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1.
Sci Rep ; 14(1): 15746, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977762

RESUMO

The aim of this study was to investigate the efficacy of the ithmid kohl/zinc-oxide nanoparticles (ZnONPs), ithmid kohl/Aloe vera, and ZnONPs/Aloe vera in the treatment of bacterial endophthalmitis. The endophthalmitis model was prepared by contaminating both eyes of 24 healthy adult male albino rabbits with a clinical isolate of Klebsiella pneumoniae. The animals were randomly divided into eight groups (A-H) according to the treatment. Group A received 1 ml of ithmid kohl/ZnONPs ointment, group B received 1 ml of ithmid kohl/Aloe vera gel ointment, group C received 1 ml of ZnONPs/Aloe vera gel ointment, and groups D, E, and F were treated with 1 ml of ithmid kohl solution (0.5 g/ml in distilled water), 1 ml of ZnONPs (0.5 g/ml) colloidal dispersion, and 1 ml of Aloe vera gel, respectively. Group G received 100 µl of a tetracycline antibiotic solution (final concentration: 16 µg/ml), and group H received sterile distilled water (no treatment). In vitro antibacterial activity was evaluated against K. pneumoniae using the agar well diffusion. The combination of ithmid kohl/ZnONPs was the most effective formulation for treating endophthalmitis model in infected rabbits within 2 days. In vitro antibacterial assay confirmed the potential of the ithmid kohl/ZnONPs formulation, which had the largest zone of inhibition (31 mm) among the compounds tested. The preparation of the ithmid kohl/ZnONPs formulation and its in vivo experiment in albino rabbits for the treatment of bacterial endophthalmitis was an innovative approach that has shown promise and may potentially serve as a viable alternative in clinical practice.


Assuntos
Aloe , Antibacterianos , Endoftalmite , Klebsiella pneumoniae , Endoftalmite/tratamento farmacológico , Endoftalmite/microbiologia , Animais , Coelhos , Masculino , Klebsiella pneumoniae/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Aloe/química , Nanopartículas/química , Testes de Sensibilidade Microbiana , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Modelos Animais de Doenças
2.
Rom J Ophthalmol ; 68(2): 182-186, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39006339

RESUMO

Objective: This case report aimed to describe the unusual clinical presentation and histopathological features of post-injection endophthalmitis. Methods: A 56-year-old male phakic patient with diabetic retinopathy received an intravitreal injection (Bevacizumab as per the patient) for neovascular glaucoma elsewhere and presented to our center one day after the dose with hypopyon. The eye was relatively white without pain or lid oedema. The patient was treated as a case of post-injection endophthalmitis with two doses of intravitreal antibiotics 48 hours apart. During the follow-up, he developed a Covid infection. After one week, when the media cleared, white exudates were seen in the vitreous cavity with a relatively healthy retina. He was taken up for pars plana vitrectomy and vitreous biopsy for histopathological study. Results: The microscopic examination of vitreous aspirate revealed crystalline deposits without any microorganisms. Two control slides, one with a mixture of intravitreal antibiotics, which were previously injected, and the other with fresh Triamcinolone were also examined. Although the findings of the drug mixture did not match the vitreous aspirate, they matched with triamcinolone, which established it as a case of pseudo endophthalmitis due to triamcinolone injected elsewhere. Discussion: Initially, it seemed like a straightforward case of post-injection endophthalmitis, but a further examination of the vitreous aspirate showed that it was pseudoendophthalmitis due to an intravitreal triamcinolone injection. Despite the patient being phakic, neovascularization or elevated intraocular pressure may have led to the disruption of the blood-ocular barrier and the migration of Triamcinolone into the anterior chamber. Conclusion: The case's uniqueness lies in being the first reported case of pseudo endophthalmitis in a phakic patient with an intact lens iris diaphragm. The case also highlighted the judicious use of available resources and out-of-the-box thinking to reach a diagnosis that may not always be obvious. Abbreviations: TA = Triamcinolone acetonide, AC = Anterior chamber, IVB = Intravitreal Bevacizumab, PL = Perception of light.


