Seyed Mohsen Rafizadeh, Mohammad Taher Rajabi, Amirhossein Aghajani, Elham Rahmanikhah, Ghazal Ghochani, Seyedeh Zahra Seyedi, Ali A Haydar
{"title":"Toxic Orbital Cellulitis and Optic Neuropathy from High-Pressure Diesel Fuel Injury: A Case Report and Literature Review.","authors":"Seyed Mohsen Rafizadeh, Mohammad Taher Rajabi, Amirhossein Aghajani, Elham Rahmanikhah, Ghazal Ghochani, Seyedeh Zahra Seyedi, Ali A Haydar","doi":"10.1080/09273948.2025.2483428","DOIUrl":"https://doi.org/10.1080/09273948.2025.2483428","url":null,"abstract":"<p><strong>Purpose: </strong>High-pressure injuries to the orbit are rare, yet they can cause severe damage due to mechanical destruction and the toxicity of the injected substance. Diesel fuel toxicity can lead to rapid necrosis and inflammation, complicating the prognosis even with prompt medical intervention.</p><p><strong>Methods: </strong>A 39-year-old male presented with a right orbital injury from a diesel fuel explosion. Initial symptoms included mild periorbital swelling and a laceration on the upper eyelid. Despite early management with antibiotics and surgical repair, the patient's condition rapidly deteriorated, developing severe periorbital swelling, pain, and decreased vision. Multiple surgical debridements were performed to remove necrotic tissue and residual diesel fuel. Aggressive treatment with broad-spectrum antibiotics and corticosteroids was administered.</p><p><strong>Results: </strong>Despite the aggressive treatment, the patient's vision deteriorated to no light perception, indicative of optic neuropathy. Over the following days, the patient showed significant improvement and was eventually discharged with ongoing antibiotic therapy. At a 6-month follow-up, the patient had good cosmetic outcomes despite mild limitations in eye movement.</p><p><strong>Conclusion: </strong>High-pressure orbital injuries, especially those involving toxic substances like diesel fuel, require early and aggressive management. A multidisciplinary approach, including prompt surgical intervention, broad-spectrum antibiotics, and corticosteroids, is essential to improve outcomes and preserve vital structures. Long-term follow-up is crucial to address functional and cosmetic sequelae. Further research is needed to develop evidence-based protocols, especially for toxic orbital cellulitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Idiopathic Multicentric Castleman's Disease Presenting with Chorioretinal Undulation: A Case Report.","authors":"Suowang Zhou, Liang Wang, Xin Li, Xiaona Zuo, Aifeng Wu, Xiaoyan Peng","doi":"10.1080/09273948.2025.2453883","DOIUrl":"https://doi.org/10.1080/09273948.2025.2453883","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of idiopathic multicentric Castleman's disease (iMCD) with initial ocular involvement, presenting with chorioretinal undulation.</p><p><strong>Methods: </strong>Observational case report of iMCD patient with ocular manifestation on fundus photography, auto-fluorescein and swept-source optical coherence tomography (SS-OCT), initially and after treatment.</p><p><strong>Results: </strong>A 75-year-old patient with painless vision loss for 2 years right eye (RE) and 3-month left eye (LE). Fundus examination revealed several yellow-white lesions along with the inferior arcade, with extensive pigment disturbance of the right eye and exudative retinal detachment of the left eye. SS-OCT showed choroid and retinal pigment epithelium (RPE) undulations, choroid thickening and hyperreflective dots at the choroidal level. Interleukin-6 (IL-6) in the anterior chamber was very high (1595 pg/ml RE and 749.3 pg/ml LE). After cervical lymph node biopsy, the patient was finally diagnosed with iMCD. Siltuximab, an interleukin-6 inhibitor, was administered. After two cycles of therapy, the patient's ocular manifestations improved significantly, the choroid and RPE undulation and the ERD resolved without local treatment.</p><p><strong>Conclusion: </strong>Chorioretinal undulation and elevated IL-6 in intraocular fluid could be ocular manifestations of MCD.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Warda Darwisch, Maria Della Volpe Waizel, Robert Patrick Finger, Kai Januschowski, Berthold Seitz, Fabian Norbert Fries, Annekatrin Rickmann
