3. The Value of Cytology Smears for Acanthamoeba Keratitis

    Science.gov (United States)

    Schaefer, Jamie L.; Paterson, Joyce; Liu, Weiguo; Gonzalez-Fernandez, Federico

    2016-01-01

    Purpose. Acanthamoeba keratitis remains a difficult diagnosis despite advances in genetic and imaging technologies. The purpose of this paper is to highlight the utility of cytology smears for diagnosis of Acanthamoeba keratitis. Methods. This is a case study of the diagnostic course for a patient with suspected Acanthamoeba keratitis. Results. A 40-year-old male with poor contact lens hygiene presented with severe left eye pain. Slit lamp examination showed two peripheral ring infiltrates without an epithelial defect. The epithelium over both infiltrates was removed with a Kimura spatula. Half of the sample was smeared on a dry microscope slide and the other half was submitted for Acanthamoeba culture and PCR. Both culture and PCR were negative for Acanthamoeba, but hematoxylin and eosin stain of the smear revealed double-walled cysts. Conclusion. H&E staining of corneal cytology specimens is an efficient and readily available test for diagnosis of Acanthamoeba keratitis. PMID:27403362

  4. A rare pigmented keratitis caused by Aspergillus fumigatus

    Institute of Scientific and Technical Information of China (English)

    Mauricio; Vélez; Kepa; Balparda; Ana; María; Díaz

    2015-01-01

    <正>Dear Sir,I am Mauricio Vélez,from the Department of Ophthalmology,Cornea Service Director,Universidad Pontificia Bolivariana in Medellín,Colombia.Below,I would like to share an interesting case I managed recently,which I’ve entitled"A rare pigmented keratitis caused by Aspergillus fumigatus".Fungi are a relatively uncommon cause of microbial keratitis

  5. A retrospective study of fungal corneal ulcer from the western part of Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Dharmendra Prasad Singh

    2015-04-01

    Full Text Available Background: Infectious keratitis is a major cause of avoidable blindness worldwide. Fungus is an important aetiological agent of infectious keratitis following corneal trauma with vegetative matter. This infection should be promptly treated to limit the morbidity and dangerous sequelae. The purpose of this study was to detect causative agents from corneal scrapings and to identify the predisposing factors of mycotic keratitis. Methods: Corneal scrapings were taken in full aseptic precautions in total 112 suspected patients for fungal etiology and were subjected to direct examination by 10% KOH mount, gram stain and culture. Results: A total 112 cases of suspected corneal ulcers were subjected to KOH mount to detect fungal elements in corneal scraping and culture to isolate aetiological agents. In our study 29 (25.8% samples were found positive in KOH mount and fungus was isolated from the all KOH positive samples. Males were more commonly affected and were mostly in the age group of 30-50 years. Fusarium species was the most common fungus isolated followed by Aspergillus species. Conclusion: Mycotic keratitis is a serious problem usually following corneal trauma, it requires rapid detection and identification of fugal agents for treatment to prevent disastrous consequences. [Int J Res Med Sci 2015; 3(4.000: 880-882

  6. [A case of mycotic keratitis due to Fusarium solani in Valdivia, Chile].

    Science.gov (United States)

    Mena, Rodrigo; Carrasco, Eduardo; Godoy-Martínez, Patricio; Stchigel, Alberto M; Cano-Lira, José F; Zaror, Luis

    2015-01-01

    Keratomycosis is one of the most prevalent ophthalmic infections, which needs a specific treatment depending on the nature of the infecting fungus. The prognosis is usually severe and depends on an early diagnosis and suitable therapy. We describe a case of keratitis due to Fusarium solani in a patient from a rural area, who, between May and October 2011, suffered a corneal trauma caused by dust particles in Valdivia, Chile. On two occasions, direct examination of eye scrapes revealed abundant septate hyphae. All cultures were positive for the same fungus, which was identified as Fusarium solani by phenotypic characterization and sequencing of ribosomal nuclear genes. The patient was initially treated with amphotericin B and afterwards successfully responded to a treatment with oral and intravenous voriconazole, although corneal opacity persisted. Although keratomycosis in Chile is rare, its diagnostic particularities must be taken into consideration to establish the most effective treatment. Thus, a rapid visualization of the fungus in the lesion, an efficient isolation of the etiologic agent in pure culture is essential, as well as its rapid identification, which requires the use of molecular sequencing techniques in the case of Fusarium species. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  7. Herpetic optic neuritis associated with herpetic keratitis.

    Science.gov (United States)

    Sáenz-Francés, F; Calvo-González, C; Jiménez-Santos, M; Méndez-Hernández, C; Fernandez-Vidal, A M; Martínez-de-la-Casa, J M; García-Sánchez, J; García-Feijoó, J

    2007-01-01

    To report a case of herpetic optic neuritis associated with herpetic keratitis. A 65 year old woman presented with oedema in the nasal sector of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation rate and C-reactive protein were all normal. The patient was diagnosed as having a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp examination showed diffuse stromal corneal oedema and a dendritic lesion in the nasal zone of the corneal epithelium. Serology for varicela-zoster virus was positive. Treatment was started with valacyclovir given orally and topical acyclovir ointment. A week later, the optic disc swelling and corneal lesions had resolved. The precise mechanism through which the papilla and cornea were successively affected in our patient is unclear but the sensitive innervation of both these structures is provided by the nasal branch of the nasociliary nerve and the spread of herpes via this nerve could affect both sites.

  8. Dermatomicose e ceratite micótica causada por Exophiala sp em um cão Dermatomycosis and mycotic keratitis caused by Exophiala sp in a dog

    Directory of Open Access Journals (Sweden)

    Paula Cristina Basso

    2008-10-01

    Full Text Available Neste trabalho, descreve-se o diagnóstico e a conduta terapêutica aplicada em caso de dermatomicose e ceratite micótica causada por Exophiala sp em um cão com um ano e seis meses de idade. Os sinais clínicos incluíam alopecia, crostas, despigmentação e ulceração do plano nasal e focinho, e ceratite superficial bilateral no canto lateral dos olhos. Na cultura fúngica foi isolado Exophiala sp e o exame histopatológico da biopsia cutânea revelou dermatite nodular superficial e profunda granulomatosa. O tratamento com itraconazol sistêmico promoveu remissão dos sinais clínicos. Conclui-se que a realização de cultura fúngica e biópsia de pele são exames complementares eficazes no diagnóstico de dermatomicoses e que o emprego de itraconazol sistêmico pode ser efetivo no tratamento de dermatite fúngica e ceratite micótica causado por Exophiala sp em cão.This report describes the diagnosis and the therapeutic conduct applied to the cases of subcutaneous dermatomycosis and mycotic keratitis caused by Exophiala sp in a one and a half year-old dog. The clinical signs included alopecia, crusts, dispigmentation, ulcerations in the nose and superficial bilateral keratitis in the corner of the eyes. In the fungal cultures, Exophiala sp was isolated and the microscopic analysis revealed characteristics of fungal dermatitis. Systemic therapy with itraconazole evidenced remission of clinical signs. The realization of fungal cultures and cutaneous biopsy are efficient complementary procedures in the diagnosis of dermatomycosis and that the usage of oral itraconazole can be effective in the treatment of fungal dermatitis and mycotic keratitis caused by Exophiala sp in dogs.

  9. Fungal prions.

    Science.gov (United States)

    Staniforth, Gemma L; Tuite, Mick F

    2012-01-01

    For both mammalian and fungal prion proteins, conformational templating drives the phenomenon of protein-only infectivity. The conformational conversion of a protein to its transmissible prion state is associated with changes to host cellular physiology. In mammals, this change is synonymous with disease, whereas in fungi no notable detrimental effect on the host is typically observed. Instead, fungal prions can serve as epigenetic regulators of inheritance in the form of partial loss-of-function phenotypes. In the presence of environmental challenges, the prion state [PRION(+)], with its resource for phenotypic plasticity, can be associated with a growth advantage. The growing number of yeast proteins that can switch to a heritable [PRION(+)] form represents diverse and metabolically penetrating cellular functions, suggesting that the [PRION(+)] state in yeast is a functional one, albeit rarely found in nature. In this chapter, we introduce the biochemical and genetic properties of fungal prions, many of which are shared by the mammalian prion protein PrP, and then outline the major contributions that studies on fungal prions have made to prion biology.

  10. Fungal Entomopathogens

    Science.gov (United States)

    Fungal entomopathogens are important biological control agents worldwide and have been the subject of intense research for more than100 years. They exhibit both sexual and asexual reproduction and produce different types of infective propagules. Their mode of action against insects involves attachme...

  11. Fractal dimension based corneal fungal infection diagnosis

    Science.gov (United States)

    Balasubramanian, Madhusudhanan; Perkins, A. Louise; Beuerman, Roger W.; Iyengar, S. Sitharama

    2006-08-01

    We present a fractal measure based pattern classification algorithm for automatic feature extraction and identification of fungus associated with an infection of the cornea of the eye. A white-light confocal microscope image of suspected fungus exhibited locally linear and branching structures. The pixel intensity variation across the width of a fungal element was gaussian. Linear features were extracted using a set of 2D directional matched gaussian-filters. Portions of fungus profiles that were not in the same focal plane appeared relatively blurred. We use gaussian filters of standard deviation slightly larger than the width of a fungus to reduce discontinuities. Cell nuclei of cornea and nerves also exhibited locally linear structure. Cell nuclei were excluded by their relatively shorter lengths. Nerves in the cornea exhibited less branching compared with the fungus. Fractal dimensions of the locally linear features were computed using a box-counting method. A set of corneal images with fungal infection was used to generate class-conditional fractal measure distributions of fungus and nerves. The a priori class-conditional densities were built using an adaptive-mixtures method to reflect the true nature of the feature distributions and improve the classification accuracy. A maximum-likelihood classifier was used to classify the linear features extracted from test corneal images as 'normal' or 'with fungal infiltrates', using the a priori fractal measure distributions. We demonstrate the algorithm on the corneal images with culture-positive fungal infiltrates. The algorithm is fully automatic and will help diagnose fungal keratitis by generating a diagnostic mask of locations of the fungal infiltrates.

  12. Ophthalmic masquerades of the atherosclerotic carotids

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    Anupriya Arthur

    2014-01-01

    Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.

  13. Treatment of neuro-ophthalmic sarcoidosis.

    Science.gov (United States)

    Frohman, Larry P

    2015-03-01

    Because of the rarity of neuro-ophthalmic sarcoidosis, there are no therapeutic guidelines based on evidence-based medicine for this disorder. Review of literature combined with personal experience. Corticosteroids are the preferred initial therapy for neuro-ophthalmic sarcoidosis. If patients cannot tolerate the requisite dose of corticosteroid needed to control their disease, or if corticosteroids fail to adequately control the disease process, the choices of a second agent are based on the consideration of rapidity of clinical response and the safety profile. Although methotrexate and mycophenolate mofetil are the medications that are often selected after corticosteroid failure, more rapidly acting agents that have been used are infliximab and intravenous cyclophosphamide.

  14. three cases of acanthamoeba keratitis (Ak in Yazd

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    MR Shoja

    2006-04-01

    Full Text Available Acanthamoeba keratitis is a vision- threatening infection and the most important risk factors are contact lenses Characteristic symptoms include disproportionately severe ocular pain, epithelial ulcer, ring stromal infiltrate and resistance to antimicrobial treatment. The aim is to report the first cases of Acanthamoeba keratitis in Yazd in a retrospective study confirmed on histopathological and confocal microscopy. All of our patients used soft contact lenses and were women. The age range was between 20-29 years. One eye was`misdiagnosed as herpes simplex keratitis and two were misdiagnosed as bacterial keratitis. A delayed visit as well as a late diagnosis led to the advanced stage of eye disease. Improvement in visual acuity following medical therapy was seen in two patients and one patient needed urgent keratoplasty for corneal necrosis A prompt clinical and laboratory diagnosis along with treatment with propamidine- isentionate resulted in significant improvement of eye condition Failure to disinfect contact lenses and introduction of tap water rinsing of storage cases were associated with increased risk of Acanthamoeba infection. Penetrating keratoplasty is an effective treatment for medically unresponsive acanthamoeba keratitis. Confocal microscopy is the most effective and a fast diagnostic tool because it ensures the detection of acanthamebic cysts and trophozoids in corneal stroma .

  15. Clinical analysis of 196 infectious keratitis in Jingzhou Region%感染性角膜炎196例临床分析

    Institute of Scientific and Technical Information of China (English)

    伍志琴; 刘剑平; 聂尚武; 王晓琴

    2013-01-01

    January 2010 to December 2012.Results Among the 196 patients (198eyes),118 (120 eyes) were male and 78 (78 eyes) were female with mean age at 58.6 years.The age distribution was mainly 41-60 years old.The important risk factors were corneal trauma,ocular surface disease,contact lens wear,steroid use and previous ocular surgery.The leading infectious keratitis was fungal keratitis (128 patients,128 eyes,63.5%) and followed by viral keratitis (47 patients,49 eyes,30.0%).Twenty-one patients (21 eyes,10.7%) were confirmed with bacterial keratitis.The positive rate of direct microscopic examination of corneal scraping was 67.2% in fungal keratitis.In 123 cultured specimens,46 cases (37.4%) were detected positive,8 showed bacterial growth,and 38 demonstrated fungal growth.The median time from inciting event to receiving treatment in our hospital was 32±7.4d.Sixty eyes received operation.Among them,26 eyes undertook local debridement with conjunctival flap covering,12 eyes received local debridement with amniotic membrane transplantation and conjunctival flap covering,8 patients went to higher hospital for keratoplasty,and 17 eyes received enucleation finally.Conclusions Fungal keretitis is the major cause of corneal infections and is followed by viral keratitis in Jingzhou Central Hospital.An incremental increase is seen in the number of fungal keratitis cases and bacterial keratitis show a decline during the study period.This disconcerting trend and the fairly high rate of blindness resulting in infectious keratitis warrant further research.Patients with infectious keratitis have generally poor visual outcomes and accepted treatment promptly may improve the outcome.Local debridement with conjunctival flap covering and/or amniotic membrane transplantation is a method reserved to be recommended when drug treatment is unhelpful.

  16. 21 CFR 886.3130 - Ophthalmic conformer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic conformer. 886.3130 Section 886.3130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... adhesions during the healing process following surgery. ] (b) Classification. Class II (special controls...

  17. Ophthalmic implications of seasonal affective disorder

    Energy Technology Data Exchange (ETDEWEB)

    Paramore, J.E.; King, V.M. (Ferris State Univ., Big Rapids, MI (USA))

    1989-07-01

    A review of seasonal affective disorder (SAD) is presented with a discussion of its standard treatment of phototherapy. A number of ophthalmic implications related to SAD are proposed. These implications relate to both the condition and the phototherapy used in its treatment, especially the use of full spectrum light which contains ultraviolet and near ultraviolet radiation. 12 references.

  18. Ophthalmic imaging features of posterior scleritis

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    Zhi Li

    2014-07-01

    Full Text Available AIM: To analyze, summarize and describe ophthalmic imaging features of posterior scleritis. METHODS: Clinical data of 16 patients(21 eyeswith posterior scleritis diagnosed in our hospital from October 2008 to June 2013 were retrospectively analyzed. The results of type-B ultrasonic, fundus chromophotograph, fundus fluorescein angiography, CT were recorded for comprehensive evaluation and analysis of ophthalmic imaging features of posterior scleritis. RESULTS: All patients underwent type-B ultrasonic examination and manifested as diffuse and nodular types. The diffuse type showed diffusely thickened sclera and a dark hypoechoic area that connected with the optic nerve to form a typical “T”-shaped sign. The nodular type showed scleral echogenic nodules and relatively regular internal structure. FFA showed that relatively weak mottled fluorescences were visible in the arterial early phase and strong multiple needle-like fluorescences were visible in the arteriovenous phase, which were then progressively larger and fused; fluorescein was leaked to the subretinal tissue in the late phase; varying degrees of strong fluorescences with less clear or unclear boundaries were visible in the optic disk. CT results showed thickened eyeball wall. CONCLUSION: Posterior scleritis is common in young female patients, whose ophthalmic imaging features are varied and more specific in type-B ultrasonic. Selection of rational ophthalmic imaging examination method, combined with clinical manifestations, can accurately diagnose posterior scleritis and avoid the incidence of missed and delayed diagnosis.

  19. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  20. Estimated burden of fungal infections in Kenya.

    Science.gov (United States)

    Guto, John Abuga; Bii, Christine C; Denning, David W

    2016-08-31

    Kenya is a developing country with a high rate of tuberculosis (TB) and a moderate HIV infection burden. No estimate of the burden of fungal diseases in Kenya is published. We used specific populations at risk and fungal infection frequencies from the literature to estimate national incidence or prevalence of serious fungal infections. Used sources were: 2010 WHO TB statistics, Kenya Acquired Immunodeficiency Syndrome (AIDS) Epidemic Update 2012, Kenya Facts and figures 2012, Kenya Demographic and Health Survey 2008-2009. Of Kenya's population of ~40 million, 43% are under 15 years old and approximately 594,660 Kenyan women get >4 episodes Candida vulvovaginitis annually (2,988/100,000). The HIV/AIDS population at risk of opportunistic infections (OI) is 480,000 and the OI estimates include 306,000 patients with oral thrush (768/100,000), 114,000 with oesophageal candidiasis (286/100,000), 11,900 with cryptococcal meningitis (29/100,000) and 17,000 patients with Pneumocystis pneumonia (42/100,000). Chronic pulmonary aspergillosis following TB has a prevalence of 10,848 cases (32/100,000). The adult asthma prevalence is 3.1% and assuming 2.5% have allergic bronchopulmonary aspergillosis then 17,696 (44/100,000) are affected.  Invasive aspergillosis, candidaemia and Candida peritonitis are probably uncommon. Tinea capitis infects 9.6% of children in Kenya, while fungal keratitis and otomycoses are difficult to estimate. At any one time, about 7% of the Kenyan population suffers from a significant fungal infection, with recurrent vaginitis and tinea capitis accounting for 82% of the infections. These estimates require further epidemiological studies for validation.

