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.

Efficacy of Topical Cyclosporine in Mild Dry Eye Patients Having Refractive Surgery

PURPOSE: To evaluate the efficacy of pre- and post-operative use of topical 0.05% cyclosporine A (CsA) in mild dry eye patients having refractive surgery. METHODS: This randomized prospective study included 40 patients with mild dry eye syndrome who were scheduled for laser in situ keratomileusis (LASIK). All patients were divided into 2 groups. Patients in the CsA group used both 0.1% sodium hyaluronate (HA) and 0.05% CsA from 2 weeks before to 8 weeks after the surgery, while patients in the control group used 0.1% HA only. Ocular surface disease index (OSDI), tear film break-up time (TF-BUT), Oxford Stain Score (OSS), and tear osmolarity were evaluated before surgery and 1, 4, and 8 weeks after surgery. RESULTS: TF-BUT was significantly longer in the CsA group at 1 and 4 weeks post-operatively (p = 0.024, p = 0.036) compared to the control group. Tear osmolarity was significantly lower in the CsA group at 1 week post-operatively (p = 0.004) compared to the control group. CONCLUSIONS: The pre- and post-operative use of topical 0.05% CsA is effective in alleviating dry eye symptom after LASIK in patients with dry eye syndrome.

Efficacy of Topical Cyclosporine in Mild Dry Eye Patients Having Refractive Surgery

PURPOSE: To evaluate the efficacy of pre- and post-operative use of topical 0.05% cyclosporine A (CsA) in mild dry eye patients having refractive surgery. METHODS: This randomized prospective study included 40 patients with mild dry eye syndrome who were scheduled for laser in situ keratomileusis (LASIK). All patients were divided into 2 groups. Patients in the CsA group used both 0.1% sodium hyaluronate (HA) and 0.05% CsA from 2 weeks before to 8 weeks after the surgery, while patients in the control group used 0.1% HA only. Ocular surface disease index (OSDI), tear film break-up time (TF-BUT), Oxford Stain Score (OSS), and tear osmolarity were evaluated before surgery and 1, 4, and 8 weeks after surgery. RESULTS: TF-BUT was significantly longer in the CsA group at 1 and 4 weeks post-operatively (p = 0.024, p = 0.036) compared to the control group. Tear osmolarity was significantly lower in the CsA group at 1 week post-operatively (p = 0.004) compared to the control group. CONCLUSIONS: The pre- and post-operative use of topical 0.05% CsA is effective in alleviating dry eye symptom after LASIK in patients with dry eye syndrome.

Rapidly Progressing Foveal Atrophy with Tuberculous Serpiginous-Like Choroiditis Despite Combined Anti-Tuberculosis and Steroid Treatment

PURPOSE: To report a case of rapidly progressing foveal atrophy with tuberculous serpiginous-like choroiditis. CASE SUMMARY: A 54-year-old female patient had decreased vision of hand motions (os) for 3 days. Fundus examination showed optic disc swelling and yellowish chorioretinal lesions in the posterior pole (os). Optical coherence tomography (OCT) showed intraretinal edema and subretinal fluid in the left macula. Routine laboratory tests, serologic tests, and magnetic resonance imaging results were normal except for erythrocyte sedimentation rate (28 mm/hr). Fluorescein angiography showed the chorioretinal lesions appeared to be early hypofluorescence followed by late hyperfluorescence. Indocyanine green angiography showed hypofluorescence during early and late phases and the result of interferon-gamma release assay was positive. Under diagnosis of tuberculous serpiginous-like choroiditis, anti-tuberculous therapy combined with systemic corticosteroid was started. Despite decreased optic disc swelling, OCT showed a rapid progression of foveal atrophy within 2 weeks. Twelve weeks later, visual acuity was finger count at 10 cm. Six months later, best-corrected visual acuity and foveal atrophy were no interval change. CONCLUSIONS: Tuberculous serpiginous-like choroiditis with foveal involvement can show rapidly progressive foveal atrophy and poor visual prognosis.