Journal of Ophthalmic Inflammation and Infection最新文献

{"title":"Efficacy of 0.05% cyclosporine A on tear inflammatory cytokines and goblet cell function after corneal refractive surgery.","authors":"Wenzhe Qian, Yue Wu, Xin Liu, Yuying Liu, Min Li, Ting Zhao, Na Chen, Bilian Ke","doi":"10.1186/s12348-025-00462-0","DOIUrl":"10.1186/s12348-025-00462-0","url":null,"abstract":"<p><strong>Background: </strong>Corneal refractive surgeries offer rapid vision correction, while dry eye disease remains a common postoperative complication that significantly impacts patients' quality of life. The etiology of postoperative dry eye is multifactorial. Cyclosporine A (CsA) has been employed in the treatment of dry eye due to its ability to suppress T cell-mediated immune responses and reduce inflammation. The present study was designed to assess the early effect of 0.05% cyclosporine A (CsA) eye drops on tear film stability, ocular surface inflammation and goblet cell function in patients following corneal refractive surgery.</p><p><strong>Methods: </strong>One hundred forty-four eyes of 72 participants undergoing corneal refractive surgery were enrolled and randomized into additional 0.05% CsA eye drops treated group or conventional schedule treated group. Ocular Surface Disease Index (OSDI), relevant ocular surface clinical parameters, tear inflammatory cytokine levels, conjunctival impression cytology, and gene expression of Keratin 7 (KRT-7) as well as Mucin5AC (Muc5AC) in conjunctival epithelial cells were measured before surgery (baseline) and at 1 month after surgery. All indicators and their changing value were compared against baseline or across different groups.</p><p><strong>Results: </strong>0.05% CsA treatment exhibited greater changes in OSDI, NIBUT, LLT and CFS in the early postoperative period (P = 0.004, P = 0.002, P = 0.032, P = 0.008). Compared to control group, there was a more significant decrease in IFN-γ and TNF-α levels in tear fluid in CsA group after surgery (P = 0.012, p = 0.032). Additionally, KRT-7 and IFN-γ showed recovery in conjunctival cells with 0.05% CsA treatment (P = 0.003, P = 0.019). The postoperative KRT-7 and Muc5AC levels were negatively correlated with corresponding IFN-γ levels in tear fluid among all subjects (r = -0.200, p = 0.016; r = -0.229, p = 0.006).</p><p><strong>Conclusions: </strong>For patients undergoing refractive surgery, the application of 0.05% CsA suppressed the expression of inflammatory cytokines such as IFN-γ and TNF-α, and preserved goblet cell function. These effects ultimately contribute to maintaining ocular surface stability and alleviating dry eye related symptoms during the early postoperative period following refractive surgery.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"36"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro efficacy of aqueous PVP-iodine solution below 5% as alternative to preoperative antisepsis in ophthalmology as the basis for an in vivo study.","authors":"Paula Zwicker, Nevin Opitz, Julia Harris, Andreas Stahl, Ulrich Kellner, Ruth Koelb-Keerl, Philipp S Muether, Anne Hunold, Axel Kramer","doi":"10.1186/s12348-025-00489-3","DOIUrl":"10.1186/s12348-025-00489-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-operative antisepsis of the conjunctiva is indicated prior to intraocular surgery to prevent post-interventional endophthalmitis. In Germany, antisepsis with 5% povidone-iodine (PI) aqueous solution is explicitly required prior to intravitreal injections (IVI), and also generally recommended for intraocular surgery. However, this concentration often leads to a foreign body sensation and an unpleasant burning in combination with dry eye symptoms. Postoperative eye pain, persistent corneal epithelial defects, and a risk of keratitis are further side effects. Due to the repetitive nature of IVI, these symptoms are particularly present in IVI patients. A reduced concentration may be favorable to decrease patient discomfort. A 1.25% PI solution does not increase the iodine concentration in the aqueous humor and is also used for prophylaxis of ophthalmia neonatorum and for preoperative antisepsis; in both cases the renal iodine excretion stays in a physiological range thus thyroid diseases are no contraindication for its use. Thus, the efficacy of reduced concentrations of PI should be evaluated in vitro.</p><p><strong>Methods: </strong>PI with dilutions below 5% (0.625 - 2.5% serial 1:2 dilution) was tested in vitro in a quantitative suspension assay and in a quantitative carrier test without and with addition of matrices to identify their antimicrobial effect against Staphylococcus epidermidis, Pseudomonas aeruginosa, Cutibacterium acnes and Candida albicans.