Journal of Ophthalmic Inflammation and Infection最新文献

{"title":"Evaluation and modulation of bactericidal potential of different antibacterial agents against bacterial pathogens from conjunctivitis infections.","authors":"Saman Arshad, Nazish Mazhar Ali, Sidra Munir, Mariam Wasif, Maham Chaudhry, Bushra Mazhar, Muhammad Ahsan Raza","doi":"10.1186/s12348-025-00474-w","DOIUrl":"10.1186/s12348-025-00474-w","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13079262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369672","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":"Evaluation of safety and efficacy of cyclosporine-A eye drops in herpetic stromal keratitis: a prospective randomized clinical trial.","authors":"Nancy M Lotfy, Hamad Alshatti, Rola Y Khachaba, Sherein M Hagras","doi":"10.1186/s12348-026-00573-2","DOIUrl":"10.1186/s12348-026-00573-2","url":null,"abstract":"<p><p>PURPOSE: To evaluate the additive effect of topical cyclosporine A (Cs-A) 0.05% eye drops with topical prednisolone compared with that of topical prednisolone acetate 1% eye drops alone for the treatment of herpetic stromal keratitis (HSK). METHODS: Patients diagnosed with HSK were randomly divided into 2 groups: Group A received Cs-A eye drops b.i.d. with prednisolone eye drops q.i.d.; Group B received topical prednisolone q.i.d. with placebo eye drops b.i.d.; both Groups A & B received a systemic acyclovir therapeutic dose of 400 mg five times daily, tapered to twice daily on the 10th day. Follow-up was performed weekly for 2 months. The primary outcome measures included duration of treatment, corneal edema (CE), haziness (CH), punctate epitheliopathy (CP) and vascularization (CV). The secondary outcome measures included best corrected visual acuity (BCVA) and intraocular pressure (IOP). RESULTS: Thirty eyes from 30 patients were included (15 in each group). At baseline, only the CP score was significantly greater in Group B. The duration of treatment was significantly shorter in Group A. At the 2-month follow-up, there were significant improvements in the CE, CH and CP scores in both groups compared with the baseline scores, but there were no significant differences between the groups. There was a significant improvement in BCVA in both groups compared with baseline scores, but there was no significant difference between the groups. Two patients in group B required topical drops to control the IOP. CONCLUSION: The addition of Cs-A eye drops to the treatment protocol for HSK patients has a significant role in shortening the duration of treatment in the management of HSK patients with and without epithelial ulceration. REGISTRATION: The study protocol was approved by the Local Review Board (Registration code: 2261), and ClinicalTrials.gov (ID: NCT05720715). </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355381","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":"Emerging zoonotic ocular sporotrichosis in southeast Asia: a case series from Thailand and systematic review of regional reports.","authors":"Usanee Reinprayoon, Trakanta Wannapanich, Buravej Assavapongpaiboon, Ngamjit Kasetsuwan, Thanachaporn Kittipibul, Suppapong Tirakunwichcha, Ariya Chindamporn, Nattapong Langsiri","doi":"10.1186/s12348-025-00565-8","DOIUrl":"10.1186/s12348-025-00565-8","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284091","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":"Intravitreal cotrimoxazole as adjuvant therapy for active ocular toxoplasmosis: a case series and literature review.","authors":"Seyedeh Maryam Hosseini, Amir Azadmanesh, Ghodsieh Zamani, Mehrdad Motamed Shariati","doi":"10.1186/s12348-026-00571-4","DOIUrl":"10.1186/s12348-026-00571-4","url":null,"abstract":"<p><p>BACKGROUND: Ocular toxoplasmosis represents the most common cause of posterior uveitis worldwide and remains a major cause of visual morbidity, particularly among young and immunocompetent individuals. The purpose of this study is to assess the efficacy and safety of combined intravitreal trimethoprim/sulfamethoxazole and dexamethasone with concurrent systemic cotrimoxazole and oral corticosteroids in patients with active Toxoplasma chorioretinitis. METHODS: This retrospective interventional case series included a total of seven eyes from seven consecutive patients with active necrotizing toxoplasma retinochoroiditis and dense vitritis involving zone 1. All examinations were performed by a uveitis specialist. Each patient received a single intravitreal injection of trimethoprim/sulfamethoxazole and dexamethasone, in addition to systemic cotrimoxazole and prednisolone. Clinical evaluation included best-corrected visual acuity (BCVA), intraocular pressure (IOP), grading of ocular inflammation, and fundus examination. Patients were followed weekly for one month and subsequently on a monthly basis for three months. RESULTS: All patients demonstrated a rapid reduction in inflammation and lesion size, accompanied by improvement in BCVA, achieving a final visual acuity of 8/10 to 10/10 at one month. No ocular or systemic complications, IOP elevation, or recurrence were observed during the three-month follow-up period. CONCLUSION: Adjuvant intravitreal cotrimoxazole therapy appears to be a safe and effective option for vision-threatening ocular toxoplasmosis, providing rapid disease control and excellent visual outcomes. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258477","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":"Rosacea scleritis and sclero-uveitis; under recognised and over treated.","authors":"Josephine Richards","doi":"10.1186/s12348-025-00546-x","DOIUrl":"10.1186/s12348-025-00546-x","url":null,"abstract":"<p><p>BACKGROUND: Rosacea episcleritis, scleritis and uveitis may be missed when clinicians focus on the eye without appraising the adnexae and facial skin. Addressing rosacea can reduce treatment failures and avoid systemic complications of less effective or more toxic drugs. CASE SERIES AND NARRATIVE REVIEW: This series presents four cases with scleritis and / or sclero-uveitis in the setting of facial or ocular rosacea. Where relevant, negative systemic scleritis work up is included. Common features were incomplete resolution or poor response to one or more of topical and systemic steroid, systemic non-steroidal anti-inflammatory, systemic immunomodulatory and topical antibiotic treatment. All cases responded promptly to treatment with oral doxycycline, allowing withdrawal of other treatment. A review of the literature is presented, updating understanding of immunogenetics and inflammatory pathways relevant to ophthalmic management of these cases. Important considerations include the role of steroids, vitamin D, microbes, toll like receptors and their influence on the cathelicidin (Ll-17) pathway in rosacea inflammation. CONCLUSION: Making a correct rosacea diagnosis and managing with doxycycline or related medication can result in rapid remission, minimising disease complications and side effects of less targeted drugs. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180675","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":"Clinical features and treatment outcomes of acute-onset endophthalmitis caused by Staphylococcus lugdunensis: a case series.","authors":"Justin A Chen, Michael Y Zhao, Lauren C Kiryakoza, Salomon Merikansky, Landon J Rohowetz, Darlene Miller, Harry W Flynn","doi":"10.1186/s12348-026-00568-z","DOIUrl":"10.1186/s12348-026-00568-z","url":null,"abstract":"<p><p>PURPOSE: To report a series of patients with acute-onset endophthalmitis caused by culture-proven Staphylococcus lugdunensis and to provide an update on the microbiologic susceptibility and clinical outcomes resulting from this organism. OBSERVATIONS: This study included 6 eyes of 6 patients. The etiologies included cataract surgery (4), intravitreal injection (1), and posterior segment surgery (1). All isolates (100%) of S. lugdunensis demonstrated sensitivity to vancomycin with minimal inhibitory concentration (MIC) values ranging from ≤ 0.5 to 1 mcg/mL and to moxifloxacin with MIC values ranging from ≤ 0.25 to 1 mcg/mL. One of 6 isolates demonstrated intermediate resistance to gentamicin with a MIC value of 8 mcg/mL. Four of 6 patients underwent pars plana vitrectomy following initial treatment with intravitreal antibiotics, and 1 eye underwent vitrectomy as initial management. Best-corrected visual acuity at last follow-up examination was≥ 20/150 in 5/6 (83.3%) of cases and ≥ 20/40 in 3/6 (50%) of cases. CONCLUSION AND IMPORTANCE: In this study, patients with acute-onset endophthalmitis caused by S. lugdunensis had relatively good outcomes, similar to a previous case series. Vancomycin continues to have consistent coverage against S. lugdunensis and remains an empiric therapeutic option for acute-onset endophthalmitis. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132148","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":"Topical mycophenolate for the treatment of uveitis-associated inflammation.","authors":"Jyoti Chauhan, Ermanno Gherardi, Hae Lin Jang, Shiladitya Sengupta","doi":"10.1186/s12348-026-00569-y","DOIUrl":"10.1186/s12348-026-00569-y","url":null,"abstract":"<p><p>OBJECTIVE: Uveitis refers to the inflammation of the uveal tract of the eye (iris, ciliary body and choroid). In the developed world, it accounts for 10–15% of all cases of blindness. Anterior uveitis accounts is the most common form of uveitis. There is an unmet need for a topically administered non-steroidal drug to treat anterior uveitis. METHODS: We tested two topical formulations of mycophenolate (MPA), an inhibitor of inosine monophosphate dehydrogenase (IMPDH) enzyme, as a potential steroid-sparing treatment for uveitis. We studied first the binding of MPA to a three-dimensional model of human IMPDH2 generated with AlphaFold 3. Next, we formulated mycophenolate sodium as an aqueous suspension and mycophenolate mofetil as an ointment. Permeability of mycophenolate through the corneal barrier was measured using a Franz cell assay using a goat eye cornea as the membrane. Drug concentration in the different compartments of the eye involved in anterior uveitis was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Both formulations were tested for acute ocular irritation in vivo, and efficacy in a rabbit model of uveitis. RESULTS: The AlphaFold 3 model of IMPDH2 offered a detailed map of the MPA binding site. MPA makes hydrogen bonds to main chain atoms of S276 and G326 and side chain atoms of S276, T333 and Q441 as well as hydrophobic interactions with S276, G415 