  1. AN OPHTHALMIC HEALTH SURVEY IN NORTHERN IRAN

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    Kh. Moradpour

    1974-06-01

    Full Text Available The province of Rudsar is located in the Caspian littoral zone of Iran. In 1970 an ophthalmic health survey was carried out in 25 units, which were selected by random sampling in these areas. A total of 2,165 persons were examined and the results of this evaluation have been prepared in 6 parts, consisting of ophthalmic conditions and health customs, infectious eye diseases, visual status and diseases, blindness and its causes, eye complications of malnutrition, and other eye disease. The prevalence of trachoma is 24% and of conjunctivitis 11.2%, but infectious eye diseases are mild in these areas and their complications are very rare, and trachoma is deviated mainly to inclusion conjunctivitis. Visual defect are important problem in the Rudsar area; 17.8% of the persons examined of 10 years of age and over, had visual defects. The most important causes of visual defects are refraction abnor­malities, especially myopic astigmatism and contact. Visual defects are more prevalent in females than in males. Of the total number of persons examined, 2.63% had infectious eye diseases, 2.77% had blindness in at least one eye and 56.7% of the blindness was caused by cataracts. The eye complications of avitaminosis A and ariboflavinosis were observed, especially in rural areas. The establish­ment of an ophthalmic clinic, the use of a mobile dispensary unit for diagnosis, procedures for introducing patients to the ophthalmic clinic, and special procedures for the health of school children would be beneficial and are recommended for the control of ophthalmic disease. It is also necessary to have a special survey on toxoplasmosis, an investigation for clarification of the causes of differences in visual defects in males and females, and a survey on the causes of blepharitis.

  2. Laboratory diagnosis of Acanthamoeba keratitis in Hungary.

    Science.gov (United States)

    Orosz, Erika; Farkas, Ágnes; Kucsera, István

    2016-09-01

    Acanthamoeba species are free-living amebae that can be found in almost every range of environments. Within this genus, numerous species are recognized as human pathogens, potentially causing Acanthamoeba keratitis (AK). AK is a corneal disease that is predominantly associated with contact lens use, the epidemiology of which is related to the specific genotype of Acanthamoeba. This study reports seven (7/16; 43.75%) positive cases. Detection of Acanthamoeba in corneal scrapings is based on cultivation and polymerase chain reaction (PCR) combined with the molecular taxonomic identification method. By PCR, seven samples were positive; cultivation was successful for five samples, probably because of the low quantity of samples. Genotype identification was carried out with a real-time fluorescence resonance energy transfer PCR assay based on sequence analysis of the 18S rRNA gene, and sensitivity and specificity were evaluated in comparison with traditional parasitological techniques. All seven detected Acanthamoeba strains belonged to the T4 genotype, the main AK-related genotype worldwide. These results confirmed the importance of a complete diagnostic protocol, including a PCR assay, for the clinical diagnosis of AK from human samples. Genotyping allowed the identification of all isolates in the T4 group, thus demonstrating the prevalence of this genotype in Hungary.

  3. Keratitis by Fusarium temperatum , a novel opportunist

    NARCIS (Netherlands)

    Al-Hatmi, Abdullah; Bonifaz, Alexandro; de Hoog, G; Vazquez-Maya, Leticia; Garcia-Carmona, Karla; Meis, Jacques F; van Diepeningen, Anne D

    2014-01-01

    Background Fusarium species are among the most common fungi present in the environment and some species have emerged as major opportunistic fungal infection in human. However, in immunocompromised hosts they can be virulent pathogens and can cause death. The pathogenesis of this infection relies on

  4. Radial keratoneuritis as a presenting sign in Acanthamoeba keratitis

    Directory of Open Access Journals (Sweden)

    Abdullah Alfawaz

    2011-01-01

    Full Text Available The visual outcomes of Acanthamoeba keratitis, a rare cause of corneal infection, can be devastating. This paper reports two contact lens wearers with severe pain and photophobia who presented to the emergency room. Biomicroscopy revealed radial keratoneuritis in both individuals. Tissue culture on a nonnutrient agar plate with Escherichia coli overlay resulted in a heavy growth of Acanthamoeba. The inpatient treatment included 0.02% polyhexamethylene biguanide, chlorhexidine, neomycin/polymyxin B/bacitracin (Neosporin, and oral fluconazole, which successfully controlled the corneal infection and improvement in the best corrected visual acuity in both patients. Infection did not recur during the 12-month follow-up period. Acanthamoeba keratitis can present as radial keratoneuritis, mimicking other common corneal infections resulting in diagnostic and treatment delays. Early diagnosis and prudent treatment of Acanthamoeba keratitis are the keys to restoring vision and avoiding the subsequent need for penetrating keratoplasty.

  5. Distinct roles for Dectin-1 and TLR4 in the pathogenesis of Aspergillus fumigatus keratitis.

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    Sixto M Leal

    Full Text Available Aspergillus species are a major worldwide cause of corneal ulcers, resulting in visual impairment and blindness in immunocompetent individuals. To enhance our understanding of the pathogenesis of Aspergillus keratitis, we developed a murine model in which red fluorescent protein (RFP-expressing A. fumigatus (Af293.1RFP conidia are injected into the corneal stroma, and disease progression and fungal survival are tracked over time. Using Mafia mice in which c-fms expressing macrophages and dendritic cells can be induced to undergo apoptosis, we demonstrated that the presence of resident corneal macrophages is essential for production of IL-1beta and CXCL1/KC, and for recruitment of neutrophils and mononuclear cells into the corneal stroma. We found that beta-glucan was highly expressed on germinating conidia and hyphae in the cornea stroma, and that both Dectin-1 and phospho-Syk were up-regulated in infected corneas. Additionally, we show that infected Dectin-1(-/- corneas have impaired IL-1beta and CXCL1/KC production, resulting in diminished cellular infiltration and fungal clearance compared with control mice, especially during infection with clinical isolates expressing high beta-glucan. In contrast to Dectin 1(-/- mice, cellular infiltration into infected TLR2(-/-, TLR4(-/-, and MD-2(-/- mice corneas was unimpaired, indicating no role for these receptors in cell recruitment; however, fungal killing was significantly reduced in TLR4(-/- mice, but not TLR2(-/- or MD-2(-/- mice. We also found that TRIF(-/- and TIRAP(-/- mice exhibited no fungal-killing defects, but that MyD88(-/- and IL-1R1(-/- mice were unable to regulate fungal growth. In conclusion, these data are consistent with a model in which beta-glucan on A.fumigatus germinating conidia activates Dectin-1 on corneal macrophages to produce IL-1beta, and CXCL1, which together with IL-1R1/MyD88-dependent activation, results in recruitment of neutrophils to the corneal stroma and TLR4

  6. Acanthamoeba keratitis - A six year epidemiological review from a tertiary care eye hospital in South India

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    Manikandan P

    2004-01-01

    Full Text Available PURPOSE: This study analyses the prevalence, demography, predisposing factors and seasonal variation of Acanthamoeba keratitis. METHODS: A retrospective review of all cases presenting with keratitis at the cornea clinic, Aravind Eye Hospital, Coimbatore, from August 1997 to July 2003, was done for screening patients with a provisional diagnosis of Acanthamoeba keratitis. Their records were further analyzed for microbiological details. Cases with culture proven Acanthamoeba keratitis were included for epidemiological analysis. RESULTS: From a total of 4519 patients who attended cornea clinic 32 (33 eyes patients were confirmed to be positive for Acanthamoeba keratitis. Twenty cases (62.5% were males. Majority (18; 54.2% of the Acanthamoeba keratitis eyes reported corneal trauma by solid objects. No peak period was observed in a year, as the number of cases was almost uniform in all months. CONCLUSION: This study indicates the increasing prevalence of Acanthamoeba keratitis among non-contact lens users in this region during the 6-year period.

  7. Microbial keratitis in Kingdom of Bahrain: Clinical and microbiology study

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    Al-Yousuf Nada

    2009-01-01

    Full Text Available Background: Microbial keratitis is a potentially vision threatening condition worldwide . Knowing the predisposing factors and etiologic microorganism can help control and prevent this problem. This is the first study of its kind in Kingdom of Bahrain. Objective: To study the profile of microbial keratitis in Bahrain with special focus on risk factors, clinical outcome and microbilogical results. Methods: A retrospective analysis of all patients admitted in Salmaniya Medical Complex over a period of three years from January 2005 to January 2007 was performed. A total of 285 patients with keratitis were analysed. Non infectious corneal ulceration were excluded. Data collected from medical records were demographic features, predisposing factors, history of corneal trauma, associated ocular conditions, visual acuity at the time of presentation and the clinical course. Predisposing risk factors measured were contact lens use, presence of blepharitis, diabetes, lid abnormalities, dry eyes, keratoplasty and refractive surgery. For contact lens wearers any contact lens related risk factors that can lead to keratitis were measured . Pearson′s chi-square test was used to carry out statistical analysis wherever required. Results: Contact lens wear, as a risk factor for microbial keratitis, formed 40% of the total study population. Other risk factors identified were dry eyes 24 cases (8%, 10 blepharitis (3%, 22 trauma (8%, abnormal lid position 14 cases (5%. 6 patients keratitis in a graft (2%, 3 had refractive surgery (1%. The most common causative organism isolated was pseudomonas aeroginosa (54% followed by streptococcus 12%, staph 10%, other organisms 6%. 95% of contact lens wearers had pseudomonas Aeroginosa. This was statistically significant (p< 0.0001. The vast majority, 92% healed with scarring. 1% needed therapeutic keratoplasty and 7% lost to follow up. Risk factors in contact lens wearers were; 41 patients (36% slept with the contact lenses

  8. Fungal Eye Infections

    Science.gov (United States)

    ... Treatment & Outcomes Statistics More Resources Fungal Nail Infections Histoplasmosis Definition Symptoms People at Risk & Prevention Sources Diagnosis & ... CDC at Work Global Fungal Diseases Cryptococcal Meningitis Histoplasmosis ... Resistance Resources Laboratory Submission Information Reportable Fungal ...

  9. N, N'-Olefin functionalized bis-imidazolium gold(I salt is an efficient candidate to control keratitis-associated eye infection.

    Directory of Open Access Journals (Sweden)

    Tapastaru Samanta

    Full Text Available Keratitis treatment has become more complicated due to the emergence of bacterial or fungal pathogens with enhanced antibiotic resistance. The pharmaceutical applications of N-heterocyclic carbene complexes have received remarkable attention due to their antimicrobial properties. In this paper, the new precursor, 3,3'-(p-phenylenedimethylene bis{1-(2- methyl-allylimidazolium} bromide (1a and its analogous PF6 salt (1b were synthesized. Furthermore, silver(I and gold(I -N-heterocyclic carbene (NHC complexes [Ag2LBr2/Au2LBr2; 2a/3a], [(Ag2L2(PF62/(Au2L2(PF62; 2b/3b] were developed from their corresponding ligands. All compounds were screened for their antimicrobial activities against multiple keratitis-associated human eye pathogens, including bacteria and fungi. Complexes 2a and 3a showed highest activity, and the effectiveness of 3a was also studied, focusing eradication of pathogen biofilm. Furthermore, the structures of 1a, 2a and 3b were determined using single crystal X-ray analysis, 2b and 3a were optimized theoretically. The mechanism of action of 3a was evaluated by scanning electron microscopy and docking experiments, suggesting that its target is the cell membrane. In summary, 3a may be helpful in developing antimicrobial therapies in patients suffering from keratitis-associated eye infections caused by multidrug-resistant pathogens.

  10. 感染性角膜炎466例共焦显微镜检查结果临床分析%Clinical features and confocal microscopic imaging characteristics of 466 cases with infectious keratitis

    Institute of Scientific and Technical Information of China (English)

    肖卉; 张德艳; 范忠义

    2014-01-01

    目的:探讨共焦显微镜在感染性角膜炎的病原学诊断上的意义。  方法:回顾性病例系列研究。对2010-01/2013-12共466例467眼感染性角膜炎共焦显微镜的检查结果进行回顾性分析,总结其共焦显微镜图像特点及各类型角膜炎的临床特征。  结果:患者466例平均54.4±13.0岁,男264例(56.7%),女202例(43.3%),诊断为真菌性角膜炎190例(40.8%),病毒性角膜炎148例(31.8%),细菌性角膜炎125例(26.8%),棘阿米巴角膜炎3例(0.6%),真菌性角膜炎可见大量真菌菌丝,棘阿米巴角膜炎可见典型阿米巴包囊。  结论:共焦显微镜是一种早期辅助诊断感染性角膜炎的有效方法,尤其对真菌及棘阿米巴角膜炎的早期诊断具有特异性,有利于感染性角膜炎的早期诊断及指导治疗。%AIM: To observe the role of confocal microscopy in infectious keratitis management. METHODS:Totally 466 patients (467 eyes) diagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized. RESULTS:All patients were recorded, the average age was 54. 4±13. 0 years, in which 264 cases (56. 7%) were male, and 202 cases ( 43. 3%) were female. In the 466 patients, 190 (40. 8%) were fungal keratitis, 148 (31. 8%) were viral keratitis, 125 (26. 8%) were bacterial keratitis and 3 ( 0.6%) were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis. CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.

  11. Treatment of keratitis-ichthyosis- deafness (KID) syndrome in children: a case report and review of the literature.

    Science.gov (United States)

    Patel, Viraat; Sun, Grace; Dickman, Meghan; Khuu, Phuong; Teng, Joyce M C

    2015-01-01

    Keratitis-ichthyosis-deafness (KID) syndrome is a rare hereditary cornification disorder resulting from mutations in connexin 26, a protein important for intercellular communication. In addition to the characteristic clinical triad of congenital bilateral sensorineural hearing loss, keratitis, and erythrokeratoderma, affected individuals also suffer from chronic bacterial and fungal infections and have an increased risk of benign and malignant cutaneous tumors. Treatments with antibiotics, antifungals, and systemic retinoids have been reported with variable response. Ocular and skeletal toxicity from prolonged exposure to systemic retinoids is a major concern especially in children. We report a case of a 7-year-old boy with KID syndrome complicated by frequent infections who responded well to acitretin 0.5-1.0 mg/kg/day. The patient had significant improvement of the hyperkeratosis on the scalp, trunk, and extremities within 4 weeks after initiating treatment. The patient has been on treatment for over a year without notable ocular, skeletal, or laboratory side effects. A review of the literature focusing on therapeutic options for KID syndrome and concerns about safety and tolerability is presented.

  12. 豚鼠镰刀菌性角膜炎模型的建立%Establishment of experimental Fusaium keratitis in a guinea pig model

    Institute of Scientific and Technical Information of China (English)

    贺丹; 高嵩; 万雪; 宗方伟; 张琳; 王丽

    2014-01-01

    Objective To establish an experimental Fusaium keratitis in a guinea pig model , which is an available animal model to the clinical and basic research for fungal keratitis .Methods The animal model of Fusaium keratitis was created by corneal scratching and corneal stroma injection methods with different spore suspension concentration of Fusarium solani .According to the symptoms of infection , the results of tissue pathological and etiological examination , the optimal inoculation method and concentration were determined .Results Guinea pig models created by corneal scratching method with mild symptoms had a lower infection rate and were easily to healing .However models created by corneal stroma injection method with the severe and persistent symptoms had a higher infection rate .Meanwhile the infec-tion rate increased with the increasing spore suspension concentration .Conclusions An experimental Fusaium keratitis in a guinea pig model is successfully established by corneal stroma injection method with higher spore suspension concentration .This animal model is practical for the further study of fungal keratitis .%目的:探讨豚鼠镰刀菌性角膜炎模型的建立方法,为真菌性角膜炎的临床和基础研究提供理想的动物模型。方法采用角膜划痕法和角膜基质注射法以不同浓度茄病镰刀菌孢子悬液感染豚鼠,建立镰刀菌性角膜炎模型,观察感染症状,进行组织病理学和病原学检查,判断最适感染方式和接种浓度。结果划痕法感染角膜病变较轻,易自愈,感染率较低;基质注射法感染病变较重,且较持久,感染率较高。随着接种孢子悬液浓度的增加感染率增高。结论利用角膜基质注射法接种较高浓度的孢子悬液成功地建立了豚鼠镰刀菌性角膜炎模型,为真菌性角膜炎的进一步研究奠定了基础。

  13. Pathogens in 131 cases of patients with infectious keratitis%131例角膜炎感染病原菌谱分析

    Institute of Scientific and Technical Information of China (English)

    徐红云; 刘春林; 袁文丽; 李红; 蒋云海; 杨忠昆; 刘海

    2011-01-01

    OBJECTIVE To investigate the distribution of the species of pathogens causing infectious keratitis, to provide bases for the early diagnosis and treatment of fungal keratitis (FK). METHODS The eye infection in hospitalized patients with corneal ulcers were collected. The pathogens from keratitis specimens were retrospectively analyzed. The data were retrospectively reviewed in order to evaluate infection characteristics and risk factors. RESULTS Totally 131 cases of culture detection rate 54. 2%, of which 71. 8% was detection rate of filamentous, fusarium was predominant, accounting for 36. 6%, followed by aspergillus, accounting for 23. 9% bacteria accounted for 28. 2% ,Gram-positive bacteria accounted for 18. 3% ,and Gram-negative bacteria accounted for 9. 9%. CONCLUSION Fungal keratitis is predominant in infectious keratitis, filamento'us fungi is the major pathogen and the infection is mainly caused by fusarium.%目的 研究感染性角膜炎病原菌分布特征及实验室检查结果,提供真菌性角膜炎的早期诊断及治疗依据.方法 收集住院感染性角膜炎患者的角膜溃疡标本,对普通细菌及真菌培养的结果进行回顾分析,评价感染特征及危险因素.结果 131例培养阳性检出率为54.2%,其中丝状真菌检出率71.8%,以镰刀菌属为主,占36.6%,其次是曲霉菌属,23.9%;细菌检出率为28.2%,其中革兰阳性菌占18.3%、革兰阴性杆菌占9.9%.结论 感染性角膜炎以真菌性角膜炎为主,主要病原菌是丝状真菌,并以镰刀菌属的感染为主.

  14. Anatomy of the Ophthalmic Artery: Embryological Consideration

    Science.gov (United States)

    TOMA, Naoki

    2016-01-01

    There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures. PMID:27298261

  15. Ophthalmic plastic and orbital surgery in Taiwan.

    Science.gov (United States)

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.

  16. Botulinum toxin in ophthalmic plastic surgery

    Directory of Open Access Journals (Sweden)

    Naik Milind

    2005-01-01

    Full Text Available Botulinum toxin chemodenervation has evolved greatly over the past 30 years since its introduction in the 1970s for the management of strabismus. Among ophthalmic plastic surgeons, botulinum toxins are often used as the first line treatment for facial dystonias. These toxins are also efficacious for the temporary management of various other conditions including keratopathies (through so called chemo-tarsorraphy, upper eyelid retraction, orbicularis overaction-induced lower eyelid entropion, gustatory epiphora, Frey′s syndrome, and dynamic facial rhytids such as lateral canthal wrinkles (crow′s feet, glabellar creases and horizontal forehead lines. This article describes the pharmacology, reconstitution techniques and common current applications of botulinum toxins in ophthalmic plastic surgery.

  17. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  18. Are we pharmacovigilant enough in ophthalmic practice?