Assuntos
Inibidores da Angiogênese , Bevacizumab , Endoftalmite , Glaucoma Neovascular , Injeções Intravítreas , Humanos , Masculino , Pessoa de Meia-Idade , Glaucoma Neovascular/diagnóstico , Glaucoma Neovascular/etiologia , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/administração & dosagem , Corpo Vítreo/patologia , Corpo Vítreo/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , COVID-19/complicações , COVID-19/diagnóstico , Vitrectomia/métodos , Glucocorticoides/uso terapêutico , Glucocorticoides/administração & dosagem , SARS-CoV-2 , Retinopatia Diabética/diagnóstico
4.
Int Ophthalmol ; 44(1): 308, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38958789

RESUMO

PURPOSE: This study aimed to investigate the demographics, clinical characteristics, and management outcomes of patients with acute infectious endophthalmitis (AIE). METHODS: This retrospective chart review was conducted on all patients admitted with the clinical diagnosis of infectious endophthalmitis from 2017 to 2022. Demographic data, patients' clinical characteristics, the type of acute infectious endophthalmitis (post-operative, post-traumatic, bleb-associated, and endogenous endophthalmitis), the type of surgical procedure in the post-operative cases, the microbiologic analysis results of vitreous samples, therapeutic measures, and visual outcomes of patients were recorded. RESULTS: In this study, 182 participants, including 122 male (67%) and 60 (33%) female, were involved. The mean age of patients was 54.56 ± 21 years, with a range of 1-88 years old. The most prevalent type of AIE was post-operative (59.9%), followed by endogenous (19.2%), post-traumatic (17%), and bleb-associated (3.8%). The most common type of intraocular surgery in the post-operative subgroups of AIE patients was phacoemulsification (57.8%). The median (interquartile range) of the primary and final BCVA of patients was 1.5 (1.35, 1.85) and 0.65 (0.35, 1.35), respectively. Vitreous haziness grade (OR, 2.89; 95% CI, 1.11-5.74; p = 0.009) and the primary VA (OR, 60.34; 95% CI, 2.87-126.8; p = 0.008) revealed statistical significance for final vision loss. CONCLUSION: AIE is a devastating condition with poor visual outcomes, which presents with acute inflammatory signs and symptoms regardless of its type. However, prompt and appropriate treatment leads to visual recovery to a functional level in many patients.


Assuntos
Endoftalmite , Infecções Oculares Bacterianas , Acuidade Visual , Humanos , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Endoftalmite/epidemiologia , Endoftalmite/terapia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Adulto , Idoso de 80 Anos ou mais , Adolescente , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/epidemiologia , Infecções Oculares Bacterianas/terapia , Adulto Jovem , Doença Aguda , Criança , Pré-Escolar , Lactente , Antibacterianos/uso terapêutico , Corpo Vítreo/microbiologia , Corpo Vítreo/patologia , Vitrectomia/métodos
5.
Medicine (Baltimore) ; 103(27): e38308, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38968536

RESUMO

The characteristics of patients with endophthalmitis due to penetrating ocular trauma are still limited. The aim of the study was to fill these gaps among Chinese population. This retrospective study included patients diagnosed as penetrating ocular traumatic endophthalmitis between January 2016 to December 2018. During the past 3-year period, a total of 201 patients with antecedent penetrating eye injuries were evaluated. Of which, 42 (20.9%) patients presented a clinical course compatible with acute infectious endophthalmitis. 39 (92.86%) patients were males, and 15 (35.71%) patients had mechanical injuries from intraocular foreign body (IOFB), the rate of endophthalmitis due to IOFB was 13.43%, higher to the rate among patients without IOFB (7.46%). The duration between injury occurrence and endophthalmitis onset was 1 day in 10 (23,80%) patients; 2 to 7 days in 31 (73.80%) patients, and 7 to 14 days in 1 (2.38%) patient. After 1 year follow-up, best corrected visual acuity (BCVA) better than 20/400 was observed in 15 (35.71%) patients, counting fingers and hand move in 17 (40.48%) patients, light perception in 5 (11.9%) patients and no light perception in 5 (11.9%) patients, respectively. Patients with promising outcomes had better initial BCVA at baseline (P < .001). Endophthalmitis is a severe ocular infectious condition that may lead to irreversible vision loss. A greater attention must be paid to penetrating eye injuries within males, who had poor BCVA at baseline, particularly with obvious IOFB.


