ABSTRACT
Pythium insidiosum is a parasitic oomycete that can cause keratitis and closely resembles fungus, both clinically and morphologically. It requires a trained microbiologist for its differentiation from fungal filaments and has poor response to antifungal therapy. We present a case of primary isolation of the organism from the vitreous cavity in a case of endophthalmitis. The infection spread quickly and involved all the ocular tissues. The eye had poor visual outcome despite a sequence of rapidly completed retinal and corneal surgeries along with initiation of anti-Pythium therapy.
Subject(s)
Corneal Ulcer , Endophthalmitis , Keratitis , Pythiosis , Pythium , Animals , Humans , Corneal Ulcer/microbiology , Corneal Ulcer/surgery , Pythiosis/diagnosis , Pythiosis/drug therapy , Pythiosis/parasitology , Keratitis/microbiology , Endophthalmitis/diagnosis , Endophthalmitis/drug therapy , Endophthalmitis/surgeryABSTRACT
A man in his 60s with proliferative diabetic retinopathy presented with vision loss in both eyes in the past 1 month. On presentation, the best corrected visual acuity was 20/60 and 20/125 for the right and left eyes, respectively. On examination, he had total tractional retinal detachment (TRD) in the left eye and macula threatening TRD in the right eye. In both eyes, the patient had pars plana vitrectomy, membrane peeling, endolaser and silicone oil injection. Though the left eye's postoperative recovery was uneventful, the subretinal fluid (SRF) in the right eye macula persisted. There was no open retinal break noted in the postoperative period, and no surgical intervention was done for the persistent SRF. The fluid was eventually absorbed over 4 months, with the recovery of vision to 20/40.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Retinal Detachment , Diabetic Retinopathy/complications , Diabetic Retinopathy/surgery , Humans , Male , Retinal Detachment/diagnosis , Retinal Detachment/etiology , Retinal Detachment/surgery , Retrospective Studies , Subretinal Fluid , Visual Acuity , VitrectomyABSTRACT
Purpose: Gut dysbiosis has been identified and tested in human trials for its role in diabetes mellitus (DM). The gut-retina axis could be a potential target for retardation of diabetic retinopathy (DR), a known complication of DM. This study reviews the evidence suggesting gut dysbiosis in DR. Methods: The published literature in the past 5 years was reviewed using predetermined keywords and articles. The review intended to determine changes in gut microbiome in DR, the hypothesized mechanisms linking to the gut-retina axis, its predictive potential for progression of DR, and the possible therapeutic targets. Results: The gut microbiota of people with DM differ from those without it, and the gut microbiota of people with DR differ from those without it. The difference is more significant in the former (DM versus no DM) and less significant in the latter (DM without DR versus DM with DR). Early research has suggested mechanisms of the gut-retina axis, but these are not different from known changes in the gut microbiome of people with DM. The current evidence on the predictive value of the gut microbiome in the occurrence and progression of DR is low. Therapeutic avenues targeting the gut-retina axis include lifestyle changes, pharmacologic inhibitors, probiotics, and fecal microbiota transplantation. Conclusions: Investigating the therapeutic utility of the gut ecosystem for DM and its complications like DR is an emerging area of research. The gut-retina axis could be a target for retardation of DR but needs longitudinal regional studies adjusting for dietary habits.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Gastrointestinal Microbiome , Probiotics , Diabetic Retinopathy/epidemiology , Dysbiosis , Ecosystem , Humans , Probiotics/therapeutic useABSTRACT
An endoscope is a useful adjunct for the retinal surgeon to overcome haze of a compromised anterior segment. It allows early surgery in trauma and infections which translates to better results. Intraocular glass foreign body is a challenging condition, demanding highly skilled surgical expertise. We present endoscopic removal of an intraocular foreign glass body in a badly traumatised and infected eye. The surgical challenge was accentuated by an imaging misdiagnosis of 'twin metallic foreign bodies'.
Subject(s)
Endophthalmitis , Eye Foreign Bodies , Eye Injuries, Penetrating , Child , Endophthalmitis/diagnosis , Endoscopes , Eye Foreign Bodies/diagnostic imaging , Eye Foreign Bodies/surgery , Eye Injuries, Penetrating/diagnostic imaging , Eye Injuries, Penetrating/surgery , Glass , Humans , MaleABSTRACT
A middle-aged man had been diagnosed as retinitis and treated with steroids previously. The patient had developed macular infarction in the course of illness. We diagnosed him to have rickettsial retinitis on the basis of clinical features and positive Weil-Felix test. The patient's condition improved after treatment with oral antibiotics. The vasculature of the infarcted macula showed partial reperfusion late in the course of follow-up.
Subject(s)
Retinal Diseases , Retinitis , Rickettsia , Humans , Infarction/diagnostic imaging , Male , Middle Aged , Retinitis/diagnosis , Retinitis/drug therapy , Vascular RemodelingSubject(s)
Dirofilariasis/therapy , Eye Diseases/parasitology , Eye Diseases/therapy , Aged , Animals , Dirofilaria , Humans , India , MaleABSTRACT
Many of the ophthalmic pathologies can co-exist and when taken together can at times give a clue to a life-threatening systemic condition. Presented here is a case of Aicardi syndrome in a prematurely born baby with retinopathy of prematurity . Early diagnosis by the ophthalmologist helped the baby for a timely neurological attention.
