Journal of Ophthalmic Inflammation and Infection最新文献

{"title":"Treatment outcomes of a Swiss non-infectious paediatric uveitis cohort: retrospective study over ten years.","authors":"Jeanne Martine Gunzinger, Seraina Palmer Sarott, Fabio Meier, Christian Böni, Alice Kitay, Brigitte Simonsz-Tóth, Christina Gerth-Kahlert","doi":"10.1186/s12348-025-00458-w","DOIUrl":"https://doi.org/10.1186/s12348-025-00458-w","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric uveitis treatment recommendations suggest a step-up treatment approach starting with topical treatment, followed by antimetabolites and thereafter biologics. With this study, we are investigating the safety and efficacy of the current treatment approach in a large cohort.</p><p><strong>Material and methods: </strong>Single center retrospective study. Patients with non-infectious uveitis under the age of 18 years at first presentation, between January 2012 and June 2022, were eligible for inclusion. Data extracted from the electronic health records included age at first presentation, sex, involved eye segment, visual acuity (VA), complications, associated systemic disease, treatments, and number of consultations. Cases were grouped according to their final treatment regime (topical only, methotrexate, TNF alpha inhibitor, other). VA outcome, treatment response, adverse events, and frequency of consultations were evaluated. The study was approved by the local ethics committee.</p><p><strong>Results: </strong>64 non-infectious paediatric uveitis cases were included. Age at first diagnosis ranged from 2 to 17 years, with a two-peak distribution, 52% were male. Anterior uveitis was the most common presentation, followed by intermediate uveitis, posterior uveitis, and panuveitis. Topical treatment achieved remission in 23%, anti-metabolites in 12%, and escalation to TNF alpha inhibitors in 30%. Alternative treatments or observation only were documented in 16% and 17%, respectively. Median duration from first presentation to the start of anti-metabolite or TNF alpha inhibitor were 115 days and 269 days, respectively. There was a median of eight consultations during the first year of follow up. Frequency of consultations during the first year increased with every treatment escalation. VA outcome did not differ between the different treatment groups.</p><p><strong>Conclusion: </strong>The step-up treatment approach shows a safe profile in regards to VA outcome. Methotrexate presents a high rate of treatment failure and adverse effects. Adalimumab and infliximab are effective and safe. Timely treatment escalation might lower treatment burden for affected children, their families, and health care providers.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"43"},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030957","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":"Fulminant endophthalmitis after open globe injury by cat claw: two case reports and literature review.","authors":"Ashley Y Gao, Ameay V Naravane, Michael A Simmons, Tyler Looysen, Sandra Montezuma, Dara Koozekanani, Hossein Nazari","doi":"10.1186/s12348-025-00487-5","DOIUrl":"https://doi.org/10.1186/s12348-025-00487-5","url":null,"abstract":"<p><strong>Objective: </strong>To describe two patients with fulminant endophthalmitis after penetrating ocular injuries by cat claw and review the literature regarding animal-related endophthalmitis.</p><p><strong>Design: </strong>Case series.</p><p><strong>Participants: </strong>In the study period, 298 patients were identified with a diagnosis of endophthalmitis, of which two were identified in association with open globe injury by cat claw.</p><p><strong>Methods: </strong>All patients with endophthalmitis after cat claw open globe injury in an academic center in a 20-year period are reported. Clinical and laboratory presentations, medical and surgical treatment, and outcomes are described. A literature review is summarized.</p><p><strong>Exposure: </strong>Open globe injury by cat claw.</p><p><strong>Main outcome measures: </strong>Interventions and ocular anatomical and functional outcomes.