Assuntos
Endoftalmite , Corpos Estranhos no Olho , Ferimentos Oculares Penetrantes , Acuidade Visual , Humanos , Endoftalmite/epidemiologia , Endoftalmite/etiologia , Masculino , Ferimentos Oculares Penetrantes/epidemiologia , Ferimentos Oculares Penetrantes/complicações , Feminino , Estudos Retrospectivos , Adulto , Corpos Estranhos no Olho/epidemiologia , Pessoa de Meia-Idade , China/epidemiologia , Adulto Jovem , Adolescente
6.
Int Ophthalmol ; 44(1): 321, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977562

RESUMO

PURPOSE: To investigate whether the clinical characteristics, treatment and prognosis of endogenous infectious endophthalmitis (EIE) have changed over the past 5 years. METHODS: Retrospectively analyze all articles about EIE published in the PubMed, Web of Science, and Embase databases from 2017 to 2021. RESULTS: A total of 128 patients and 147 eyes (46 left and 60 right) were included in the study. The mean age at diagnosis was 51 ± 19 years. The most common risk factors were diabetes and intravenous drug use. From 2017 to 2021, Klebsiella was the most common pathogenic microorganism (22%), and vitreous culture had the highest positivity rate. The most common complaint was blurred vision. The mean visual acuity (logMAR) at onset was 2.84, and the clinical symptoms were vitreal inflammation and opacity (63%), ocular pain (37%), and conjunctival congestion (36%). The ocular inflammation could be reduced by intraocular antibiotics or vitrectomy. However, the visual prognosis, with a mean logMAR of 2.73; only 50% of the eyes reached a visual acuity level of finger count and above. Changes in diagnostics over the past 5 years have mainly manifested as more diverse microorganism culture methods. In addition to conventional culture methods, PCR, sputum culture and aqueous humour culture are also commonly used for the diagnosis of pathogenic bacteria, improving the positive culture rate and visual prognosis. CONCLUSION: The prognosis of EIE is poor. It is recommended to pay attention to the pathogenic bacteria culture results and accompanying systemic diseases and to diagnose and treat patients as soon as possible.


Assuntos
Antibacterianos , Endoftalmite , Infecções Oculares Bacterianas , Acuidade Visual , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Endoftalmite/terapia , Humanos , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/terapia , Prognóstico , Antibacterianos/uso terapêutico , Vitrectomia/métodos , Estudos Retrospectivos , Corpo Vítreo/microbiologia , Bactérias/isolamento & purificação , Fatores de Risco , Masculino , Feminino
7.
Invest Ophthalmol Vis Sci ; 65(6): 12, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38842829

RESUMO

Purpose: To test the hypothesis that (C-C motif) ligand 2 (CCL2) and CCL3 impact retinal function decline and inflammation during Staphylococcus aureus endophthalmitis. Methods: Experimental endophthalmitis was initiated by intravitreal injection of 5000 colony-forming units of S. aureus into the eyes of C57BL/6J, CCL2-/-, or CCL3-/- mice. At 12 and 24 hours post-infection, retinal function, bacterial load, and myeloperoxidase levels were quantified. Results: During S. aureus endophthalmitis, we observed a significant improvement in retinal function in CCL2-/- mice relative to C57BL/6J mice at 12 hours but not at 24 hours. In CCL3-/- mice, retinal function was significantly improved relative to C57BL/6J mice at 12 and 24 hours. The absence of CCL2 did not alter intraocular S. aureus intraocular concentrations. However, CCL3-/- mice had significantly lower intraocular S. aureus at 12 hours but not at 24 hours. No difference in myeloperoxidase levels was observed between C57BL/6J and CCL2-/- mice at 12 hours. CCL3-/- mice had almost no myeloperoxidase at 12 hours. At 24 hours, increased myeloperoxidase was observed in CCL2-/- and CCL3-/- mice relative to C57BL/6J mice. Conclusions: Although the absence of CCL2 resulted in improved retinal function retention at 12 hours, CCL3 deficiency resulted in improved retinal function at 12 and 24 hours. CCL3 deficiency, but not CCL2 deficiency, resulted in almost no inflammation at 12 hours. However, at 24 hours, the absence of CCL2 or CCL3 resulted in significantly increased inflammation. These results suggest that, although both CCL2 and CCL3 impact intraocular infection outcomes, CCL3 may have a more significant impact in S. aureus endophthalmitis.


