ABSTRACT
OBJECTIVES: Ocular infections due to Achromobacter xylosoxidans are extremely uncommon; their diagnosis is a challenge and the optimal treatment remains controversial. We present a case of A. xylosoxidans in a contact lens user and a review of the literature to facilitate diagnostic suspicion and empirical therapeutic management. METHODS: Review of the literature in PubMed and MEDLINE. We also document a case diagnosed in our department in January 2016. SETTING: Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain. RESULTS: According to the literature, clinical manifestations and antibiotic sensitivity of A. xylosoxidans varied greatly. Our patient with no history of keratopathy presented three risk factors that made the diagnosis suspicious. The infection was resolved with topical moxifloxacin and fluorometholone. CONCLUSIONS: A. xylosoxidans is an uncommon cause of infection, but must be suspected in atypical keratitis, reported contact with warm or still waters, use of contact lenses, or previous corneal damage. In these cases, microbiological studies and antibiotic sensitivity testing are particularly important.
Subject(s)
Achromobacter denitrificans/isolation & purification , Contact Lenses/microbiology , Eye Infections, Bacterial/etiology , Gram-Negative Bacterial Infections/etiology , Keratitis/etiology , Adult , Contact Lenses/adverse effects , Equipment Contamination , Eye Infections, Bacterial/microbiology , Gram-Negative Bacterial Infections/microbiology , Humans , Keratitis/diagnosis , Keratitis/microbiology , MaleABSTRACT
PURPOSE: To establish normal values for retinal nerve fiber layer (RNFL), macular thickness, and macular volume in children using spectral-domain optical coherence tomography (OCT). METHODS: A descriptive cross-sectional study was performed in healthy children between 3 and 14 years of age. Each child underwent a comprehensive ophthalmic examination that included 3 OCT scans with Spectralis (Heidelberg Engineering, Heidelberg, Germany). All measurements were performed by the same operator, and one eye was randomly selected. The influence of age, sex, and refraction on OCT measurements was analyzed. RESULTS: The sample consisted of 162 Caucasian subjects, mean age 8.1 ± 3.03 years. The spherical equivalent was 0.03 ± 0.19 D (range ±4 D, astigmatism <1 D). The average values were 263.69 ± 4.54 µm for central macular thickness, 0.21 ± 0.01 mm3 for central macular volume, and 100.45 ± 1.98 µm for RNFL. A significant correlation between RNFL and spherical equivalent was found for the nasal (p = 0.001), inferior (p = 0.009), and inferior nasal (p = 0.005) sectors. No differences were found with regard to sex (p>0.05). However, central macular thickness and central macular volume were correlated with age (p = 0.027, p = 0.02). CONCLUSIONS: This study provides reference values for macular thickness, macular volume, and RNFL in healthy children.
Subject(s)
Nerve Fibers , Refraction, Ocular/physiology , Retina/anatomy & histology , Retinal Ganglion Cells/cytology , Tomography, Optical Coherence/methods , Adolescent , Age Distribution , Aging/physiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Reference Values , Sex Distribution , White PeopleABSTRACT
PURPOSE: To study the biomechanical effect of riboflavin-ultraviolet A irradiation (UVA)-induced collagen cross-linking (CXL) in porcine corneas using two different exposure times of 30 and 60 min. METHODS: Seventeen enucleated porcine eyes were divided into three groups: group A, six eyes without any treatment, group B, six eyes treated by UVA CXL for 30 min, and group C, five eyes treated by UVA CXL for 60 min. Riboflavin (vitamin B2) was used as a photosensitizer in both groups of treatment. Then, the stress-strain behavior of all the specimens was measured to compare the corneal biomechanical properties among the three groups. The Young's modulus E of the mean curve of each group shows the stiffness of treated and untreated tissue. The stress data necessary for stretches of 6, 8, and 12% were used to perform the statistical analysis of the values. RESULTS: Group B (riboflavin-UVA-CXL, 30 min, E = 46 MPa) showed a stiffer behavior than group A (control, E = 29 MPa) . Group C (60 min CXL, E = 28 MPa) showed lower stiffness than group B and a similar mechanical behavior than group A. The statistical analysis of the stress-strain curves showed significant differences in the corneal response between group B and the control at the three values of stretch considered, 6, 8, and 12% (p = 0.025, p = 0.025 and p = 0.037, respectively) and between group B and group C (p = 0.028, p = 0.028, and p = 0.028). No statistically significant difference was found between group C and control (p = 0.855, p = 0.715, and p = 0.584). CONCLUSIONS: The application of 30-min UVA CXL treatment with riboflavin increased stiffness of the porcine corneal tissue. A 60-min UVA-radiated tissue presents lower stiffness than the 30-min treated tissue, showing a similar biomechanical behavior than the untreated corneas. A prolongation of the UVA irradiation time may cause structural weakening of the porcine corneas.
