Bloodborne viral infections: Seroprevalence and relevance of preoperative screening in Indian eye care system - A retrospective study.

PURPOSE: To report the seroprevalence of bloodborne viral infection (BBVI) in patients undergoing ophthalmic surgeries and assess the utility and feasibility of preoperative screening for BBVI in India's current eye care system. METHODS: This retrospective, hospital-based, descriptive study included data from patients undergoing preoperative screening for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) at a tertiary eye care institute from 2018 to 2022. Rapid diagnostic tests (RDTs) were performed on the blood samples after obtaining informed consent from the patients. Seroreactive patients underwent surgery with additional safety precautions. The demographic data and surgical details of these patients were collected and analyzed. ANOVA was used to carry out statistical analysis between groups. During the study period, the number of healthcare workers (HCWs) sustaining needle stick injury (NSI) and accidental sharp injury (ASI) in the operating theater (OT) and details of these injuries were recorded. RESULTS: Samples from 28,563 patients were included. The seroprevalence of BBVI was 1.87% (536/28563). Hepatitis B virus (322, 60.1%) was the most commonly detected infection, and HIV (59, 11%) was the least detected infection. The mean age of the seroreactive patients was 60.3 ± 30.8 years. The incidence of NSI was 0.49/1000 surgeries. Nurses (11) and technicians (4) in the OT sustained maximum NSI. None of the HCWs had seroconversion after NSI. CONCLUSION: The overall seroprevalence of BBVI in the current study is lower than that reported in previously published studies from eye care organizations. Currently, mandatory preoperative screening for BBVI to prevent transmission of these infections to HCWs working in the eye care sector in India appears to be less cost-effective.

Fluoroquinolone resistance in bacterial isolates from ocular infections: Trend in antibiotic susceptibility patterns between 2005-2020.

Purpose: To assess the fluoroquinolone resistance pattern and trends among bacterial isolates from ocular infections over a 16-year period and explore alternative antibiotics in fluoroquinolone-resistant strains. Methods: In this retrospective, longitudinal study, the microbiology laboratory records of patients with different ocular infections diagnosed at an eye institute in central India from 2005-2020 were reviewed to determine the pattern of fluoroquinolone (ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin) resistance. Antibiotic susceptibility testing was done using the Kirby-Bauer disc diffusion method. Results: In 725 Gram-positive bacteria, the resistance of ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin was 55.9% (95% confidence interval [CI]: 52.2 - 59.6), 42.7% (95% CI: 39.0 - 46.4), 47.6% (95% CI: 43.9 - 51.3), and 45.6% (95% CI: 41.7-49.5), respectively. In 266 Gram-negative bacteria, the resistance of ciprofloxacin, ofloxacin, gatifloxacin, and moxifloxacin was 57.9% (95% CI: 51.9 - 63.9), 56.0% (95% CI: 49.7 - 62.1), 59.9% (95% CI: 53.8 - 66.0), and 74.3% (95% CI: 68.3 - 80.2), respectively. A declining trend in resistance to ciprofloxacin (P < 0.001), ofloxacin (P < 0.001), and moxifloxacin (P < 0.001) was seen in Gram-positive bacteria, whereas a reduction in resistance to only moxifloxacin (P = 0.04) was seen in Gram-negative bacteria. In fluoroquinolone-resistant Gram-positive bacteria, cefuroxime exhibited the highest susceptibility, whereas in fluoroquinolone-resistant Gram-negative bacteria, colistin exhibited the highest susceptibility. Conclusion: Fluoroquinolone resistance was high among bacteria from ocular infections in central India, but a declining trend in resistance to some of the fluoroquinolones was observed in recent times. Cefuroxime and colistin emerged as alternatives in fluoroquinolone-resistant Gram-positive and Gram-negative bacterial infections, respectively.

Retinopathy of Prematurity: How to Prevent the Third Epidemics in Developing Countries.

Retinopathy of prematurity (ROP) is vasoproliferative disease affecting preterm infants and is a leading cause of avoidable childhood blindness worldwide. The world is currently experiencing the third epidemic of ROP, where majority of the cases are from middle-income countries. Over 40% of the world's premature infants were born in India, China, Bangladesh, Pakistan, and Indonesia. Together with other neighboring nations, this region has unique challenges in ROP management. Key aspects of the challenges including heavier and more mature infants developing severe ROP. Current strategies include adoption of national screening guidelines, telemedicine, integrating vision rehabilitation and software innovations in the form of artificial intelligence. This review overviews some of these aspects.

Successful treatment of aggressive posterior retinopathy of prematurity with diode laser in ocular albinism: A case report.

Oculocutaneous albinism is characterized by partial or complete absence of melanin in retinal pigment epithelium (RPE) and uveal melanocytes. Absence of typical fundal background from RPE and choroid makes it difficult to diagnose retinal disorders in ocular albinism. Lack of melanin in RPE makes the laser photocoagulation very challenging in these cases. This report presents a unique case of preterm infant of oculocutaneous albinism diagnosed as aggressive posterior retinopathy of prematurity (APROP), which was successfully treated with diode laser photocoagulation. The parameters of the laser used in this case were higher than usual, just enough to achieve blanching of retina. This report highlights the fact that the diagnosis of APROP and its treatment with laser is challenging in the presence of oculocutaneous albinism, but it is possible to achieve complete regression using diode laser at higher parameters.

Pars Plana Vitrectomy With in Vivo Cyst Lysis for Intraocular Cysticercosis.

BACKGROUND AND OBJECTIVE: To evaluate efficacy and safety of pars plana vitrectomy (PPV) and in vivo cyst lysis for intraocular cysticercosis. PATIENTS AND METHODS: Retrospective analysis of the records of 15 patients undergoing PPV for intraocular cysticercosis at a tertiary eye care center was done. All patients had undergone in vivo cyst lysis. Of these 15 patients, one had intravitreal cysticercosis (IVC) with vitritis, two cases had IVC with vitritis with tractional retinal detachment (TRD), four cases had subretinal cysticercosis (SRC), four cases had SRC with extensive fibrosis without TRD, and five cases had SRC with fibrosis with TRD. Postoperative visual acuity at 3 months of follow-up was analyzed as the primary outcome measure. RESULTS: Mean age of patients was 26 years ± 12.27 years. Four out of 15 patients were female. Mean preoperative best-corrected visual acuity (BCVA) was 1.55 logMAR units ± 0.62 logMAR units, whereas mean postoperative BCVA at last follow-up (3 months) was 1.26 logMAR units ± 0.65 log-MAR units. Mean visual gain (0.29 logMAR units) post-surgery was statistically significant (P = .018). The final visual acuity correlated with preoperative BCVA with Pearson's coefficient being 0.78 (95% CI, 0.44-0.92; P = .001). Anatomical success was achieved in 13 of 15 (87%) cases. In one case the cyst was dead and calcified and could not be removed. TRD was associated with poor visual gain. CONCLUSION: Intravitreal cyst lysis is a safe and successful approach for managing intraocular cysticercosis. Visual results depend on preoperative condition. TRD implicates poor visual prognoses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:665-669.].