Assuntos
Quimiocina CCL2 , Quimiocina CCL3 , Modelos Animais de Doenças , Endoftalmite , Infecções Oculares Bacterianas , Camundongos Endogâmicos C57BL , Infecções Estafilocócicas , Staphylococcus aureus , Animais , Endoftalmite/microbiologia , Endoftalmite/metabolismo , Camundongos , Infecções Estafilocócicas/microbiologia , Infecções Oculares Bacterianas/microbiologia , Quimiocina CCL2/metabolismo , Quimiocina CCL3/metabolismo , Camundongos Knockout , Peroxidase/metabolismo , Retina/metabolismo , Retina/microbiologia , Eletrorretinografia
8.
Medicina (Kaunas) ; 60(6)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38929513

RESUMO

We present a case of bilateral endogenous endophthalmitis with an extremely rare etiology of Capnocytophaga canimorsus. A 42-year-old asplenic patient with bilateral deterioration of visual acuity presented to the Emergency Department. The sudden deterioration of visual acuity, which prompted the patient to visit the ophthalmologist, was the first sign of the onset of sepsis. The physicians' attention, in addition to poor visual acuity and intense inflammation on ophthalmologic examination, was drawn to the reported flu-like symptoms. They were accompanied by high C-reactive protein results and abnormalities in echocardiography. A blood culture isolated the bacterium Capnocytophaga canimorsus. Immunocompromised patients are particularly susceptible to C. canimorsus infection. Endophthalmitis of this etiology has a very aggressive course, both ophthalmic and systemic. Therefore, quick diagnosis and initiation of adequate therapy are crucial.


Assuntos
Capnocytophaga , Endoftalmite , Infecções por Bactérias Gram-Negativas , Sepse , Humanos , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Capnocytophaga/isolamento & purificação , Adulto , Sepse/complicações , Sepse/microbiologia , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/complicações , Masculino , Antibacterianos/uso terapêutico
9.
Turk J Ophthalmol ; 54(3): 175-179, 2024 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-38860516

RESUMO

A 78-year-old man with a history of lung cancer, chemotherapy, radiotherapy, and coronavirus disease 2019 infection experienced visual deterioration of two-weeks' duration in his right eye. There was multifocal, yellowish-white retinitis foci, vascular engorgement, and scattered intraretinal hemorrhages extending from posterior pole to retinal periphery in the right eye, whereas the left eye was normal. Intravitreal vancomycin, ceftazidime, clindamycin, and dexamethasone were given for endogenous endophthalmitis initially. Vitreous culture confirmed the presence of Aspergillus lentulus, and he was treated with intravitreal amphotericin-B and voriconazole injections together with systemic amphotericin-B, voriconazole, posaconazole, and micafungin therapy. During follow-up, vitreoretinal surgery was performed because of rhegmatogenous retinal detachment, and he received one additional cycle of chemotherapy due to recurrence of the cancer. Although the retina was attached, enucleation was eventually required due to painful red eye. Atypical squamous cells beneath the neurosensory retina suggesting metastasis were noted on histopathological examination. Timely ocular examination is crucial for any immunocompromised patient having ocular symptoms. High level of suspicion for a fungal etiology is a must in these patients.