</p><p><strong>Results: </strong>Case 1: A 27-year-old female sustained a penetrating injury of the left eye by a cat claw. The laceration was repaired the next day, and intravitreal antibiotics injections were given. She developed acute fulminant endophthalmitis the following day and underwent pars plana vitrectomy, anterior chamber washout, and intravitreal antibiotics injection. Cultures isolated Propionibacterium acnes. A retinal detachment was noted after 48 days, requiring a second pars plana vitrectomy and tamponade with sulfur hexafluoride gas. The retina remained attached. Visual acuity at 14 months follow-up was 20/200. Case 2: A 42-year-old male developed endophthalmitis two days after a penetrating injury of the right eye by a cat claw. Pars plana vitrectomy and intravitreal antibiotics injections were performed the same day. Cultures identified Pasteurella multocida. The patient progressed to panophthalmitis in 24 h and received intravenous antibiotics. He developed proliferative vitreoretinopathy with recurrent retinal detachments requiring multiple vitrectomies. His visual acuity was hand motions at 7 months follow-up.</p><p><strong>Conclusions and relevance: </strong>Open globe injuries caused by cat claw may result in hyperacute and acute endophthalmitis. Propionibacterium acnes and Pasteurella multocida were isolated from the two cases reported here. Despite immediate interventions, both patients developed retinal detachment and had poor final visual acuity. Our report reveals that endophthalmitis caused by animal trauma is rare with potentially devastating outcomes, thereby requiring timely diagnosis and treatment.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"41"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968305","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 pediatric non-infectious anterior uveitis in long-term follow-up: population-based cohort study.","authors":"Mira Siiskonen, Roosa Pesälä, Pasi Ohtonen, Anna-Maria Kubin, Nina Hautala","doi":"10.1186/s12348-025-00499-1","DOIUrl":"https://doi.org/10.1186/s12348-025-00499-1","url":null,"abstract":"<p><strong>Background: </strong>Pediatric uveitis is often asymptomatic, which may expose to sight-threatening ocular complications. The impact of modern medication on frequency of long-term ocular complications in pediatric patients with anterior idiopathic uveitis (idio-U) or juvenile idiopathic arthritis associated uveitis (JIA-U) is not fully understood. We aimed to evaluate the occurrence of ocular complications during the era of modern treatment on the population-based cohort of children with idio-U or JIA-U.</p><p><strong>Methods: </strong>A longitudinal, population-based cohort study of children with idio-U or JIA-U in 2008-2020. Variables assessed included age, gender, age at diagnosis, laterality, chronicity, vision, and ocular complications.</p><p><strong>Results: </strong>107 pediatric patients and 172 eyes with either idio-U (19 patients) or JIA-U (88 patients) were included. The mean age at uveitis onset was 10.0 ± 3.7 and 5.4 ± 3.2 years in idio-U and JIA-U, respectively (p < 0.001). Uveitis was chronic in 58% in idio-U and 74% in JIA-U patients, respectively. Uveitis was complicated with glaucoma in 45% of idio-U and 18% of JIA-U patients (p = 0.019). Cataract was developed in 31% of idio-U and 22% of JIA-U eyes (p = 0.28), and posterior synechiae in 21% and 9% of the eyes with idio-U and JIA-U, respectively. None of the eyes were hypotonic. Female gender was overrepresented in ocular complications. Glaucoma surgery was accomplished in 25 (15%) and cataract surgery in 19 (11%) eyes. Bilateral visual acuity remained > 0.5 in all patients.</p><p><strong>Conclusions: </strong>Glaucoma, ocular hypertension, and cataract were the most typical complications of uveitis. Complications occurred mostly in girls and in idio-U patients. JIA-U patients with severe uveitis, young age at uveitis onset and female gender were predisposing factors for surgical management.