    Directory of Open Access Journals (Sweden)

    Ashok Dubey

    2013-01-01

    Full Text Available No drug is absolutely safe. Pharmacovigilance is the science related to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. The ocular medications and devices can cause localized and systemic adverse effects. Not all adverse effects are known when a drug or device is launched in market because of limitations of clinical trials. Many adverse effects are recognized due to the spontaneous reporting of the vigilant doctors who observe and report such events encountered in their practice. Despite a large ophthalmic patient population base, India does not have robust adverse drug reaction (ADR database because of lack of reporting culture. Government of India recently launched the Pharmacovigilance Programme of India (PvPI to monitor ADRs and create awareness among the healthcare professionals about the importance of ADRs. Suspecting and reporting a possible drug reaction is very important in developing a safe and rational ophthalmic practice.

  19. Frozen section diagnosis in ophthalmic pathology

    Directory of Open Access Journals (Sweden)

    Biswas Jyotirmay

    1993-01-01

    Full Text Available Frozen section diagnosis is extensively used in various branches of pathology, but its application in ophthalmic pathology was recognised only in the 1970s. We studied 10 sections of ocular and adenexal lesions by frozen section diagnosis, which included orbital lesions (4 cases, lid lesions (3 cases, and intraocular tissue (1 case. The time taken for processing ranged between 10 to 15 minutes. Diagnoses based on frozen section evaluation included lymphoma, mesenchymal chondrosarcoma, solar keratosis, compound naevus, silicone oil globules in cataractous lens, neurofibromatosis, pseudotumour, retinoblastoma, and chronic blepharitis. Although further histopathologic examination correlated well with the frozen section (100% observations, the diagnosis was deferred in the case of naevus and reactive lymphoid hyperplasia. Our study shows that frozen section diagnosis in ophthalmic surgery is quite reliable and is particularly useful in ocular adenexal lesions

  20. Oncocytic lesions of the ophthalmic region

    DEFF Research Database (Denmark)

    Østergaard, Jens; Prause, Jan U; Heegaard, Steffen

    2011-01-01

    Purpose: This study aimed to make a nationwide clinicopathological study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin (CK) expression. Methods: All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25-year period...... were collected and re-evaluated using a monoclonal antimitochondrial antibody (MU213-UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anti-CK antibodies. Results: A total of 34 oncocytic lesions were identified and reviewed. The incidence...... that required surgical intervention in the Danish population could be approximated to 0.3 lesions per million capita per year. Patient ages ranged from 45 years to 89 years, with a peak incidence in the eighth decade. Female patients were twice as common as male. Lesions were typically described as red...

  1. Clinical Efficacy of Oral Ganciclovir for Prophylaxis and Treatment of Recurrent Herpes Simplex Keratitis

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2015-01-01

    Full Text Available Background: Herpes simplex keratitis (HSK caused by herpes simplex virus 1 (HSV-1, which has high recurrent rate and incidence of severe vision loss, is the leading cause of infectious blindness in the world. The aim was to explore the clinical efficacy of oral ganciclovir (GCV in the prevention of recurrent HSK. Methods: A multicenter, prospective, randomized, single-blind, and controlled clinical trial was conducted from April 2010 to June 2013. One hundred seventy-three patients (173 eyes involved who were diagnosed as recurrent HSK definitely, including stromal keratitis and corneal endotheliitis, were divided into three groups randomly: negative control (placebo group was topically administered with 0.15% GCV ophthalmic gel, 4 times per day and 0.1% fluorometholone eye drops, 3 times per day until resolution of HSK; positive control acyclovir (ACV group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks. The symptoms and signs were evaluated before and after the therapy 1 st week, 2 nd week and then followed up every 2 weeks until recovery. Furthermore, we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time, recurrent rate and adverse reactions. Results: One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months, but 34 patients were failed to follow-up. The cure time was 12.1 ± 4.3, 11.9 ± 4.0 weeks in negative control (placebo group and positive control ACV group respectively (P = 0.991, which was longer than that in test GCV group (8.6 ± 2.8 weeks and there was a significant difference between test GCV group and negative control (placebo group or positive control ACV group (P

  2. Ophthalmic clues to the endocrine disorders.

    Science.gov (United States)

    Liu, Z; Chen, Y; Lin, Z; Shi, X

    2017-01-01

    Eye is a vital sense organ and reflects the physical and mental wellbeing of a person. Detailed examination of the eye is an essential part in the clinical evaluation of patients with any systemic disorder. The interaction between ophthalmologists and endocrinologists is often limited to Graves' ophthalmopathy and diabetic retinopathy. However, there are many ophthalmic manifestations, which are characteristically seen in endocrine disorders. In this review, we shall discuss the ocular manifestations of the endocrine syndromes excluding the Graves' ophthalmopathy and diabetic retinopathy. We performed a PubMed search of articles published in English showing the ophthalmic features in the endocrine disorders. Relevant cited articles were also retrieved. Most of the publications included in the review were case reports and review articles. Many endocrine disorders have characteristic manifestations pertaining to the various structures of the eye. The involvement is seen from the external structures of the eye to the inner most layers of the retina. Many ocular-endocrine syndromes also exist with characteristic clues to the clinical diagnosis. The endocrinologists need to be aware of these ocular signs that help in the early diagnosis of the underlying disorder. A syndromic approach is essential in the diagnosis of endocrinopathy in patients presenting with ophthalmic features.

  3. A retrospective study of nine cases of Acanthamoeba keratitis

    Directory of Open Access Journals (Sweden)

    Tetsuya Mutoh

    2010-10-01

    Full Text Available Tetsuya Mutoh, Isao Ishikawa, Yukihiro Matsumoto, Makoto ChikudaDokkyo Medical University Koshigaya Hospital, Saitama, JapanPurpose: To evaluate the clinical features of Acanthamoeba keratitis in nine patients diagnosed at Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.Methods: In nine eyes of nine patients, Acanthamoeba keratitis was diagnosed by direct light microscopy of corneal scrapings stained by the Parker ink-potassium hydroxide method between September 2006 and September 2009. Their clinical features and course were studied retrospectively. Antifungal eye drops, systemic antifungal therapy, and surgical debridement of the corneal lesions were performed in all patients.Results: At presentation, the clinical stage was initial in six cases, transient in one case, and complete in two cases. The patients were all contact lens wearers who had washed their lens storage cases with tap water. After treatment, final visual acuity was improved in six cases, unchanged in one case, and worse in two cases. The patient with the worst final vision (hand motion had rheumatoid arthritis and was taking oral prednisolone, which led to corneal perforation and prevented adequate debridement from being done.Conclusion: Acanthamoeba keratitis is closely related to wearing contact lenses and washing the lens storage case with tap water. Although final visual acuity improved after treatment in most patients, insufficient surgical debridement resulted in a poor visual prognosis.Keywords: surgical debridement, Acanthamoeba keratitis, contact lens wearers

  4. [Treatment of Acanthamoeba keratitis: possibilities, problems, and new approaches].

    Science.gov (United States)

    Walochnik, Julia; Duchêne, Michael; Eibl, Hansjörg; Aspöck, Horst

    2003-01-01

    Acanthamoeba keratitis is a corneal disease associated predominantly with contact lens wear. The occurrence of Acanthamoeba keratitis has been rising since 1990 in correlation to the growing number of contact lens wearers. To date approximately 2000 cases have been published around the world. Due to the complicated diagnostics, the elaborate treatment and the usually bad compliance of the patients, Acanthamoeba keratitis unfortunately very often takes a serious progression, which may lead to serious visual loss and perforating keratoplasty. Today, local treatment with a combination of polyhexamethylene biguanide (PHMB) and propamidine isethionate (Brolene) is considered the first line therapy for Acanthamoeba keratitis. Alternatively also a combination of propamidine and chlorhexidine or neomycine achieves good therapeutic results. However, the complicated mode of application consistently remains a problem. The intensive local treatment, i.e. hourly application of therapeutics during the first three days day and night makes hospitalization inevitable. Moreover, sufficient efficacy can not always be achieved, and also resistance against propamidine has already been observed. Recently propamidine has sometimes been replaced by hexamidine, which seems to have a greater cysticidal activity. A new path might be struck by the application of alkylphosphocholines. These are phosphocholines esterified to aliphatic alcohols. They exhibit in vitro and in vivo antineoplastic activity and have been shown to be cytotoxic against Leishmania donovani, Trypanosoma cruzi, and Entamoeba histolytica. A recent study has demonstrated that particularly hexadecylphosphocholine is highly effective also against various strains of Acanthamoeba.

  5. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment

    Directory of Open Access Journals (Sweden)

    Lorenzo-Morales Jacob

    2015-01-01

    Full Text Available Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections.

  6. Incidence of contact lens-associated microbial keratitis

    NARCIS (Netherlands)

    Cheng, K.H.; Leung, S.L.; Hoekman, J.W.; Beekhuis, W.H.; Mulder, P.G.H.; Geerards, A.J.M.; Kijlstra, A.

    1999-01-01

    Background. The incidence of contact-lens-associated microbial keratitis is uncertain and its related morbidity in the general population of contact-lens wearers is not known. We examined these issues in a prospective epidemiological study. Methods. We surveyed all practising ophthalmologists in the

  7. An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment.

    Science.gov (United States)

    Lorenzo-Morales, Jacob; Khan, Naveed A; Walochnik, Julia

    2015-01-01

    Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections.

  8. Spectrum and Sensitivity of Bacterial Keratitis Isolates in Auckland

    Science.gov (United States)

    Swift, S.; Dean, S. J.; Ormonde, S. E.

    2016-01-01

    Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%), followed by Pseudomonas (21.3%). Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p ≤ 0.05). Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%), cefuroxime (33.3%), and chloramphenicol (94.7%) showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51%) and ciprofloxacin (98.8%) showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres. PMID:27213052

  9. Spectrum and Sensitivity of Bacterial Keratitis Isolates in Auckland

    Directory of Open Access Journals (Sweden)

    S. Marasini

    2016-01-01

    Full Text Available Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%, followed by Pseudomonas (21.3%. Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p≤0.05. Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%, cefuroxime (33.3%, and chloramphenicol (94.7% showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51% and ciprofloxacin (98.8% showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres.

  10. Ophthalmic regional blocks: management, challenges, and solutions

    Directory of Open Access Journals (Sweden)

    Palte HD

    2015-08-01

    Full Text Available Howard D Palte Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The impact of the burgeoning geriatric population is that an increasing number of elderly patients will present for eye surgery. In order to accommodate increased patient volumes and simultaneously satisfy administrative initiatives directed at economic frugality, administrators will seek assistance from anesthesia providers in adopting measures that enhance operating room efficiency. The performance of eye blocks in a holding suite meets many of these objectives. Unfortunately, most practicing anesthesiologists resist performing ophthalmic regional blocks because they lack formal training. In future, anesthesiologists will need to block eyes and manage common medical conditions because economic pressures will eliminate routine preoperative testing. This review addresses a variety of topical issues in ophthalmic anesthesia with special emphasis on cannula and needle-based blocks and the new-generation antithrombotic agents. In a constantly evolving arena, the sub-Tenon’s block has gained popularity while the deep angulated intraconal (retrobulbar block has been largely superseded by the shallower extraconal (peribulbar approach. Improvements in surgical technique have also impacted anesthetic practice. For example, phacoemulsification techniques facilitate the conduct of cataract surgery under topical anesthesia, and suture-free vitrectomy ports may cause venous air embolism during air/fluid exchange. Hyaluronidase is a useful adjuvant because it

  11. A case of radial keratoneuritis in non-Acanthamoeba keratitis

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    Mutoh T

    2012-09-01

    Full Text Available Tetsuya Mutoh, Yukihiro Matsumoto, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanAbstract: A case of non-Acanthamoeba keratitis with radial keratoneuritis, which is thought to be pathognomonic for Acanthamoeba keratitis, is reported. A healthy 32-year-old woman with a history of frequent replacement of her contact lenses due to wear was examined at Dokkyo Medical University Koshigaya Hospital (Saitama, Japan and found to have a slight corneal opacity that was accompanied by radial keratoneuritis. Based on both the patient’s clinical findings and past history, the presence of Acanthamoeba keratitis was highly suspected. However, direct light microscopy of corneal scrapings stained by the Parker ink–potassium hydroxide method only found Acanthamoeba-type material in the specimen collected at her initial visit. In all other specimens collected from the patient, no Acanthamoeba was found either when using the same method or when performing cultures of the surgical debridement of the corneal lesion. In addition, topical antifungal eye drops, systemic antifungal drugs, and surgical debridement were also not effective in this case. Since a precise diagnosis could not be made, the patient was treated with topical 0.1% betamethasone sodium, which ultimately resulted in a dramatic improvement of her corneal inflammation. At 23 days after initiation of topical administration of 0.1% betamethasone sodium, visual acuity was 20/250, with a slight corneal opacity noted at the original site of infection. The outcome of the current case suggests that radial keratoneuritis is not always pathognomonic for Acanthamoeba keratitis.Keywords: radial keratoneuritis, non-Acanthamoeba keratitis, topical corticosteroid

  12. Prospective Study of the Diagnostic Accuracy of the In Vivo Laser Scanning Confocal Microscope for Severe Microbial Keratitis.

    Science.gov (United States)

    Chidambaram, Jaya D; Prajna, Namperumalsamy V; Larke, Natasha L; Palepu, Srikanthi; Lanjewar, Shruti; Shah, Manisha; Elakkiya, Shanmugam; Lalitha, Prajna; Carnt, Nicole; Vesaluoma, Minna H; Mason, Melanie; Hau, Scott; Burton, Matthew J

    2016-11-01

    To determine the diagnostic accuracy of in vivo confocal microscopy (IVCM) for moderate to severe microbial keratitis (MK). Double-masked prospective cohort study. Consecutive patients presenting to Aravind Eye Hospital, Madurai, India, between February 2012 and February 2013 with MK (diameter ≥3 mm, excluding descemetocele, perforation, or herpetic keratitis). Following examination, the corneal ulcer was scanned by IVCM (HRT3/RCM, Heidelberg Engineering, Heidelberg, Germany). Images were graded for the presence or absence of fungal hyphae or Acanthamoeba cysts by the confocal microscopist who performed the scan (masked to microbial diagnosis) and 4 other experienced confocal graders (masked to clinical features and microbiology). The regrading of the shuffled image set was performed by 3 graders, 3 weeks later. Corneal-scrape samples were collected for microscopy and culture. The main outcome measures were sensitivity, specificity, and positive and negative predictive values of IVCM compared with those of a reference standard of positive culture or light microscopy. Sensitivities and specificities for multiple graders were pooled and 95% confidence intervals calculated using a bivariate random-effects regression model. The study enrolled 239 patients with MK. Fungal infection was detected in 176 (74%) and Acanthamoeba in 17 (7%) by microbiological methods. IVCM had an overall pooled (5 graders) sensitivity of 85.7% (95% confidence interval [CI]: 82.2%-88.6%) and pooled specificity of 81.4% (95% CI: 76.0%-85.9%) for fungal filament detection. For Acanthamoeba, the pooled sensitivity was 88.2% (95% CI: 76.2%-94.6%) and pooled specificity was 98.2% (95% CI: 94.9%-99.3%). Intergrader agreement was good: κ was 0.88 for definite fungus; κ was 0.72 for definite Acanthamoeba. Intragrader repeatability was high for both definite fungus (κ: 0.88-0.95) and definite Acanthamoeba classification (κ: 0.63-0.90). IVCM images from 11 patients were considered by all 5

  13. [Clinical forms of acanthamoeba keratitis as viewed from the standpoint of biomicroscopy and confocal microscopy].

    Science.gov (United States)

    Maĭchuk, Iu F; Maĭchuk, D Iu

    2004-01-01

    Clinical cases of 60 patients with acanthamebic keratitis examined by biomicroscopy and of 22 patients largely examined by confocal microscopy are generalized. Acanthamebic keratitis is a slowly progressing infectious lesion of the cornea, which is caused by acanthamebas freely residing in soil and water. Contaminated contact lenses are the key risk factor. The main clinical features of acanthamebic keratitis are defined; they are presence of risk factors; a unilateral lesion in young, healthy and immune-competent persons; a typical clinical pattern of surface keratitis mainly of the ring shape; corneal neuritis without corneal neovascularization but with a severe pain in the eye; and a slow chronic clinical course, i.e. lasting for several weeks and months. Confocal microscopy is the most effective and fast diagnostic tool because it ensures the detection of acanthamebic cysts and trophozoids in all strata of the corneal stroma. The authors isolate, within the clinical course of acanthamebic keratitis, 5 stages; they are surface epithelial keratitis; surface epithelial punctate keratitis; stromal ring-shaped keratitis; ulcerous keratitis; and keratoscleritis.

  14. Epidemiological and Microbiological Profile of Patient’s Having Microbial Keratitis.

    Directory of Open Access Journals (Sweden)

    Saurabh Patel, Akshay M Chaudhari, Trupti M Solu, Vaibhav Gharat

    2014-01-01

    Conclusion: Trauma is most common predisposing factor responsible for microbial keratitis. Direct microscopic examination of corneal scraping is key tool for rapid diagnosing and institution of antimicrobial therapy."

  15. Adjustable fluidic lenses for ophthalmic corrections.

    Science.gov (United States)

    Marks, Randall; Mathine, David L; Peyman, Gholam; Schwiegerling, Jim; Peyghambarian, Nasser

    2009-02-15

    We report on two fluidic lenses that have been developed for ophthalmic applications. The lenses use a circular aperture to demonstrate optical powers between -20 and +20 D and a rectangular aperture to demonstrate astigmatism with values ranging from 0 to 8 D. Measurements of image quality were made with the fluidic lens using a model eye. Both lenses were variable and controllable by adjusting the fluid volume of the lens. To the best of our knowledge this is the first demonstration of a continuously variable lens for control of astigmatism.

  16. Ion exchange tempering of glass ophthalmic lenses.

    Science.gov (United States)

    Keeney, A H; Duerson, H L

    1975-08-01

    We performed low velocity drop-ball tests using 5/8-, 7/8-, and 1-inch diameter steel balls on ophthalmic crown glass lenses chemically tempered by the ion exchange process. Four representative dioptric strengths (+ 2.50 spherical, - 2.50 spherical, -2.50 cylindrical, and plano) were studied with the isolated lenses mounted, convex side up, on the American National Standards Institute Z80 test block. New ion exchange lenses exhibited a 100 to 350% greater capacity for attenuation of energy from low velocity, large size missiles than matched lenses of similar strength prepared by the conventional heat-treating and air-quenching process.

  17. 21 CFR 524.1200b - Kanamycin ophthalmic aqueous solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Kanamycin ophthalmic aqueous solution. 524.1200b Section 524.1200b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 524.1200b Kanamycin ophthalmic aqueous solution. (a) Specifications. The drug, which is in an...