Assuntos
Aspergilose , Aspergillus , Endoftalmite , Infecções Oculares Fúngicas , Hospedeiro Imunocomprometido , Neoplasias Pulmonares , Humanos , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Masculino , Idoso , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/microbiologia , Neoplasias Pulmonares/diagnóstico , Aspergilose/diagnóstico , Aspergilose/microbiologia , Aspergillus/isolamento & purificação , Antifúngicos/uso terapêutico , COVID-19/complicações , Corpo Vítreo/microbiologia , Injeções Intravítreas , SARS-CoV-2
10.
Medicine (Baltimore) ; 103(24): e38456, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38875407

RESUMO

Infective endophthalmitis is an ophthalmic infection that in severe cases can cause complete loss of vision. In children, the defense against infection is low and eye tissue is not fully developed, leading to increased vulnerability to endophthalmitis. Children may be unable to understand the symptoms; thus, developing a method for prevention and treatment of this disease in children is important. Therefore, we analyzed the clinical and pathogenic characteristics of infectious endophthalmitis in children and provided evidence for clinical treatment. The clinical data of 78 children (78 eyes) with infectious endophthalmitis were retrospectively analyzed. The clinical characteristics, pathogen distribution, drug sensitivity, clinical medication, and treatments were summarized and analyzed. In total, 74 (94.87%) had ocular infections caused by trauma and 75 (96.15%) were from rural townships. A total of 108 sterile specimens were examined, with a positive detection rate of 37.04%. The sensitivity rates of Gram-positive cocci and bacilli to vancomycin were 100%. The sensitivity rates of Gram-negative bacilli to ceftazidime, piperacillin/tazobactam, amikacin, gentamicin, ciprofloxacin, and levofloxacin were 100%. Of the 78 patients, 53 (67.95%) received intravitreal injection and 54 (69.23%) underwent vitrectomy. Trauma is the main factor leading to infectious endophthalmitis in children, wherein Gram-positive bacteria are the most common pathogens. Thus, a timely understanding of the pathogen and drug sensitivity is needed. Intravitreal injection and vitrectomy are effective treatments.


Assuntos
Antibacterianos , Endoftalmite , Humanos , Endoftalmite/microbiologia , Endoftalmite/epidemiologia , Endoftalmite/tratamento farmacológico , Estudos Retrospectivos , Criança , Masculino , Feminino , Pré-Escolar , Antibacterianos/uso terapêutico , Lactente , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/epidemiologia , Adolescente , Testes de Sensibilidade Microbiana , Vitrectomia , Injeções Intravítreas
11.
J Infect Public Health ; 17(7): 102461, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38852231

RESUMO

Endogenous bacterial endophthalmitis (EE) is an intraocular infection with a poor prognosis. Timely diagnosis and prompt treatment are crucial to prevent vision loss. In this communication, we describe a case of EE caused by Streptococcus pyogenes (Group A Streptococcus [GAS]) in an HIV-positive patient with poorly controlled type 2 diabetes mellitus (DM). A 60-year-old man with a history of HIV and poorly controlled type 2 diabetes, presented with progressive blurry vision, left eye pain, redness, and headache. EE was diagnosed based on the clinical presentation and gram stain analysis of blood culture. Treatment with vitreous tap, intravitreal, topical antibiotics, and systemic antibiotics significantly improved the patient's symptoms. The case highlights the rarity of GAS as a causative agent of EE, particularly in patients with risk factors such as HIV infection and DM.


Assuntos
Antibacterianos , Diabetes Mellitus Tipo 2 , Endoftalmite , Infecções por HIV , Infecções Estreptocócicas , Streptococcus pyogenes , Humanos , Endoftalmite/microbiologia , Endoftalmite/tratamento farmacológico , Endoftalmite/diagnóstico , Masculino , Pessoa de Meia-Idade , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Antibacterianos/uso terapêutico , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/diagnóstico , Streptococcus pyogenes/isolamento & purificação , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/complicações
12.
BMC Ophthalmol ; 24(1): 214, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760776

RESUMO

BACKGROUND: Endogenous endophthalmitis (EE) is a rare but highly destructive eye emergency secondary to systemic infection. Acute endophthalmitis can lead to irreversible vision impairment or even loss of the whole eye, unless being diagnosed and treated promptly. CASE PRESENTATION: This study reports three typical EE cases of endogenous endophthalmitis secondary to different severe systemic diseases. Patients were recruited from the Department of ophthalmology at Zhongnan hospital of Wuhan University and the Department of ophthalmology at the Second Affiliated Hospital of Fujian Medical University. Patients were followed up for up to 60 days. Among these cases, the eye symptoms is the initial manifestations while secondary to original different special systemic conditions. Patients have been treated under dynamically prompt response undergoing systemic treatment and eye treatment at the same time. Best corrected visual acuity were 20/40, 20/60 and light perception during follow-up evaluation. CONCLUSIONS: Our observation suggest that prompt identification and treatment could save patients' vision from EE.