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"42"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002838","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":"Subconjunctival dexamethasone implant (Ozurdex^®) in the management of refractory Non-Infectious anterior scleritis.","authors":"Battuya Ganbold, Ba Trung Nguyen, Jia-Horung Hung, Azadeh Mobasserian, Zheng Xian Thng, Hashem Ghoraba, Negin Yavari, Dalia El Feky, Cigdem Yasar, Aim-On Saengsirinavin, Xiaoyan Zhang, Frances Andrea Anover, S Saeed Mohammadi, Ngoc Tuong, Trong Than, Anadi Khatri, Osama Elaraby, Amir Akhavanrezayat, Ankur Sudhir Gupta, Woong Sun Yoo, Quan Dong Nguyen, Christopher Or","doi":"10.1186/s12348-025-00494-6","DOIUrl":"https://doi.org/10.1186/s12348-025-00494-6","url":null,"abstract":"<p><strong>Objective: </strong>To report a case series of non-infectious anterior scleritis resistant to multiple lines of conventional therapies which were eventually successfully treated with off-label subconjunctival dexamethasone implant (Ozurdex^®) injection (SDI).</p><p><strong>Methods: </strong>A retrospective case series of 4 patients (6 eyes).</p><p><strong>Results: </strong>In the index case series, the patients had a mean age of 57.2 years (range 36 to 82 years, SD 19.2 years) with 50% being female. Two patients had underlying autoimmune diseases: rheumatoid arthritis (n = 1), and granulomatosis with polyangiitis (GPA) (n = 1). The other patients were diagnosed with idiopathic anterior scleritis after extensive systemic investigations (n = 2). The mean follow-up duration and the mean number of concomitant therapies prior to SDI was 27 (SD 17.7) months and 2 (SD 0.81), respectively. In all patients, symptom resolution and significant improvement in disease activity were achieved after SDI, persisting for an extended period following the resorption of the implant. No scleral melt, infection or ocular hypertension were noted following SDI.</p><p><strong>Conclusion: </strong>SDI may be a safe and effective therapeutic option for resistant non-infectious anterior scleritis.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"40"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014911","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":"Reproxalap in patients with seasonal allergic conjunctivitis: a systematic review and meta-analysis.","authors":"Ammar Elgadi, Malaz M Abdalmotalib, Tibyan Noorallah, Egbal Abdelazim, Fatma Ali Merghani Mohammed","doi":"10.1186/s12348-025-00497-3","DOIUrl":"https://doi.org/10.1186/s12348-025-00497-3","url":null,"abstract":"<p><strong>Introduction: </strong>Seasonal allergic conjunctivitis (SAC) is a hypersensitivity condition characterized by itching, tearing, and redness. It affects over 20% of the general population with limited therapeutic options. Reproxalap, a novel small-molecule aldehyde trap, has emerged as a potential treatment option for SAC by targeting reactive aldehydes involved in inflammation. In this systematic review and meta-analysis, we assessed the efficacy and safety of Reproxalap in treating SAC.</p><p><strong>Methods: </strong>Multiple databases were searched including PubMed, Cochrane Library, Scopus, and Google Scholar, to identify relevant studies. Clinical trials involving patients diagnosed with SAC and treated with Reproxalap (0.25% or 0.5%) were included. The primary outcomes were symptom relief (efficacy) and side effects (safety). Data extraction and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted using RevMan 5.4 software.</p><p><strong>Results: </strong>Five RCTs involving 625 participants were included. Reproxalap significantly reduced ocular itching compared to control groups for both 0.25% (SMD: -0.31, 95% CI: -0.50 to -0.13, P = .001) and 0.5% concentrations (SMD: -0.31, 95% CI: -0.51 to -0.10, P = 0.004). No significant difference was observed between the two doses (SMD: -0.02, 95% CI: -0.23 to 0.19, P = 0.83). Side effects were more frequent in both Reproxalap groups compared to controls, with odds ratios of 35.31 (95% CI: 17.83 to 69.90, P < 0.00001) for 0.25% and 45.64 (95% CI: 18.49 to 112.66, P < 0.00001) for 0.5%. The 0.5% dose had significantly higher odds of side effects compared to the 0.25% dose (OR: 1.66, 95% CI: 1.10 to 2.51, P = 0.02). Heterogeneity was low for all outcomes (I² = 0%).</p><p><strong>Conclusion: </strong>Reproxalap reduces ocular itching associated with SAC. While both 0.25% and 0.5% concentrations are effective, safe and tolerable. Further research should focus on the long-term benefits and applicability of Reproxalap on diverse populations.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"39"},"PeriodicalIF":2.