{"title":"Long-Term Treatment Outcomes with a Single 0.19 Mg Fluocinolone Acetonide Implant in Non-Infectious Uveitis - A Real-World Study.","authors":"Warda Darwisch, Maria Della Volpe Waizel, Robert Patrick Finger, Kai Januschowski, Berthold Seitz, Fabian Norbert Fries, Annekatrin Rickmann","doi":"10.1080/09273948.2025.2478207","DOIUrl":"10.1080/09273948.2025.2478207","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate time to first additional treatment following intravitreal 0.19 mg fluocinolone acetonide (FAc) in non-infectious uveitis with posterior segment involvement (NIU-PS) in a real-world setting.</p><p><strong>Methods: </strong>Prospective observational study on 37 eyes (30 patients) with chronic or recurrent NIU-PS, treated with FAc after achieving control - indicated by absence of vitreous haze or clearly visible posterior pole. Over a median follow-up of 48.0 ± 0.0 months, we assessed time to and number of additional treatments, inflammatory activity, central subfield macular thickness (CSMT), visual acuity (VA) and intraocular pressure (IOP).</p><p><strong>Results: </strong>Restricted mean time to first adjuvant treatment was 31.9 ± 2.97 months, with 52.8% requiring no additional treatment ≥ 48 months. VA remained stable (baseline 0.56 ± 0.44 logMAR, <i>p</i> = 0.86). A negative correlation was found between the number of prior steroid implants (DEX-I) and time to additional treatment (<i>r</i> = -0.44, <i>p</i> = 0.001). For up to 24 months, FAc reduced anterior chamber flare (0.44 ± 0.81 to 0.00 ± 0.00, <i>p</i> < 0.001), vitreous haze (0.28 ± 0.51 to 0.00 ± 0.00, <i>p</i> = 0.01), and CSMT (407.1 ± 135.9 µm at baseline to 324.2 ± 75.7 µm at M24, <i>p</i> = 0.001). Within 48 months, ocular hypertension (≥25 mmHg) occurred in 22.2% of eyes (8/36), with 19.4% (7/36) requiring new-onset IOP-lowering drops.</p><p><strong>Conclusion: </strong>FAc demonstrated efficacy in managing low-grade NIU-PS, reducing the need for additional treatments and controlling intraocular inflammation for an average of 32 months.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agnieszka Leszyńska, Dominika Kozłowska, Julia Bałoniak, Julia Linke, Emilia Bachoń, Michalina Doligalska, Aleksandra Stremel, Wiktoria Wesołowska
{"title":"Ocular Manifestations in Selected Dermatological Disorders: A Narrative Review.","authors":"Agnieszka Leszyńska, Dominika Kozłowska, Julia Bałoniak, Julia Linke, Emilia Bachoń, Michalina Doligalska, Aleksandra Stremel, Wiktoria Wesołowska","doi":"10.1080/09273948.2025.2477194","DOIUrl":"https://doi.org/10.1080/09273948.2025.2477194","url":null,"abstract":"<p><p>Skin disorders are often associated with ocular symptoms. In this review, we aim to identify the most common ocular manifestations observed in selected dermatological diseases, specifically psoriasis, atopic dermatitis, rosacea, and pemphigus. We highlight key ophthalmological conditions linked to these diseases to raise awareness among ophthalmologists who may encounter patients with these dermatological conditions in their clinical practice. Analyzing the original studies, the most common ocular manifestations include various types of inflammation, such as conjunctivitis and blepharitis. Additionally, more severe conditions, such as keratitis, uveitis, and meibomian gland dysfunction, are frequently observed. Ocular symptoms in pemphigus vulgaris and rosacea can precede dermatological signs. Dry eye disease is commonly seen across various dermatological conditions. Treatments like calcineurin inhibitors (used for atopic dermatitis and psoriasis) have shown efficacy for both dermatological and ocular symptoms. In atopic dermatitis, the use of dupilumab has been linked to increased rates of conjunctivitis, necessitating collaboration between dermatologists and ophthalmologists to distinguish drug side effects from disease manifestations. Psoriasis treatments, including phototherapy and biologics like secukinumab and ustekinumab, require careful monitoring for potential ocular effects, as their safety profiles are still being evaluated. For ocular rosacea, cyclosporine has demonstrated superior efficacy over doxycycline in managing symptoms such as burning and corneal involvement. This review underscores the importance of recognizing the interplay between dermatological and ocular health. Early diagnosis, interdisciplinary collaboration, and tailored treatments are essential for managing these complex conditions effectively.