  18. 21 CFR 524.1484a - Neomycin sulfate ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate ophthalmic ointment. 524.1484a... § 524.1484a Neomycin sulfate ophthalmic ointment. (a) Specifications. Each gram of the ointment contains 5 milligrams of neomycin sulfate equivalent in activity to 3.5 milligrams of neomycin base....

  19. 75 FR 36101 - Dermatologic and Ophthalmic Drugs Advisory Committee; Cancellation

    Science.gov (United States)

    2010-06-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee... Dermatologic and Ophthalmic Drugs Advisory Committee scheduled for June 28, 2010, is cancelled. This meeting...

  20. 21 CFR 524.575 - Cyclosporine ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Cyclosporine ophthalmic ointment. 524.575 Section... § 524.575 Cyclosporine ophthalmic ointment. (a) Specifications. Each gram of ointment contains 2 milligrams of cyclosporine. (b) Sponsor. See No. 000061 in § 510.600(c) of this chapter. (c) Conditions of...

  1. The role of LOX-1 on innate immunity against Aspergillus keratitis in mice

    Science.gov (United States)

    He, Kun; Yue, Li-Hui; Zhao, Gui-Qiu; Li, Cui; Lin, Jing; Jiang, Nan; Wang, Qian; Xu, Qiang; Peng, Xu-Dong; Hu, Li-Ting; Zhang, Jie

    2016-01-01

    AIM To explore the effects of lectin-like ox-LDL receptor (LOX-1) on innate immunity against Aspergillus fumigatus (A. fumigatus ) in mice cornea. METHODS The mRNA levels of LOX-1 were tested in normal and A. fumigatus infected corneas of C57BL/6 and BALB/c mice. The expression of LOX-1, pro-inflammatory cytokines TNF-α, CXCL1 and IL-6, anti-inflammatory cytokines IL-10, and matrix metalloproteinase 9 (MMP9) were tested with treatment with LOX-1 neutralizing antibody or control IgG in A. fumigatus infected corneas of C57BL/6. Macrophages and neutrophils were extracted from susceptible C57BL/6 mice, and pretreated with LOX-1 neutralizing antibody or IgG, then stimulated with A. fumigatus. The mRNA levels of LOX-1, TNF-α, CXCL1, IL-6, IL-10 and MMP9 were evaluated by polymerase chain reaction. RESULTS The expression of LOX-1 was significantly increased in C57BL/6 mice corneas after A. fumigatus infection compared with BABL/c mice. After treatment with LOX-1 neutralizing antibody, the expression of LOX-1, TNF-α, CXCL1, IL-6, MMP9 and IL-10 in C57BL/6 corneas were significantly decreased compared with treatment with control IgG; the expression of LOX-1, CXCL1, IL-6 and IL-10 were significantly decreased in macrophages, while TNF-α and MMP9 expressions had no change; LOX-1, TNF-α, CXCL1, IL-6, MMP9 and IL-10 expressions were significantly decreased in neutrophils. CONCLUSION The expression of LOX-1 can affect the expression of pro-inflammatory and anti-inflammatory cytokines in fungal infected corneas, macrophages and neutrophils of C57BL/6. LOX-1 inhibition rebalances the inflammatory response of fungal keratitis in mice. PMID:27672585

  2. Ophthalmic contributions of Raja Serfoji II (1798–1832)

    Science.gov (United States)

    Biswas, Jyotirmay; Badrinath, Vasanthi; Badrinath, Sengamedu S

    2012-01-01

    Purpose: To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832). Materials and Method: A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Results: Forty-four patient's ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. Conclusion: In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji's amazing contribution to medicine lies in 50 charts and manuscripts. PMID:22824599

  3. Ophthalmic contributions of Raja Serfoji II (1798-1832

    Directory of Open Access Journals (Sweden)

    Jyotirmay Biswas

    2012-01-01

    Full Text Available Purpose: To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832. Materials and Method: A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Results: Forty-four patient′s ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. Conclusion: In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji′s amazing contribution to medicine lies in 50 charts and manuscripts.

  4. Ophthalmic contributions of Raja Serfoji II (1798-1832).

    Science.gov (United States)

    Biswas, Jyotirmay; Badrinath, Vasanthi; Badrinath, Sengamedu S

    2012-07-01

    To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832). A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Forty-four patient's ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji's amazing contribution to medicine lies in 50 charts and manuscripts.

  5. Report of the Eye Bank Association of America medical advisory board subcommittee on fungal infection after corneal transplantation.

    Science.gov (United States)

    Aldave, Anthony J; DeMatteo, Jennifer; Glasser, David B; Tu, Elmer Y; Iliakis, Bernardino; Nordlund, Michael L; Misko, Jachin; Verdier, David D; Yu, Fei

    2013-02-01

    To investigate the incidence of fungal infections after corneal transplantation to determine whether storage media supplementation with an antifungal should be considered. Adverse reactions reported to the Eye Bank Association of America through the online adverse reaction reporting system between January 1, 2007, and December 31, 2010, were reviewed to identify cases of recipient fungal infection. Data were collected regarding the donor, the donor cornea, recovery and processing, and mate culture and clinical course of the recipients. Thirty-one cases of culture-proven fungal keratitis (n = 14) and endophthalmitis (n = 17) were reported out of 221,664 corneal transplants performed using corneal tissue distributed by domestic eye banks (1.4 cases per 10,000 transplants performed). Although the annual incidence of postkeratoplasty fungal infection has not increased significantly since 2005, a trend toward an increasing rate of fungal infection has been observed. Fungal infections were more commonly reported after endothelial keratoplasty procedures (0.022%) than penetrating keratoplasty procedures (0.012%), but the difference was not statistically significant (P = 0.076). Additionally, no association was found between fungal infection after endothelial keratoplasty and whether the lamellar tissue cut was performed by the surgeon or the eye bank technician. Seventy-three percent (16 of 22) of the fungal cultures performed on the mate corneas were positive, with infection developing in 67% (10 of 15) of recipient eyes (endophthalmitis in 6 eyes and keratitis in 4 eyes). Although a nonsignificant increasing trend in the rate of fungal infection has been observed over the past 6 years, it is not sufficiently compelling to pursue antifungal supplementation of donor storage media.

  6. Acanthamoeba keratitis: an emerging disease gathering importance worldwide?

    Science.gov (United States)

    Lorenzo-Morales, Jacob; Martín-Navarro, Carmen María; López-Arencibia, Atteneri; Arnalich-Montiel, Francisco; Piñero, José E; Valladares, Basilio

    2013-04-01

    Acanthamoeba keratitis (AK) is increasingly being recognized as a severe sight-threatening ocular infection worldwide. Although contact lens wear is the leading risk factor for AK, Acanthamoeba parasites are also an important cause of keratitis in non-contact lens wearers. Diagnosis of AK is challenging, and the available treatments are lengthy and not fully effective against all strains. The pathogenesis of Acanthamoeba is still under study, and the identification of the key factors involved in this process should be useful for the development of fully effective therapies. This review focuses on recent developments on AK pathogenesis and diagnosis as well as novel strategies for the evaluation of anti-amoebic agents that could be applied in the near future against these pathogens.

  7. Current advances in diagnostic methods of Acanthamoeba keratitis

    Institute of Scientific and Technical Information of China (English)

    Wang Yuehua; Feng Xianmin; Jiang Linzhe

    2014-01-01

    Objective The objective of this article was to review the current advances in diagnostic methods for Acanthamoeba keratitis (AK).Data sources Data used in this review were retrieved from PubMed (1970-2013).The terms "Acanthamoeba keratitis" and "diagnosis" were used for the literature search.Study selection Data from published articles regarding AK and diagnosis in clinical trials were identified and reviewed.Results The diagnostic methods for the eight species implicated in AK were reviewed.Among all diagnostic procedures,corneal scraping and smear examination was an essential diagnostic method.Polymerase chain reaction was the most sensitive and accurate detection method.Culturing of Acanthamoeba was a reliable method for final diagnosis of AK.Confocal microscopy to detect Acanthamoeba was also effective,without any invasive procedure,and was helpful in the early diagnosis of AK.Conclusion Clinically,conjunction of various diagnostic methods to diagnose AK was necessary.

  8. National Strategies of Ophthalmic Education in Iran

    Directory of Open Access Journals (Sweden)

    B Einollahi

    2012-01-01

    Full Text Available Background: Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010Methods: A qualitative investigation using focus group discussion has been implemented successfully for developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study.Results: Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific inter-departmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives.Conclusion: Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability.

  9. National Strategies of Ophthalmic Education in Iran

    Science.gov (United States)

    Entezari, A; Javadi, MA; Einollahi, B

    2012-01-01

    Background: Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010 Methods: A qualitative investigation using focus group discussion has been implemented successfully for developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study. Results: Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific inter-departmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives. Conclusion: Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability. PMID:23113125

  10. Ophthalmic abnormalities in children with Down syndrome.

    Science.gov (United States)

    Creavin, Alexandra L; Brown, Ray D

    2009-01-01

    A comprehensive review of the available literature was performed to determine the common ophthalmic disorders in children aged 0 to 16 years with Down syndrome. The UK National Library for Health interface was used to search seven electronic databases, including MEDLINE and EMBASE. Terms related to Down syndrome, ophthalmology, and pediatrics were combined in the search strategy, which yielded 230 articles. Application of exclusion criteria left 23 articles to include in the review. Literature synthesis demonstrated that children with Down syndrome are at risk for several ocular disorders. Refractive error was a common finding, particularly hyperopia. Strabismus was also reported regularly, particularly esodeviation. Other frequent findings included poor visual acuity, nystagmus, and blepharitis, whereas cataract and glaucoma were less common but had potentially serious implications for future vision. Only one study compared routine pediatric examination to that of a pediatric ophthalmologist. The findings of this review confirm the need for an ophthalmic screening program for children with Down syndrome. Additional work should investigate how such a program could be best implemented and ascertain how to involve different professionals in such a service.

  11. Pulsed UV laser technologies for ophthalmic surgery

    Science.gov (United States)

    Razhev, A. M.; Chernykh, V. V.; Bagayev, S. N.; Churkin, D. S.; Kargapol’tsev, E. S.; Iskakov, I. A.; Ermakova, O. V.

    2017-01-01

    The paper provides an overview of the results of multiyear joint researches of team of collaborators of Institute of Laser Physics SB RAS together with NF IRTC “Eye Microsurgery” for the period from 1988 to the present, in which were first proposed and experimentally realized laser medical technologies for correction of refractive errors of known today as LASIK, the treatment of ophthalmic herpes and open-angle glaucoma. It is proposed to carry out operations for the correction of refractive errors the use of UV excimer KrCl laser with a wavelength of 222 nm. The same laser emission is the most suitable for the treatment of ophthalmic herpes, because it has a high clinical effect, combined with many years of absence of recrudescence. A minimally invasive technique of glaucoma operations using excimer XeCl laser (λ=308 nm) is developed. Its wavelength allows perform all stages of glaucoma operations, while the laser head itself has high stability and lifetime, will significantly reduce operating costs, compared with other types of lasers.

  12. STREPTOCOCCUS PNEUMONIAE KERATITIS FOLLOWING LASER IN SITU KERATOMILEUSIS

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    A 22-year-old man underwent bilateral laser in situ keratomileusis and developed Streptococcus pneumoniae keratitis after surgery.This complication occurred one day after the procedure in both eyes.Topical and systemic antibiotics were promptly administered.Bacterial culture was performed following corneal flap lift and scraping of the lesions.Afterwards,the therapeutic regimen was readjusted according to the culture results.Streptococcus pneumoniae was identified from the culture.Three months after the sur...

  13. [Novel approach to treatment of lagophthalmos-associated neuroparalytic keratitis].

    Science.gov (United States)

    Kasparov, А А; Sobkova, О I; Kasparova, Evg А; Kasparova, Еl А

    2015-01-01

    Aim - to develop effective treatment approaches to lagophthalmos-associated neuroparalytic keratitis. A total of 34 patients (36 eyes) with neuroparalytic keratitis were enrolled. Group 1 consisted of 20 patients (21 eyes), in whom autoconjunctivoplasty was performed in combination with eyelid surgery. Group 2 consisted of 12 lagophthalmic patients (13 eyes) with purulent corneal ulcers, who additionally underwent corneal transplantation. Group 3 included 2 patients (2 eyes) with central corneal ulcer in the only seeing eye, who received, besides other things, upper sector iridectomy intended to serve as a pupil (RU 2299048 with priority date of 15.07.2005). In group 1, corneal re-epithelization and complete recovery was achieved in all patients within 3.00±0.69 weeks. Visual acuity (VA) has generally increased over the first year after treatment from 0.14±0.06 to 0.25±0.13 in group 1 and from 0.09±0.05 to 0.21±0.13 in group 2. In group 3, sector iridectomies also yielded an increase in VA - from 0.01 to 0.02 in one case and from 0.2 to 0.6 in the other. Autoconjunctivoplasty enabled rapid and stable re-epithelization of corneal defects in all cases. One-stage corneal and eyelid surgery has been shown to be more effective in treating lagophthalmos-associated neuroparalytic keratitis than previous methods. The novel approach ensures acute symptoms of keratitis resolve and the eye is saved, moreover, it allows to maintain visual acuity and prevent recurrences in 64% and 65% of patients, respectively.

  14. Voriconazole for the treatment of refractory Aspergillus fumigatus keratitis

    Directory of Open Access Journals (Sweden)

    Mehta Hijab

    2008-01-01

    Full Text Available We report a case of Aspergillus fumigatus keratitis in a 53-year-old, well-controlled diabetic female who did not respond to standard antifungal treatment. She was started on topical natamycin eye drops, but the infiltrate continued to progress. Topical amphotericin B and systemic ketoconazole was added, however, there was no response and the infiltrate increased further. She was then switched to topical and systemic voriconazole. Steady resolution of the infiltrate was noted within 2 weeks of therapy.

  15. Acanthamoeba keratitis - A six year epidemiological review from a tertiary care eye hospital in South India

    OpenAIRE

    Manikandan P; Bhaskar M; Revathy R; John R.; Narendran V; Panneerselvam K

    2004-01-01

    PURPOSE: This study analyses the prevalence, demography, predisposing factors and seasonal variation of Acanthamoeba keratitis. METHODS: A retrospective review of all cases presenting with keratitis at the cornea clinic, Aravind Eye Hospital, Coimbatore, from August 1997 to July 2003, was done for screening patients with a provisional diagnosis of Acanthamoeba keratitis. Their records were further analyzed for microbiological details. Cases with culture proven Acanthamoeba keratitis were incl...

  16. Recent advances in the treatment of Acanthamoeba keratitis.

    Science.gov (United States)

    Kumar, Raman; Lloyd, David

    2002-08-15

    Infection of the eye caused by Acanthamoeba species constitutes a burgeoning and unsolved problem. Of individuals with Acanthamoeba keratitis, 85% wear contact lenses; abrasion of the cornea is implicated. Corneal infection often can be prevented by good lens care and hygiene. Severe Acanthamoeba keratitis often can be very difficult to treat; surgery can be less than successful and may lead to further problems. The encysted stage in the life cycle of Acanthamoeba species appears to cause the most problems; many biocides are ineffective in killing the highly resistant cysts. Combination therapy--that is, use of 2 or 3 biocides, sometimes with antibacterial antibiotics--appears to work best. Recurrence is common if treatment is stopped prematurely. Immunologic methods are being investigated as a form of prevention, and oral immunization of animals recently has been successful in the prevention of Acanthamoeba keratitis by inducing immunity before infection occurs. Immunization thus may eventually become the best approach for reduction of the incidence of amebic infection in humans.

  17. Keratocyte loss in Acanihamoeba Keratitis: Phagocytosis, necrosis or apoptosis?

    Directory of Open Access Journals (Sweden)

    Vemuganti Geeta

    2000-01-01

    Full Text Available Purpose: Pathogenesis of Acanthamoeba keratitis involves breakdown of epithelial barrier, stromal invasion by Acanthamoeba, loss of keratocytes, inflammatory response and finally stromal necrosis. The loss of keratocytes, believed to be due to the phagocytic activity of the parasite, occurs disproportionate to and independent of the parasite load, thereby suggesting additional modes of cell loss. To test our hypothesis that the loss of keratocytes in Acanthamoeba keratitis is due to apoptosis, we did both histology and histochemistry on the corneal tissues. Methods: Routine Haematoxylin and Eosin, Gomori′s Methenamine Silver and Periodic acid Schiff stained sections of five corneal tissues from penetrating keratoplasty and eviscerated eyes were reviewed. TUNEL staining was done for morphological detection of apoptosis in three cases, using formalin-fixed, paraffin-processed tissues. Results: Histological changes were epithelial ulceration, loss of keratocytes in all layers, inflammation in anterior two-thirds of the stroma with necrosis, and deeper quiet stroma. Acanthamoeba trophozoites were found in the anterior stroma while the cysts were more in the deeper stroma, with minimal or no inflammatory response. TUNEL staining was positive in keratocytic nuclei in all layers. Conclusions: This study demonstrates that one of the modes of keratocyte loss in Acanthamoeba keratitis is by apoptosis, possibly in addition to the necrotic process and phagocytic activity of the parasite. The death of inflammatory cells also appears to be mediated by apoptosis.

