Dexamethasone diffusion across contact lenses is inhibited by Staphylococcus epidermidis biofilms in vitro.

PURPOSE: This study was designed to measure the impact of bacterial biofilms on diffusion of an ocular therapeutic through silicone hydrogel bandage lenses in vitro. METHODS: An assay was designed to study the passage of a commonly used steroid, dexamethasone, through silicone hydrogel soft contact lenses. Diffused dexamethasone was measured using a spectrophotometer over a period of 18 hours and quantified using a standard curve. This assay was performed with control and Staphylococcus epidermidis biofilm-coated contact lenses comprised of lotrafilcon A and methafilcon. Biofilms were formed in brain heart infusion broth supplemented with D-glucose. RESULTS: The presented data validate a simple in vitro model that can be used to measure the penetration of a topical therapeutic through silicone hydrogel soft contact lenses. Using this model, we measured a reduction in dexamethasone diffusion up to 88% through S. epidermidis biofilm-coated silicone hydrogel lenses compared with control lenses. CONCLUSIONS: The results of this in vitro study demonstrate that bacterial biofilms impede dexamethasone diffusion through silicone hydrogel contact lenses and warrant future studies regarding the clinical benefit of using ocular therapeutics in the setting of bandage contact lens use for corneal epithelial defects.

Clinical Tests of Ultra-Low Vision Used to Evaluate Rudimentary Visual Perceptions Enabled by the BrainPort Vision Device.

PURPOSE: We evaluated whether existing ultra-low vision tests are suitable for measuring outcomes using sensory substitution. The BrainPort is a vision assist device coupling a live video feed with an electrotactile tongue display, allowing a user to gain information about their surroundings. METHODS: We enrolled 30 adult subjects (age range 22-74) divided into two groups. Our blind group included 24 subjects (n = 16 males and n = 8 females, average age 50) with light perception or worse vision. Our control group consisted of six subjects (n = 3 males, n = 3 females, average age 43) with healthy ocular status. All subjects performed 11 computer-based psychophysical tests from three programs: Basic Assessment of Light Motion, Basic Assessment of Grating Acuity, and the Freiburg Vision Test as well as a modified Tangent Screen. Assessments were performed at baseline and again using the BrainPort after 15 hours of training. RESULTS: Most tests could be used with the BrainPort. Mean success scores increased for all of our tests except contrast sensitivity. Increases were statistically significant for tests of light perception (8.27 ± 3.95 SE), time resolution (61.4% ± 3.14 SE), light localization (44.57% ± 3.58 SE), grating orientation (70.27% ± 4.64 SE), and white Tumbling E on a black background (2.49 logMAR ± 0.39 SE). Motion tests were limited by BrainPort resolution. CONCLUSIONS: Tactile-based sensory substitution devices are amenable to psychophysical assessments of vision, even though traditional visual pathways are circumvented. TRANSLATIONAL RELEVANCE: This study is one of many that will need to be undertaken to achieve a common outcomes infrastructure for the field of artificial vision.

Ciguatera fish poisoning and sea surface temperatures in the Caribbean Sea and the West Indies.

Ciguatera fish poisoning (CFP) is a circumtropical disease caused by ingestion of a variety of reef fish that bioaccumulate algal toxins. Distribution and abundance of the organisms that produce these toxins, chiefly dinoflagellates of the genus Gambierdiscus, are reported to correlate positively with water temperature. Consequently, there is growing concern that increasing temperatures associated with climate change could increase the incidence of CFP. This concern prompted experiments on the growth rates of six Gambierdiscus species at temperatures between 18 degrees C and 33 degrees C and the examination of sea surface temperatures in the Caribbean and West Indies for areas that could sustain rapid Gambierdiscus growth rates year-round. The thermal optimum for five of six Gambierdiscus species tested was >/=29 degrees C. Long-term SST data from the southern Gulf of Mexico indicate the number of days with sea surface temperatures >/=29 degrees C has nearly doubled (44 to 86) in the last three decades. To determine how the sea surface temperatures and Gambierdiscus growth data correlate with CFP incidences in the Caribbean, a literature review and a uniform, region-wide survey (1996-2006) of CFP cases were conducted. The highest CFP incidence rates were in the eastern Caribbean where water temperatures are warmest and least variable.