Assuntos
Endoftalmite , Infecções Oculares Bacterianas , Acuidade Visual , Humanos , Antibacterianos/uso terapêutico , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Acuidade Visual/fisiologia
13.
Int Ophthalmol ; 44(1): 216, 2024 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-38705908

RESUMO

PURPOSE: To evaluate clinical features, treatment protocol, outcomes, and complications that developed in this case series of 24 patients who had consecutive sterile endophthalmitis after intravitreal bevacizumab (IVB) injection. METHODS: In this retrospective case series, IVB was repackaged in individual aliquots from the three batches that were used on the same day. IVB was injected into 26 eyes of 26 patients due to diabetic macular edema, age-related macular degeneration, and branch retinal vein occlusion. All patients had intraocular inflammation. Patients were divided into two groups severe and moderate inflammation according to the intraocular inflammation. The medical records of all patients were reviewed. At each follow-up visit, the complete ophthalmologic examination was performed, including best corrected visual acuity (BCVA), intraocular pressure, biomicroscopy, and posterior fundus examination. RESULTS: Twenty-four of 26 patients were included in the study. Two patients were excluded from this study since they didn't come to follow-up visits. The mean BCVA was 1.00 ± 0.52 Log MAR units before IVB. At the final visit, the BCVA was 1.04 ± 0.47 Log MAR units. These differences were not significant (p = 0.58). Of the 24 eyes, 16 eyes had severe, and 8 eyes had moderate intraocular inflammation. Eleven eyes in the severe inflammation group underwent pars plana vitrectomy due to intense vitreous opacity. Smear, culture results, and polymerase chain reaction results were negative. CONCLUSION: Sterile endophthalmitis may occur after IVB injection. Differential diagnosis of sterile endophthalmitis from infective endophthalmitis is crucial to adjust the appropriate treatment and prevent long-term complications due to unnecessary treatment.


Assuntos
Inibidores da Angiogênese , Bevacizumab , Endoftalmite , Injeções Intravítreas , Acuidade Visual , Humanos , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Endoftalmite/diagnóstico , Endoftalmite/etiologia , Estudos Retrospectivos , Masculino , Feminino , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/efeitos adversos , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Edema Macular/tratamento farmacológico , Edema Macular/diagnóstico , Edema Macular/etiologia , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/tratamento farmacológico , Oclusão da Veia Retiniana/complicações , Seguimentos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/tratamento farmacológico
14.
Int Ophthalmol ; 44(1): 225, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748185

RESUMO

PURPOSE: To evaluate the importance of the status of posterior vitreous in eyes with endophthalmitis following intravitreal anti-vascular endothelial growth factor (anti-VEGF). METHODS: The absence or existence of posterior vitreous detachment (PVD) was elicited in 23 eyes of 23 patients with injection related endophthalmitis, during pars plana vitrectomy (PPV) and compared with 24 control eyes of 24 patients who received intravitreal anti-VEGF without any complication. RESULTS: Thirtten (54.2%) out of 24 patients in the control group had full PVD, whereas only 2 (9.5%) out of 23 eyes in endophthalmitis group (p < 0.001) had full PVD. In all eyes without PVD, posterior vitreous was inducted to be detached at least from optic nerve and macular area without any iatrogenic tear. CONCLUSION: The absence of PVD is a factor that increases the risk of endophthalmitis after intravitreal injections. Uncomplicated separation of the posterior vitreous from the retina in PPV contributes to better prognosis.