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of Syphilitic Optic Neuropathy: A Prospective Cross-Sectional Study.","authors":"Kui-Fang Du, Hai-Yan Li, Xiao-Dan Wang, Xiao-Na Li, Wen-Jun Kong, Lian-Yong Xie, Ming Zhang, Zhen-Zhen Yan, Wen-Jia Weng, Hong-Wei Dong, Yan-Qing Gao","doi":"10.1080/09273948.2025.2456654","DOIUrl":"https://doi.org/10.1080/09273948.2025.2456654","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical features of syphilis optic neuropathy (SON) and explore its underlying pathogenesis by measuring the peripapillary retinal nerve fiber layer (pRNFL).</p><p><strong>Methods: </strong>This was a prospective cross-sectional study. Syphilitics, regardless of ocular complaints, in the ophthalmology department in 2020 were screened for SON, which was defined as isolated optic neuropathy without overt signs of syphilitic uveitis. We analyzed the demographic and clinical information, including ultra-wide-field fundus photographs, fundus fluorescein angiography (FFA), and pRNFL thickness measured by spectral-domain-OCT (SD-OCT).</p><p><strong>Results: </strong>Of 577 cases with syphilis, 25 patients (4.3% ± 0.8%) presented with optic disc edema and 7 patients (1.2% ± 0.5%) with optic atrophy. Of the eyes with optic disc edema, (35 eyes, 40% biocular), 40% had no ocular symptoms, and 45.7% had visual acuity (VA) better than 20/25, whereas 100% showed optic disc leakage in FFA. Of the eyes with optic atrophy (14 eyes, 100% biocular), 100% were male and presented severe vision impairment (VA worse than 20/70), but no optic disc leakage in FFA. A higher rapid plasma reagin (RPR) level was more frequently observed in patients with SON (p = 0.009). Additionally, the pRNFL thickness in non-ocular syphilis was not related to the RPR level or the syphilis duration (all p > 0.05).</p><p><strong>Conclusion: </strong>The SONs could manifest as asymptomatic optic disc edema or blinding optic atrophy, which were independent episodic reactions from ocular or cerebral syphilis, respectively. Our data highlighted the need for ophthalmic screening and prompt neurosyphilis treatment.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Increased Risk of Retinal Vasculitis May Be Associated with Aflibercept 8 mg: A Pharmacovigilance Analysis of the FAERS Database.","authors":"M Hossein Nowroozzadeh, Maryam Hajipourkhorasani","doi":"10.1080/09273948.2025.2476061","DOIUrl":"https://doi.org/10.1080/09273948.2025.2476061","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the risk of retinal vasculitis and related adverse events (AEs) among five commercially available anti-vascular endothelial growth factor (anti-VEGF) agents using data from the FDA Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>A retrospective pharmacovigilance study was conducted using FAERS data from Q1 2004 to Q4 2024. Adverse drug reactions (ADRs) were categorized using the Medical Dictionary for Regulatory Activities (MedDRA), with \"Retinal Vasculitis\" as the primary outcome and \"Uveitis\" and \"Vitritis\" as secondary outcomes. Disproportionality analysis was performed using ranibizumab as the reference drug. Logistic regression identified associations between demographic factors and ADRs. The analysis included only reports linking a single drug to the ADR and was limited to patients aged ≥18 years.