</p><p><strong>Results: </strong>No differences in the antimicrobial effect was seen due to reduced concentrations of PI in comparison to a 5% solution. However, a trend was seen regarding the required contact time of the antiseptic solution.</p><p><strong>Conclusion: </strong>The in-vitro tests have shown adequate antisepsis of 1.25% PI prior to intraocular surgery. However, it is important to pay attention to a sufficient contact time of the antiseptic of about 1 min before ophthalmologic intervention. In order to give final recommendations, in vivo testing is needed to build a robust data foundation.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"35"},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgG4-related ophthalmic disease presenting as posterior scleritis in a pediatric patient.","authors":"Irmak Karaca, Albert John Bromeo, Azadeh Mobasserian, Amir Akhavanrezayat, Charles DeBoer, Zheng Xian Thng, Jia-Horung Hung, Woong-Sun Yoo, Anadi Khatri, Negin Yavari, Ba Trung Nguyen, Dalia El Feky, Cigdem Yasar, Osama Elaraby, Aim-On Saengsirinavin, Xiaoyan Zhang, Frances Andrea Anover, Ankur Sudhir Gupta, Diana V Do, Christopher Or, Quan Dong Nguyen","doi":"10.1186/s12348-025-00459-9","DOIUrl":"10.1186/s12348-025-00459-9","url":null,"abstract":"<p><strong>Purpose: </strong>To report IgG4-related ophthalmic disease (IgG4-ROD) presenting as posterior scleritis in a pediatric patient.</p><p><strong>Observations: </strong>A 7-year-old girl presented with proptosis, painful eyelid swelling, and restricted extraocular movements (EOM) of her left eye (OS). Visual acuity (VA) was 20/20 in right eye (OD) and counting fingers (CF) at 1 foot in OS. Slit lamp examination revealed 2 + anterior chamber (AC) cells, optic disc edema (ODE) with elevated appearance of macula in OS. Optical coherence tomography (OCT) showed significant subretinal fluid (SRF) in macula, B-scan ultrasound (US) demonstrated T-sign in OS. Orbital MRI was also consistent with posterior scleritis and periorbital inflammation. Extensive systemic work-up was unremarkable. Thus, the patient was started on intravenous methylprednisolone (IVMP) 30 mg/kg/day for 3 days, along with topical therapy in OS, which led to an improvement of proptosis, EOM restriction, AC cells, as well as ODE and SRF in macula in OS. Fluorescein angiography (FA) showed leakage from optic disc in OS. The patient was then switched to oral prednisone with slow tapering and started on methotrexate (MTX). Given the recurrence of proptosis and painful eyelid swelling on systemic steroid tapering, serum IgG4 levels were ordered and found to be elevated at 149.9 mg/dL (range, 1-99). Therefore, the patient was diagnosed as 'possible' IgG4-ROD (based on diagnostic criteria) and started on infliximab (7.5 mg/kg) and IVMP monthly infusions with continuation of MTX 20 mg weekly and slower tapering of oral prednisone, which led to resolution of clinical findings, improvement of VA to 20/20 in OS.</p><p><strong>Conclusion and importance: </strong>Posterior scleritis may be the initial presentation of IgG4-ROD in children. Refractory course is not uncommon. Biologics are effective in the long-term control of inflammation.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"34"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic riddle- case report of ocular syphilis.","authors":"Marta Bociąga-Kożuch, Aleksandra Raczyńska, Dorota Trela, Aleksander Garlicki, Tomasz Berus","doi":"10.1186/s12348-025-00488-4","DOIUrl":"10.1186/s12348-025-00488-4","url":null,"abstract":"<p><p>Syphilis is one of sexually transmitted infections (STIs). The incidence of Treponema pallidum infection has increased in the last 20 years. This rise is also evident in ophthalmological practice, with cases of ocular syphilis becoming more frequent.We present a case of a 29-year-old patient with blurred vision in his left eye. Patient showed no general symptoms, nor previous history of eye disorders. On ophthalmological examination, the best-corrected visual acuity (BCVA) was 20/20 in the right eye (OD) and 20/80 in the left eye (OS). The left eye presented high intraocular pressure (IOP) of 31 mmHg and symptoms of anterior uveitis with a linear branching corneal erosion. A B-scan ultrasound of the left eye revealed no vitritis. The preliminary diagnosis of herpetic infection was made, and antiviral therapy was introduced. Despite the initial improvement, symptoms of active anterior uveitis were found on follow-up visits. After approximately 4 weeks of ambulatory treatment, the patient was admitted to the hospital because of roseolae and lumps of the left iris, which appeared accompanied by a rash on patients' lower limbs. Laboratory tests confirmed syphilis and human immunodeficiency virus (HIV) coinfection. During hospitalization intravenous treatment with penicillin and antiretroviral drugs was introduced. Therapy with penicillin was continued to 21 days with improvement in examination. On a follow-up visit after 6 months BCVA in both eyes was 20/20.It is crucial to consider testing for STIs, especially Treponema pallidum infection, in the diagnostic process of patients with nontypical or nonresponsive to treatment ocular symptoms.