Assuntos
Inibidores da Angiogênese , Endoftalmite , Injeções Intravítreas , Fator A de Crescimento do Endotélio Vascular , Vitrectomia , Descolamento do Vítreo , Humanos , Endoftalmite/etiologia , Endoftalmite/diagnóstico , Endoftalmite/epidemiologia , Injeções Intravítreas/efeitos adversos , Masculino , Feminino , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/efeitos adversos , Fatores de Risco , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Idoso , Pessoa de Meia-Idade , Vitrectomia/efeitos adversos , Vitrectomia/métodos , Corpo Vítreo , Ranibizumab/administração & dosagem , Ranibizumab/efeitos adversos , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Idoso de 80 Anos ou mais
15.
Medicina (Kaunas) ; 60(5)2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38792883

RESUMO

We present a case of endogenous endophthalmitis with urinary tract infection (UTI) caused by group B Streptococcus (GBS). An 86-year-old female initially presented with ocular pain and sudden visual disturbance of the left eye. The patient did not complain of other symptoms and had no history of recent ocular surgery or trauma. Endogenous endophthalmitis was clinically diagnosed based on ophthalmic examination, history, and lab results showing systemic infection. A few days later, GBS was identified in her aqueous humor, blood, and urine cultures. Intravitreal ceftazidime and vancomycin injections, as well as fortified ceftazidime and vancomycin eye drops, were used immediately after clinical diagnosis. However, the symptoms worsened despite repeated intravitreal injections, so evisceration was performed. Endogenous endophthalmitis caused by GBS is very virulent and may present without evident systemic symptoms. The early recognition of the disease and systemic work up, followed by prompt treatment, is necessary.


Assuntos
Antibacterianos , Endoftalmite , Infecções Estreptocócicas , Streptococcus agalactiae , Infecções Urinárias , Humanos , Feminino , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Infecções Urinárias/complicações , Idoso de 80 Anos ou mais , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Endoftalmite/tratamento farmacológico , Streptococcus agalactiae/isolamento & purificação , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/diagnóstico , Antibacterianos/uso terapêutico , Vancomicina/uso terapêutico , Ceftazidima/uso terapêutico , Ceftazidima/administração & dosagem
16.
Ned Tijdschr Geneeskd ; 1682024 May 20.
Artigo em Holandês | MEDLINE | ID: mdl-38780203

RESUMO

The general physician as well as the medical specialist may be confronted with a patient with one or two red eyes. To be adequately equipped we answer a series of questions on diagnosis, treatment and referral of patients with red eyes after trauma, or with conjunctivitis, keratitis, scleritis, uveïtis, endophthalmitis or acute glaucoma. Refer to an ophthalmologist or not?


Assuntos
Oftalmopatias , Humanos , Doença Aguda , Conjuntivite/diagnóstico , Conjuntivite/etiologia , Diagnóstico Diferencial , Endoftalmite/diagnóstico , Oftalmopatias/diagnóstico , Encaminhamento e Consulta , Esclerite/diagnóstico , Esclerite/tratamento farmacológico
17.
Transl Vis Sci Technol ; 13(5): 14, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38767905

RESUMO

Purpose: Extracellular vesicles (EVs) are messenger pigeons of the cells that communicate about cellular microenvironment. In this study, we evaluated the expression of C8α and calpain-2 in EVs from vitreous of patients with bacterial endophthalmitis to assess its utility as a diagnostic marker. Methods: EVs were isolated from vitreous of patients with bacterial endophthalmitis (culture positive and culture negative) and noninfectious control by exosome isolation reagent and characterized, and the levels of C8α and calpain-2 was assessed by enzyme-linked immunosorbent assay in isolated EVs and direct vitreous. The receiver operating characteristic curve was generated to assess the diagnostic performance. Results: Scanning electron microscopy (SEM) and dynamic light scattering (DLS) confirmed the presence of EVs having a diameter (nm) of 275.2 ± 93, 92 ± 22, and 77.28 ± 12 in culture-positive (CP), culture-negative (CN), and control respectively. The expression level (ng/mL) of C8α in the EVs obtained from CP was 144 ± 22 and CN was 31.2 ± 9.8, which was significantly higher (P < 0.01) than control 3.7 ± 2.4. Interestingly, C8α is not expressed directly in the vitreous of CN and controls. Calpain-2 was significantly downregulated (P ≤ 0.0001) in CP (0.94 ± 0.16) and CN (0.70 ± 0.14) than control. The sensitivity and specificity of 1 for C8α and calpain-2 in the EVs implied that its diagnostic accuracy was significant. Conclusions: This study showed that the EV proteins C8α and calpain-2 could be suitable diagnostic markers for endophthalmitis. However, the presence of C8α in the EVs of CN samples but not in direct vitreous promises EVs as the future of diagnostics. Translational Relevance: Expression levels of EV-calpain-2 and EV-C8α could diagnose CN bacterial endophthalmitis.


