Investigating the Bactericidal Activity of an Ocular Solution Containing EDTA, Tris, and Polysorbate 80 and Its Impact on the In Vitro Efficacy of Neomycin Sulfate against Staphylococcus aureus: A Preliminary Study.

In the current context of emerging and spreading antimicrobial resistance in human and animal infections, new strategies need to be developed to improve the efficacy of commonly prescribed antibiotics and preserve more critical compounds for multi-drug-resistant infections. This preliminary study aimed at evaluating the benefits of an eye cleaning solution containing 0.1% EDTA, 0.02% Tris, and 0.1% Polysorbate 80 in veterinary ophthalmology. A first in vitro study was performed to assess the bactericidal activity of the test solution against Staphylococcus aureus and Pseudomonas aeruginosa strains. A second in vitro study evaluated the impact of the test solution on the antimicrobial activity of neomycin against Staphylococcus aureus. The test solution alone did not show bactericidal activity against Staphylococcus aureus and Pseudomonas aeruginosa. The test solution seemed to increase the activity of Neomycin Sulfate against Staphylococcus aureus. These findings warrant further research to better characterize the impact on the bactericidal activity of antimicrobials used in veterinary ocular surface infections of the solution containing 0.1% EDTA, 0.02% Tris, and 0.1% Polysorbate 80 as well as of each individual ingredient for a thorough understanding of how this test solution could provide a new strategy to address the growing antimicrobial resistance issue worldwide.

Evaluation of the effects of mono or combined use of topical antiglaucomatous drops on conjunctival flora and antibiotic susceptibility.

PURPOSE: To evaluate the effects of mono or combined use of topical antiglaucomatous drops (AGD) on conjunctival flora and antibiotic susceptibility. METHODS: The study group consisting of 84 glaucoma patients using AGDs and 32 healthy controls were evaluated. Groups were formed according to the use of 1, 2 and 3 AGDs. A swab was taken from the conjunctival sac from each patient and cultures were made. Patients with conjunctival hyperemia were classified according to their appearance. RESULTS: The mean age was 58.61 ± 14.55 years. Conjunctival culture positivity was 84.37%, 89.28% and 90.6% according to the use of 1, 2, and 3 AGDs, respectively, and it was 93.75% in the control group. Staphylococcus hominis (S. hominis) was statistically significantly higher in all glaucoma patients compared to healthy volunteers (p = .030). S. hominis was significantly higher especially in those using 2 (42.85%) and 3 (50%) AGDs, compared to those who received mono treatment (31.25%). Candida spp. was also significantly higher in glaucoma patients (p = .039). In patients with conjunctival hyperemia in glaucoma patients, the most common two bacteria were S. hominis (55.5%) and Staphylococcus epidermidis (S. epidermidis) (33%), respectively. In the relationship between isolated bacterial species and conjunctival hyperemia grades, Bacillus spp. (p = .013) was statistically significant.In glaucoma patients, norfloxacin and erythromycin resistance were found to be statistically significantly higher compared to the control group (p = .01). CONCLUSION: Considering the statistically significant increase in isolates in all glaucoma patients, we suggest that more care should be taken in terms of infection in surgical procedures planned for glaucoma patients.

COVID-19-related Conjunctivitis Review: Clinical Features and Management.

PURPOSE: The ongoing coronavirus disease-2019 (COVID-19) pandemic has greatly impacted theworld. In this review article, we discuss the conjunctival and nasolacrimal mucosa as a potential route for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission, its ocular manifestations, and management. METHODS: Literature review was conducted in the PubMed, Google Scholar and EMBASE databases using keywords such as "coronavirus", COVID-19", "SARS-CoV-2", "conjunctivitis", "ocular surface", "eye" and "ophthalmology". RESULTS: The ocular surface may serve as an entry point and reservoir for the virus. Frequency of hand-eye contact was an independent risk factor for COVID-19-related conjunctivitis. Therefore, appropriate protective eyewear or face shields are recommended, especially for health-care workers. Bilateral conjunctival sampling within 9 days of symptom onset provides a higher positive yield rate. Pooled analysis shows an incidence of 11.4% (95%CI = 6.4-17.2%) of ocular manifestations in patients with SARS-CoV-2 infection, including hospitalized and non-hospitalized patients. CONCLUSION: Conjunctivitis was the most common ocular manifestation, of which ocular redness or congestion, ocular pain, and follicular conjunctivitis were the most common presentation.COVID-19-related conjunctivitis has a self-limiting disease course, and treatment should be mainly supportive.

More than Antibiotics: Latest Therapeutics in the Treatment and Prevention of Ocular Surface Infections.

Ocular surface infections have been common issues for ophthalmologists for decades. Traditional strategies for infection include antibiotics, antiviral agents, and steroids. However, multiple drug-resistant bacteria have become more common with the prevalence of antibiotic use. Furthermore, an ideal treatment for an infectious disease should not only emphasize eliminating the microorganism but also maintaining clear and satisfying visual acuity. Immunogenetic inflammation, tissue fibrosis, and corneal scarring pose serious threats to vision, and they are not attenuated or prevented by traditional antimicrobial therapeutics. Herein, we collected information about current management techniques including stem-cell therapy, probiotics, and gene therapy as well as preventive strategies related to Toll-like receptors. Finally, we will introduce the latest research findings in ocular drug-delivery systems, which may enhance the bioavailability and efficiency of ocular therapeutics. The clinical application of improved delivery systems and novel therapeutics may support people suffering from ocular surface infections.

Evaluation of Accessory Lacrimal Gland in Muller's Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease.

PURPOSE: The accessory lacrimal glands (ALGs) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential, and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. MATERIALS AND METHODS: ALG tissues obtained from Muller's muscle conjunctival resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. RESULTS: Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2, and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. CONCLUSIONS: Thus, we report for the first time that human ALG tissues contain precursor marker-positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES, and isolate candidate precursor cells from ALG tissue.