Ahmed implant coated with poly(2-methacryloyloxyethyl phosphorylcholine) inhibits foreign body reactions in rabbit eyes.

PURPOSE: Wound healing after Ahmed glaucoma valve (AGV) implantation often entails fibrosis as a foreign body reaction to the silicone plate. Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) forms an antifouling surface that inhibits fibrosis during wound healing. In this study, we aimed to compare the effects of the implantation of AGV coated with PMPC (wPMPC) versus AGV without PMPC (woPMPC) in rabbits. METHODS: Six New Zealand White rabbit does underwent AGV implantation in both eyes. For each rabbit, one eye was randomly selected for implantation of AGV wPMPC and a conventional AGV (woPMPC) was implanted in the contralateral eye. Gross conjunctival vascularity was compared between the two groups at the first, second, and fourth weeks after surgery. The eyes were enucleated in four weeks and subjected to staining with hematoxylin and eosin and Masson's trichrome stain. The fibrosis and inflammation status among the eye samples were compared by measuring the thickness of the fibrotic walls and counting the number of chronic inflammatory cells around the AGV. Counting of inflammatory cells and measuring fibrotic wall thickness were done in a blinded method to eliminate observer bias. Statistical analysis was performed using the Mann-Whitney U test. RESULTS: Gross and histological examinations revealed no toxic effects of PMPC. There were no apparent differences in overall conjunctival vascularity between the two groups at weeks 1, 2, and 4 after surgery. The average inflammatory cell counts were 14.3 ± 5.8 per slide and 27.3 ± 8.6 per slide in the wPMPC and woPMPC groups, respectively (p = 0.037). The average thicknesses of the fibrotic wall were 57.9 ± 11.3 µm and 81.5 ± 21.3 µm in the wPMPC and woPMPC groups, respectively (p = 0.025). CONCLUSION: Compared to the woPMPC group, the number of inflammatory cells and fibrosis were significantly decreased in the wPMPC group.

Correlation between pathogenic species and clinical findings, disease severity, and visual outcome in patients with fungal keratitis / Correlação entre espécies patogênicas e achados clínicos, gravidade da doença e desfecho visual em pacientes com ceratite fúngica

ABSTRACT Purpose: To determine whether a correlation exists between pathogenic species and clinical findings, disease severity, and visual outcome in patients with keratitis and fungal growth in microbiological culture. Methods: A retrospective study of patients with fungal growth in the microbiological culture of corneal scrapings. Patients were treated at an ophthalmologic reference center in Southeastern Brazil from January 1992 to October 2015. Results: Medical records of 181 patients (131 males and 50 females) with a mean age of 47 ± 18 years were analyzed. The three most common etiologies were Fusarium sp. (38.7%), Aspergillus sp. (15%), and Candida sp. (13.2%). Among these, Fusarium sp. was the most frequent in patients aged £50 years (p=0.002) and in those with a recent history of a foreign body and/or ocular trauma (p=0.01). Candida sp. was the most frequent etiology in patients aged >50 years (p=0.002), in those with postoperative ocular surgery (p=0.002); in those with a previous ocular pathology (p=0.0007); and in immunodepressed patients (p=0.0004). Conclusion: Fusarium sp. was predominant in patients aged £50 years and those with a recent history of foreign body and/or ocular trauma, whereas Candida sp. was predominant in older adults, in those with a postoperative ocular surgery, in those with a previous ocular pathology, and in immunodepressed patients.

RESUMO Objetivo: Determinar se existe uma correlação entre espécies patogênicas e achados clínicos, gravidade da doença e resultado visual em pacientes com ceratite e crescimento de fungos em cultura microbiológica. Métodos: Estudo retrospectivo de pacientes com crescimento de fungos na cultura microbiológica de raspado de córnea. Os pacientes foram tratados em um centro de referência oftalmológica no Sudeste do Brasil de janeiro de 1992 a outubro de 2015. Resultados: Foram analisados registros médicos de 181 pacientes (131 homens e 50 mulheres) com idade média de 47 ± 18 anos. As três etiologias mais comuns foram Fusarium sp. (38,7%), Aspergillus sp. (15%) e Candida sp. (13,2%). Entre estas, Fusarium sp. foi a mais frequente em pacientes com idade £50 anos (p=0,002) e naqueles com história recente de corpo estranho e/ou trauma ocular (p=0,01). Candida sp. foi a etiologia mais frequente em pacientes com idade >50 anos (p=0,002), naqueles com cirurgia ocular pós-operatória (p=0,002); naqueles com patologia ocular prévia (p=0,0007); e em pacientes imunodeprimidos (p=0,0004). Conclusão: Fusarium sp. foi predominante em pacientes com idade £50 anos e naqueles com história recente de corpo estranho e/ou trauma ocular; enquanto Candida sp. foi predominante em adultos mais velhos, naqueles com cirurgia ocular pós-operatória, naqueles com patologia ocular prévia e em pacientes imunodeprimidos.