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"33"},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of acute retinal pigmentepithelitis.","authors":"Daniel Ahmed-Balestra, Martin Stattin, Katharina Krepler, Siamak Ansari-Shahrezaei","doi":"10.1186/s12348-025-00491-9","DOIUrl":"10.1186/s12348-025-00491-9","url":null,"abstract":"<p><strong>Purpose: </strong>To present a pediatric case of acute retinal pigment epitheliitis (ARPE) and propose a classification based on imaging findings and prognosis.</p><p><strong>Methods: </strong>A case report with literature review.</p><p><strong>Results: </strong>The case demonstrated hallmark ARPE features alongside an atypical disease course, indicating a broader clinical spectrum. Multimodal imaging plays a crucial role in differentiating ARPE from mimicking retinal disorders.</p><p><strong>Conclusion: </strong>ARPE may represent a spectrum of subtypes with varying prognostic implications. A classification based on age, laterality and imaging biomarkers could improve diagnostic accuracy and patient management.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"32"},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uveitis output in high-impact clinical ophthalmology journals: a bibliometric analysis.","authors":"Baotram V Nguyen, Priyanka Bhatnagar, Daniel C Lee, Meghan K Berkenstock","doi":"10.1186/s12348-025-00490-w","DOIUrl":"10.1186/s12348-025-00490-w","url":null,"abstract":"<p><strong>Background: </strong>Despite uveitis subspecialty workforce shortages, uveitis specialists remain engaged in research. This study examines the relationship between the proportions of uveitis-focused articles in high-impact ophthalmology journals and fellowship-trained uveitis specialists on their editorial boards.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted on articles published from 2014 to 2023 in the five highest-impact ophthalmology journals: Ophthalmology, JAMA Ophthalmology, British Journal of Ophthalmology (BJO), American Journal of Ophthalmology (AJO), and Investigative Ophthalmology and Visual Science (IOVS). Editorial board members with uveitis or ocular immunology fellowships were identified from public domain sources. Articles were screened using uveitis MeSH terms. Data analysis was performed using STATA to assess the relationship between the proportions of uveitis-focused articles and uveitis-trained editors.</p><p><strong>Results: </strong>From 2014 to 2023, 3.57% (575/16,093) of articles published in the five journals were uveitis-focused. The proportion of uveitis-focused articles ranged from 1.74% in IOVS to 5.89% in AJO. On average, fellowship-trained uveitis specialists comprised 5.28% of editorial board members annually. There were positive correlations between the proportions of uveitis-focused articles and uveitis-trained editors annually (r = 0.6799, p < 0.00005) and over the 10-year period (r = 0.2675, p < 0.00005). No significant correlation was observed within individual journals.</p><p><strong>Conclusions: </strong>Uveitis research remains underrepresented in high-impact ophthalmology journals despite research productivity in the field. While a positive correlation between uveitis-trained editors and uveitis-focused articles was found across all journals, this trend did not hold within individual journals. Enhancing uveitis research visibility in high-impact journals is essential to advancing clinical knowledge, improving patient outcomes, and inspiring ophthalmologists to enter this underserved subspecialty.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"31"},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive bony destructive orbital aspergillosis in an immunocompetent child: a case report.","authors":"Seyed Mohsen Rafizadeh, Amir Mousavi, Mohammad Taher Rajabi, Amirhossein Aghajani, Zohreh Nozarian, Amin Zand","doi":"10.1186/s12348-025-00485-7","DOIUrl":"10.1186/s12348-025-00485-7","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of invasive sino-orbital aspergillosis, a rare condition in a healthy child. The patient presented with orbital involvement and bone destruction, an exceedingly uncommon occurrence that mimics other invasive inflammatory or neoplastic orbital lesions.