  18. Bimatoprost ophthalmic solution 0.03% lowered intraocular pressure of normal-tension glaucoma with minimal adverse events

    Directory of Open Access Journals (Sweden)

    Tsumura T

    2012-09-01

    Full Text Available Toyoaki Tsumura,1 Keiji Yoshikawa,2 Hirotaka Suzumura,3 Tairo Kimura,4 Satoshi Sasaki,5 Itaru Kimura,6 Ryuji Takeda71Department of Ophthalmology, Fussa Hospital, Fussa, Tokyo, Japan; 2Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 3Department of Ophthalmology, Nakano General Hospital, Nakano, Tokyo, Japan; 4Ueno Eye Clinic, Ueno, Tokyo, Japan; 5Sasaki Eye Clinic, Ueno, Tokyo, Japan; 6Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan; 7Department of Biological Chemistry, Faculty of Agriculture, Kinki University, Nara, Nara, JapanPurpose: The aim of this study was to evaluate the efficacy and safety of bimatoprost ophthalmic solution 0.03% (bimatoprost in Japanese normal-tension glaucoma (NTG patients with an intraocular pressure (IOP of 18 mmHg or less.Methods: Bimatoprost was instilled into the unilateral conjunctival sac of Japanese NTG patients with a baseline IOP of 18 mmHg or less. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 2, 4, 8, and 12 weeks post bimatoprost instillation.Results: Thirty-two of the 38 enrolled NTG patients (mean age, 64.1 ± 12.6 years; 19 males and 19 females completed the study, with six patients unable to complete the study (two patients discontinued because of side effects and four patients withdrew. The levels of IOP in the treated eyes were significantly reduced (P < 0.0001 from the baseline IOP levels. No significant change in IOP was observed in the fellow eyes. There were significant increases in conjunctival hyperemia. No significant superficial punctate keratitis scores were noted between the baseline and each point examined. Eyelash disorder, eyelid pigmentation, and deepening of the upper eyelid sulcus were observed in 28, six, and three eyes, respectively.Conclusion: Bimatoprost effectively lowered the IOP. It was well tolerated in Japanese NTG patients, with few patients having to discontinue

  19. Changing patterns of infectious keratitis : Overview of clinical and histopathologic features of keratitis due to acanthamoeba or atypical mycobacteria, and of infectious crystalline keratopathy

    Directory of Open Access Journals (Sweden)

    Kinota Stanislaus

    1993-01-01

    Full Text Available Acanthamoeba keratitis, infectious crystalline keratopathy and atypical mycobacterial keratitis have recently emerged as important types of infectious keratitis. These corneal infections have been associated with contact lens wear and with corneal surgical procedures such as radial keratotomy and penetrating keratoplasty, and the clinical setting of each of these infections is important in alerting the clinician to the possible diagnosis. There have been improvements in rapid diagnostic techniques for such infections in the last several years. Treatment has also improved, but remains a difficult problem, especially for Acanthamoeba. An overview of recent developments in the clinical and histopathologic methods for diagnosis and treatment options of these three corneal infections is provided.

  20. Entomopathogenic fungal endophytes

    Science.gov (United States)

    Fungal endophytes are quite common in nature and some of them have been shown to have adverse effects against insects, nematodes, and plant pathogens. An introduction to fungal endophytes will be presented, followed by a discussion of research aimed at introducing Beauveria bassiana as a fungal endo...

  1. Multidrug-resistant Fusarium in keratitis: a clinico-mycological study of keratitis infections in Chennai, India.

    Science.gov (United States)

    Tupaki-Sreepurna, Ananya; Al-Hatmi, Abdullah M S; Kindo, Anupma J; Sundaram, Murugan; de Hoog, G Sybren

    2017-04-01

    In this study, we aimed to present the first molecular epidemiological data from Chennai, India, analyse keratitis cases that have been monitored in a university hospital during 2 years, identify the responsible Fusarium species and determine antifungal susceptibilities. A total of 10 cases of keratitis were included in the study. Fusarium isolates were identified using the second largest subunit of the RNA polymerase gene (RPB2) and the translation elongation factor 1 alpha (TEF1). Antifungal susceptibility was tested by the broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) methodology. The aetiological agents belonged to Fusarium solani species complex (FSSC) (n = 9) and Fusarium sambucinum species complex (FSAMSC) (n = 1), and the identified species were Fusarium keratoplasticum (n = 7), Fusarium falciforme (n = 2) and Fusarium sporotrichioides (n = 1). All strains showed multidrug resistance to azoles and caspofungin but exhibited lower minimum inhibitory concentration (MIC) to natamycin and amphotericin B. Fusarium keratoplasticum and Fusarium falciforme belonging to the Fusarium solani species complex were the major aetiological agents of Fusarium keratitis in this study. Early presentation and 5% topical natamycin was associated with better patient outcome. Preventative measures and monitoring of local epidemiological data play an important role in clinical practice. © 2016 Blackwell Verlag GmbH.

  2. Acanthamoeba keratitis in a non-contact lens wearer with human immunodeficiency virus

    DEFF Research Database (Denmark)

    Hansen, Birgitte Rønde; Kronborg, Gitte

    2003-01-01

    Acanthamoeba keratitis is potentially blinding and often associated with contact lens wearing. A human immunodeficiency virus (HIV)-positive patient, a non-contact lens wearer, presented with keratitis. She experienced a protracted course of disease, characterized by exacerbations and remissions...

  3. [Oclusion of upper ophthalmic vein--a case report].

    Science.gov (United States)

    Kácerik, M; Alexík, M; Lipková, B

    2009-07-01

    Thrombosis of upper ophthalmic vein is both rare and serious pathologic event. Authors present a case of isolated unilateral upper ophthalmic vein thrombosis in 76-year-old woman, who despite treatment ended with amaurosis and secondary neovascular glaucoma. In differential diagnosis authors focused on searching for inflammatory process of orbit with adjacent structures as well as local and general causes leading to venous thrombosis. None of these were proven; it was a rare case of a patient with isolated upper ophthalmic vein thrombosis.

  4. A polycarbonate ophthalmic-prescription lens series.

    Science.gov (United States)

    Davis, J K

    1978-08-01

    Improvements in polycarbonate material, production techniques, and scratch-resistant coatings, combined with a process-oriented design, have resulted in a precision lens series. Surface quality is comparable to that of untreated glass ophthalmic lenses. The repeatability of the process results in closely controlled axial power and off-axis performance. For most lens prescriptions, the ANSI Z80.1 optical-center specifications for prescription accuracy are maintained through a total field of view of 40 deg for an 8-mm range of center-of-rotation distances. Off-axis astigmatism is controlled for near-point seeing. The lenses are both lighter and thinner than those of crown glass. A scratch-resistant coating reduces the reflections normally associated with high-index (1.586) materials. Impact resistance exceeds that required by ANSI Z80.7 and is many times that required by ANSI Z80.1.

  5. An historical ophthalmic study of Jane Austen.

    Science.gov (United States)

    Wilson, Graham A

    2012-11-01

    Today, no other classic novelist has the popularity or power of Jane Austen, and in 2013 the world will celebrate 200 years of her comic masterpiece Pride and Prejudice. Her millions of fans have an abiding fascination with all aspects of her life, including her health and the cause of her death. This historical ophthalmic study of Jane Austen, based on very incomplete medical bibliographic data, finds that she had a mild ocular surface disorder from age 23. This disorder did not significantly impact on her visual performance for writing. There are many references to eyes in her novels, but Jane's eyes and those of her characters cannot contribute further to the debate around the cause of her death at age 41.

  6. Coherent methods for measuring ophthalmic surfaces

    Science.gov (United States)

    Rottenkolber, Matthias; Podbielska, Halina

    1996-01-01

    Topographic analysis of the ophthalmic surfaces is an important task. Especially recently, when a laser assisted refractive surgery becomes more and more popular in a daily clinical praxis. Ophthalmologists need to know exact corneal parameters as a basis for proper operational approach, as well as for monitoring of the post-operative process. The fitting of the contact lenses can be more accurate when topography of both, cornea and contacts, can be precisely measured. We develop new coherent methods for measuring of the topography of curved optical surfaces. One of the proposed techniques is based on interferometry with a special distance measurement unit and spatial phase shifting interferogram evaluation. The other one uses deflectometry with spatial carrier frequency. The sensitivity of this method is adjustable and thus it closes the gap between the white light and interferometric measuring methods. The techniques proposed here can be suitable for measurement of the contact lenses or corneal surface.

  7. Flow analysis of the ophthalmic artery

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Kuniaki; Hashimoto, Masato; Bandoh, Michio; Odawara, Yoshihiro; Kamagata, Masaki; Shirase, Ryuji [Sapporo Medical Univ. (Japan). Hospital

    2003-02-01

    The purpose of this study was to analyze the hemodynamics of ophthalmic artery flow using phase contrast MR angiography (PC-MRA). A total of 14 eyes from 10 normal volunteers and a patient with normal tension glaucoma (NTG) were analyzed. The optimal conditions were time repetition (TR)/echo time (TE)/flip angle (FA)/nex=40 ms/minimum/90 deg/2, field of view (FOV)=6 cm, matrix size=256 x 256. The resistive index (RI) and pulsatillity index (PI) values were significantly raised in the patient with NTG when compared to the control group. We therefore believe that PC-MRA may be a useful clinical tool for the assessment of the mechanism of NTG. (author)

  8. Mini drug pump for ophthalmic use.

    Science.gov (United States)

    Saati, Saloomeh; Lo, Ronalee; Li, Po-Ying; Meng, Ellis; Varma, Rohit; Humayun, Mark S

    2010-03-01

    To evaluate the feasibility of developing a novel mini drug pump for ophthalmic use. Using principles of microelectromechanical systems engineering, a mini drug pump was fabricated. The pumping mechanism is based on electrolysis and the pump includes a drug refill port as well as a check valve to control drug delivery. Drug pumps were tested first on the bench-top and then after implantation in rabbits. For the latter, we implanted 4 elliptical (9.9 x 7.7 x 1.8 mm) non-electrically active pumps into 4 rabbits. The procedure is similar to implantation of a glaucoma aqueous drainage device. To determine the ability to refill and also the patency of the cannula, at intervals of 4-6 weeks after implantation, we accessed the drug reservoir with a transconjunctival needle and delivered approximately as low as 1 microL of trypan blue solution (0.06%) into the anterior chamber. Animals were followed by slit lamp examination, photography, and fluorescein angiography. Bench-top testing showed 2.0 microL/min delivery when using 0.4 mW of power for electrolysis. One-way valves showed reliable opening pressures of 470 mmHg. All implanted devices refilled at 4-6 weeks intervals for 4-6 months. No infection was seen. No devices extruded. No filtering bleb formed over the implant. A prototype ocular mini drug pump was built, implanted, and refilled. Such a platform needs more testing to determine the long term biocompatibility of an electrically-controlled implanted pump. Testing with various pharmacological agents is needed to determine its ultimate potential for ophthalmic use.

  9. Adjunctive Oral Voriconazole Treatment of Fusarium Keratitis: A Secondary Analysis From the Mycotic Ulcer Treatment Trial II.

    Science.gov (United States)

    Prajna, N Venkatesh; Krishnan, Tiruvengada; Rajaraman, Revathi; Patel, Sushila; Shah, Ranjeet; Srinivasan, Muthiah; Devi, Lumbini; Das, Manoranjan; Ray, Kathryn J; O'Brien, Kieran S; Oldenburg, Catherine E; McLeod, Stephen D; Zegans, Michael E; Acharya, Nisha R; Lietman, Thomas M; Rose-Nussbaumer, Jennifer

    2017-06-01

    Fusarium keratitis is common and often results in poor outcomes. No new treatments since natamycin have become available. To explore the role of adjuvant oral voriconazole on clinical outcomes in Fusarium keratitis. In this prespecified subgroup analysis of a multicenter, double-masked, placebo-controlled randomized clinical trial, 240 patients from the Aravind Eye Care System in India, the Lumbini Eye Hospital and Bharatpur Eye Hospital in Nepal, and the University of California, San Francisco, who had culture-positive fungal ulcer and baseline visual acuity of 20/400 or worse were randomized to receive oral voriconazole vs placebo. Enrollment started May 24, 2010, and the last patient study visit was November 23, 2015. All patients received topical voriconazole, 1%, and after the results of the Mycotic Ulcer Treatment Trial (MUTT) II became available, topical natamycin, 5%, was added for all patients. Data analysis was performed from September 2 to October 28, 2016. The primary outcome of the trial was the rate of corneal perforation or the need for therapeutic penetrating keratoplasty. Secondary outcomes included rate of reepithelialization, best spectacle-corrected visual acuity, and infiltrate or scar size at 3 months. Of the 240 study participants, 72 (30.4%) were culture positive for Fusarium species (41 [56.9%] male and 31 [43.1%] female; median [interquartile range] age, 50 [45-57] years). Of these, 33 (45.8%) were randomized to oral voriconazole and 39 (54.2%) to placebo. Fusarium ulcers randomized to oral voriconazole had a 0.43-fold decreased hazard of perforation or therapeutic penetrating keratoplasty compared with placebo after controlling for baseline infiltrate depth (95% CI, 0.22-fold to 0.84-fold; P = .01). Multiple linear regression revealed a 1.89-mm decreased infiltrate and/or scar size at 3 weeks (95% CI, -2.69 to -1.09 mm; P Fusarium keratitis may benefit from the addition of oral voriconazole to topical natamycin, and physicians

  10. Glaucoma awareness among ophthalmic patients at Menelik II ...

    African Journals Online (AJOL)

    admin

    Raising awareness about glaucoma among the general public, ophthalmic patients and health professionals would ... media to be the main source of information about glaucoma. ..... This can be seen in relation to that of rural Indian study in ...

  11. HIV seroprevalence in patients undergoing Ophthalmic surgery in ...

    African Journals Online (AJOL)

    THAMPY

    3 HIV positive cases were detected out of 41 ophthalmic .... southern African countries, the national adult HIV prevalence rate has risen ... Africa with a population of 140 million people. ... Corneal transplantation is a possible route of viral.

  12. Fusarium keratitis in Brazil: genotyping, in vitro susceptibilities, and clinical outcomes

    Directory of Open Access Journals (Sweden)

    Oechsler RA

    2013-08-01

    Full Text Available Rafael A Oechsler,1 Tiago M Yamanaka,1 Paulo JM Bispo,1 Juliana Sartori,1 Maria Cecilia Zorat Yu,1 Analy Salles A Melo,2 Darlene Miller,3 Ana Luisa Hofling-Lima1 1Ophthalmology Department, 2Division of Infectious Diseases, Internal Medicine Department, Federal University of São Paulo, São Paulo, Brazil; 3Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Background: The purpose of this paper is to describe clinical characteristics and determine correlations between clinical outcomes and antifungal susceptibility among molecularly characterized ocular Fusarium isolates in Brazil. Methods: Forty-one Fusarium isolates obtained from 41 eyes of 41 patients were retrieved from the ophthalmic microbiology laboratory at São Paulo Federal University and grown in pure culture. These isolates were genotyped and antifungal susceptibilities determined for each isolate using a broth microdilution method. The corresponding medical records were reviewed to determine clinical outcomes. Results: The 41 isolates were genotypically classified as Fusarium solani species complex (36 isolates, 88%, Fusarium oxysporum species complex (two isolates, 5%, Fusarium dimerum species complex (one isolate, 2% and two isolates that did not group into any of the species complexes. Final best corrected visual acuity varied from 20/20 to light perception and was on average 20/800 (logarithm of the minimum angle of resolution (LogMAR 1.6. A history of trauma was the most common risk factor, being present in 21 patients (51%. Therapeutic penetrating keratoplasty was necessary in 22 patients (54%. Amphotericin B had the lowest minimum inhibitory concentration for 90% of isolates (MIC90 value (2 µg/mL and voriconazole had the highest (16 µg/mL. There was an association between a higher natamycin MIC and need for therapeutic penetrating keratoplasty (Mann–Whitney test, P < 0.005. Conclusion: Trauma was the main risk factor, and

  13. Risk factors of ophthalmic disorders in children with developmental delay

    DEFF Research Database (Denmark)

    Sandfeld, L.N.; Jensen, H.; Skov, L.

    2008-01-01

    PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12......PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12...

  14. Association between Ophthalmic Timolol and Hospitalisation for Bradycardia

    OpenAIRE

    2015-01-01

    Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol ...

  15. Effects of antiviral medications on herpetic epithelial keratitis in mice.

    Science.gov (United States)

    Komoto, Shohei; Higaki, Shiro; Fukuda, Masahiko; Shimomura, Yoshikazu

    2015-05-01

    Aciclovir (ACV), valaciclovir (VACV) and famciclovir (FCV) are used for systemic infections caused by herpes virus. In Japan, only topical ACV is permitted for use against herpetic keratitis. We investigated the effectiveness of topical ACV, oral VACV and oral FCV on mouse epithelial herpetic keratitis. C57/BL76 mice were inoculated with HSV-1 McKrae strain in the cornea. Once infection was confirmed 4 days after inoculation, topical ACV, oral VACV and FCV were started and administered for 5 days. Control groups were given either topical or oral saline. On days 2, 4, 6 and 10 after medication started, tears, eyeballs, and trigeminal ganglia were examined using viral culture and real-time PCR. Viral culture of tears detected no HSV in the topical ACV group on day 4 after administration start; with similar results for the oral VACV group on day 4; and the oral FCV group on day 6. Real-time PCR of the eyeballs showed significant decrease of HSV DNA copy number in the topical ACV group on days 4 and 6 compared to the topical saline group. Real-time PCR of the trigeminal ganglia showed significant decrease of HSV DNA copy number in the oral VACV group on days 4 and 6, and in the oral FCV group on day 6 compared to the oral saline group. We suggest that 5-day administration of topical ACV, oral VACV and oral FCV are effective for mouse epithelial herpetic keratitis and sufficiently decrease HSV amounts in the ocular surface and eyeballs.

  16. Metabolic Acidosis with Ophthalmic Dorzolamide in a Neonate.

    Science.gov (United States)

    Capino, Amanda C; Dannaway, Douglas C; Miller, Jamie L

    2016-01-01

    Carbonic anhydrase inhibitors are a common cause of normal anion gap metabolic acidosis; however, development is less commonly associated with ophthalmic administration of these agents. We report a case of a premature neonate who was being treated at our institution with betaxolol, dorzolamide, and latanoprost ophthalmic products for suspected bilateral congenital glaucoma. In addition, the patient was also receiving caffeine, ursodiol, and acidified liquid human milk fortifier. The patient developed a normal anion gap metabolic acidosis, and both dorzolamide ophthalmic solution and the acidified human milk fortifier were considered potential causes. Upon discontinuation of the dorzolamide ophthalmic solution and the switching of liquid human milk fortifiers, the normal anion gap metabolic acidosis gradually resolved. As a result of the pH and acidity, the acidified liquid human milk fortifier is thought to be associated with an anion gap acidosis; therefore, dorzolamide is suspected to be the primary cause of a normal gap acidosis. This case demonstrates that systemic effects can occur with ophthalmic administration of dorzolamide in a premature neonate. Ophthalmic agents should not be overlooked as a potential cause of systemic toxicity.

  17. Microsporidial keratitis in patients with hot springs exposure.

    Science.gov (United States)

    Fan, Nai-Wen; Wu, Chih-Chiau; Chen, Te-Li; Yu, Wei-Kuang; Chen, Chien-Pei; Lee, Shui-Mei; Lin, Pei-Yu

    2012-02-01

    This retrospective study included 10 eyes of 9 patients diagnosed with microsporidial keratitis. All of them were known to contract this disease after taking baths in hot springs. The disease was diagnosed based on detecting microsporidia in corneal scrapings using Gram stain and the modified Kinyoun's acid-fast stain. The specimens from the last six patients were subjected to PCR and then sequencing. All of them revealed that the microorganism identified has a high similarity to Vittaforma corneae. Repeated debridement of the epithelial lesions successfully eradicated the microsporidial infection in all nine patients.

