Clinical Analysis of the 0.3% Tosufloxacin Ophthalmic Solution Effect on Conjunctival Normal Flora

PURPOSE: To report the outcomes of clinical analysis on the negative culture rate of normal ocular surface flora and the anterior chamber penetration after the preoperative prophylactic use of 0.3% tosufloxacin ophthalmic solution. METHODS: From July 2010 to June 2012, 38 eyes of 38 patients who were scheduled to receive intravitreal injection or cataract surgery were examined for bacterial culture positive rate using conjunctival scraping. The patients were treated with 0.3% tosufloxacin eyedrops preoperatively 5 times a day for 2 days before surgery. After the treatment, the bacterial culture negative rate based on conjunctival scraping was assessed to evaluate the drug efficacy. Of the 38 patients, 19 had cataract surgery. The concentration of tosufloxacin at anterior chamber was assessed in the 19 patients. Additionally, any side effects from the drug were monitored during the treatment. RESULTS: Among the 38 eyes, 21 eyes showed a bacterial culture positive rate before treatment. After the drug treatment, the bacterial culture negative rate was 57.1% (12/21). Coagulase-negative staphylococci were most frequently cultured in 15 (39%) of the 38 eyes before treatment and the negative rate of bacterial culture was 86.7% (13/15) after treatment. Average antibiotic residue concentrations in aqueous humor was 0.050 +/- 0.038 microg/mL. No side effects from the drug were reported during the experimental period. CONCLUSIONS: Although the 0.3% tosufloxacin eyedrops were not effective in all bacterial strains and showed relatively low penetration rate into the anterior chamber, they were effective in some gram positive organisms, particularly in coagulase-negative staphylococci of normal ocular surface flora.

Lupus Vulgaris with Endopthalmitis - A rare manifestation of extra-pulmonary tuberculosis in India.

We report a case of 17-year-old girl who presented with gradual destruction of the nose along with endopthalmitis and loss of vision of the left eye. On nasal examination, left alae nasi and nasal cartilage was destroyed. Left eye showed signs of endopthalmitis with pthisis bulbi with complete loss of vision. Skin biopsy, FNAC of the lymph nodes were suggestive of tubercular etiology. However, patient did not have any evidence of pulmonary TB. We report this case due to the rare clinical features .The importance of a high index of suspicion and prompt treatment in such atypical forms to prevent morbidity cannot be over-emphasised.

Prognostic Factors in Patients With Endogenous Endophthalmitis

PURPOSE: We evaluated the causative microorganisms, dispositions, and visual prognosis of endogenous endophthalmitis. METHODS: The records of 12 eyes of 10 patients who were diagnosed with endogenous endophthalmitis were retrospectively reviewed with respect to the causative microorganisms, dispositions, visual prognosis, initial visual acuity, time interval between onset of symptom, and the course of treatment. RESULTS: Three of the four eyes infected with a candida species recovered a visual acuity of 0.1 or better; none of the other infected eyes reached higher than 0.1 (p=0.024). Initial visual acuity of less than hand movement reached globe loss in three eyes, while 5 eyes with initial visual acuity of better than hand movement of seven eyes did not lose the globe (p=0.045). Three out of patients with a time interval between onset of symptoms and treatment of more than five days did not lose the globe, while those with a time interval of less than five days of eight eyes did not lose the globe. CONCLUSIONS: Visual prognosis and globe survival depends mainly on the underlying microorganism, initial visual acuity, the time interval between the onset of symptom, and treatment. Patients with candida endophthalmitis had good visual outcome compared with the others, and thus microbial culture identification is a useful predictor of visual acuity and treatment.