Macular injuries secondary to handheld lasers in a paediatric population-clinical characteristics and indicators of visual impact.

BACKGROUND/OBJECTIVES: Aim to identify incidence and prevalence of laser-induced retinal injuries in the Northern Ireland paediatric population and to determine negative clinical and OCT indicators in relation to visual acuity. SUBJECTS/METHODS: A retrospective analysis was conducted of retinal injuries secondary to handheld laser pens over a 6-year time period with presenting and final visual acuity (VA), laser source and circumstances of the injury recorded. Fundus photographs and OCT images for each case were also collated. RESULTS: Sixty-five patients (74 eyes) were identified of which 72% were male and mean age was 11.6 years. 40% of patients were symptomatic. Mean presenting VA was 0.16 LogMAR. VA was ≤0.30 LogMAR in 20 eyes (27%) at presentation. Features which impacted VA to a significant level were foveolar location, diffuse morphology, ELM and BM/RPE/IDZ disruption and ORH presence on presenting OCT images. ORHs or ELM disruption resulted in a significant risk ratio of 3.5 (p = 0.002) and 3.4 (p = <0.001) respectively. Mean presenting VA was demonstrated to improve during follow-up from 0.36 to 0.22 LogMAR (n = 20, p = 0.03). When VA was ≤0.30 LogMAR at presentation, mean presenting VA improved from 0.56 to 0.29 LogMAR (p < 0.01) with 58% of eyes improving to a VA of better than 0.30 LogMAR. CONCLUSIONS: The overall visual loss from macular laser injuries was low and we have identified features on retinal imaging that significantly impact presenting VA. When VA is affected following macular laser injury there is evidence of recovery with >50% of those presenting with VA ≤ 0.30 LogMAR improving to better than 0.30 LogMAR.

Torpedo maculopathy: disease spectrum and associated choroidal neovascularisation in a paediatric population.

PURPOSE: Torpedo maculopathy is a rare lesion of the retinal pigment epithelium. This study set out to look at these lesions in the paediatric population and determine the spectrum and features of the disease. METHODS: The paediatric ophthalmology database was used to identify eight children with torpedo maculopathy between 2012 and 2017. Fundal images and optical coherence tomography (OCT) was used to analyse the cases. RESULTS: Eight patients with torpedo maculopathy were identified, making the prevalence approximately 2 per 100,000 population under 16 years old. The OCT images were classified using the previously described subtypes: Type 1 in patients 5 and 6 and Type 2 in patients 1, 2, 3, 4 and 8. The average age of presentation of Type 1 and Type 2 lesions was 8 and 7 years old respectively. We also report patient 8, who is the youngest reported case of choroidal neovascular membrane associated with torpedo maculopathy. Good anatomical response to a single injection of anti-Vegf was shown. CONCLUSIONS: This study is the first case series of torpedo maculopathy in the paediatric population. Contrary to previous reports of two distinct types of lesion on OCT representing different stages of the same disease, our case series indicates that Type 1 and Type 2 lesions are in fact different phenotypic entities both of which can occur at a young age. We also present the associated risk of choroidal neovascular membrane formation which is an important consideration for long term follow-up.

Effect of inhibitory extracts derived from liquid smoke combined with postprocess pasteurization for control of Listeria monocytogenes on ready-to-eat meats.

Surface pasteurization was examined in combination with low-phenolic antimicrobial extracts derived from liquid smoke to inhibit and prevent the growth of Listeria monocytogenes during the shelf life of ready-to-eat meats. In preliminary trials with retail frankfurters, one smoke derivative (2-min dip) produced a 0.3-log reduction of L. monocytogenes and a 1-min in-bag pasteurization (73.9 degrees C) produced a 2.9-log reduction, whereas a combination of the two treatments produced a 5.3-log reduction that resulted in no detectable Listeria by week 3 under accelerated shelf-life conditions (10 degrees C). In trials with frankfurters manufactured without lactate or diacetate that were treated with a shortened 1-s dip, this smoke extract and one with reduced smoke flavor and color both produced a > 4.5-log reduction of L. monocytogenes on frankfurters when heated at 73.9 degrees C for 1 min, with no recoverable Listeria detected for 10 weeks when stored at 6.1 degrees C. When deli turkey breast chubs manufactured without lactate, diacetate, or nitrite were treated with a 1-s dip in combination with radiant-heat pasteurization (270 degrees C), growth of L. monocytogenes was retarded but not prevented. However, in a similar study in which smoke extract treatment of deli turkey breast was combined with in-bag postpackage pasteurization (water submersion at 93.3 degrees C), a 60-, 45-, or even 30-s heat treatment resulted in a 2- to 3-log reduction of L. monocytogenes, with no growth on the meat during 10 weeks of storage at 6.1 degrees C. These findings indicate that reduced-acid low-phenolic antimicrobial liquid smoke derivatives combined with surface pasteurization are capable of reducing or preventing growth of L. monocytogenes to meet the criteria for the U.S. Department of Agriculture Food Safety and Inspection Service Alternative 1 process for ready-to-eat deli meat products manufactured without lactate or diacetate.

Microplate fluorescence assay for measurement of the ability of strains of Listeria monocytogenes from meat and meat-processing plants to adhere to abiotic surfaces.

Listeria monocytogenes is a significant food-borne pathogen that is capable of adhering to and producing biofilms on processing equipment, making it difficult to eliminate from meat-processing environments and allowing potential contamination of ready-to-eat (RTE) products. We devised a fluorescence-based microplate method for screening isolates of L. monocytogenes for the ability to adhere to abiotic surfaces. Strains of L. monocytogenes were incubated for 2 days at 30 degrees C in 96-well microplates, and the plates were washed in a plate washer. The retained cells were incubated for 15 min at 25 degrees C with 5,6-carboxyfluorescein diacetate and washed again, and then the fluorescence was read with a plate reader. Several enzymatic treatments (protease, lipase, and cellulase) were effective in releasing adherent cells from the microplates, and this process was used for quantitation on microbiological media. Strongly adherent strains of L. monocytogenes were identified that had 15,000-fold-higher levels of fluorescence and 100,000-fold-higher plate counts in attachment assays than weakly adherent strains. Strongly adherent strains of L. monocytogenes adhered equally well to four different substrates (glass, plastic, rubber, and stainless steel); showed high-level attachment on microplates at 10, 20, 30, and 40 degrees C; and showed significant differences from weakly adherent strains when examined by scanning electron microscopy. A greater incidence of strong adherence was observed for strains isolated from RTE meats than for those isolated from environmental surfaces. Analysis of surface adherence among Listeria isolates from processing environments may provide a better understanding of the molecular mechanisms involved in attachment and suggest solutions to eliminate them from food-processing environments.