and Y430. The computational analysis shed new insights on the mechanism of mycophenolate inhibition and allosteric regulation of the enzyme. Mycophenolate was stable over 6 months in both suspension and ointment. Topical application of mycophenolate sodium 1% and 2% suspension eye drop exhibited a drug flux of 81·81ug/cm2 and 140.42 ug/cm2, respectively, through the corneal barrier, greater than 11.01 ug/cm2 and 26.54 ug/cm2 achieved with mycophenolate mofetil 1% and 2% ointments, respectively. The formulations were non-irritant to eyes of New Zealand white rabbits. No systemic clinical signs of toxicity and necropsy findings were observed. Mycophenolate sodium 2% suspension-treated group showed significant reduction (p < 0.0010) in the uveitis score with reduced leukocyte counts in the anterior chamber compared to vehicle control and was not statistically different from positive control prednisone steroid (p = 0.44). CONCLUSION: Topical mycophenolate sodium 2% suspension could emerge as an effective non-steroidal treatment for anterior uveitis and merits clinical evaluation. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":"8"},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132168","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":"From pathogen to prognosis: microbial keratitis spectrum and treatment outcomes in a 5-Year tertiary center experience.","authors":"Bagim Aycin Cakir Ince, Onder Ayyildiz, Gokhan Ozge","doi":"10.1186/s12348-025-00524-3","DOIUrl":"10.1186/s12348-025-00524-3","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"99"},"PeriodicalIF":2.3,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856904","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":"Management and outcomes of cataract surgery in uveitic eyes with chronic hypotony: a two-case series.","authors":"Fawzia Alhaimi, Walaa Bakhamees","doi":"10.1186/s12348-025-00554-x","DOIUrl":"10.1186/s12348-025-00554-x","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>To evaluate the effectiveness of a tailored surgical and immunosuppressive approach for patients with uveitis, cataracts, and chronic hypotony (IOP ≤ 5 mmHg).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"15 1","pages":"95"},"PeriodicalIF":2.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856887","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":"Scleritis and associated systemic diseases: contribution of systemic examination, follow-up, and additional investigations.","authors":"Mathilde Soubrier, Caroline Vasseneix, Robin Jacquot, Arthur Bert, Mathieu Gerfaud-Valentin, Thibaud Mathis, Laurent Kodjikian, Pascal Sève","doi":"10.1186/s12348-025-00566-7","DOIUrl":"10.1186/s12348-025-00566-7","url":null,"abstract":"<p><strong>Background: </strong>Identifying underlying disease associations in patients with scleritis remains a clinical challenge. This study aimed to assess the contribution of systemic examination, longitudinal follow-up, and additional investigations to the identification of associated diseases in patients with scleritis.</p><p><strong>Methods: </strong>We retrospectively reviewed 98 patients with scleritis in whom no associated disease had been identified at presentation, assessed in two internal medicine departments in Lyon between July 2011 and September 2023. Data were collected at the initial presentation, prior to the identification of any underlying disease. The primary outcome was the contribution of systemic examination to the identification of associated diseases.</p><p><strong>Results: </strong>After a median follow-up of 42 months [15.5-100], an associated disease was identified in 37 patients (37.8%), including 23 systemic diseases (23.5%), 12 infectious diseases (12.2%), and 2 cases of drug-induced scleritis (2.0%). Systemic examination contributed to the identification of an associated disease in 20 patients (20.4%), mainly through ear, nose and throat (ENT) and dermatological assessments. In 70% of these patients, systemic manifestations preceded the first episode of scleritis, while in the remaining 30% they developed during follow-up. In three patients, scleritis was the initial and sole manifestation, and the diagnosis was established through additional investigations during follow-up. The positive predictive value (PPV) of non-specific anti-neutrophil cytoplasmic antibodies (ANCA) was 29%, with a negative predictive value (NPV) of 98%. When specific ANCA testing was performed, the PPV increased to 86%. Repeating laboratory investigations during follow-up did not yield additional diagnoses.</p><p><strong>Conclusion: </strong>Systemic examination contributed to the identification of an associated disease in one-fifth of patients. Scleritis may be the first clinical manifestation of an underlying systemic disease, supporting the need for systematic and prolonged follow-up. These findings also underline the diagnostic value of specific ANCA testing, whereas repeating laboratory investigations after an initial negative assessment appears of limited utility.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":"7"},"PeriodicalIF":2.3,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12847570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827967","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}