Seasonal and Temporal Trends of Infectious Keratitis in Northern Vietnam.

The epidemiology of corneal ulcers in Vietnam has not been well characterized. In this report, we reviewed retrospectively the microbiological data of patients with a clinical diagnosis of corneal ulcer at the microbiology laboratory of Vietnam National Eye Hospital from January 1, 2010 to March 31, 2023. We observed a seasonal pattern for fungal and microsporidial keratitis, with an annual peak in November, and an inverse relationship between fungal keratitis and inclement weather. The November peak coincided with one of the major harvesting seasons in Vietnam. We also observed increasing numbers of microsporidial and Acanthamoeba keratitis cases in recent years. Knowledge of these trends are helpful in guiding empirical treatment of corneal infections and preventing corneal blindness.

Tectonic Deep Anterior Lamellar Keratoplasty to Treat Corneal Perforation and Descemetocele from Microbial Keratitis.

PURPOSE: To evaluate the result of tectonic deep anterior lamellar keratoplasty (DALK) for keratitis with perforation and descemetocele. PATIENTS AND METHODS: A prospective clinical study of 36 patients (36 eyes) treated with tectonic DALK for corneal perforation or descemetocele from microbial keratitis managed at the Vietnam National Eye Hospital over a two-year period. The surgical technique was manual lamellar dissection. The grafts were harvested from the anterior corneal cap of pre-cut donor tissues used for DSAEK or donor corneas with a low endothelial cell count. RESULTS: A mean age was 55.36 ± 13.98 years (ranged from 25 to 75 years). Female gender represented 52%. causative agents were herpes simplex virus (58.3%), bacteria (22.2%), fungi (13.9%) and microsporidia (5.6%). There were 24 eyes with descemetocele (66.7%) and 12 with perforation (33.3%). There were 33 successful cases (91.7%) and 3 failed cases (8.3%). Best corrected visual acuity (BCVA) improved in 28 eyes (84.8%). The range of post-operative BCVA was from hand motions to 20/70. Eleven eyes (33.3%) attained vision 20/200 and higher. Clear graft was obtained in 15 eyes (45.5%), while mild or severe graft opacity was observed in 14 eyes (42.4%), and 4 eyes (12.1%), respectively. Surgical complications included descemet rupture (20.8%), pseudo anterior chamber (41.6%), persistent corneal epithelial defects (8.3%), reinfection (11.1%), glaucoma or ocular hypertension (5.6%) and cataract (8.3%). CONCLUSION: The study demonstrates that DALK is an effective procedure to treat corneal descemetocele, especially when an urgent penetrating keratoplasty (PKP) cannot be performed.

Novel Cytokine Multiplex Assay for Tear Fluid Analysis in Sjogren's Syndrome.

Purpose: Sjögren's syndrome (SS) is an autoimmune disease associated with ocular surface inflammation. The goals of this study were to establish a novel bead-based protein microarray for simultaneous analysis of 11 cytokines from tear fluid collected with Schirmer strips from patients with SS.Methods: Three to ten microliter of tear fluid was collected with Schirmer strips from both eyes of 13 healthy controls and 12 SS patients. Tear fluid was eluted from the Schirmer strips, total protein and concentrations of 11 different cytokines were analyzed.Results: The multiplex assay demonstrated high assay sensitivity with LoDs between 1.4 and 55.3 pg/µl with mean CVs between 3.7% and 9.7%. Statistically significant upregulation (p < .005) of eight cytokines was observed in SS patients compared to controls. Additionally, four patient cytokine values showed a significant inverse correlation (r<-0.7) with Schirmer strip readings.Conclusion: The assay offers analytical reliability for quantification of biomarkers in small amounts of tear fluid with potential utility for treatment monitoring of SS and other types of Dry Eye Disease.