Measuring Choroid Thickness as a Marker of Systemic Inflammation in Patients With Ankylosing Spondylitis.

BACKGROUND AND OBJECTIVE: Ankylosing spondylitis (AS) is an inflammatory disease, and choroidal thickness (CT) has been proposed and evaluated as a potential marker of systemic inflammation associated with AS and other inflammatory diseases. This study compared CT measurements taken from patients with severe AS disease activity without eye inflammation with those taken from healthy subjects. METHODS: This cross-sectional, multicenter study compared CT in 44 patients with high AS disease activity, and no history of eye inflammation with CT in 44 matched healthy subjects aged between 18 and 65 years. In the AS group, the correlation between CT and C-reactive protein, human leukocyte antigen (HLA) B27 positivity, disease duration, and disease activity was calculated. RESULTS: Mean CT values of patients with AS were significantly higher in the right eye, the left eye, and the thickest choroid eye. The right eye mean CT was 338.3 ± 82.8 µm among patients with AS and 290.5 ± 71.2 µm among healthy subjects (p = 0.005). The left eye mean CT was 339.5 ± 84.7 µm for patients with AS and 298.4 ± 68.9 µm for healthy subjects (P = 0.015). The thickest choroid eye CT was 358.4 ± 82.1 µm among patients with AS and 314.1 ± 65.2 µm among healthy subjects (P = 0.006). We did not find a significant correlation between CT and disease activity, C-reactive protein, human leukocyte antigen B27 positivity, or disease duration. CONCLUSIONS: Patients with active AS but without a history of eye inflammation had a thicker choroid than healthy subjects. This finding suggests that CT is a marker of systemic inflammation in patients with inflammatory disease, regardless of known eye symptoms.

Myopic LASIK in psychiatric patients.

PURPOSE: To evaluate the surgical results obtained in patients with psychiatric disorders who underwent myopic laser in situ keratomileusis. (LASIK). METHODS: Retrospective study of 156 eyes of 82 patients who underwent LASIK to correct a myopic spherical equivalent (SE) at Clínica Baviera-Instituto Oftalmológico Europeo, Bilbao, Spain. All procedures were performed with the Technolas Keracor 217 Z excimer laser. Patients had a preoperative diagnosis of bipolar disorder (79 eyes of 42 patients), schizophrenia (61 eyes of 32 patients), or obsessive-compulsive disorder (16 eyes of 8 patients). Before surgery, the average sphere of the series was -3.92 ± 2.24 D in the first group, -3.45 ± 2.03 D in the second group, and -3.39 ± 1.97 D in the third group. We surveyed the patients to analyze subjective assessment from the patient's perspective. RESULTS: At the last available visit after treatment, we obtained an SE of ±0.50 D in 85.71% of eyes with bipolar disorder, 88.52% of eyes with schizophrenia, and 93.75% of eyes with obsessive-compulsive disorder. The efficacy index was 1.00 ± 0.20 in the first group, 1.03 ± 0.21 in the second group, and 1.00 ± 0.07 in the third group. No eye lost 2 lines or more of best spectacle-corrected visual acuity. CONCLUSIONS: We found that patients with compensated psychiatric disorders, of which the surgeon was aware, achieved excellent results after surgery, with no remarkable complications. Patients tolerated the procedures well and were satisfied.

Effectiveness of intracameral cefuroxime in preventing endophthalmitis after cataract surgery Ten-year comparative study.

PURPOSE: To determine the differences in the endophthalmitis rates in cataract surgery before and after prophylactic use of intracameral cefuroxime. SETTING: University Hospital Fundación Alcorcón, Madrid, Spain. METHODS: This prospective study evaluated patients who had cataract surgery at a university eye center over a 10-year period (1999 to 2008). Since the protocol's approval by the Hospital Board in October 2005 to the end of the 10-year period, cataract patients were routinely treated with prophylactic intracameral cefuroxime. A database was used to measure the occurrence of endophthalmitis postoperatively. Then, the incidence of endophthalmitis before and after generalized use of prophylactic cefuroxime was compared. The effect of cefuroxime was evaluated by the relative risk. RESULTS: From January 1999 to December 2008, 13 652 patients had cataract surgery. Forty-two cases of postoperative bacterial endophthalmitis were reported. The endophthalmitis rate was 0.30% (95% confidence interval [CI], 0.26%-0.35%) overall, 0.59% (95% CI, 0.50%-0.70%) from January 1999 to September 2005, and 0.043% (95% CI, 0.02%-0.06%) from October 2005 to December 2008. The relative risk was 0.07 (range 0.022 to 0.231; P<.05). CONCLUSION: Intracameral cefuroxime proved to be effective in reducing the risk for acute-onset endophthalmitis after cataract surgery.

Adherence of two strains of Staphylococcus epidermidis to contact lenses.

PURPOSE: To compare the adherence of biofilm-producer and nonbiofilm-producer Staphylococcus epidermidis in vitro to different soft contact lenses (CLs) to study its possible contribution to the pathogenesis of keratitis. METHODS: Strains of S. epidermidis slime-positive ATCC 35984 (biofilm-producer) and slime-negative ATCC 12228 (nonbiofilm-producer) were used with eight types of soft CLs from the four groups determined by the United States Food and Drug Administration (FDA), according to the ionicity and water content. The lenses were incubated overnight with the bacteria, then sonicated and vortexed to separate the adhered bacteria. Quantitative cultures were performed and the results statistically analyzed. RESULTS: Slime-negative strains of S. epidermidis were able to adhere to all CLs but at a lower level than slime-positive strains. There were significant differences in bacterial attachment among the four FDA groups. On the whole, there was higher bacterial adhesion to nonionic and low-water content materials. Contact lenses produced by soft molding were less adherent than CLs produced by either lathe-cutting or spin-casting. CONCLUSIONS: Bacterial biofilm favors bacterial adhesiveness and colonization of soft CLs. Bacterial attachment was less in soft molding CLs (etafilcon A), which provide a more homogeneous and smoother surface.