</p><p><strong>Results: </strong>Out of 49,114 initial reports 45,768 met the inclusion criteria. Retinal vasculitis was reported in 314 cases (0.7%), vitritis in 689 cases (1.5%), and uveitis in 1,344 cases (2.9%). Older age (OR 1.012; <i>p</i> = 0.045) and female sex (OR 1.747; <i>p</i> < 0.001) were significantly associated with retinal vasculitis. All agents showed higher odds of uveitis and retinal vasculitis compared to ranibizumab, with brolucizumab having the highest reporting odds ratio (ROR) for retinal vasculitis (331.61). Aflibercept 8 mg showed a significantly higher ROR (62.8) for retinal vasculitis compared to the 2 mg dose (3.82).</p><p><strong>Conclusions: </strong>This study identified a safety signal indicating a possible increased risk of retinal vasculitis with aflibercept 8 mg compared to the conventional 2 mg dose. This finding requires confirmation through future postmarketing studies.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivek B Wani, Deepashri Mutalik, Padmamalini Mahendradas, Mounesh Patil
{"title":"A Case of Bilateral Irreversible Loss of Vision in a Young Child Due to Mumps Retinitis.","authors":"Vivek B Wani, Deepashri Mutalik, Padmamalini Mahendradas, Mounesh Patil","doi":"10.1080/09273948.2025.2476062","DOIUrl":"10.1080/09273948.2025.2476062","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of severe visual loss due to bilateral retinitis after mumps fever in a young child.</p><p><strong>Methods: </strong>Observational case report.</p><p><strong>Case report: </strong>A five-year-old boy presented with bilateral blindness 2 days after suffering from fever and parotid swelling. His examination showed vision of only perception of light, grade 2 anterior chamber activity, outer retinal necrosis involving whole retina with frosted branch angiitis like picture, inferior retinal detachment and few retinal hemorrhages in both eyes. His optical coherence tomography of retina showed diffuse thickening of the retina, subfoveal fluid and subretinal hypereflective material (SHRM) at the posterior pole with diffuse disruption of EZ and external limiting membrane (ELM). The serological test was positive for IgG and IgM antibodies against mumps virus. He did not respond to intravenous methylprednisolone, oral valganciclovir, hyperbaric oxygen and plasmapheresis. He developed foveal thinning, loss of external limiting membrane, ellipsoid zone and retinal pigment epithelial signals on optical coherence tomography with final vision of perception of light only.</p><p><strong>Conclusions: </strong>Mumps retinitis is rare and can result in severe visual loss. The unique findings in our case were exudative retinal detachment, subretinal fluid and hyperreflective material at the posterior pole.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wesam Shamseldin Shalaby, Eric J Shiuey, Tejal M Patel, Christopher J Rapuano, Zeba A Syed
{"title":"Risk Factors for Progression of Graft Rejection to Graft Failure Following Penetrating Keratoplasty.","authors":"Wesam Shamseldin Shalaby, Eric J Shiuey, Tejal M Patel, Christopher J Rapuano, Zeba A Syed","doi":"10.1080/09273948.2025.2470883","DOIUrl":"https://doi.org/10.1080/09273948.2025.2470883","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the risk factors for graft failure in eyes with endothelial graft rejection following penetrating keratoplasty (PK).</p><p><strong>Methods: </strong>Single-center, retrospective study that included patients who underwent PK at Wills Eye Hospital (2007-2018) who later presented with endothelial graft rejection, defined as clinical appearance of keratic precipitates or anterior chamber reaction. Among patients with rejection across multiple grafts, only the first PK of the first eye with documented rejection was included. The primary outcome measures were progression to graft failure, defined as irreversible and visually significant stromal edema, haze, or scarring, and acute graft failure, defined as failure within 6 months of rejection.