Cornea open最新文献

{"title":"Case Report of Candida Parapsilosis Keratitis After Cataract Surgery Leading to Corneal Perforation","authors":"Brian Hwang, J. Jia, Frank S Hwang","doi":"10.1097/coa.0000000000000013","DOIUrl":"https://doi.org/10.1097/coa.0000000000000013","url":null,"abstract":"\u0000 \u0000 The objective of this study was to report and document a rare case of Candida parapsilosis keratitis that occurred following a routine clear corneal incision cataract surgery, ultimately resulting in a perforated corneal ulcer and subsequent need for a penetrating keratoplasty (PK). By presenting this case, the study aims to contribute to the existing literature and raise awareness about the potential risk of C. parapsilosis keratitis as a complication of cataract surgery.\u0000 \u0000 \u0000 \u0000 In this case report, we describe the presentation and management of a rare fungal infection following routine cataract extraction in an 80-year-old male patient. The patient initially received treatment for suspected endophthalmitis and bacterial keratitis but experienced worsening symptoms, including a small corneal perforation. Upon referral to the clinic, the patient exhibited a fluffy stromal infiltrate near the cataract wound site, an epithelial defect, and a hypopyon. Treatment with compounded topical 1% voriconazole was initiated but did not prevent the progression of the corneal perforation. Attempts to seal the perforation with corneal glue were unsuccessful, leading to the decision to perform a PK. During the surgery, corneal tissue was biopsied and cultured to identify the causative agent.\u0000 \u0000 \u0000 \u0000 Following PK, the corneal cultures revealed the growth of C. parapsilosis, confirming the fungal nature of the infection. The patient was then reinitiated on topical voriconazole for a prolonged course of 7 months. Throughout this period, the patient was closely monitored and followed up in the clinic. Fortunately, there were no recurrences of the fungal lesion during this time.\u0000 \u0000 \u0000 \u0000 No prior cases of a perforated corneal ulcer resulting from C. parapsilosis keratitis after routine cataract surgery have been reported in the literature to our knowledge. Our patient experienced postoperative complications characterized by recurrent inflammation, which was treated with potent and frequent topical steroids. This treatment masked the underlying mycotic infection and contributed to corneal perforation. Ultimately, the patient underwent a successful PK procedure to remove the infectious nidus, followed by an extended 7-month course of topical voriconazole. No recurrence of the lesion was observed. Therefore, clinicians should be vigilant for mycotic keratitis, specifically C. parapsilosis, in patients who display late-onset, persistent inflammation and white plaques at the clear corneal incision site after cataract surgery. The combination of PK and an extended postoperative treatment with topical antifungal agents proves to be an effective strategy for managing corneal perforations caused by C. parapsilosis keratitis.\u0000","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"196 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75078994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Penetrating Keratoplasty and Vitreoretinal Surgery With Temporary Keratoprosthesis","authors":"Theresa N. Cooney, R. Kinast, L. Juratli, Priscila Novaes Pedreira, S. Saxe, D. Musch, S. Mian","doi":"10.1097/coa.0000000000000012","DOIUrl":"https://doi.org/10.1097/coa.0000000000000012","url":null,"abstract":"","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80460398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apollo Rising: Acute Conjunctivitis Outbreak in India, 2022.","authors":"N Venkatesh Prajna, Lalitha Prajna, Vishnu Teja, Ramesh Gunasekaran, Cindi Chen, Kevin Ruder, Lina Zhong, Danny Yu, David Liu, Thomas Abraham, Wendy Ao, Michael Deiner, Armin Hinterwirth, Gerami Seitzman, Thuy Doan, Thomas Lietman","doi":"10.1097/coa.0000000000000009","DOIUrl":"10.1097/coa.0000000000000009","url":null,"abstract":"<p><strong>Purpose: </strong>To identify pathogens associated with the 2022 conjunctivitis outbreak in Tamil Nadu, India.</p><p><strong>Methods: </strong>This prospective study was conducted in November of 2022. Patients with presumed acute infectious conjunctivitis presenting to the Aravind Eye Clinic in Madurai, India were eligible. Anterior nares and conjunctival samples from participants were obtained and processed for metagenomic RNA deep sequencing (RNA-seq).