1/234. exophiala (Wangiella) dermatitidis keratitis after keratoplasty.We report the first French case of an intraocular infection due to exophiala (Wangiella) dermatitidis. Two months after a second corneal transplant for congenital hereditary endothelial dystrophy, the patient presented with ocular pain and corneal infiltrates leading to the graft rejection. Diagnosis was established by positive direct examination and cultures of the same fungus from corneal buttons, iris biopsies and ablated sutures.- - - - - - - - - - ranking = 1keywords = keratitis, ocular (Clic here for more details about this article) |
2/234. Mycotic keratitis in non-steroid exposed vernal keratoconjunctivitis.PURPOSE: To report a patient with vernal keratoconjunctivitis who developed mycotic keratitis in absence of known risk factors. methods: A 17-year-old male suffering from vernal keratoconjunctivitis presented with infective keratitis. The patient had been treated in the past with topical antihistaminics and vasoconstrictors. The patient had not been exposed to topical steroids in 2 years of follow-up. He did not have dry eye or corneal micro or macroerosions prior to the development of infective keratitis. Corneal scrapings were obtained and subjected to KOH wet mount smear, calcofluor and Grams stain as well as bacterial culture sensitivity and fungal culture. RESULTS: Clinical diagnosis of mycotic keratitis in association with vernal conjunctivitis was supported by microbiological investigations. KOH wet mount and calcofluor staining showed presence of filamentous septate hyphae while fungal culture showed growth of aspergillus fumigatus. Antifungal therapy was initiated in the form of topical natamycin 5% suspension to which the patient responded and recovered 6/6 final visual acuity. CONCLUSION: The authors wish to conclude that patients suffering from vernal keratoconjunctivitis, even in the absence of corneal involvement, steroid exposure and trauma, may be at increased risk of developing keratomycosis.- - - - - - - - - - ranking = 1.9994905552986keywords = keratitis (Clic here for more details about this article) |
3/234. Exserohilum rostratum causing keratitis in india.A case of mycotic keratitis due to atypical Exserohilum rostratum is reported in a 42-year-old male with Hansens disease.- - - - - - - - - - ranking = 1.2496815970616keywords = keratitis (Clic here for more details about this article) |
4/234. Fungal corneal ulcers of onion harvesters in southern taiwan.Fungal corneal ulcers related to agriculture has been reported throughout the world, especially in tropical areas. Most of them were sporadic and had histories of ocular trauma or use of topical corticosteroids and topical antibiotics. Five onion harvesters had fungal corneal ulcers during the same harvest period in Southern taiwan. The authors think that this is the first report of a group occurrence relating to agricultural workers. Although all of the patients improved after medical and surgical management, their vision was greatly decreased. It is suggested that the tropical climate, the harvest procedure, the characteristic monsoon, and lack of eye protection were involved. Therefore, the importance of the eye protection, hygiene education, and improving medical care to reduce the occurrence of fungal corneal ulcer in agriculture workers must be emphasised.- - - - - - - - - - ranking = 0.00012736117534583keywords = ocular (Clic here for more details about this article) |
5/234. chrysosporium parvum keratomycosis.PURPOSE: To report a case of corneal infection with chrysosporium parvum, a filamentous fungus usually associated with pulmonary infections. methods: A 43-year-old Saudi man had a corneal stromal infiltrate and perforation of his left eye. He was treated with a therapeutic penetrating keratoplasty and topical and systemic antifungal therapy. Corneal scrapings, microbiologic evaluation, and histopathologic examination of the surgical specimen were performed to establish the diagnosis. After the development of recurrent stromal keratitis at the graft-host junction, similar diagnostic and therapeutic maneuvers were performed. RESULTS: Corneal scrapings and histopathologic examination were positive for numerous septate hyphae with endospores, consistent with a diagnosis of filamentous keratomycosis. Microbiologic isolation confirmed the diagnosis of chrysosporium parvum. Similar diagnostic maneuvers for recurrent keratitis produced identical results. CONCLUSION: To our knowledge, this is the first case of chrysosporium parvum keratomycosis.- - - - - - - - - - ranking = 0.49987263882465keywords = keratitis (Clic here for more details about this article) |
6/234. Mycotic keratitis due to Curvularia senegalensis and in vitro antifungal susceptibilities of Curvularia spp.A case of mycotic keratitis due to Curvularia senegalensis is reported. This case represents the third known reported infection caused by this rare species. Fungal hyphae were detected in corneal scrapings, and repeated cultures were positive for this fungi. The patient was presumed cured after a corneal transplant and treatment with itraconazole, but the infection recurred and the patient is waiting for a keratoplasty. The in vitro antifungal susceptibilities of the case strain and another 24 strains belonging to seven species of Curvularia were tested for six antifungal agents. With the exception of flucytosine, and occasionally fluconazole, the other drugs assayed (amphotericin b, miconazole, itraconazole, and ketoconazole) were highly effective in vitro.- - - - - - - - - - ranking = 1.2496815970616keywords = keratitis (Clic here for more details about this article) |
