AIM: To analyze the lab diagnosis and etiology of infectious endophthalmitis.
METHODS: The medical and microbial records of 36 patients diagnosed with infectious endophthalmitis and 8 patients diagnosed with intraocular lens (IOL)-related inflammation between Nov. 1999 and Dec. 2009 were retrospectively reviewed for lab diagnosis and etiology.
RESULTS: The inflammatory cell counts in all aqueous humor specimens from infectious endophthalmitis patients were more than in all aqueous humor specimens from patients with IOL-related inflammation. Sixteen of the 36 aqueous humor samples (44.4%) and 11 of the 24 vitreous humor samples (45.8%) from infectious endophthalmitis patients showed positive results in smears; while 17 aqueous humor samples (47.2%) and 15 vitreous humor samples (62.5%) from infectious endophthalmitis patients showed positive results in culture.
CONCLUSION: The inflammatory cell count may be an important index for infectious endophthalmitis; while, smears can show etiological information earlier. 相似文献
Objective: To determine the incidence and characteristics of acute intraocular inflammation after intravitreal bevacizumab injections from a tertiary care retinal practice.Design: Retrospective cohort study.Participants: A consecutive series of patients who had received bevacizumab injections performed by a single surgeon.Methods: We reviewed the records of all patients with severe anterior chamber inflammation and (or) vitritis after bevacizumab injections.Results: A total of 693 bevacizumab injections were performed on 193 eyes of 173 patients between June 2006 and March 2008. There were a total of 9 cases of acute intraocular inflammation for an incidence of 1.30% (95% CI: 0.69%-2.47%). All patients had a worse visual acuity at the end of follow-up than on injection day. The mean loss of vision was 6.1 lines of Snellen visual acuity; one patient developed inflammation-induced glaucoma which required surgical intervention.Conclusions: Intravitreal injection of bevacizumab is associated with a low but significant risk of acute intraocular inflammation and may result in significant visual loss. 相似文献
Background: Mannose‐binding lectin plays a central effector role in the lectin pathway of complement activation. Frequently occurring MBL2 polymorphisms result in mannose‐binding lectin deficiency, which increases susceptibility to infection. We characterized mannose‐binding lectin levels and function in non‐inflamed and inflamed human eyes, and evaluated its relationship to blood mannose‐binding lectin levels and function. Design: Prospective, observational clinical study with controls and cases. Participants: Twenty‐seven patients with paired blood and ocular samples (aqueous and/or vitreous) including 15 controls (non‐inflamed) and 12 cases (inflamed). Methods: Blood and ocular samples were collected from controls (n = 15) with quiet eyes during elective cataract surgery and cases with inflamed eyes including proven/suspected endophthalmitis (n = 11) and herpetic retinal vasculitis (n = 1). Mannan‐binding and C4 deposition enzyme‐linked quantify mannose‐binding lectin levels and function. Main Outcome Measures: Blood and ocular mannose‐binding lectin levels and function. Results: Of 27 patients, 10 (37%) were mannose‐binding lectin‐deficient (defined as blood mannose‐binding lectin levels <500 ng/mL). Blood mannose‐binding lectin levels (P= 0.16) or function (P= 0.43) were not significantly different between controls and cases. As expected, there was a high correlation between blood mannose‐binding lectin levels and function (r2= 0.74). However, there was significantly more mannose‐binding lectin in inflamed eyes than non‐inflamed eyes measured as level (P < 0.01) or C4 deposition function (P < 0.01). Conclusions: Our study demonstrated that mannose‐binding lectin is significantly elevated in inflamed human eyes but virtually undetectable in non‐inflamed control eyes, suggesting a role in sight‐threatening ocular inflammation. 相似文献
To review the clinical experience of fungal keratitis cases at King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia.
Methods
Retrospective observational review and analysis of 124 patient charts with confirmed diagnosis of fungal keratitis between 1984 and 2004.
Results
One hundred and twenty four eyes of 124 patients had proven fungal infection; 101 eyes had fungal keratitis and 23 eyes had fungal endophthalmitis complicating keratitis. Estimated proportion of fungal keratitis and endophthalmitis was 10.3%. Mean age was 55 years with male predominance (79.0%). Commonly associated factors were previous intraocular surgery (38.7%) and trauma (20.9%). Major risk factor for progressing to endophthalmitis was previous intraocular surgery (65.2%), p < 0.001. Initial laboratory results were fungal positive only in 30.6% (p < 0.001). Commonest organisms isolated were Aspergillus spp. (29.8%) followed by Trichophyton sp. (16.1%), then Candida and Fusarium sp. Comparison of both phases of the study showed improvement in the rate of successfully treated cases from 34.6% to 58.3%, and a decline in cases progressing to endophthalmitis from 25.0% to 13.9%. Therapeutic penetrating keratoplasty increased from 26.9% to 73.6% (p < 0.001). Thirteen eyes required enucleation or evisceration.
Conclusions
In contrast to other studies on fungal keratitis, Aspergillusspp. and Trichophyton sp. were the most commonly isolated fungal pathogens; the former carries the worst prognosis. Risk factors included previous intraocular surgery and trauma. Poor outcome was associated with Aspergillus spp., delayed presentation, previous intraocular surgery and late surgical intervention. This study recommends early surgical intervention to improve the outcome. 相似文献
We describe a simple modified technique for draping the eye in cataract surgery under topical anaesthesia. This method minimizes prolapse of the eyelashes into the surgical field without compromising patient comfort and confers several advantages over previously used techniques. 相似文献
Purpose: To review antibiotic resistance associated with S. aureus endophthalmitis and the virulence of S. aureus.
Methods: Review of the current and prospective approaches for treating S. aureus endophthalmitis.
Results: Bacterial endophthalmitis remains to be a major threat for vision. S. aureus endophthalmitis specifically, carries a poor visual prognosis making early diagnosis and treatment crucial. Methicillin resistant Staphylococcus aureus (MRSA) endophthalmitis represents a significant number of S. aureus endophthalmitis cases. MRSA with reduced susceptibility to glycopeptide antibiotics such as vancomycin (vancomycin intermediate S. aureus, VISA) have also emerged in the ocular infections, and there has been a rise in S. aureus resistance to new and old generation fluoroquinolones that are commonly used for prophylaxis after intravitreal injections and intraocular surgeries.
Conclusions: With the rise in the number of penetrating procedures in the ophthalmology practice and the parallel rise in antibiotic resistance, prophylaxis and awareness of the antimicrobial resistance profiles remain crucial and the identification of novel antimicrobials is essential. 相似文献