Correlation between pathogenic species and clinical findings, disease severity, and visual outcome in patients with fungal keratitis.

PURPOSE: To determine whether a correlation exists between pathogenic species and clinical findings, disease severity, and visual outcome in patients with keratitis and fungal growth in microbiological culture. METHODS: A retrospective study of patients with fungal growth in the microbiological culture of corneal scrapings. Patients were treated at an ophthalmologic reference center in Southeastern Brazil from January 1992 to October 2015. RESULTS: Medical records of 181 patients (131 males and 50 females) with a mean age of 47 ± 18 years were analyzed. The three most common etiologies were Fusarium sp. (38.7%), Aspergillus sp. (15%), and Candida sp. (13.2%). Among these, Fusarium sp. was the most frequent in patients aged £50 years (p=0.002) and in those with a recent history of a foreign body and/or ocular trauma (p=0.01). Candida sp. was the most frequent etiology in patients aged >50 years (p=0.002), in those with postoperative ocular surgery (p=0.002); in those with a previous ocular pathology (p=0.0007); and in immunodepressed patients (p=0.0004). CONCLUSION: Fusarium sp. was predominant in patients aged £50 years and those with a recent history of foreign body and/or ocular trauma, whereas Candida sp. was predominant in older adults, in those with a postoperative ocular surgery, in those with a previous ocular pathology, and in immunodepressed patients.

Epidemiology and clinical outcome of intraocular foreign bodies in Hong Kong: a 13-year review.

The purpose of this study was to describe the epidemiology, visual outcome and prognostic factors of intraocular foreign body (IOFB) injuries in a tertiary centre in Hong Kong. A retrospective review of 21 eyes in 21 patients with IOFB that presented to United Christian Hospital from January 2001 to July 2014 was performed. IOFB represented 16 % of all open-globe traumas. There was a high male predominance (90 %). The mean age was 42. Work-related injuries (86 %) were the main cause, where only 10.5 % had eye protection. Hammering was the commonest mechanism of injury (43 %). Most IOFBs were metallic (67 %). The IOFB was found in the anterior segment in 31 % and posterior segment in 69 %. 57 % presented with an initial visual acuity of ≥0.1, and up to 24 % of patients had an initial visual acuity of better than or equal to 0.5. Most cases (76 %) received prompt surgical intervention within 24 h, and there was a low (0 %) endophthalmitis rate. Forty-eight percent had an improvement in visual acuity, defined as final visual acuity more than or equal to 2 lines of improvement from initial visual acuity, and 48 % attained a final visual acuity of better than or equal to 0.5. One case underwent evisceration. A smaller IOFB size (<5 mm) was associated with a good final visual acuity of better than or equal to 0.5 (p = 0.048). It was also found that a posterior segment IOFB was more likely to give a final VA of less than 0.5 (p = 0.035). IOFB remains a significant complication of work-related injuries in Hong Kong. This is the first local study that explores the epidemiology of IOFB injuries in Hong Kong. The favourable visual outcome and low endophthalmitis rate may be related to early removal of IOFB. Despite legal ordinances for mandatory eye protection, the uptake of eye protection was low.

Tarantula Hair Keratoconjunctivitis with Concurrent Fungal Infection in a Rat Terrier.

A 9 yr old rat terrier presented with corneal ulceration and conjunctivitis that developed acutely after digging among dry leaves in wooded northern Arizona. Ophthalmic examination revealed multiple linear foreign bodies throughout the adnexal tissue and cornea of the left eye. Manual removal of material was unsuccessful. The palpebral conjunctiva required excision with tenotomy scissors to remove structures and allow corneal healing. Microscopic examination revealed structures believed to be setae from a Theraphosidae tarantula. This was confirmed morphologically by an entomologist and by comparison with hairs from a captive spider of the suspected species. The excised tissue also contained fruiting bodies, hyphae, and microconidia consistent with Aspergillus spp. The captive spider hairs also cultured positive for Aspergillus, suggesting a relationship between this fungus and tarantulas in captivity and in their native habitat. This is the first report in the veterinary literature to confirm tarantula hair as the causative agent in keratoconjunctivitis and corneal ulceration, adding it to the list of differential diagnoses for ocular foreign body. This is also the first report to suggest a relationship between Aspergillus and tarantulas of the Theraphosidae family, which should be considered in the diagnostics and treatment of patients with suspected tarantula hair keratoconjunctivitis.