Journal of Ophthalmic Inflammation and Infection最新文献

Conjunctivitis is one of the most common eye infections seen in hospitals. Youngsters under the age of seven, women at age 22 and men at age 28 are most likely to be diagnosed with this infection. The current study was designed to identify and characterize the conjunctivitis associated pathogens and to evaluate their sensitivity or resistance against commonly used antibiotics (metronidazole, ciprofloxacin, azithromycin, and levofloxacin), aqueous plant extracts (Ficus religiosa, Syzygium cumini, Azadirachta indica, Allium cepa, Eucalyptus camaldulensis, Syzygium aromaticum, Aloe barbadensis, and Citrus limon) and green synthesized silver nanoparticles. The samples were taken at Fatima Memorial Hospital, Lahore. Blood agar test was used for screening of alpha and beta hemolytic bacterial pathogens. Antibacterial activity against pathogenic isolates was done using well diffusion method. Antibiotics showed range of bactericidal potential against pathogens considerably more effective against isolated bacteria. Maximum antibacterial activity against bacterial strains was observed in E. camaldulensis, S. cumini, and C. limon (13.66 ± 1.20 to 9 ± 0.57, 15.5 ± 0.76 to 10.33 ± 1.45, and 21.33 ± 0.88 to 12.66 ± 0.33 respectively). Green synthesized silver nanoparticles showed better results as antibacterial agents with the zones of inhibition measuring 11.66 ± 0.66 to 8.83 ± 0.72; 12.5 ± 0.62 to 9.83 ± 0.72; 16.16 ± 1.09 to 10.83 ± 1.01; 13.33 ± 1.20 to 8.83 ± 0.72; 12.16 ± 1.16 to 7.33 ± 0.66, and 13.16 ± 0.59 to 8.33 ± 0.88 respectively. Biochemical and molecular characterization of pathogens was done. Bacterial strains were identified as Bacillus thuringiensis, Bacillus cereus, Bacillus paramycoides, Bacillus coahuilensis and Pseudomonas aeruginosa. This study showed that because of mis- use or over use of antibiotics, pathogens have developed resistance. So conventional medication may be replaced by biological antibacterial tools such as plant extracts and green synthesized silver nanoparticle.

Background: To describe the clinical features, diagnostic approaches, and treatment outcomes of ocular sporotrichosis through an institutional case series and systematic review of reports from Southeast Asia.

Methods: Five patients diagnosed with ocular sporotrichosis at a tertiary referral center in Thailand (2020-2024) were retrospectively reviewed for clinical presentation, diagnostic confirmation, and treatment outcomes. A systematic review of PubMed, Embase, Scopus, and MEDLINE (last searched March 20, 2025) identified published cases from Southeast Asia. Eligible reports were narratively synthesized; no meta-analysis was performed due to clinical heterogeneity.

Results: All five institutional cases presented with chronic granulomatous conjunctivitis, frequently associated with cat exposure. Diagnosis was confirmed by fungal culture and/or histopathology in all patients. Oral itraconazole was prescribed in every case, with adjunctive topical antifungals used selectively. Most patients improved clinically, though several were lost to follow-up. The systematic review included 12 studies comprising 23 patients reported between 2018 and 2024. The median age was 32 years (IQR 22.5-55.0), and 78.3% were female. Most cases were unilateral (91.3%), with microbiological confirmation in 87%. Oral itraconazole was the primary treatment, with topical or intralesional antifungals in some cases. Clinical outcomes were generally favorable, though one patient developed limbal stem cell deficiency.

Conclusions: Ocular sporotrichosis is an emerging zoonotic infection in Southeast Asia, often linked to cat exposure. Early recognition and prompt antifungal therapy are critical to achieve good outcomes and prevent sight-threatening complications.

Background: Microbial keratitis is a vision-threatening corneal infection frequently encountered in tertiary eye care settings. Early identification of risk factors and prompt empirical treatment are essential for preventing permanent visual impairment and maintaining anatomical integrity. This study aimed to define the clinical and microbiological profiles of microbial keratitis and to evaluate empirical treatment responses and surgical outcomes.

Methods: This was a descriptive, retrospective study conducted through a review of clinical records over a five-year period (2020-2025). A total of 73 patients diagnosed with microbial keratitis at a tertiary eye care center were included. Data on demographic characteristics, predisposing risk factors, clinical presentation, microbiological culture results, and treatment modalities were collected. The patients' responses to empirical medical therapy and the need for surgical interventions, including penetrating keratoplasty, pars plana vitrectomy and evisceration were evaluated.

Results: Positive microbial cultures were obtained in 58.9% of the cases. Among these, Staphylococcus spp. was the most commonly isolated organism (36.9%), followed by Streptococcus spp. (21.7%), Klebsiella spp. (11.0%), Pseudomonas aeruginosa (9.0%) and fungal pathogens (4.3%). Trauma was identified as the most frequent predisposing risk factor across all age groups. Clinical improvement was observed in 65.8% of patients following topical empirical therapy. Surgical intervention was required in 25 patients due to clinical deterioration, including penetrating keratoplasty, re-keratoplasty, pars plana vitrectomy and evisceration. Endophthalmitis developed in 7 patients (9.5%) with causative organisms including Staphylococcus (44.4%), Streptococcus (33.3%), Klebsiella (11.1%) and Pseudomonas aeruginosa (11.1%). The anatomical success rate following treatment was 85.7%.

Conclusions: Initiation of empirical therapy targeting regionally prevalent pathogens may may contribute to better visual outcomes in selected cases. In cases unresponsive to medical management, early intervention with penetrating keratoplasty prior to limbal involvement or corneal perforation may improve prognosis and reduce the incidence of severe complications such as endophthalmitis.

Background: Cataract surgery in uveitic eyes with persistent hypotony is considered high-risk and is often deferred. This report describes the perioperative management and visual outcomes in such complex cases.

Objective: To evaluate the effectiveness of a tailored surgical and immunosuppressive approach for patients with uveitis, cataracts, and chronic hypotony (IOP ≤ 5 mmHg).

Methods: A retrospective review of two cases: a 21-year-old female with chronic intermediate non-granulomatous uveitis and a 17-year-old male with Vogt-Koyanagi-Harada (VKH) disease. Both developed bilateral cataracts and persistent hypotony. A multi-step protocol was implemented, involving aggressive immunosuppression (azathioprine/methotrexate plus adalimumab) and an average of two periocular triamcinolone acetonide (40 mg/mL) injections per eye to elevate IOP to a safe surgical threshold (≥ 8 mmHg). After achieving ≥ 3 months of quiescent inflammation and normalized IOP, patients underwent lens aspiration with intravitreal triamcinolone injection and were intentionally left aphakic.

Results: Preoperative IOP was successfully elevated to a mean of 10 mmHg. One eye experienced an intraoperative complication (dropped nucleus) requiring pars plana vitrectomy; this eye later developed corneal decompensation necessitating penetrating keratoplasty. Postoperative inflammation resolved within one week in all eyes. On long-term follow-up (mean 24 months), inflammation remained controlled on maintenance immunosuppression. At the two-year follow-up, best-corrected visual acuity was 20/30 in three eyes and 20/50 in the eye that required additional surgeries. IOP was maintained at ≥ 8 mmHg in all eyes.

Conclusion: A meticulously planned, multi-modal approach-involving aggressive control of inflammation, targeted reversal of hypotony with periocular steroids, and strategic surgical timing with intentional aphakia-can lead to successful anatomical and visual outcomes in high-risk uveitic patients with cataracts and persistent hypotony.