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022784","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":"Bilateral acute multifocal retinitis and retinal vasculitis secondary to Rickettsia typhi infection.","authors":"Weilin Song, Adrian Au, David Sarraf, Pradeep Prasad, Edmund Tsui","doi":"10.1186/s12348-025-00496-4","DOIUrl":"https://doi.org/10.1186/s12348-025-00496-4","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of acute multifocal retinitis (AMR) and retinal vasculitis associated with Rickettsia typhi.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 37-year-old previously healthy female presented with acute bilateral panuveitis that was preceded by a febrile illness with pneumonitis and transaminitis. On exam she had bilateral multifocal small white retinal lesions, vascular sheathing, and hemorrhages. The retinal lesions, which appeared consistent with infiltrates and/or ischemia, were confined within the inner or middle retinal layers on optical coherence tomography (OCT) and corresponded to late leakage on fluorescein angiography (FA). There was no evidence of choroidal involvement on indocyanine green angiography (ICGA). Based on the imaging findings and history, the diagnosis of AMR with associated small vessel retinal vasculitis was made and the patient was started empirically on doxycycline. Workup was positive for R. typhi. At follow-up, there was resolution of visual symptoms and nearly all retinal lesions.</p><p><strong>Conclusions: </strong>Rickettsial disease should be highly suspected in a patient with AMR and occlusive small vessel vasculitis. Retinal lesions may be either infiltrative or ischemic in nature. Diagnosis, which can be aided by multimodal retinal imaging, is essential for prompt initiation of appropriate antibiotic therapy.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"38"},"PeriodicalIF":2.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005703","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":"Ab externo open conjunctiva XEN^® 63 μm: a novel surgical alternative in uveitic glaucoma-a case report.","authors":"Yann Bertolani, Júlia Angrill-Valls, Laura Sánchez-Vela, Eric Kirkegaard-Biosca, Antonio Dou, Nieves Martín-Begué, Marta Castany","doi":"10.1186/s12348-025-00493-7","DOIUrl":"https://doi.org/10.1186/s12348-025-00493-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the efficacy and safety of the ab externo open-conjunctiva XEN^® 63 μm gel stent in uveitic glaucoma.</p><p><strong>Case presentation: </strong>A case report of a 15-year-old patient with bilateral uncontrolled uveitic glaucoma secondary to chronic anterior uveitis was presented. Several medical ophthalmological and rheumatological evaluation visits were conducted. Preoperative intraocular pressure was 28 mmHg in the right eye and 32 mmHg in the left eye. She underwent a trabeculectomy in her right eye developing hypotonic maculopathy and decompression retinopathy, requiring surgical revision. Considering the complications endured in the right eye, it was decided to perform an ab externo open-conjunctiva XEN^® 63 μm implant in her left eye with no postoperative complications. Postoperative course was uneventful with well-controlled intraocular pressure (11 mmHg) and no progression of glaucomatous damage, one year after the procedure. Anterior segment optical coherence tomography evidenced a well-functioning and non-encapsulated bleb along the follow up. Eventually, there were no postoperative uveitic episodes, with 40 mg Adalimumab as a steroid-sparing agent.</p><p><strong>Conclusion: </strong>Uveitic glaucoma presents both clinical and therapeutic challenges. Traditional surgery such as trabeculectomy may entail postoperative complications such as hypotonic maculopathy and decompression retinopathy. This is the first case reporting the efficacy and safety of ab externo open-conjunctiva XEN^® 63 μm implant in uveitic glaucoma, highlighting its potential usefulness in such clinical scenarios.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"37"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972469","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":"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}