First identification of Gordonia sputi in a post-traumatic endophthalmitis patient - a case report and literatures review.

BACKGROUND: We present a case of post-traumatic endophthalmitis with relatively good prognosis caused by Gordonia sputi, which, to our knowledge is the first case in the literature. CASE PRESENTATION: A 24 year old man, who underwent an intraocular foreign body extraction half a month before presentation in the left eye, was referred to us complaining of blurred vision and slight pain for 5 days. His first presentation showed moderate intracameral and intravitreous purulent inflammation with a best corrected vision of counting fingers. After gram staining of the intravitreous samples revealed a gram-positive bacilli infection, a combination of amikacin and vancomycin was initially injected intravitreously. The left eye kept stable for three days but deteriorated on the 4th day. On the 5th day after presentation conventional culture characterized the bacterium as an Actinomyces sp. while 16S ribosomal RNA gene sequencing confirmed it as Gordonia sputi. Thereby a complete pars plana vitrectomy combined with lensectomy and silicone oil tamponade was performed. During the surgery an intraocular irrigation with penicillin G was adopted, followed by administration of intravenous penicillin G twice one day for a week. A relatively normal fundus with slight intracameral inflammation was observed a week after the operation, and the best corrected vision recovered to 0.15. One year later his vision remained 0.1. CONCLUSION: Gordonia sputi should be taken into consideration in patients with post-traumatic endophthalmitis especially due to foreign body penetration. Compared to conventional laboratories, molecular methods are recommended for an accurate diagnosis. A comprehensive strategy of antimicrobial agents and vitrectomy may render a satisfactory result.

[Clinical results of ultrasound biometry in silicone oil-filled eye].

OBJECTIVE: To evaluate a method of ultrasound biometry in silicone oil-filled eye and its clinical results. METHODS: This was a series case study. According to the principle of measuring a distance with ultrasound, we compared the measured distance between a space filed with balanced salt solution and silicone oil at same height, to calculate a conversion factor (0.674) between them. A formula for corrective axial length in silicone oil-filled eye was established. The formula = ab + 0.674 x bc (a, b and c standing for the apex of the cornea, the posterior pole of the lens or the center of the capsular membrane and the anterior surface of the macular, respectively). The axial lengths of 150 silicone oil-filled eyes in 150 cases were then measured before and after silicone oil removal with Vivid 7 Dimension ultrasound. According to the axial length, they were divided into two groups, namely group 1 (the length < 25 mm) and group 2 (the length > or = 25 mm). In 76/150 eyes, before combined silicone oil removal and intraocular lens (IOL) implantation, the SRKT formula was used for intraocular lens calculation; the post-operative actual refraction was compared with the pre-operative predicted refraction and statistics analysis was made. RESULTS: The retinal condition of 150 silicone oil-filled eyes in 150 cases after 3 months' follow-up was stable after surgery. The results of the biometry were as follows. In the first group, the mean corrective axial lengths of 111 silicone oil-filled eyes before silicone oil removal was (22.77 +/- 1.00) mm (ranging from 21.10 to 24.90 mm); the mean axial lengths after silicone oil removal was (22.76 +/- 0.99) mm (ranging from 21.00 to 24.70 mm). The difference between them was not statistically significant (t = 0.518, P > 0.05). The vitreous cavity depth before and after silicone oil removal was (26.57 +/- 2.14) mm and (17.90 +/- 1.38) mm, respectively. The ratio of the latter to the former was 0.673 78. In the second group, the mean corrective axial lengths of 39 silicone oil-filled eyes before silicone oil removal was (26.52 +/- 1.31) mm (ranging from 25.00 to 30.58 mm); the mean axial lengths after silicone oil removal was (26.53 +/- 1.29) mm (ranging from 25.00 to 30.59 mm). The difference between them was not statistically significant (t = 0.109, P > 0.05). The vitreous cavity depth before and after silicone oil removal was (32.01 +/- 2.90) mm and (21.57 +/- 2.04) mm, respectively. The ratio of the latter to the former was 0.673 95. In 76 eyes with IOL, the post-operative actual refraction after at least 3 months follow-up was compared with the pre-operative predicted refraction (-1.50 DS) in both groups. The differences between them were not statistically significant (t(1) = 0.253, P(1) > 0.05; t(2) = 0.209, P(2) > 0.05) in each group. CONCLUSION: Ultrasound biometry in silicone oil-filled eye is accurate and simple, and has good results in clinical measurement.