</p><p><strong>Results: </strong>296 eyes from 296 patients were included with mean age of 54.4 ± 21.3 years. Average follow-up duration was 4.5 ± 2.9 years and rejection occurred 16.2 ± 18.7 months after transplantation. The rate of graft failure was 45.9% and the rate of acute failure was 31.4%. Predictors of failure after rejection included history of systemic autoimmune disorders (OR = 8.99, 95% CI = 2.03-39.77, <i>p</i> = 0.004), prior glaucoma surgery (OR = 2.73, 95% CI = 1.05-7.11, <i>p</i> = 0.039), and postoperative lens status as aphakia (OR = 7.59, 95% CI = 1.00-57.52, <i>p</i> = 0.0497). Predictors of acute graft failure after rejection included history of systemic autoimmune disorders (OR = 4.69, 95% CI = 1.20-18.33, <i>p</i> = 0.026), active microbial infection (OR = 3.52, 95% CI = 1.69-7.31, <i>p</i> = 0.001), and prior glaucoma surgery (OR = 3.50, 95% CI = 1.42-8.62, <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>Systemic autoimmune disorders and prior glaucoma surgery predicted both overall and acute graft failure, suggesting more aggressive rejection episodes in these cohorts.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Progress of Research and Comparative Analysis on the Combination of Mast Cell Stabilizers and Antihistamines in Allergic Conjunctivitis Treatment.","authors":"Xin Wang, LiYing Shang, ChenYu Song, YaNan Xu, Ming Yue Wang, XueYuan Bai, Wei Zheng, Wei Zhang","doi":"10.1080/09273948.2025.2462194","DOIUrl":"https://doi.org/10.1080/09273948.2025.2462194","url":null,"abstract":"<p><p>Allergic conjunctivitis (AC) is a common ophthalmological condition primarily associated with type I and IV allergic responses. Although AC typically does not cause visual impairments, it can significantly reduce the quality of life of individuals, regardless of age, with severe cases possibly affecting the cornea and potentially impairing vision. However, the mechanisms of action of primary therapeutic drugs-antihistamines, mast cell stabilizers, and their combination-remain unclear. This review introduces the pathogenesis of allergic conjunctivitis, including seasonal, perennial, and vernal keratoconjunctivitis. This study found that dual-acting drugs offer advantages over single-agent treatments. Compared to antihistamines or mast cell stabilizers used alone, dual-acting drugs have fewer adverse reactions, avoid side effects such as drowsiness, dizziness, and nausea, and do not cross the blood-brain barrier, thereby preventing potential impacts on learning and memory in both children and adults.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-19"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jerry Hsu, Michael J Weiss, James C Tsai, Anita Gupta
{"title":"Infectious Crystalline Keratopathy Following Initiation of Mycophenolate Mofetil.","authors":"Jerry Hsu, Michael J Weiss, James C Tsai, Anita Gupta","doi":"10.1080/09273948.2025.2470913","DOIUrl":"https://doi.org/10.1080/09273948.2025.2470913","url":null,"abstract":"<p><strong>Purpose: </strong>To present a case of infectious crystalline keratopathy (ICK) associated with recent initiation of systemic mycophenolate mofetil (MMF).</p><p><strong>Methods: </strong>Retrospective case report.</p><p><strong>Results: </strong>A 68-year-old man with prior Descemet's stripping automated endothelial keratoplasty (DSAEK) in his right eye developed graft failure and was scheduled for a second DSAEK. He had been using topical prednisolone acetate four times daily in his right eye. Given a prior history of anterior uveitis, preoperative MMF was initiated 3 weeks prior to repeat DSAEK. On the day of surgery, the patient was noted to have a new large arborizing non-suppurative stromal infiltrate despite minimal visual changes or symptoms, consistent with ICK. Corneal cultures grew <i>Streptococcus sanguinis</i> which responded to topical antibiotics with discontinuation of MMF. Therapeutic penetrating keratoplasty (PKP) was required for corneal scarring with no further recurrence of disease. Gram stain of the host corneal tissue demonstrated persistence of intrastromal bacteria despite clinically inactive disease.</p><p><strong>Conclusion: </strong>While typically reported in cases of local immunosuppression on topical steroids and/or post-PKP, infectious crystalline keratoplasty can occur shortly after the initiation of systemic immunosuppression with a rapid yet insidious onset. Bacterial colonies may persist long after clinical resolution of disease.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}