</p><p><strong>Results: </strong>Samples from 29 patients were sequenced. A pathogen was identified in 28/29 (97%) patients. Coxsackievirus A24v, a highly infectious RNA virus, was the predominant pathogen and detected in 23/29 patients. Human adenovirus D (HAdV-D), a DNA virus commonly associated with conjunctivitis outbreaks, was detected in the remaining patients (5/29). Hemorrhagic conjunctiva was documented in both HAdV-D and coxsackievirus A24v affected patients but was not the predominant clinical presentation. Phylogenetic analysis of coxsackievirus A24v revealed a recent divergence from the 2015 outbreak.</p><p><strong>Conclusions: </strong>Coxsackievirus A24v and HAdV-D were co-circulating during the 2022 conjunctivitis outbreak in Tamil Nadu, India. Clinical findings were similar between patients with HAD-V and coxsackievirus A24v associated conjunctivitis. As high-throughput technologies become more readily accessible and cost-effective, unbiased pathogen surveillance may prove useful for outbreak surveillance and control.</p>","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10279496","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 Simultaneous Penetrating Keratoplasty: A 40-Year Odyssey","authors":"Clara M. Castillejo Becerra, W. M. Bourne, S. V. Patel","doi":"10.1097/coa.0000000000000011","DOIUrl":"https://doi.org/10.1097/coa.0000000000000011","url":null,"abstract":"","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"2013 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87733267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment trials for viral conjunctivitis: what we have learned and how we can improve.","authors":"Kyongjin Cho,&nbsp;Irene C Kuo","doi":"10.1097/coa.0000000000000006","DOIUrl":"https://doi.org/10.1097/coa.0000000000000006","url":null,"abstract":"","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299741/pdf/nihms-1864758.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9726346","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":"Metalloproteinase-9 in the ocular surface of patients with implanted Boston type 1 keratoprosthesis.","authors":"Andrea C Arteaga, Margaret C Weiss, Raiza Perez, María Soledad Cortina","doi":"10.1097/coa.0000000000000008","DOIUrl":"10.1097/coa.0000000000000008","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the presence of ocular surface inflammation, using matrix metalloproteinase 9 (MMP-9) as a marker, in the ocular surface of eyes with implanted Boston Keratoprosthesis type 1 (KPro).</p><p><strong>Methods: </strong>Patients with implanted KPro at a single tertiary center were recruited to assess ocular inflammation. MMP-9 was measured using InflammaDry^® test in both eyes of each patient. The non-KPro eye served as control. Rate of positivity of MMP-9 was compared between groups. Possible associations between ocular surface inflammation and the development of postoperative complications were evaluated using univariate statistical analysis.</p><p><strong>Results: </strong>Fifty eyes from 25 patients were included. The mean age was 50 years old. Non-inflammatory indications for KPro were predominant among patients. Eighty eight percent of KPro eyes had a positive test for MMP-9 while only 25% of control eyes were positive (p<001). The most common complications were retroprosthetic membrane, epithelial defects, and sterile corneal melt. The presence of a strong positive result was associated to a higher frequency of complications (80% of eyes) compared to a faint positive test (54%) and a negative test (33%).</p><p><strong>Conclusion: </strong>The KPro device appears to increase MMP-9 levels in the ocular surface. High MMP-9 levels may be associated with higher risk of complications. MMP-9 testing can be useful to assess subclinical ocular surface inflammation with a potential role in the postoperative care of KPro patients.