7/234. The development of choroidal neovascularization in pregnancy.PURPOSE: To evaluate the possible association between the development of choroidal neovascularization (CNV) and pregnancy. methods: A retrospective review was performed of the clinical records of three patients who were pregnant at the time a choroidal neovascular membrane (CNVM) was diagnosed. The clinical presentations and treatment of the CNVM occurring in association with the pregnancies are described. RESULTS: Each patient had a decrease in visual acuity during her pregnancy: one in the first trimester, one in the second trimester, and one in the third trimester. Two patients were diagnosed with CNV related to presumed ocular histoplasmosis syndrome (POHS) and one with an idiopathic CNVM. The two-patients with POHS showed progression of CNV after childbirth. All patients received laser photocoagulation directly to the site of the CNV. The two patients with ocular histoplasmosis experienced recurrence after treatment; one received further photocoagulation treatment, and the other underwent vitrectomy with removal of the CNVM. CONCLUSIONS: pregnancy and the immediate postpartum period may be associated with development or recurrence of CNV in POHS or idiopathic cases. This may be related to hormonal changes during pregnancy, or the cases described may reflect only a coincidental association. This report discusses possible causal factors and mechanisms.- - - - - - - - - - ranking = 0.00025472235069166keywords = ocular (Clic here for more details about this article) |
8/234. Treatment of acanthamoeba keratitis combined with fungal infection with polyhexamethylene biguanide.From July 1996 to March 1997, three cases of acanthamoeba keratitis combined with fungal infection were diagnosed and treated at our ophthalmic department. Specimens from all of these cases were obtained by corneal scraping, keratectomy and anterior chamber paracentesis. The diagnosis was confirmed by either the results of smear test or pathology reports. All of these patients received aggressive treatment with polyhexamethylene biguanide (PHMB) 0.02%, fluconazole, and anegyn eye drops. After the infection had been controlled without extension, therapeutic penetrating keratoplasty was performed on all of these patients despite the existence of infiltration beyond the edge of the graft. Postoperatively, eye drops were tapered gradually, and treatment was continued for 1 to 2 months. All three cases achieved good results and there was no recurrence of infection. Two cases had visual acuity of 20/100 and 20/20, while the other one perceived hand movement only due to later graft rejection. These cases suggest that early diagnosis and immediate use of PHMB and anti-fungal agents are effective in the treatment of acanthamoeba keratitis combined with fungal infection.- - - - - - - - - - ranking = 1.499617916474keywords = keratitis (Clic here for more details about this article) |
9/234. A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.OBJECTIVE: To evaluate short-term safety and the effects on visual acuity and fluorescein angiography of single or multiple sessions of photodynamic therapy with verteporfin for choroidal neovascularization (CNV) not related to age-related macular degeneration (AMD), including pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes. DESIGN: A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial. SETTING: Four ophthalmic centers in europe and north america providing retinal care. PARTICIPANTS: Thirteen patients with subfoveal CNV due to pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, or idiopathic causes. methods: Standardized protocol refraction, visual acuity testing, ophthalmic examinations, color photographs, and fluorescein angiograms were used to evaluate the results of photodynamic therapy treatments with verteporfin. Follow-up ranged from 12 weeks for patients who were treated once to 43 weeks for patients who were treated up to 4 times. RESULTS: Verteporfin therapy was well tolerated in patients with CNV not related to AMD. No deterioration in visual acuity was observed; most patients gained at least 1 line of vision. Reduction in the size of leakage area from classic CNV was noted in all patients as early as 1 week after verteporfin therapy, with complete absence of leakage from classic CNV in almost half of the patients. Improvement in visual acuity after verteporfin therapy was greatest ( 6, 8, and 9 lines) in 3 patients with relatively poor initial visual acuity (between 20/200 and 20/800). Up to 4 treatments were found to have short-term safety even with retreatment intervals as short as 4 weeks. CONCLUSIONS: Treatment of CNV not related to AMD with verteporfin therapy achieves short-term cessation of fluorescein leakage from CNV in a small number of patients without loss of vision. Further randomized clinical trials including a larger number of patients are under way to confirm whether verteporfin therapy is beneficial for subfoveal CNV not related to AMD.- - - - - - - - - - ranking = 0.00076416705207499keywords = ocular (Clic here for more details about this article) |
10/234. Subretinal surgery for choroidal neovascularization in patients with high myopia.OBJECTIVE: To analyze the visual outcome in patients undergoing surgical removal of subfoveal choroidal neovascularization (CNV) in eyes with high myopia. methods: We retrospectively reviewed the medical records of 48 consecutive patients with high myopia (> or =6 diopters [D]) who underwent vitrectomy with surgical removal of subfoveal CNV. The patient population consisted of 2 groups. Group 1 included 23 patients with findings only of myopic degeneration, and group 2 included 25 patients with presumed ocular histoplasmosis syndrome and myopia of 6 D or more. RESULTS: In group 1, the visual acuity improved by 2 or more Snellen lines in 9 eyes (39%), decreased in 8 eyes (35%), and remained unchanged in 6 (26%), with a mean follow-up of 24 months (range, 8-60 months). The preoperative visual acuity was 20/40 or better in only 1 eye (4%), but 8 (35%) achieved a final visual acuity of 20/40 or better. In group 2, the visual acuity improved in 16 eyes (64%), was stable in 4 (16%), and deteriorated in 5 (20%), with a mean follow-up of 18 months (range, 6-44 months). Only 3 eyes (12%) had a preoperative visual acuity of 20/40 or better, but 11 (44%) achieved a final visual acuity of 20/40 or better. recurrence occurred in 13 (57%) of the 23 eyes in group 1 and in 9 (36%) of the 25 eyes in group 2. Univariate analysis demonstrated a significant relation between younger patient age (group 1) and absence of postoperative CNV recurrence (group 2) and an improvement of visual acuity (P<.01). CONCLUSIONS: Surgical removal of CNV may provide visual benefit in selected cases of subfoveal CNV associated with high myopia. The determination of whether surgical intervention is appropriate in these cases requires a prospective, randomized, clinical trial.- - - - - - - - - - ranking = 0.00012736117534583keywords = ocular (Clic here for more details about this article) |
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