</p><p><strong>Case presentation: </strong>A 4-year-old female presented with an ill-defined, irregular, erythematous mass-like lesion measuring 8 × 10 mm on the left upper eyelid. Orbital computed tomography (CT) revealed an infiltrative soft tissue mass with bone erosions and destruction on the medial side of the frontal bone, extending toward the fronto-maxillary suture in the anterior orbit. Except for the left anterior ethmoidal sinus, the other paranasal sinuses were nearly clear. Magnetic resonance imaging (MRI) showed enhancement of the adjacent dura mater near the site of bony erosion and lesion expansion. The lesion was surgically excised, with drainage of mucopurulent discharge. Pathological examination revealed necrotizing granulomatous inflammation and fungal hyphae, with Aspergillus fumigatus growth confirmed by culture. The patient was diagnosed with invasive orbital aspergillosis. She was treated with intravenous and then oral voriconazole, and there was no recurrence of the disease.</p><p><strong>Conclusions: </strong>Invasive orbital aspergillosis with bone destruction of the orbital walls can occur in immunocompetent individuals, including children, without any predisposing factors. It can mimic other invasive orbital diseases, leading to delayed diagnosis and treatment, which may result in life-threatening outcomes if intracranial spread occurs. Therefore, timely orbital biopsy of the lesions is crucial.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"30"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular complications in psoriatic patients: a systematic review and meta-analysis.","authors":"Adriano Cypriano Faneli, Dillan Cunha Amaral, Isabelle Rodrigues Menezes, Guilherme Nunes Marques, Jaime Guedes, Rodrigo Brazuna, Ricardo Danilo Chagas Oliveira, Cristina Muccioli","doi":"10.1186/s12348-025-00486-6","DOIUrl":"10.1186/s12348-025-00486-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence of ocular findings in patients with psoriasis and compare the odds of developing these conditions between the psoriatic and control population through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Embase, Cochrane, and Web of Science databases to identify studies reporting ocular findings in psoriasis patients. Inclusion criteria encompassed cross-sectional, case-control, cohort studies, case series, and case studies. Data extraction and quality assessment followed PRISMA guidelines. The Newcastle-Ottawa Scale evaluated the risk of bias. Heterogeneity was assessed using Cochran's Q-test and I² statistics, with a random-effects model applied where significant heterogeneity was present.</p><p><strong>Results: </strong>30 studies comprising 131,687 patients (13,788 with psoriasis and 117,899 controls) were included. The relative likelihood of ocular findings in psoriasis patients showed to be increased in conjunctival hyperemia (OR = 7.38; 95% CI: 2.47-22.04), conjunctivitis (OR = 4.63; 95% CI: 1.42-15.08), dry eye (OR = 3.47; 95% CI: 2.06-5.83), and meibomian gland dysfunction (OR = 7.13; 95% CI: 2.14-23.72) compared to controls. In contrast, blepharitis, cataracts, episcleritis, glaucoma, pinguecula, pterygium, and uveitis did not differ significantly between the two groups.</p><p><strong>Conclusions: </strong>Psoriasis patients are at increased risk for certain ocular conditions, particularly conjunctival hyperemia, conjunctivitis, dry eye, and meibomian gland dysfunction. Further research is needed to understand the underlying mechanisms and to develop targeted management strategies.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"29"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in the management of endophthalmitis: a 5-year retrospective cohort study.","authors":"Ohisa Harley, Yufilia Suci Amelia, Elsa Gustianty, Nanny N M Soetedjo, Arief S Kartasasmita","doi":"10.1186/s12348-025-00468-8","DOIUrl":"10.1186/s12348-025-00468-8","url":null,"abstract":"<p><strong>Background and purpose: </strong>Post-operative endophthalmitis has a risk of vision loss if the treatment is delayed. Managing endophthalmitis based on visual outcome has become controversial. This study primarily aimed to evaluate the effectiveness of early pars plana vitrectomy (PPV) combined with intravitreal antibiotics in improving visual acuity and reducing complications in patients with post-operative endophthalmitis. Secondary objectives included identifying prognostic factors influencing visual outcomes after PPV, assessing the effectiveness of different intravitreal antibiotic regimens on visual recovery, and evaluating the role of steroid as adjunctive therapy in influencing visual outcome and controlling inflammation.