  18. Keratoprosthesis in pediatric keratitis-icthyosiform-deafness syndrome.

    Science.gov (United States)

    Brown, Cortlyn; Rowlands, Megan; Lee, Daniel; Geffin, Joel A; Huang, John

    2016-02-01

    We report the first case of Boston Keratoprosthesis (KPro) implantation in a 7-year-old girl with keratitis-ichthyosiform-deafness syndrome and persistent, highly vascular corneal surface disease. An adult aphakic KPro with 8.5 mm backplate was implanted successfully and without operative or postoperative complications following 3 failed penetrating keratoplasties. Visual acuity improved from hand motions to 20/70 in the left eye 22 months after KPro surgery and from hand motion to hand motion with direction in the right eye. Glaucoma developed in the left eye, but intraocular pressure was successfully controlled with Ahmed valve placement and topical dorzolamide-timolol.

  19. A Case of Non-Contact Lens related Acanthamoeba keratitis in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Kamel, A. G.

    2005-01-01

    Full Text Available Acanthamoeba is a ubiquitous free-living amoeba and is responsible for an uncommon yet increasingly diagnosed keratitis in humans. Acanthamoeba keratitis is perhaps the most challenging ocular infection to manage successfully and it can result in permanently impaired vision or blindness. Although contact lens use is the principal risk factor, about 10% of cases occur following trauma and exposure to contaminated soil or water. Cases of Acanthamoeba keratitis involving contact lens wearers have previously been reported in Malaysia but this is the first time, a non-contact lens relatedAcanthamoeba keratitis is reported. The case involved a 28 year old Indonesian male construction worker who had a trauma of the right eye. While working his eye was struck by some sand and dust particles and he quickly washed his eye with water from an open tank at the construction site. He then experienced pain, redness, glaring and blurring of vision of the right eye. The diagnosis was missed at the initial presentation but subsequent culture of the corneal scraping demonstrated Acanthamoeba as the aetiological agent. The history, clinical findings, diagnosis and treatment of non-contact lens related Acanthamoeba keratitis are briefly discussed in this communication. We hope to create awareness especially among the medical and paramedical staff about the existence of this infection in the country and fully support the consideration of Acanthamoeba keratitis as part of the differential diagnosis of most cases of presumed microbial keratitis.

  20. Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease

    Directory of Open Access Journals (Sweden)

    Takahiko Hayashi

    2008-06-01

    Full Text Available Takahiko Hayashi1, Misaki Ishioka2, Norihiko Ito1, Yoko Kato1, Hisashi Nakagawa3, Hiroshi Hatano4, Nobuhisa Mizuki11Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan; 2Ryogoku Eye Clinic, Tokyo, Japan; 3Tokushima Eye Clinic, Higashimurayama-shi, Tokyo, Japan; 4Lumine Hatano Eye Clinic, Fujisawa, Fujisawa-shi, Kanagawa, JapanPurpose: To describe a case of bilateral herpes simplex keratitis accompanying chronic graft-versus-host disease (GVHD.Design: Observational case report.Case report: An 11-year-old boy with myelocytic leukemia underwent allogeneic bone marrow transplantation. He developed symptoms of the skin, eyes, and mouth, and lip biopsy indicated chronic GVHD. Persistent keratitis with corneal filaments and neovascularization was noted in both eyes. Sodium hyaluronate, autoserum, and 0.1% fluorometholone eyedrops were instilled for approximately 2 years to treat this keratitis, and there were no other ocular changes. Bilateral herpes simplex keratitis developed with geographic ulcers after topical betamethasone therapy, but responded to acyclovir ointment.Conclusions: Herpes keratitis should be considered in the differential diagnosis of bilateral keratitis in patients with reduced immunocompetence. During the course of chronic GVHD, corneal herpes may occur, so ocular treatment with topical corticosteroids should be managed by an ophthalmologist to monitor sight-threatening conditions such as corneal herpes.Keywords: chronic graft-versus-host disease, bone marrow transplant, corneal herpes, bilateral herpes simplex keratitis, dry eyes

  1. Exploring leptin antagonism in ophthalmic cell models.

    Directory of Open Access Journals (Sweden)

    Laura Scolaro

    Full Text Available BACKGROUND: Emerging evidence suggests that angiogenic and pro-inflammatory cytokine leptin might be implicated in ocular neovascularization. However, the potential of inhibiting leptin function in ophthalmic cells has never been explored. Here we assessed mitogenic, angiogenic, and signaling leptin activities in retinal and corneal endothelial cells and examined the capability of a specific leptin receptor (ObR antagonist, Allo-aca, to inhibit these functions. METHODS AND RESULTS: The experiments were carried out in monkey retinal (RF/6A and bovine corneal (BCE endothelial cells. Leptin at 50-250 ng/mL stimulated the growth of both cell lines in a dose-dependent manner. The maximal mitogenic response (35±7 and 27±3% in RF6A and BCE cells, respectively was noted at 24 h of 250 ng/mL leptin treatments. Leptin-dependent proliferation was reduced to base levels with 10 and 100 nM Allo-aca in BCE and RF6A cells, respectively. In both cell lines, leptin promoted angiogenic responses, with the maximal increase in tube formation (163±10 and 133±8% in RF6A and BCE cultures, respectively observed under a 250 ng/mL leptin treatment for 3 h. Furthermore, in both cell lines 250 ng/mL leptin modulated the activity or expression of several signaling molecules involved in proliferation, inflammatory activity and angiogenesis, such as STAT3, Akt, and ERK1/2, COX2, and NFκB. In both cell lines, leptin-induced angiogenic and signaling responses were significantly inhibited with 100 nM Allo-aca. We also found that leptin increased its own mRNA and protein expression in both cell lines, and this autocrine effect was abolished by 100-250 nM Allo-aca. CONCLUSIONS: Our data provide new insights into the role of leptin in ocular endothelial cells and represent the first original report on targeting ObR in ophthalmic cell models.

  2. Characterization of Fusarium Keratitis Outbreak Isolates: Contribution of Biofilms to Antimicrobial Resistance and Pathogenesis

    Science.gov (United States)

    Mukherjee, Pranab K.; Chandra, Jyotsna; Yu, Changping; Sun, Yan; Pearlman, Eric; Ghannoum, Mahmoud A.

    2012-01-01

    Purpose. Fusarium is a major cause of microbial keratitis, and its ability to form biofilms was suggested as a contributing factor in recent outbreaks. We investigated the ability of outbreak Fusarium isolates (F. solani species complex [FSSC] and F. oxysporum species complex [FOSC]) to form biofilms in vitro and in vivo, and evaluated their antifungal susceptibilities. Methods. Biofilm formation was assessed using our in vitro contact lens model and in vivo murine model. Biofilm architecture was assessed using confocal laser scanning microscopy (CLSM). Susceptibility against amphotericin B (AmB), voriconazole (VCZ), and natamycin (NAT) was determined using the CLSI-M38-A2 method and XTT metabolic assay. Results. FSSC strains formed more biofilms than FOSC, in a strain- and clade-dependent manner. CLSM analyses revealed that “high biofilm forming” (HBF) strains had denser and thicker biofilms than “low biofilm forming” (LBF) strains of both species (thickness 51 vs. 41 μm for FSSC and 61 vs. 45 μm for FOSC strains, P Fusarium biofilms exhibited species-dependent antifungal susceptibilities (e.g., FSSC biofilms AmB minimal inhibitory concentrations [MIC] ≥16 μg/mL, while NAT or VCZ MICs were 2–8 μg/mL). FSSC-infected mice had severe corneal opacification independent of biofilm thickness, while FOSC infection resulted in moderate corneal opacification. Corneal fungal burden of mice infected with HBF strains was higher than those of the LBF strains. In contrast, the reference ATCC isolate was unable to cause infection. Conclusions. The ability to form biofilms is a key pathogenicity determinant of Fusarium, irrespective of the thickness of these biofilms. Further studies are warranted to explore this association in greater detail. PMID:22669723

  3. Dose uniformity of loteprednol etabonate ophthalmic gel (0.5% compared with branded and generic prednisolone acetate ophthalmic suspension (1%

    Directory of Open Access Journals (Sweden)

    Marlowe ZT

    2013-12-01

    Full Text Available Zora T Marlowe, Stephen R DavioPharmaceutical Product Development, Global Pharmaceutical Research and Development, Bausch and Lomb, Inc, Rochester, NY, USAIntroduction: Loteprednol etabonate (LE ophthalmic gel 0.5% (Lotemax® is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte® and a generic prednisolone acetate suspension 1% were used as comparators.Methods: Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing – consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC method and reported as a percentage of the declared (labeled concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity.Results: Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD] percent declared concentration of 102% (1.92% over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively, with mean concentrations for both falling significantly

  4. Epidemiological and etiological characteristics of infectious keratitis in the elderly%老年人感染性角膜炎病因及病原学特征分析

    Institute of Scientific and Technical Information of China (English)

    孔令宇; 肖凤枝; 郑素惠; 姜皓; 赵爱华; 王彩云; 刘素媛; 张小利

    2015-01-01

    Objective To investigate the pathogenic and etiological characteristics of infectious keratitis in the elderly.Method All 668 proven cases (671 eyes) of infectious keratitis in the elderly aged 60 years and older from January 2013 to December 2014 were retrospectively reviewed.Results The cases of infectious keratitis in the elderly which occupy 49.5% were major component in inpatient of the department of ocular surface disease, 402 patients (60.2%) were not treat regularly, 148 patients were in hospital after onset 7 days, 154 cases (33.0%) had corneal lesions larger than 5mm, 81 (71.7%) bacterial keratitis in the elderly were complicated by dacrocystitis or viral keratitis, 31 (21.2%) fungal keratitis in the elderly were complicated by viral keratitis, 277 (67.7%) viral keratitis were recurrence.65 cases (9.7%) which were of no effect or improved but not cured with medication were received operation.Causative agent were cultured as 26 fungi, half of them were fusarium species, and 16 bacteria in which there were 4 streptococcus salivarius (30.8%) separately.The mean course of disease to fungal and bacteria and viral keratitis in our hospital were 18 days and 13 days and 7 days respectively.Conclusions Chronic and recurrent ocular surface diseases play an important role in the infectious keratitis in the elderly.Infectious keratitis in the elderly has long course of disease.They treat lately in early stage and hardly to cure in later period.Fungal keratitis in the elderly has its own feature and should be known and study more to reduce its morbidity and improve its prognosis.%目的 分析老年人感染性角膜炎的病因、病原学特征.方法 对唐山市眼科医院于2013年1月至2014年12月确诊为感染性角膜炎的668例(671只眼),60岁以上住院患者进行回顾性研究,对其病因及病原学特征进行分析.结果 老年人感染性角膜炎人数多,占角膜病49.5%(668/1350),院前未规律治疗402例(60.2% 402

  5. OPHTHALMIC DISORDERS AMONG STUDENTS OF SCHOOL FOR THE DEAF

    Directory of Open Access Journals (Sweden)

    Omolase C O

    2012-08-01

    Full Text Available Aim: This study aimed at determining the prevalence and pattern of ophthalmic disorders among students of School for the Deaf, Akure, Ondo State, Nigeria.Methodology: This is a cross sectional descriptive study was conducted in October, 2011 as part of activities marking the Annual Physicians’ week of Nigerian Medical Association (NMA,Ondo State. Ethical clearance was obtained from the Ethical Review Committee of Federal Medical Centre, Owo prior to commencement of this study. The permission of the School Authority was also obtained before the commencement of this study. The respondents were selected by simple random sampling technique. All enrolled participants were interviewed with the aid of the study instrument (questionnaire by the authors and interpreters (school teachers.Results: The respondents comprised of 91(56.9% Males and 69 Females (43.1%. Nearly all the respondents;158(98.8% were deaf and dumb. Most respondents; 116(72.5% had ocular examination in the past. Few respondents; 118(73.75% had ophthalmic disorder. The commonest ophthalmic disorder was refractive error which was found in 16 respondents (38.1%. Myopia was diagnosed in 9 respondents.CONCLUSION: Most of the respondents were deaf and dumb. Few respondents had ophthalmic disorder. The commonest ophthalmic disorder was refractive error. Myopia was the most predominant refractive error. There is need for periodic ocular screening and treatment atthe School for the Deaf.

  6. Ultraviolet Keratitis: From the Pathophysiological Basis to Prevention and Clinical Management.

    Science.gov (United States)

    Willmann, Gabriel

    2015-12-01

    Ultraviolet keratitis is caused by the toxic effects of acute high-dose ultraviolet radiation (UVR) reflecting the sensitivity of the ocular surface to photochemical injury. The clinical syndrome presents with ocular pain, tearing, conjunctival chemosis, blepharospasm, and deterioration of vision typically several hours after exposure, lasting up to 3 days. Mountaineers, skiers, and beach recreationalists are particularly at risk to suffer from ultraviolet (UV) keratitis as the reflectivity of UVR in these environments is extremely high. The aim of this review is to raise awareness about the potential of UV damage on the eye with an emphasis on UV keratitis, to highlight the pathophysiological basis of corneal phototoxicity, and to provide practical guidance for the prevention and clinical management of UV keratitis commonly known as snow blindness.

  7. An atypical presentation of Acanthamoeba keratitis in a noncontact lens wearer.

    Science.gov (United States)

    Speer, Christine E; Hofmeister, Elizabeth M; Cohen, Elisabeth J

    2003-01-01

    This article presents the case of a 49-year-old man who did not have a history of wearing contact lenses and who developed a rapidly progressive course of Acanthamoeba keratitis. The patient developed stromal keratitis that did not respond to herpes simplex virus therapies. Within 1 week after presentation, the patient progressed from mild anterior stromal haze and edema to a ring infiltrate, epithelial loss, and significant corneal edema. Corneal scrapings demonstrated cysts consistent with Acanthanmoeba keratitis. The patient was admitted to the hospital and placed on intensive medical therapy. He responded to therapy, and at 5 months showed central scarring in a quiet eye. This article presents a case of Acanthamoeba keratitis in a non-contact lens wearer, who was diagnosed clinically and histopathologically within 1 week of onset of symptoms. His case was atypical given his lack of contact lens wear or antecedent trauma and rapid progression to a ring infiltrate, usually seen as late findings.

  8. Acanthamoeba keratitis in a non-contact lens wearer with human immunodeficiency virus.

    Science.gov (United States)

    Hansen, Birgitte; Kronborg, Gitte

    2003-01-01

    Acanthamoeba keratitis is potentially blinding and often associated with contact lens wearing. A human immunodeficiency virus (HIV)-positive patient, a non-contact lens wearer, presented with keratitis. She experienced a protracted course of disease, characterized by exacerbations and remissions, and was treated with various topical antibiotics and steroids. 13 months after symptom onset the eye was removed owing to serious scarring of cornea and unbearable pain. Microbiological and histopathological examination of the cornea showed Acanthamoeba. In non-contact lens wearers suffering from Acanthamoeba keratitis the diagnosis is delayed, pathognomonic features are often not seen and visual outcome is usually poor. There is no known relation between HIV infection and Acanthamoeba keratitis.

  9. Acanthamoeba keratitis in a non-contact lens wearer with human immunodeficiency virus

    DEFF Research Database (Denmark)

    Hansen, Birgitte Rønde; Kronborg, Gitte

    2003-01-01

    Acanthamoeba keratitis is potentially blinding and often associated with contact lens wearing. A human immunodeficiency virus (HIV)-positive patient, a non-contact lens wearer, presented with keratitis. She experienced a protracted course of disease, characterized by exacerbations and remissions......, and was treated with various topical antibiotics and steroids. 13 months after symptom onset the eye was removed owing to serious scarring of cornea and unbearable pain. Microbiological and histopathological examination of the cornea showed Acanthamoeba. In non-contact lens wearers suffering from Acanthamoeba...... keratitis the diagnosis is delayed, pathognomonic features are often not seen and visual outcome is usually poor. There is no known relation between HIV infection and Acanthamoeba keratitis....

  10. Therapeutic Effect of 0.1% Topical Tacrolimus for Childhood Interstitial Keratitis Refractory to Cyclosporine.

    Science.gov (United States)

    Joko, Takeshi; Shiraishi, Atsushi; Ogata, Miki; Ohashi, Yuichi

    2016-01-01

    To report our findings in a case of childhood refractory interstitial keratitis successfully treated with 0.1% topical tacrolimus. A 12-year-old boy presented with a 3-year history of interstitial keratitis. For the recurrent interstitial keratitis he had been treated with topical and systemic acyclovir, steroids, and topical cyclosporine for 3 years. Our examinations revealed severe stromal infiltrates and neovascularization. Treatment was changed from topical 0.5% cyclosporine to topical 0.1% tacrolimus combined with topical acyclovir and betamethasone. After 2 weeks of treatment with topical tacrolimus, the degree of stromal infiltrates decreased. Although the improvements were slow, the stromal infiltrates resolved somewhat, and neovascularization and topical acyclovir and betamethasone were tapered and stopped in 18 months. Since then, the patient has not shown any recurrence for 9 months without medication. Our findings indicate that topical tacrolimus should be considered for treating refractory interstitial keratitis in children.

  11. Clinical Observation of a Child with KID (Keratitis-Ichthyosis-Deafness Syndrome

    Directory of Open Access Journals (Sweden)

    V.A. Klymenko

    2015-10-01

    Full Text Available A clinical case of keratitis-ichthyosis-deafness (KID syndrome in an infant is described. The article familia-rizes pediatricians and family doctors with difficulties in the diagnosis of this rare genetic disease in infants.

  12. Contact lens-related polymicrobial keratitis from Pantoea agglomerans and Escherichia vulneris

    Directory of Open Access Journals (Sweden)

    Vincent D. Venincasa

    2016-04-01

    Conclusions: This is the first report of P. agglomerans and E. vulneris keratitis in association with contact lens wear. Both strains of P. agglomerans and E. vulneris were pansensitive to all tested antibiotics.

  13. Synthetic fiber from a teddy bear causing keratitis and conjunctival granuloma

    DEFF Research Database (Denmark)

    Farooq, Mohammed Kashaf; Prause, Jan U; Heegaard, Steffen

    2011-01-01

    Background To report a case of keratitis and a case of conjunctivitis caused by synthetic fibers from toy teddy bears. Case presentation Case stories with histopathological analysis. 1) A two-year-old girl developed a severe case of keratitis and corneal ulceration. The initial treatment with var......Background To report a case of keratitis and a case of conjunctivitis caused by synthetic fibers from toy teddy bears. Case presentation Case stories with histopathological analysis. 1) A two-year-old girl developed a severe case of keratitis and corneal ulceration. The initial treatment...... by demonstration of marked birefringence of the synthetic fibers. Microscopical examination of synthetic fibers from two different types of fur (whiskers and face hairs) from the two-year-old girl's teddy bear was performed. Hairs from the face of the teddy bear were morphologically and microscopically identical...

