Cases reported "Endophthalmitis"

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1/29. Remarkable case of early Aspergillus endophthalmitis.

    BACKGROUND: This case demonstrates the early stage of Aspergillus endophthalmitis and is the second ultrastructural study of endogenous Aspergillus endophthalmitis. It is the first description of phagocytosis of Aspergillus fungi by retinal pigment epithelium (RPE). methods: A case report and detailed light- and electron microscopic findings are presented. RESULTS: Histopathological examination of serial sections of the affected right eye displayed a spread of aspergillus fumigatus fungi along two separate paths: via the retinal and choroidal vessels. The retinal and choroidal lesions were not contiguous. The organisms penetrated blood vessel walls, Bruch's membrane and the internal limiting membrane, but not the RPE layer. A curious accumulation of the Aspergillus fungi was present on the internal aspect of Bruch's membrane, where the RPE acted as a barrier and the subretinal space was not invaded. phagocytosis of fungi by the RPE was observed. No inflammatory cells were present between Bruch's membrane and the RPE. CONCLUSIONS: This report describes a remarkable barrier function, possible local immunosuppression and phagocytosis by the RPE cells in a case of early Aspergillus endophthalmitis.
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keywords = membrane
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2/29. Perfluorodecalin-induced intravitreal inflammation.

    OBJECTIVE: To report an unusual case of intravitreal inflammation in a human eye caused by the presence of residual perfluorodecalin in a case of giant retinal tear and retinal detachment. methods: The posterior capsule of the lens, which was infiltrated with deposits, was collected during surgery. The specimen was stained with hematoxylin and eosin, with periodic acid-Schiff, and for melanin. Part of it was examined with electron microscopy. Immunohistochemical staining was performed to demonstrate CD68 antigens, cytokeratin, and glial fibrillary acid protein. RESULTS: Vacuolated macrophages and retinal pigment epithelial cells infiltrated the posterior capsule. Electron microscopy showed the presence of membrane-lined vacuoles within the macrophages. A monolayer of epithelial cells covered the cellular infiltration. CONCLUSION: Residual perfluorodecalin can induce an intraocular chronic macrophage response.
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keywords = membrane
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3/29. Clinicopathological report of Candida granuloma from an endogenous candidal endophthalmitis.

    fluconazole was reported to be an effective alternative to amphotericin b for candidal endophthalmitis. However, the dose for systemic use had not been determined and few pathological reports on its use have been published. An epiretinal membrane harvested from a regressed candidal endophthalmitis in a patient treated with fluconazole (200 mg/day) was sent for pathologic study. On the inner side of the retina, a granuloma was found. Fungal debris was found within the center of the granuloma, but an intact fungus was seen next to the granuloma. Pathologic study showed incomplete treatment in this case, although systemic status had improved. The use of systemic fluconazole should be maintained for a longer period of time to treat candidal endophthalmitis.
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ranking = 176.90191678878
keywords = epiretinal membrane, epiretinal, membrane
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4/29. Visual and anatomical outcome following submacular surgery for choroidal neovascularization secondary to Candida endophthalmitis.

    PURPOSE: To report the long-term visual and anatomical outcomes for patients treated with submacular surgery for choroidal neovascularization associated with endogenous candidal endophthalmitis. methods: review of the medical records, fluorescein angiograms, fundus photographs, and histopathologic specimens of patients treated with submacular surgery for choroidal neovascularization following candidal endophthalmitis. RESULTS: This series included 3 patients (1 woman and 2 men) who were 26, 30, and 60 years of age. Each patient had received systemic antifungal treatment for culture-proven candidal septicemia before the development of choroidal neovascularization. Each patient had bilateral choroidal neovascularization diagnosed by biomicroscopic examination and angiographic appearance: 2 eyes had an active subfoveal membrane; 2, an active juxtafoveal subretinal membrane; and 2, a mixture of active subfoveal neovascularization with subfoveal fibrosis. Submacular surgery was performed on five eyes with choroidal neovascularization; one eye with subfoveal fibrosis was observed. visual acuity improved substantially in 4 eyes of 3 patients treated with submacular surgery. Visual improvement was limited in the two eyes with preexisting submacular fibrosis. During 13-month to 82-month follow-ups, vision remained stable, with no recurrence of neovascularization. CONCLUSION: choroidal neovascularization can cause severe visual loss in patients with endogenous candidal infection. Submacular surgery with removal of choroidal neovascularization may restore vision in selected patients. Subfoveal fibrosis may limit visual improvement.
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5/29. Late-onset bacteria endophthalmitis following glaucoma drainage implantation.