</p>","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9388709","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 Case of Bilateral Keratitis and Bilateral Anterior Uveitis Induced by Pembrolizumab","authors":"H. Fukuoka, Maya Yoshioka, Hitomi Kobayashi, Takahiro Okumura, C. Sotozono","doi":"10.1097/coa.0000000000000007","DOIUrl":"https://doi.org/10.1097/coa.0000000000000007","url":null,"abstract":"","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72942805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Infectious Keratitis in Opioid Users in a County Hospital Setting.","authors":"Jacqueline B Lopez, Lawrence Chan, Murtaza Saifee, Gerami D Seitzman, Madeline Yung, Matilda F Chan","doi":"10.1097/coa.0000000000000010","DOIUrl":"10.1097/coa.0000000000000010","url":null,"abstract":"<p><strong>Purpose: </strong>To determine risk factors and clinical course of corneal ulcers in the setting of opioid use.</p><p><strong>Methods: </strong>A retrospective cohort study was performed of patients presenting with bacterial or fungal keratitis at a county hospital from 2010-2021. Subjects were separated into three groups: opioid drug users (heroin, methadone, fentanyl), non-opioid drug users, and non-drug users. 24 opioid users, 77 non-opioid drug users, and 38 non-drug users were included in the study. Chi-square and t-tests were used to compare hospitalization for corneal ulcer treatment; length of hospitalization; loss to follow-up; final best corrected visual acuity (BCVA); medication noncompliance; time to ulcer resolution; and visual disability (defined either by the legal limit for driving in California or the federal limit for blindness).</p><p><strong>Results: </strong>Opioid users had higher rates of unemployment (p=0.002), homelessness (p=0.018), and psychiatric conditions (p=0.024) compared with non-opioid and non-drug users. They had more severe presentations, with worse initial BCVA of the affected eye (p=0.003), larger ulcer size (p=0.023), and higher rates of individuals below the legal vision thresholds for driving (p=0.009) and blindness (p=0.033) at initial presentation. Opioid use was associated with increased rate of hospitalization (p<0.001), higher fortified antibiotic use (p=0.009), worse final BCVA of the affected eye (p=0.020), and increased rates of BCVA worse than the legal vision thresholds for driving (p=0.043) and blindness (p<0.001) on final presentation.</p><p><strong>Conclusions: </strong>Infectious keratitis associated with opioid use is associated with more severe presentations and poorer outcomes, including higher rates of visual disability.</p>","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110437","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":"Corneal Melt Associated With Cancer Immunotherapy","authors":"Jerry Hsu, Lena Dixit, Vishal Jhanji, Sumayya Ahmad","doi":"10.1097/coa.0000000000000005","DOIUrl":"https://doi.org/10.1097/coa.0000000000000005","url":null,"abstract":"Purpose: The purpose of this study was to describe cases of corneal melt associated with systemic cancer immunotherapy. Methods: This is a case series of 6 patients. Results: Corneal melt was noted in all eyes, including 1 patient on an epidermal growth factor receptor (EGFR) inhibitor and another on a human epidermal growth factor 2 (HER2) inhibitor that resolved on serum tears; 1 patient on a fibroblast growth factor receptor (FGFR) inhibitor that stabilized on serum tears and amniotic membrane; 1 patient on a Bruton tyrosine kinase (BTK) inhibitor and another on a breakpoint cluster region protein-abelson murine leukemia viral oncogene homolog 1 (BCR-ABL) inhibitor that both had corneal thinning with perforation; and 1 patient with bilateral corneal thinning complicated by a fungal superinfection after long-term use of a programmed cell death protein 1 (PD-1) inhibitor. Conclusions: While primarily described with EGFR inhibitors, corneal melt may present with vision-threatening consequences in other classes of cancer immunotherapy including FGFR inhibitors, PD-1 inhibitors, and other tyrosine kinase inhibitors.","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"480 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135533754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Year Follow-up of Biomechanical Changes in Very Asymmetric Ectasia","authors":"S. Koh, Ryota Inoue, Sayo Maeno, N. Maeda, Renato Ambrósio, V. Jhanji, K. Nishida","doi":"10.1097/coa.0000000000000001","DOIUrl":"https://doi.org/10.1097/coa.0000000000000001","url":null,"abstract":"","PeriodicalId":72708,"journal":{"name":"Cornea open","volume":"666 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79035973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}