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?AlM:To evaluate and observe the efficacy of silicon oil ( SO ) , perfluoropropane ( C3 F8 ) and balanced salt solution ( BSS ) that can be used as tamponade during vitrectomy to treat proliferative diabetic retinopathy ( PDR) complicated with vitreous hemorrhage ( VH) . ?METHODS: Studied retrospectively on 74 eyes of 60 patients who underwent vitrectomy surgery with diabetic vitreous hemorrhage in our hospital during June 2008 and June 2014. Based on repeated prior examines on fundus details and the vitrectomy tamponades were chosen. All the patients had been followed up at least 3mo. Depending on different tamponades, the paitents were nonrandomized in three groups and contrasted as visual acuity, intraocular pressure ( lOP ) and complications respectively. ?RESULTS: There was statistically significant difference among these three groups in preoperative eyesight ( P0. 05). The difference being statistically difference in the postoperative vision among these three groups ( P 0. 05). The preoperative visual function was in contrast to the postoperative (P0. 05). However,the difference among three groups being statistically in the postoperative vision(P ? CONCLUSlON: Vitrectomy is a safe and effective treatment that can help patients who have diabetic vitreous hemorrhage obtain better visual improvement. Because of the physicochemical properties and different conditions, there still has complications after surgery.
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Secondary glaucoma is a kind of complications after vitrectomy, its etiologies are various and complex. Ineffective therapies might cause irreversible damage on optic nerves and visual field defect, even the loss in visual function. Nowadays, this project has been paid great attention by various researches both in China and abroad. Both the pathogens and therapies of secondary glaucoma after vitrectomy are analyzed as follows.
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Background Acanthamoeba keratitis is a sort of serious infectious eye disease with high causing-blindness rate.Acanthamoeba keratitis often is misdiagnosed as fungal keratitis or viral keratitis in the early stage.Because conventional clinical diagnosis methods show a low specificity and take a long time,timely treatment often is delayed.Conventional PCR does not apply well because the lesion sample is not enough to extract DNA.However,direct PCR can amplify 18S rRNA conserved sequence of acanthamoeba keratitis without the extraction of DNA.Objective This study was to discuss the feasibility for rapid diagnosis of acanthamoeba keratitis using direct PCR to amplify the gene 18S rRNA fragment.Methods Ten acanthamoeba strains were isolated from 10 eyes with acanthamoeba keratitis in Qingdao Eye Hospital.The sensitivity of the direct PCR assay was tested using different numbers of amoebas.The specificity of the assay was tested using DNA extracted from acanthamoeba,candida albicans,pseudomonas aeruginosa,herpes simplex virus-1 (HSV-1) and normal human corneal epithelial cell.Acanthamoeba keratitis models were established using infected method in clean 6-week-old female BALB/c mice.Corneal lesion samples were obtained 1 day,3,5,7,10,15 days after modeled.The effectivity and feasibility of the direct PCR assay for rapid diagnosis of acanthamoeba keratitis were evaluated and compared with culture method,corneal smear examination and real-time PCR.Results Direct PCR primers could only amplify DNA of acanthamoeba rather than other pathogens,and 10 stains of acanthamoeba were detected at least in each sample.During the development of acanthamoeba keratitis in the mice,the diagnosis positive rate of direct PCR was 80.0％,90.0％,80.0％,70.0％,70.0％ and 50.0％ in 1 day,3,5,7,10,15 days after modeled with the total positive rate 73.3％,which was higher than 31.7％ of culture method,56.7％ of corneal smear examination and 61.7％ of realtime PCR,with a significant difference between the direct PCR and culture method (P =0.005),but no significant difference was seen in the total positive rate between the direct PCR and real-time PC R (P =0.172) or corneal smear examination (P =0.056).Conclusions The direct PCR assay is a simple,rapid,highly specific and sensitive method for the rapid diagnosis of acanthamoeba keratitis,especially for the limited lesion sample.
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<p><b>BACKGROUND</b>Hypopyon is common in eyes with fungal keratitis. The evaluation of the clinical features, culture results and the risk factors for hypopyon and of the possible correlation between hypopyon and the treatment outcome could be helpful for making treatment decisions.</p><p><b>METHODS</b>The medical records of 1066 inpatients (1069 eyes) with fungal keratitis seen at the Shandong Eye Institute from January 2000 to December 2009 were reviewed retrospectively for demographic features, risk factors, clinical characteristics, laboratory findings and treatment outcomes. The incidence of hypopyon, the fungal culture positivity for hypopyon, risk factors for hypopyon and the effect of hypopyon on the treatment and prognosis were determined.</p><p><b>RESULTS</b>We identified 1069 eyes with fungal keratitis. Of the 850 fungal culture-positive eyes, the Fusarium species was the most frequent (73.6%), followed by Alternaria (10.0%) and Aspergillus (9.0%). Upon admission, 562 (52.6%) eyes with hypopyon were identified. The hypopyon of 66 eyes was evaluated via fungal culturing, and 31 eyes (47.0%) were positive. A total of 194 eyes had ocular hypertension, and 172 (88.7%) of these eyes had hypopyon (P < 0.001). Risk factors for incident hypopyon included long duration of symptoms (P < 0.001), large lesion size (P < 0.001) and infection caused by the Fusarium and Aspergillus species (P < 0.001). The positivity of fungal culture for hypopyon was associated with duration of symptoms and lesion size. Surgical intervention was more common in cases with hypopyon (P < 0.001). Hypopyon was a risk factor for the recurrence of fungal keratitis after corneal transplantation (P = 0.002).</p><p><b>CONCLUSIONS</b>Hypopyon is common in patients with severe fungal keratitis and can cause ocular hypertension. About half of the hypopyon cases were positive based on fungal culture. Long duration of symptoms, large lesion size and infection with the Fusarium and Aspergillus species were risk factors for hypopyon. The presence of hypopyon increases the likelihood of surgical intervention.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anterior Chamber , Pathology , Aspergillus , Virulence , Eye Infections, Fungal , Microbiology , General Surgery , Fusarium , Virulence , Keratitis , Microbiology , General Surgery , Microscopy, Confocal , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
Objective To study normal flora components of conjunctiva, explore the relationship between normal flora and ocu- lar bacterial infections.Methods The data of 1 198 bacterial cultures of conjunctiva in non-infectious cataract patients were re- viewed and compared with the results of 985 specimens of conjunctivitis, keratitis and endophthalmitis from January 2000 to December 2004.Results Positive culture of conjunctiva in non-infectious cataract patients was 628 in 1 198 specimens (52.4%).These bacteria including gram-positive cocci and gram-neganve bacilli constituted the normal flora of conjunctiva. Staphylococcus epidermidis was the predominant bacteria (51.1%, 341/667) and its prevalence increased during this 5-year period.S.epidermidis and S.aureus were also the most frequently isolated pathogens in specimens of conjunctivitis, keratitis and endophthalmitis.The correlation was statistically significant between the positive rate in normal eye and conjunctivitis or keratitis in terms of these two species, but not statistically significant between normal eye and endophthalmitis.The resistance rate of normal flora of conjunctiva to ampicillin, amikacin, tobramycin, ciprofloxacin, and ofloxacin increased year by year. The resistance rate to gentamicin and the combination of two drugs decreased.The changing resistant pattern was similar in pa- tients with eye infection.Conclusions There is a close relationship between the normal flora S.aureus and S.epidermidis of conjunctiva and the bacterial infection of ocular surface, but no significant correlation between normal flora and the pathogen of endophthalmitis.