Post-keratoplasty Endophthalmitis by Multidrug-resistant Pseudomonas Aeruginosa With Positive Culture of the Contralateral Donor Cornea: A Case Report.

PURPOSE: The aim of this paper is to present the case report of a patient developing endophthalmitis after penetrating keratoplasty caused by a multidrug-resistant Pseudomonas aeruginosa, detected only in the contralateral donor tissue. CASE REPORT: A 77-year-old man underwent an uneventful penetrating keratoplasty with a preoperative culture-negative donor cornea; however, the fellow cornea grew multidrug-resistant Pseudomonas aeruginosa. The patient developed and was treated for endophthalmitis after penetrating keratoplasty, and aqueous and vitreous taps grew P. aeruginosa with antibiotic resistance identical to the isolate from the mate cornea. Sequence analysis of the 16S ribosomal gene from the two isolates and confirmation analyzing the sequence of P. aeruginosa heat shock protein gene (groES) were performed showing the same strain for both organisms. CONCLUSION: This case report documents the presence of the same multidrug-resistant P. aeruginosa causing endophthalmitis after penetrating keratoplasty and in the contralateral donor tissue, suggesting that we must be cautious in deciding to transplant tissues with positive culture in the contralateral donor cornea.

Ophthalmic features of spinocerebellar ataxia type 7.

PurposeTo analyze the relation between ophthalmologic and motor changes in spinocerebellar ataxia type 7 (SCA7).Patients and methodsThis was a case series study. Sixteen SCA7 patients underwent a comprehensive ophthalmic examination, including ocular extrinsic motility testing, color vision test, and optical coherence tomography of the optic nerve and macula. Changes in the corneal endothelium, electroretinographic patterns, and a complete neurologic evaluation using the Scale for the Assessment and Rating of Ataxia (SARA) were evaluated. Correlations of endothelial cell density (ECD) with number of CAG repetitions and the SARA scores were estimated.ResultsAll patients showed various degrees of visual impairment mainly due to macular deterioration. Notably, they also presented decreased ECD. Pairwise correlations of ECD with number of CAG repeats and severity of motor symptoms quantified with the SARA scores were inverse (r=-0.46, P=0.083 and r=-0.64, P=0.009, respectively). Further analyses indicated an average ECD decrease of 48 cells/mm2 (P=0.006) per unit of change on the number of CAG repeats, and of 75 cells/mm2 (P=0.001) per unit of change on the SARA scores.ConclusionsThe results agree with previous ophthalmological findings regarding the widespread effect of SCA7 mutation on the patient's visual system. However, the results also show a significant negative correlation of decreased ECD with both CAG repetitions and SARA scores. This suggests that motor systems could degenerate in parallel with visual systems, although more research is needed to determine whether the degeneration is caused by the same mechanisms.

Análisis ultrabiomicroscópico de quistes iridianos / Ultrasound biomicroscopic analysis of iris cysts

OBJETIVO: Describir los hallazgos ultrabiomicroscópicos y complicaciones de pacientes con quistes iridianos. DISEÑO: Serie de casos, restrospectivo. MÉTODO: Se incluyó a 13 pacientes con diagnóstico de quistes de iris, confirmado mediante ultrabiomicroscopia (UBM) en un periodo de 10 años (2002-2012) en un centro oftalmológico de la ciudad de México. Se incluyeron datos demográficos, historia clínica médica y ocular, características clínicas y ultrabiomicroscópicas (tipo, número, localización y hallazgos acústicos), así como complicaciones asociadas. Se realizó un análisis descriptivo, incluyendo medias y desviación estándar. RESULTADOS: La distribución por sexo fue 8 mujeres y 5 hombres, con edad promedio de 44,5 años ± 15,5 (rango de 6 a 70 años). El 92,3% fueron quistes del epitelio pigmentado y 7,7% del estroma; el 76,9% se encontraron en la periferia y 69,2% entre los meridianos de las II y las VI horas del reloj. Todos los quistes mostraron una pared con reflectividad moderada a alta. El 38,5% presentó complicaciones (el 15,4% cierre parcial del ángulo camerular; el 15,4% glaucoma secundario de ángulo cerrado y el 7,7% discoria). CONCLUSIONES: La mayoría de los quistes de iris son derivados del epitelio pigmentado, de curso benigno y con una baja tasa de complicaciones. La UBM es una herramienta indispensable que nos permite planear tratamientos localizados, específicos, más conservadores y menos destructivos, con un daño potencial menor de las estructuras oculares y, por lo tanto, mejor pronóstico visual

PURPOSE: To describe the ultrasound biomicroscopic (UBM) features and complications associated with iris cysts. DESIGN: A retrospective case series. METHODS: Thirteen patients with iris cysts were identified in a 10 year period study at a ophthalmologic reference Center in Mexico City. The variables included demographic data, ocular and medical history, clinical course, and complications. All patients were examined by UBM, and type, number, location, and acoustic characteristics of cysts were evaluated. Descriptive statistics were performed. RESULTS: Thirteen patients were included (8 men and 5 women). The mean age was 44.5 ± 15.5 years (range 6-70 years). The origin most prevalent was neuroepithelial (92.3%), and 7.7% had stromal cysts. Regarding to location 76.9% were found in the periphery, and 69.2% between meridians II and VI. All cysts showed a moderate to high reflectivity in the wall. Complications were present in 38.5% of cases (15.4% partial angle closure, 15.4% secondary angle closure glaucoma and 7.7% dyscoria). CONCLUSIONS: Most cysts are derived from iris pigmented epithelium, with a benign course and a minor rate of complications. The UBM is an indispensable tool that allows us to plan more specific and conservative treatments, with less damage to ocular structures and, therefore, better visual prognosis

Ultrasound biomicroscopic analysis of iris cysts.

PURPOSE: To describe the ultrasound biomicroscopic (UBM) features and complications associated with iris cysts. DESIGN: A retrospective case series. METHODS: Thirteen patients with iris cysts were identified in a 10 year period study at a ophthalmologic reference Center in Mexico City. The variables included demographic data, ocular and medical history, clinical course, and complications. All patients were examined by UBM, and type, number, location, and acoustic characteristics of cysts were evaluated. Descriptive statistics were performed. RESULTS: Thirteen patients were included (8 men and 5 women). The mean age was 44.5 ± 15.5 years (range 6-70 years). The origin most prevalent was neuroepithelial (92.3%), and 7.7% had stromal cysts. Regarding to location 76.9% were found in the periphery, and 69.2% between meridians II and VI. All cysts showed a moderate to high reflectivity in the wall. Complications were present in 38.5% of cases (15.4% partial angle closure, 15.4% secondary angle closure glaucoma and 7.7% dyscoria). CONCLUSIONS: Most cysts are derived from iris pigmented epithelium, with a benign course and a minor rate of complications. The UBM is an indispensable tool that allows us to plan more specific and conservative treatments, with less damage to ocular structures and, therefore, better visual prognosis.