  14. Reliability and validity of an indicator system for assessing the quality of ophthalmic nursing

    Directory of Open Access Journals (Sweden)

    Jing-Hua Shi

    2016-12-01

    Conclusions: The indicator system for evaluating the quality of ophthalmic nursing has favorable reliability and validity, which means that it is a suitable clinical tool for assessing the quality of ophthalmic nursing.

  15. Support of the Laboratory in the Diagnosis of Fungal Ocular Infections

    Science.gov (United States)

    Vanzzini Zago, Virginia; Alcantara Castro, Marino; Naranjo Tackman, Ramon

    2012-01-01

    This is a retrospective, and descriptive study about the support that the laboratory of microbiology aids can provide in the diagnosis of ocular infections in patients whom were attended a tertiary-care hospital in México City in a 10-year-time period. We describe the microbiological diagnosis in palpebral mycose; in keratitis caused by Fusarium, Aspergillus, Candida, and melanized fungi; endophthalmitis; one Histoplasma scleritis and one mucormycosis. Nowadays, ocular fungal infections are more often diagnosed, because there is more clinical suspicion and there are easy laboratory confirmations. Correct diagnosis is important because an early medical treatment gives a better prognosis for visual acuity. In some cases, fungal infections are misdiagnosed and the antifungal treatment is delayed. PMID:22518339

  16. Clinical resistance of Staphylococcus keratitis to ciprofloxacin monotherapy.

    Directory of Open Access Journals (Sweden)

    Sharma Vijay

    2004-01-01

    Full Text Available PURPOSE: To review the in vitro susceptibility and the clinical response to 0.3% ciprofloxacin in Staphylococcus aureus keratitis. METHODS: This is a non-comparative case series derived from a prospectively collected database and analysed retrospectively. One hundred and twenty one patients presenting in the cornea service of LV Prasad Eye Institute, Hyderabad, India, between January 1993 and December 2000, and identified to have S. aureus keratitis were included in the study. All patients had received slitlamp evaluation of the cornea and diagnostic microbiologic workup. They were treated with topical antimicrobial therapy based on smear and culture results. All S. aureus isolates were tested for antibiotic susceptibility by disk diffusion and those resistant to ciprofloxacin were confirmed by testing for minimum inhibitory concentration. The patients′ clinical response to the antimicrobial therapy was noted. RESULTS: Twenty-five (20.6% of 121 isolates resistant to ciprofloxacin on in vitro susceptibility testing were further analysed in this study. Fifteen of these 25 (60% patients were initially treated with topical ciprofloxacin. Twelve of 15 (80% patients showed no clinical improvement (3-8 days. Based on antibiotic susceptibility results, the antibiotic therapy was modified to fortified cefazolin and gentamicin in seven (58.3%, to vancomycin in one and to chloramphenicol in four cases. The corneal infiltrate resolved in 11 (73.3% of 15 cases. Two patients required penetrating keratoplasty (PK, one required evisceration, and one patient was lost to follow up. Nine of 25 patients were initially started on fortified cefazolin and gentamicin therapy based on smear positive for gram-positive cocci; this resulted in resolution of infiltrate in 44.4% (4/9 while three required change of antibiotics (vancomycin-2, chloramphenicol-1, one required PK and one patient was lost to follow up. One of 25 patients started and continued on chloramphenicol

  17. Dose uniformity of loteprednol etabonate ophthalmic gel (0.5%) compared with branded and generic prednisolone acetate ophthalmic suspension (1%)

    Science.gov (United States)

    Marlowe, Zora T; Davio, Stephen R

    2014-01-01

    Introduction Loteprednol etabonate (LE) ophthalmic gel 0.5% (Lotemax®) is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte®) and a generic prednisolone acetate suspension 1% were used as comparators. Methods Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing – consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC) method and reported as a percentage of the declared (labeled) concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity. Results Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD]) percent declared concentration of 102% (1.92%) over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively), with mean concentrations for both falling significantly below the declared concentration for drops expressed at the beginning of the 2-week dosing regimen and significantly above the declared concentration for drops expressed

  18. THE ROLE OF REPRESENTATIVES IN OPHTHALMIC PATHOLOGY HERPESVIRUS

    Directory of Open Access Journals (Sweden)

    Kashpur NV,

    2012-10-01

    Full Text Available The goal was to establish a place of herpesviruses (HSV1, HSV2, HHV6, SMV, VZV, EBV in the etiological structure of the eye’s diseases. The study involved 35 patients diagnosed with recurrent keratitis (15 patients and viral uveitis (n = 20. Was carried out virological examination, including a study using fluorescent antibody scrapings from the cornea and conjunctiva for the presence of herpesvirus antigen in leukocytes and determination of the blood antigens of viruses with the calculation of the fluorescence index (FI. Set of different herpesvirus persistence in leukocytes of blood in 95% of patients with viral uveitis and 32% of patients with keratitis. In the each second patient with viral uveitis (10 detected association of three or more herpesvirus antigens in blood leukocytes. Most often these associations are found antigens of viruses EBV, SMV, and HHV6.

  19. Increasing incidence of ophthalmic lymphoma in Denmark from 1980 to 2005

    DEFF Research Database (Denmark)

    Sjö, Lene D; Ralfkiær, Elisabeth Methner; Prause, Jan U;

    2008-01-01

    PURPOSE: To evaluate patient characteristics and incidence of ophthalmic lymphoma in Denmark during the period 1980 to 2005. METHODS: All patients in Denmark with a diagnosis of ophthalmic lymphoma during the period 1980 to 2005 were retrieved from three different population-based registries......: In the Danish population ophthalmic lymphoma consists primarily of orbital MALT lymphoma. Although it is a rare disease in mostly elderly patients, the incidence of ophthalmic lymphoma is increasing at a rapid pace....

  20. Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods.

    Science.gov (United States)

    Grey, Katherine R; Warshaw, Erin M

    Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

  1. Fungal Genomics Program

    Energy Technology Data Exchange (ETDEWEB)

    Grigoriev, Igor

    2012-03-12

    The JGI Fungal Genomics Program aims to scale up sequencing and analysis of fungal genomes to explore the diversity of fungi important for energy and the environment, and to promote functional studies on a system level. Combining new sequencing technologies and comparative genomics tools, JGI is now leading the world in fungal genome sequencing and analysis. Over 120 sequenced fungal genomes with analytical tools are available via MycoCosm (www.jgi.doe.gov/fungi), a web-portal for fungal biologists. Our model of interacting with user communities, unique among other sequencing centers, helps organize these communities, improves genome annotation and analysis work, and facilitates new larger-scale genomic projects. This resulted in 20 high-profile papers published in 2011 alone and contributing to the Genomics Encyclopedia of Fungi, which targets fungi related to plant health (symbionts, pathogens, and biocontrol agents) and biorefinery processes (cellulose degradation, sugar fermentation, industrial hosts). Our next grand challenges include larger scale exploration of fungal diversity (1000 fungal genomes), developing molecular tools for DOE-relevant model organisms, and analysis of complex systems and metagenomes.

  2. Microbiological assay for the determination of azithromycin in ophthalmic solutions

    Institute of Scientific and Technical Information of China (English)

    Hérida Regina Nunes SALGADO; Ana Flavia Ferreira RONCARI

    2005-01-01

    The validation of a simple, sensitive and specific agar diffusion bioassay, applying cylinder-plate method, for the determination of the antibiotic azithromycin in ophthalmic solutions is described. Using a strain of Bacillus subtilis ATCC 9372 as the test organism, azithromycin at concentrations ranging from 50.0 to 200.0 μg·mL -1 could be measured in 1.666 7 mg·mL -1 ophthalmic solutions. A prospective validation of the method showed that the method was linear (r=0.999 9) and precise (RSD=0.70) and accurate (it measured the added quantities). The results obtained by bioassay method could be statistically calculated by linear parallel model and by means of regression analysis and verified using analysis of variance (ANOVA). We conclude that the microbiological assay is satisfactory for quantification of azithromycin in ophthalmic solutions.

  3. Smart ophthalmics: the future in tele-ophthalmology has arrived

    Science.gov (United States)

    Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin

    2016-05-01

    Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.

  4. Pathogenic Free-Living Amoebae Isolated From Contact Lenses of Keratitis Patients

    Directory of Open Access Journals (Sweden)

    Elham HAJIALILO

    2015-12-01

    Full Text Available Background: Free-living amoeba (FLA-related keratitis is a progressive infection of the cornea with poor prognosis. The present study aimed to investigates the con­tact lenses of patients with keratitis for pathogenic free-living amoebae.Methods: Overall, 62 contact lenses and their paraphernalia of patients with kerati­tis cultured and tested for the presence of free-living amoebae using morphological criteria. Unusual plates including plates containing mix amoebae and Vermamoeba were submitted to molecular analysis. Results: Out of 62 plates, 11 revealed the outgrowth of free living amoeba of which 9 were Acanthamoeba, one plates contained mix amoebae including Acan­thamoeba and Vermamoeba and one showed the presence of Vermamoeba. These two latter plates belonged to patients suffered from unilateral keratitis due to the mis­used of soft contact lenses. One of the patients had mix infection of Acanthamoeba (T4 and V. vermiformis meanwhile the other patient was infected with the V. vermiformis. Conclusion: Amoebic keratitis continues to rise in Iran and worldwide. To date, various genera of free-living amoebae such as Vermamoeba could be the causative agent of keratitis. Soft contact lens wearers are the most affected patients in the country, thus awareness of high-risk people for preventing free-living amoebae re­lated keratitis is of utmost importance.

  5. Methicillin-Resistant Staphylococcus aureus Keratitis after Descemet's Stripping Automated Endothelial Keratoplasty

    Directory of Open Access Journals (Sweden)

    Tatsuro Miyamoto

    2013-11-01

    Full Text Available Purpose: We report a case of methicillin-resistant Staphylococcus aureus (MRSA keratitis after Descemet's stripping automated endothelial keratoplasty (DSAEK. Case Report: An 87-year-old woman who had undergone a DSAEK 4 months previously was referred to Tokushima University Hospital with a diagnosis of infectious keratitis after DSAEK. A white abscess and infiltration in the inferior cornea of the right eye were observed. We started an empiric therapy using topical levofloxacin and chloramphenicol on the basis of the microscopic findings of the corneal scraping concurrently with cultivation of the cornea. Results: A strain of MRSA was isolated from the corneal sample. Although the strain was susceptible to chloramphenicol, it was resistant to quinolone. The keratitis improved rapidly due to empiric therapy, and topical steroids could be resumed 6 days after initiation of the empiric therapy. Conclusions: To our knowledge, this is the first case of MRSA keratitis, and the second case of bacterial keratitis, after DSAEK. MRSA keratitis can occur following uneventful DSAEK. The empiric therapy on the basis of results from a light microscopic examination of a Gram-stained corneal scraping and restarting topical steroids in the early stages of medication contributed to the good clinical course of this case.

  6. Rabbit model of aspergillus keratitis induced by modified corneal surface lens method%改良角膜表面镜片术法建立兔曲霉菌性角膜炎动物模型

    Institute of Scientific and Technical Information of China (English)

    刘廷; 徐园园; 陈豪; 谢立信

    2011-01-01

    子/ml组仅在造模3d时可见菌丝生长.结论 改良角膜表面镜片术法可成功制备兔曲霉菌性角膜炎动物模型,是一种简便、易于操作的真菌性角膜炎动物模型制作方法.%Background Animal model of fungal keratitis is an available tool to the experimental study of the pathogenesis mechanism of fungal keratitis. Current modeling methods of fungal keratitis include corneal scratching, corneal stroma injection and corneal surface lens methods. But these methods still have their own shortages. Objective This experiment was to create a fungal keratitis animal model by modifying corneal surface lens method. Methods Modified animal models of fungal keratitis were created by modified corneal surface lens method in 12 general adult New Zealand white rabbits. The filter papers soaked 108 spores / ml or A106spores / ml of spergillus fumigatus suspension were attached on the de-epithelial cornea surface and fixed with contact lens and tarsorrhaphy for 2 days, and the filter paper with physiological saline was used as control group. The symptoms of anterior segment were examined under the slit lamp in 3 ,7 and 14 days after surgery and scored based on the criteria of Dong. Corneal scraping was stained with 10% potassium hydroxide and calcofluor white stain to observed mycelium under the fluorescence microscope. Corneal tissue sections were examined by hematoxylin-eosin staining and periodic acid Schiff staining under the light microscope. The use of animal followed the Standard of Association for Research in Vision and Ophthalmology. Results Fungal keratitis models were successfully established in 6 eyes and 4 eyes in 108 spores/ml group (6/6) and 106 spores/ml group respectively. The symptom was more severer and score was higher in the eyes of 108 spores/ml group than that in 106 spores/ml group. At 3 and 7 days after surgery,the symptom scores of fungal keratitis models were higher than those of control group from 3 through 7 days with the statistically

  7. Emerging Threats for Human Health in Poland: Pathogenic Isolates from Drug Resistant Acanthamoeba Keratitis Monitored in terms of Their In Vitro Dynamics and Temperature Adaptability

    Directory of Open Access Journals (Sweden)

    Lidia Chomicz

    2015-01-01

    Full Text Available Amphizoic amoebae generate a serious human health threat due to their pathogenic potential as facultative parasites, causative agents of vision-threatening Acanthamoeba keratitis (AK. Recently, AK incidences have been reported with increasing frequency worldwide, particularly in contact lens wearers. In our study, severe cases of AK in Poland and respective pathogenic isolates were assessed at clinical, morphological, and molecular levels. Misdiagnoses and the unsuccessful treatment in other ophthalmic units delayed suitable therapy, and resistance to applied chemicals resulted in severe courses and treatment difficulties. Molecular assessment indicated that all sequenced pathogenic corneal isolates deriving from Polish patients with AK examined by us showed 98–100% homology with Acanthamoeba genotype T4, the most prevalent genotype in this human ocular infection worldwide. In vitro assays revealed that the pathogenic strains are able to grow at elevated temperature and have a wide adaptive capability. This study is our subsequent in vitro investigation on pathogenic Acanthamoeba strains of AK originating from Polish patients. Further investigations designed to foster a better understanding of the factors leading to an increase of AK observed in the past years in Poland may help to prevent or at least better cope with future cases.

  8. Emerging Threats for Human Health in Poland: Pathogenic Isolates from Drug Resistant Acanthamoeba Keratitis Monitored in terms of Their In Vitro Dynamics and Temperature Adaptability.

    Science.gov (United States)

    Chomicz, Lidia; Conn, David Bruce; Padzik, Marcin; Szaflik, Jacek P; Walochnik, Julia; Zawadzki, Paweł J; Pawłowski, Witold; Dybicz, Monika

    2015-01-01

    Amphizoic amoebae generate a serious human health threat due to their pathogenic potential as facultative parasites, causative agents of vision-threatening Acanthamoeba keratitis (AK). Recently, AK incidences have been reported with increasing frequency worldwide, particularly in contact lens wearers. In our study, severe cases of AK in Poland and respective pathogenic isolates were assessed at clinical, morphological, and molecular levels. Misdiagnoses and the unsuccessful treatment in other ophthalmic units delayed suitable therapy, and resistance to applied chemicals resulted in severe courses and treatment difficulties. Molecular assessment indicated that all sequenced pathogenic corneal isolates deriving from Polish patients with AK examined by us showed 98-100% homology with Acanthamoeba genotype T4, the most prevalent genotype in this human ocular infection worldwide. In vitro assays revealed that the pathogenic strains are able to grow at elevated temperature and have a wide adaptive capability. This study is our subsequent in vitro investigation on pathogenic Acanthamoeba strains of AK originating from Polish patients. Further investigations designed to foster a better understanding of the factors leading to an increase of AK observed in the past years in Poland may help to prevent or at least better cope with future cases.

  9. Fungal DNA barcoding.

    Science.gov (United States)

    Xu, Jianping

    2016-11-01

    Fungi are ubiquitous in both natural and human-made environments. They play important roles in the health of plants, animals, and humans, and in broad ecosystem functions. Thus, having an efficient species-level identification system could significantly enhance our ability to treat fungal diseases and to monitor the spatial and temporal patterns of fungal distributions and migrations. DNA barcoding is a potent approach for rapid identification of fungal specimens, generating novel species hypothesis, and guiding biodiversity and ecological studies. In this mini-review, I briefly summarize (i) the history of DNA sequence-based fungal identification; (ii) the emergence of the ITS region as the consensus primary fungal barcode; (iii) the use of the ITS barcodes to address a variety of issues on fungal diversity from local to global scales, including generating a large number of species hypothesis; and (iv) the problems with the ITS barcode region and the approaches to overcome these problems. Similar to DNA barcoding research on plants and animals, significant progress has been achieved over the last few years in terms of both the questions being addressed and the foundations being laid for future research endeavors. However, significant challenges remain. I suggest three broad areas of research to enhance the usefulness of fungal DNA barcoding to meet the current and future challenges: (i) develop a common set of primers and technologies that allow the amplification and sequencing of all fungi at both the primary and secondary barcode loci; (ii) compile a centralized reference database that includes all recognized fungal species as well as species hypothesis, and allows regular updates from the research community; and (iii) establish a consensus set of new species recognition criteria based on barcode DNA sequences that can be applied across the fungal kingdom.

  10. Turkish Contribution to Ophthalmic Literature From 1990 to 2013

    Directory of Open Access Journals (Sweden)

    Hüseyin Bayramlar

    2014-12-01

    Full Text Available Objectives: To investigate the frequency and distribution of ophthalmic articles with Turkish origin on Pubmed search engine and to compare these data with those of the world’s leading countries in that field. Materials and Methods: Using the words “ophthalmology” and “Turkey”, an online retrospective search was conducted on Pubmed for the period from 1990 to 2013. Additionally, same search was performed for each ophthalmic journal indexed in Science Citation Index Expanded (SCI-E (n=56 and not indexed in SCI-E (n=8, separately. The articles were divided into two groups (research articles and the other articles as case reports, letters, correspondence, editorials and reviews. Results: A total of 5044 articles in the area of ophthalmology were from Turkey in that period. The United States of America, Japan, and Germany had the maximum number of published articles (25%, 6.8%, and 4.9% of all, respectively. There were 3334 articles on ophthalmic journals. 2822 articles were published in SCI-E journals and of those, 2321 were research articles and 501 were other types of articles. Three SCI-E indexed ophthalmic journals which mostly published Turkish articles are the European Journal of Ophthalmology, Journal of Cataract and Refractive Surgery, and the Ophthalmologica (361, 183, and 152, respectively. Conclusion: In this period, the rate of the published ophthalmic articles originated from Turkey was 1.5%. We observed that the number of Turkish ophthalmic articles has been increasing gradually. (Turk J Ophthalmol 2014; 44: 465-70

  11. Fungal arthritis and osteomyelitis.

    Science.gov (United States)

    Kohli, Rakhi; Hadley, Susan

    2005-12-01

    Fungal arthritis and osteomyelitis are uncommon diseases and generally present in an indolent fashion. The incidence of fungal bone and joint dis-ease is increasing with an increase in the prevalence of factors predisposing to invasive fungal disease, such as the use of central venous catheters, broad spectrum antibiotics, immunosuppression, and abdominal surgery. Definitive diagnosis relies on bone or synovial culture or biopsy. Successful management has traditionally consisted of amphotericin B in combination with surgical debridement. Given the rarity of this disease, treatment is not well defined, but reports of success with the use of azole antifungal agents, including itraconazole, fluconazole, voriconazole, and posaconazole, are promising.