    A clinicopathologic report of late-onset bacterial endophthalmitis 4 years after implantation of a Baerveldt drainage implant is described. An 80-year-old woman with glaucoma presented 8 years after tube shunt implantation with clinical endophthalmitis. During surgical removal of the implant, a small conjunctival buttonhole caused by the suture securing the plate to the sclera was noted to be the only entry site. Vitreous and anterior chamber taps were performed with intravitreal antibiotics. Cultures revealed streptococcus pneumoniae infection. The pathologic analysis showed epithelialization of the conjunctival button-hole and diffuse ocular inflammation, mucopurulent material, and fibrovascular membranes. Due to severe pain, the eye was enudeated after 1 week.
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keywords = membrane
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6/29. retinal detachment and phthisis bulbi after implantation of an iris prosthetic system.

    We report 2 eyes of 2 patients who developed persistent inflammation, hypotony, and total retinal detachment after secondary implantation of an iris prosthetic system (IPS) in association with cataract surgery. The first patient had an uneventful history of 16 years despite a retained intraocular glass foreign body and the second patient, of 38 years after sustaining penetrating corneoscleral injury with iris tissue loss. Both patients were thoroughly assessed clinically, and the enucleated globe in the first patient was examined by light microscopy. Both eyes had chronic inflammation with retrocorneal and cyclitic membrane formation around the artificial iris-lens diaphragm. These cases suggest that implantation of an IPS combined with cataract surgery can trigger decompensation of posttraumatic eyes that had been stable over a long period.
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keywords = membrane
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7/29. Inadvertent corneal button inversion during penetrating keratoplasty.

    Inadvertent inversion of a corneal button during corneal transplantation for pseudophakic bullous keratopathy occurred with subsequent intense intraocular inflammation but a relatively compact graft. The diagnosis was made by a superficial corneal biopsy of Descemet's membrane, and a repeat corneal transplantation resulted in a clear graft and no evidence of epithelial downgrowth. histology revealed the persistence of the donor epithelium on the inverted donor button but no residual endothelium on the externalized surface. Although laboratory attempts to duplicate an inversion of a corneal graft revealed that this occurs only with considerable difficulty, this operative complication may explain some of the unexpected primary graft failures reported in the literature.
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keywords = membrane
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8/29. Endogenous endophthalmitis after otitis media.

    PURPOSE: To report a case of bacterial endophthalmitis after otitis media in a healthy adult. DESIGN: Interventional case report. methods: A healthy 49-year-old Caucasian woman developed acute otitis media of the right ear. Three weeks after the first onset there was a recurrence of the otitis media, with perforation of the tympanic membrane. Two days after this, the woman presented at our clinic with endophthalmitis of the right eye. RESULTS: A culture of vitreous material grew streptococcus pyogenes (Streptococcus Lancefield group A). The same strain was found in a smear from the perforated ear. Despite aggressive treatment, the affected eye had to be eviscerated. CONCLUSIONS: otitis media can result in a bacteremia. This may, even in a healthy adult, lead to a devastating endogenous bacterial endophthalmitis.
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ranking = 0.25
keywords = membrane
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9/29. Bilateral candida albicans endophthalmitis associated with an infected deep venous thrombus.

    BACKGROUND: To describe the clinical and histopathologic findings in a patient with bilateral candida albicans endophthalmitis due to an infected deep venous thrombus. CASE: A 43-year-old patient with bilateral candida albicans endophthalmitis due to an infected central venous thrombus. The patient's ophthalmology and hospital charts were reviewed. Histopathologic sections of the candida albicans retinal granuloma were examined under light microscopy. OBSERVATIONS: Our patient had multiple blood cultures positive for candida albicans owing to an infected subclavicular venous thrombosis. Bilateral Candida albicans endophthalmitis was diagnosed. Bilateral vitrectomy and membrane peeling for macular traction retinal detachments were performed. In the right eye, a large retinal granuloma was excised during surgery to adequately relieve traction on the macula. Vision improved in both eyes after surgery. Histopathologic findings revealed branching hyphae surrounded by giant cells, endothelial cell-lined vascular channels, and inflammatory cells. CONCLUSIONS: This is the first report of an infected deep venous thrombosis causing bilateral endogenous endophthalmitis. Appropriate management of these patients requires clear differentiation between endogenous chorioretinitis and endophthalmitis. patients with documented fungemia should have a dilated fundus examination on a regular basis until complete clearance of the infection.
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keywords = membrane
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10/29. Pseudohypopyon following intravitreal triamcinolone acetonide injection.

    OBJECTIVE: To report a case of a pseudohypopyon that developed after intravitreal injection of triamcinolone acetonide for choroidal neovascularization from age-related macular degeneration. methods: Observational case report. RESULTS: A 62-year-old woman received an intravitreal injection of triamcinolone acetonide for the treatment of a choroidal neovascular membrane that developed as a result of age-related macular degeneration. A layer of yellowish deposits was observed in the anterior chamber 1 day after the injection. The patient denied any pain or reduced vision, and there was no redness noted on examination. The deposits cleared spontaneously on the fourth postoperative day. CONCLUSIONS: Pseudohypopyon may develop after intravitreal injection of triamcinolone acetonide. Distinguishing this from a true hypopyon is important because the treatment and prognosis are very different for the two conditions.
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keywords = membrane
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