</p><p><strong>Methods: </strong>A 5-year retrospective cohort study was conducted, reviewing medical records of patients diagnosed with post-operative endophthalmitis between 2019 and 2023. Data collected included patient demographics, medical and surgical history, culture results, treatments administered, baseline best-corrected visual acuity (BCVA), and BCVA outcomes within three months after vitrectomy.</p><p><strong>Results: </strong>40 eyes of 40 patients with acute post-operative endophthalmitis underwent early PPV followed by intravitreal antibiotics. Median logMAR BCVA improved from 2.0 at presentation to 0.4 three months post-vitrectomy (p < 0.05), with a mean final logMAR BCVA of 0.94 ± 1.13. No significant difference was observed in visual outcomes or complication rates between patients treated with intravitreal vancomycin and ceftazidime versus moxifloxacin monotherapy. Univariate analysis identified high intraocular pressure (p = 0.004, β = 2.42), hypopyon (p = 0.01, β = 1.79), and a history of surgery more than seven days prior (p = 0.032, β = 1.74) as significant predictive of visual outcomes. Multivariate analysis confirmed intraocular pressure (p = 0.008, β = 2.55) and surgical history (p = 0.045, β = 1.84) as independent predictors. Baseline BCVA, fibrin, retinal findings, and symptom onset were not significantly associated with outcomes. Neither antibiotics regimen nor steroid use significantly influenced treatment results.</p><p><strong>Conclusion: </strong>This study supports performing early PPV combined with intravitreal antibiotics as an effective primary treatment to improve visual outcomes in post-operative endophthalmitis. Negative prognostic factors included hypopyon, elevated intraocular pressure, and a surgical history of more than seven days. Management should prioritize clinical signs over microbiological culture results to prevent delays in treatment.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"28"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A complicated Vogt-Koyanagi-Harada presenting with bilateral papillitis in a 5-year-old- case report.","authors":"Salem Almerri, Raed Behbehani","doi":"10.1186/s12348-025-00481-x","DOIUrl":"10.1186/s12348-025-00481-x","url":null,"abstract":"<p><strong>Purpose: </strong>We report a case of a 5-year-old patient with Vogt-Koyanagi-Harada presenting atypically with bilateral papillitis and refractory inflammation, leading to uveitic glaucoma and necessitating an escalation of adalimumab to 40 mg biweekly.</p><p><strong>Observations: </strong>A 5-year-old girl presented with a 3-week history of eye redness, excessive lacrimation, and photophobia. Her medical history was unremarkable. On examination, her best-corrected visual acuity (BCVA) were 20/80 and 20/100 in right and left eye, respectively, with normal intraocular pressure (IOP). Anterior segment examination revealed fine keratic precipitates, anterior chamber inflammation (+ 4 cells and flare), and semi-dilated pupils with posterior synechiae. Posterior segment evaluation was limited by severe vitritis. Laboratory investigations were unremarkable except for HLA-DR4, DR52, and DR53 positivity. Optical coherence tomography (OCT) of the optic nerve showed increased retinal nerve thickness. Initial treatment with corticosteroids and methotrexate failed to achieve remission. Attempts to taper corticosteroids resulted in recurrence of anterior chamber flare, prompting the introduction of adalimumab at 20 mg/biweekly. Despite relative stability, persistent anterior chamber inflammation and subsequent corticosteroid tapering led to the development of uncontrolled uveitic glaucoma requiring surgical peripheral iridectomy. Postoperatively, adalimumab was escalated to 40 mg/biweekly, enabling successful tapering of corticosteroids. Over a 9-month follow-up period, the patient remained flare-free, with BCVA improving to 20/20 in both eyes.</p><p><strong>Conclusions and importance: </strong>This case highlights an atypical presentation of VKH in a preschool-aged child, characterized by bilateral papillitis without exudative retinal detachment. Escalation of adalimumab to 40 mg biweekly effectively controlled inflammation, facilitated corticosteroid tapering, and preserved visual acuity.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"27"},"PeriodicalIF":2.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}