  12. 21 CFR 524.1880 - Prednisolone-neomycin sulfate ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Prednisolone-neomycin sulfate ophthalmic ointment... ANIMAL DRUGS § 524.1880 Prednisolone-neomycin sulfate ophthalmic ointment. (a) Specifications. Prednisolone-neomycin sulfate ophthalmic ointment contains 2 milligrams prednisolone and 5 milligrams...

  13. 77 FR 8262 - Dermatologic and Ophthalmic Drugs Advisory Committee; Amendment of Notice

    Science.gov (United States)

    2012-02-14

    ... HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee... Administration (FDA) is announcing an amendment to the notice of the meeting of the Dermatologic and Ophthalmic... that a meeting of the Dermatologic and Ophthalmic Drugs Advisory Committee would be held on February 27...

  14. Keratitis by Aspergillus flavus infection after cataract surgery

    Directory of Open Access Journals (Sweden)

    João Luiz Pacini Costa

    Full Text Available ABSTRACT We report a case of keratis infection after cataract phacoemulsification with intraocular lens implantation in a 65-year-old female patient. The patient initially underwent cataract surgery on the right eye. Intraocular inflammation appeared on the second post-operative day and was initially treated as Toxic Anterior Segment Syndrome (TASS. The inflammation was reduced and vision improved initially but very aggressive and progressive keratitis destroyed the cornea due to the delay in correct diagnosis. Aspergillus flavus was isolated from a biopsy.The infection was treated with antifungal agents and loss of the eye was avoided by total corneal transplantation associated with Gundersen conjunctiva cover. To restore the lost vision, a second penetrating corneal graft with removal of the conjunctiva cover was performed 17 months later. The final best-corrected vision was 20/40 but prognosis for long-term graft survival is poor.

  15. Raman microspectroscopy analysis in the treatment of acanthamoeba keratitis.

    Directory of Open Access Journals (Sweden)

    Giulia Rusciano

    Full Text Available Acanthamoeba keratitis is a rare but serious corneal disease, often observed in contact lens wearers. Clinical treatment of infected patients frequently involves the use of polyhexamethylene biguanide (PHMB, a polymer used as a disinfectant and antiseptic, which is toxic also for the epithelial cells of the cornea. Prompt and effective diagnostic tools are hence highly desiderable for both starting early therapy and timely suspension of the treatment. In this work we use Raman microspectroscopy to analyse in vitro a single Acanthamoeba cell in cystic phase. In particular, we investigate the effect of PHMB at the single-cell level, providing useful information on both the underlying biochemical mechanism and the time frame for Acanthamoeba eradication in ocular infections. Furthermore, we demonstrate that Raman spectroscopy, in conjunction with standard multivariate analysis methods, allows discriminating between live and dead Acanthamoebas, which is fundamental to optimizing patients' treatment.

  16. Double-Biguanide Therapy for Resistant Acanthamoeba Keratitis

    Directory of Open Access Journals (Sweden)

    Giulio Ferrari

    2011-11-01

    Full Text Available Aims: To report the clinical and diagnostic findings of a patient with Acanthamoeba keratitis resistant to both polyhexamethylene biguanide (PHMB-hexamidine and chlorhexidine-hexamidine treatment. Methods: Slit-lamp biomicroscopy, corneal cell scraping and histopathology were performed on a 39-year-old woman presenting with corneal ulcer in her left eye. Results: The patient was successfully treated with PHMB-chlorhexidine association therapy. Subsequent perforating keratoplasty remained clear at the last follow-up visit after 7 months and increased visual acuity to 20/20 with correction. Conclusions: This case emphasizes the proteiform aspects of Acanthamoeba drug resistance, and suggests that PHMB-chlorhexidine association might represent an additional option for cases resistant to standard therapy.

  17. A case of keratitis associated with limbal relaxing incision

    Directory of Open Access Journals (Sweden)

    Aravind Haripriya

    2016-01-01

    Full Text Available We report a case of keratitis associated with limbal relaxing incision (LRI. The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD, he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site.

  18. A case of keratitis associated with limbal relaxing incision

    Science.gov (United States)

    Haripriya, Aravind; Smita, Anand

    2016-01-01

    We report a case of keratitis associated with limbal relaxing incision (LRI). The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD), he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site. PMID:28112139

  19. Raman microspectroscopy analysis in the treatment of acanthamoeba keratitis.

    Science.gov (United States)

    Rusciano, Giulia; Capriglione, Paola; Pesce, Giuseppe; Del Prete, Salvatore; Cennamo, Gilda; Di Cave, David; Cerulli, Luciano; Sasso, Antonio

    2013-01-01

    Acanthamoeba keratitis is a rare but serious corneal disease, often observed in contact lens wearers. Clinical treatment of infected patients frequently involves the use of polyhexamethylene biguanide (PHMB), a polymer used as a disinfectant and antiseptic, which is toxic also for the epithelial cells of the cornea. Prompt and effective diagnostic tools are hence highly desiderable for both starting early therapy and timely suspension of the treatment. In this work we use Raman microspectroscopy to analyse in vitro a single Acanthamoeba cell in cystic phase. In particular, we investigate the effect of PHMB at the single-cell level, providing useful information on both the underlying biochemical mechanism and the time frame for Acanthamoeba eradication in ocular infections. Furthermore, we demonstrate that Raman spectroscopy, in conjunction with standard multivariate analysis methods, allows discriminating between live and dead Acanthamoebas, which is fundamental to optimizing patients' treatment.

  20. Acanthamoeba T4 genotype associated with keratitis infections in Tunisia.

    Science.gov (United States)

    Dendana, F; Sellami, H; Trabelsi, H; Neji, S; Cheikhrouhou, F; Makni, F; Ayadi, A

    2013-01-01

    Acanthamoeba keratitis (AK) is a sight-threatening infection. We report five cases of AK diagnosed from 2005 to 2009 in the Laboratory of Parasitology-Mycology at Habib Bourguiba Sfax Hospital, Tunisia. All were associated with improper care of contact lenses (rinsing of contact lenses with tap water and inappropriate cleaning) and lens storage. The patients displayed different clinical presentations: corneal inflammation, corneal ulceration, and corneal abscess. The diagnosis was made after direct examination, culture, and polymerase chain reaction amplification with specific primers. The genotype classification was based on the highly variable DF3 region in the 18S rRNA gene. This is the first study characterizing Acanthamoeba genotype in Tunisia and North Africa. All Acanthamoeba isolates were associated to the T4 genotype. Three different DF3 sequence types were related to AK infections T4/10, T4/15, and T4/16.

  1. [Role of Herpes simplex virus in the immune stromal keratitis].

    Science.gov (United States)

    Vinagre, C; Martínez, M J; Vogel, M; Traipe, L; Stoppel, J; Squella, O; Srur, M; Charlín, R

    2001-03-01

    Herpes simplex virus (HSV) infection of the cornea is a leading cause of blindness in occidental countries and a common recurrent manifestation of it is the immune stromal keratitis (ISK). However, it is not known whether active viral replication occurs during the acute phase of the disease, because isolation of the virus by conventional culture techniques has not been accomplished. To establish the presence of HSV in patients with ISK. Fourteen corneal swabbing samples, from active diseased eyes of patients with clinical diagnosis of ISK, were submitted to Herpchek and PCR for the identification of HSV antigens and genome. All ISK samples were negative by both techniques. It was not possible to identify HSV antigens nor their genome by the methodology used. It is likely that, they can't be detected in corneal superficial layers or probably there is no viral replication at this stage of the disease, so antiviral therapy should be reconsidered.

  2. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela.

    Science.gov (United States)

    Yepez, Juan B; Murati, Felipe A; Pettito, Michele; Peñaranda, Carlos F; de Yepez, Jazmin; Maestre, Gladys; Arevalo, J Fernando

    2017-05-01

    The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were

  3. Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

    Science.gov (United States)

    Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

    2015-01-01

    On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

  4. [Emergency Keratoplasty with Porcine Xenografts in Necrotizing Keratitis].

    Science.gov (United States)

    Drozhzhyna, Galyna I; Gaidamaka, Tetiana B; Cursiefen, Claus; Bachmann, Björn O; Ivanovska, Olena V; Ostashevsky, Viktor L; Kogan, Boris M; Usov, Volodymyr J; Pasyechnikova, Natalija V

    2017-07-06

    Background The great shortage of donor material in Ukraine makes it necessary to find additional sources of transplant material. A possible suitable material are the porcine corneas, as they are similar in structure and biomechanical parameters to the human cornea. The purpose of our study was to analyze the results of therapeutic keratoplasty (KP) with keratoxenotransplants from cryolyophilized porcine corneas in patients with severe necrotizing keratitis. Methods A retrospective analysis of 32 xenotransplantations patients with severe necrotizing keratitis (17 lamellar, 6 stepped perforating, 4 perforating, 5 "biological coverage" according to Puchkovskaya) was completed. Results All eyes could be preserved, but the graft was rejected in all eyes. A semitransparent xenograft (XG) was achieved in 9 patients (33.3%). The best results were obtained after lamellar XKP with an XT diameter of 3.5 - 6.5 mm. Lamellar XTs with larger diameters (7.0 - 10.0 mm) were opaque. Postoperatively, the intensity of the inflammatory response after stepped XKP was slightly lower than that of the classical perforating XKP. A new KP with human corneas had to be performed in 5 patients, in one case combined with an antiglaucomatous operation and in another case with cataract extraction. Antiglaucomatous surgery had to be performed in 5 patients (15.6%). Conclusion In the absence of human donor corneas, a porcine keratoxenoimplant can be used as temporary therapeutic keratoplasty in case of emergency stop the inflammation process and to save the eye. In cases of keratoxenoimplant, a poor visual outcome is expected. Georg Thieme Verlag KG Stuttgart · New York.

  5. IL-17A-mediated protection against Acanthamoeba keratitis.

    Science.gov (United States)

    Suryawanshi, Amol; Cao, Zhiyi; Sampson, James F; Panjwani, Noorjahan

    2015-01-15

    Acanthamoeba keratitis (AK) is a very painful and vision-impairing infection of the cornea that is difficult to treat. Although past studies have indicated a critical role of neutrophils and macrophages in AK, the relative contribution of the proinflammatory cytokine, IL-17A, that is essential for migration, activation, and function of these cells into the cornea is poorly defined. Moreover, the role of the adaptive immune response, particularly the contribution of CD4(+) T cell subsets, Th17 and regulatory T cells , in AK is yet to be understood. In this report, using a mouse corneal intrastromal injection-induced AK model, we show that Acanthamoeba infection induces a strong CD4(+) T effector and regulatory T cell response in the cornea and local draining lymph nodes. We also demonstrate that corneal Acanthamoeba infection induces IL-17A expression and that IL-17A is critical for host protection against severe AK pathology. Accordingly, IL-17A neutralization in Acanthamoeba-infected wild-type mice or Acanthamoeba infection of mice lacking IL-17A resulted in a significantly increased corneal AK pathology, increased migration of inflammatory cells at the site of inflammation, and a significant increase in the effector CD4(+) T cell response in draining lymph nodes. Thus, in sharp contrast with other corneal infections such as herpes and Pseudomonas aeruginosa keratitis where IL-17A exacerbates corneal pathology and inflammation, the findings presented in this article suggest that IL-17A production after Acanthamoeba infection plays an important role in host protection against invading parasites.

  6. Data set of Aspergillus flavus induced alterations in tear proteome: Understanding the pathogen-induced host response to fungal infection

    Directory of Open Access Journals (Sweden)

    Jeyalakshmi Kandhavelu

    2016-12-01

    Full Text Available Fungal keratitis is one of the leading causes of blindness in the tropical countries affecting individuals in their most productive age. The host immune response during this infection is poorly understood. We carried out comparative tear proteome analysis of Aspergillus flavus keratitis patients and uninfected controls. Proteome was separated into glycosylated and non-glycosylated fractions using lectin column chromatography before mass spectrometry. The data revealed the major processes activated in the human host in response to fungal infection and reflected in the tear. Extended analysis of this dataset presented here complements the research article entitled “Aspergillus flavus induced alterations in tear protein profile reveal pathogen-induced host response to fungal infection [1]” (Jeyalakhsmi Kandhavelu, Naveen Luke Demonte, Venkatesh Prajna Namperumalsamy, Lalitha Prajna, Chitra Thangavel, Jeya Maheshwari Jayapal, Dharmalingam Kuppamuthu, 2016. The mass spectrometry proteomics data have been deposited in the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PRIDE:PXD003825.

  7. Identification problems with sterile fungi, illustrated by a keratitis due to a non-sporulating Chaetomium-like species.

    Science.gov (United States)

    Vinod Mootha, V; Shahinpoor, P; Sutton, Deanna A; Xin, Lian; Najafzadeh, M J; de Hoog, G Sybren

    2012-05-01

    A 39-year-old farm worker was injured in her right eye by a piece of wire, which resulted in a corneal ulcer unresponsive to antibiotic treatment. The clinical appearance was that of a corneal infiltrate with feathery borders resembling fungal keratitis. Corneal scrapings were collected and the patient was started on natamycin 5% eye drops, fluconazole 0.3% eye drops, and oral fluconazole. A non-sporulating fungus was isolated from the samples. Based upon macroscopic and microscopic morphologic features, it was provisionally identified as a Papulaspora species due to the fact that members of this genus generally do not form diagnostically useful conidia. However, it was found through the use of ITS sequencing that the isolate clustered within the ascomycete genus Chaetomium. The sequence did not fully match with any sequences of available ex-type strains of Chaetomium, Thielavia and Papulaspora and hence might belong to an undescribed specie. However, without diagnostic morphological features the taxon cannot be introduced as a novel member of the genus Chaetomium. Antifungal susceptibility testing was performed according to published standards. The corneal ulcer was successfully treated with six weeks of antifungal therapy.

  8. Insect pathology and fungal entomopathogens

    Science.gov (United States)

    Fungi that occur inside asymptomatic plant tissues are known as fungal endophytes. Different genera of fungal entomopathogens have been reported as naturally occurring fungal endophytes, and it has been shown that it is possible to inoculate plants with fungal entomopathogens, making them endophytic...

  9. JGI Fungal Genomics Program

    Energy Technology Data Exchange (ETDEWEB)

    Grigoriev, Igor V.

    2011-03-14

    Genomes of energy and environment fungi are in focus of the Fungal Genomic Program at the US Department of Energy Joint Genome Institute (JGI). Its key project, the Genomics Encyclopedia of Fungi, targets fungi related to plant health (symbionts, pathogens, and biocontrol agents) and biorefinery processes (cellulose degradation, sugar fermentation, industrial hosts), and explores fungal diversity by means of genome sequencing and analysis. Over 50 fungal genomes have been sequenced by JGI to date and released through MycoCosm (www.jgi.doe.gov/fungi), a fungal web-portal, which integrates sequence and functional data with genome analysis tools for user community. Sequence analysis supported by functional genomics leads to developing parts list for complex systems ranging from ecosystems of biofuel crops to biorefineries. Recent examples of such 'parts' suggested by comparative genomics and functional analysis in these areas are presented here

  10. [Pathogenesis of invasive fungal infections].

    Science.gov (United States)

    Garcia-Vidal, Carolina; Carratalà, Jordi

    2012-03-01

    Invasive fungal infections remain a life-threatening disease. The development of invasive fungal disease is dependent on multiple factors, such us colonization and efficient host immune response. We aimed to review the pathogenesis of invasive fungal infections, in particular, those caused by Candida and Aspergillus. For this we propose, to describe the fungal characteristics, to detail the host defence mechanisms against fungus and to analyse the host risk factors for invasive fungal infection.

  11. A rare case of fungal maxillary sinusitis due to Paecilomyces lilacinus in an immunocompetent host, presenting as a subcutaneous swelling

    Directory of Open Access Journals (Sweden)

    Harish S Permi

    2011-01-01

    Full Text Available Paecilomyces is a colonizing fungal species which usually causes keratitis, endocarditis, sinusitis, nephritis, fungemia, cutaneous, and subcutaneous infections in immunocompromised host. Very rarely, it causes similar infection in immunocompetent host without any risk factors. We report a case of maxillary sinusitis due to Paecilomyces lilacinus in a 65-year-old immunocompetent male, who presented with a subcutaneous swelling below the left eye. The lesion was excised by surgery and treated with itraconazole for 6 months based on culture and sensitivity. After 1 year of follow up, he is free of symptoms with no evidence of recurrence.

  12. Role of in vivo confocal microscopy in the management of infectious keratitis%活体共聚焦显微镜在感染性角膜炎诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    梁庆丰; 孙旭光; LABBE Antoine

    2013-01-01

    感染性角膜炎是一种严重的致盲性眼病,早期病原学诊断直接影响着患者的治疗效果.如何快速、准确地鉴别致病病原体目前还是一个挑战.活体共聚焦显微镜检查(IVCM)作为一种非侵入性图像诊断技术,可在细胞水平提供高分辨率图像以显示眼表组织的结构特征.IVCM对感染性角膜炎中棘阿米巴性角膜炎及丝状真菌性角膜炎的诊断具有重要应用价值,已在临床开始推广使用,逐渐成为感染角膜炎随诊的客观依据.本文对近年来IVCM在感染性角膜炎诊治中的应用及进展进行综述.%Infectious keratitis remains a severe ocular condition that can lead to irreversible conplications and even blindness.An early diagnosis of an infective microorganism leading to effective treatment may improve the outcome of infectious keratitis.However,the accurate and rapid identification of the infectious agent remains a challenge for the ophthalmologist.In vivo confocal microscopy (IVCM) is a noninvasive imaging technique that provides high-resolution images of ocular surface structures at a cellular level and infectious keratitis represents one of its most important clinical uses.The value of IVCM has been demonstrated in the diagnosis of acanthamoeba and filamentous fungal keratitis.The follow-up of such corneal infections may also be improved by this noninvasive imaging technique.However,the current resolution of IVCM limits its use in cases of bacterial and viral keratitis.