Assuntos
Biomarcadores , Calpaína , Endoftalmite , Vesículas Extracelulares , Corpo Vítreo , Calpaína/metabolismo , Humanos , Corpo Vítreo/metabolismo , Corpo Vítreo/microbiologia , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Endoftalmite/metabolismo , Endoftalmite/patologia , Vesículas Extracelulares/metabolismo , Biomarcadores/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Ensaio de Imunoadsorção Enzimática , Idoso , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/metabolismo , Infecções Oculares Bacterianas/patologia , Curva ROC , Microscopia Eletrônica de Varredura , Adulto
18.
Invest Ophthalmol Vis Sci ; 65(4): 44, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38687493

RESUMO

Purpose: Fungal endophthalmitis is characterized by chronic inflammation leading to the partial or complete vision loss. Herein, we analyzed the transcriptomic landscape of Aspergillus flavus (A. flavus) endophthalmitis in C57BL/6 mice to understand the host-pathogen interactions. Methods: Endophthalmitis was induced by intravitreal injection of A. flavus spores in C57BL/6 mice and monitored for disease progression up to 72 hours. The enucleated eyeballs were subjected to histopathological analysis and mRNA sequencing using the Illumina Nextseq 2000. Pathway enrichment analysis was performed to further annotate the functions of differentially expressed genes (DEGs) and validation of cytokines was performed in vitreous of patients with fungal endophthalmitis using multiplex ELISA. Results: Transcriptomic landscape of A. flavus endophthalmitis revealed upregulated T-cell receptor signaling, PI3K-AKT, MAPK, NF-κB, JAK-STAT, and NOD like receptor signaling pathways. We observed significant increase in the T-cells during infection especially at 72 hours infection along with elevated expression levels of IL-6, IL-10, IL-12, IL-18, IL-19, IL-23, CCR3, and CCR7. Furthermore, host-immune response associated genes, such as T-cell interacting activating receptor, TNF receptor-associated factor 1, TLR1, TLR9, and bradykinin receptor beta 1, were enriched. Histopathological assessment validated the significant increase in inflammatory cells, especially T-cells at 72 hours post-infection along with increased disruption in the retinal architecture. Additionally, IL-6, IL-8, IL-17, TNF-α, and IL-1ß were also significantly elevated, whereas IL-10 was downregulated in vitreous of patients with Aspergillus endophthalmitis. Conclusions: Regulating T-cell influx could be a potential strategy to modulate the excessive inflammation in the retina and potentially aid in better vision recovery in fungal endophthalmitis.


Assuntos
Imunidade Adaptativa , Aspergilose , Aspergillus flavus , Citocinas , Modelos Animais de Doenças , Endoftalmite , Infecções Oculares Fúngicas , Perfilação da Expressão Gênica , Imunidade Inata , Camundongos Endogâmicos C57BL , Animais , Aspergillus flavus/genética , Camundongos , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/genética , Infecções Oculares Fúngicas/imunologia , Endoftalmite/microbiologia , Endoftalmite/imunologia , Endoftalmite/genética , Aspergilose/microbiologia , Aspergilose/genética , Aspergilose/imunologia , Imunidade Adaptativa/genética , Imunidade Inata/genética , Citocinas/metabolismo , Citocinas/genética , Transcriptoma , Ensaio de Imunoadsorção Enzimática , Corpo Vítreo/microbiologia
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