Subject(s)
Collagen/metabolism , Cornea/metabolism , Cross-Linking Reagents/metabolism , Elasticity/physiology , Photosensitizing Agents/therapeutic use , Riboflavin/therapeutic use , Ultraviolet Rays , Animals , Biomechanical Phenomena/physiology , Cornea/radiation effects , Corneal Stroma/metabolism , Corneal Stroma/radiation effects , Prospective Studies , Swine , Tensile Strength/physiology , Time Factors , Treatment OutcomeABSTRACT
A 58-year-old woman had successful phacoemulsification with intraocular lens (IOL) implantation in January 2001. Two years later, nonpenetrating glaucoma surgery with mitomycin-C (MMC) 0.02% was performed for uncontrolled glaucoma. Two months later, opacification of the anterior IOL surface was observed. The IOL was removed and a hydrophobic acrylic AcrySof IOL (Alcon) implanted. The opacified IOL was studied by flame atomic absorption spectrometry, which showed the presence of calcium carbonate. A new IOL of the same model was placed in an aqueous solution with calcium carbonate and basic pH, and the same opacification developed. We hypothesize that the change in aqueous humor pH after glaucoma surgery and the characteristics of the IOL precipitated deposition of calcium.
Subject(s)
Antibiotics, Antineoplastic/administration & dosage , Glaucoma, Open-Angle/surgery , Lenses, Intraocular , Mitomycin/administration & dosage , Postoperative Complications , Prosthesis Failure , Sclerostomy , Calcinosis/etiology , Calcium Carbonate/analysis , Combined Modality Therapy , Device Removal , Female , Glaucoma, Open-Angle/drug therapy , Humans , Hydrogen-Ion Concentration , Intraocular Pressure , Lens Implantation, Intraocular , Middle Aged , Phacoemulsification , Reoperation , Spectrophotometry, AtomicABSTRACT
Hemos realizado un estudio de 60 ojos sometidos a queratoplastia penetrante para determinar los factores asociados con una elevación precoz (menos de tres meses), o tardía (más de tres meses) de la presión intraocular. Analizamos la incidencia y los factores de riesgo en la aparición de glaucoma en las queratoplastias realizadas en nuestro servicio en los últimos tres años. Mostramos la asociación entre la aparición de glaucoma y la indicación de queratoplastia, glaucoma previo, cirugía de catarata previa y tipo de intervención. La queratopatia bullosa presentó un riesgo mayor
We conducted an análisis of 60 eyes that underwent penetrating keratoplsaties to determine the factors associated with early (less than three months) and late (more than three months) postoperative increases in intraocular pressure. We analyze the incidence and risk factors for the development of postkeratoplasty glaucoma in keratoplasties performed in our Service in the last three years. We show a significant association between postkeratoplasty glaucoma and the indication for keratoplasty, preexisting glaucoma, preexisting cataract surgery and type of surgery performed. Pseudophakic bullous keratopathy had higher risk
