Diagnosis of fungal keratitis caused by Nectria haematococca through next-generation sequencing: review of literature and report of three cases.

OBJECTIVES: Fungal keratitis (FK) is a kind of serious corneal infection and penetrating keratoplasty (PKP) is needed when medical therapy fails. Although Nectria haematococca is found as endophytes in the roots of some plant species, there has been no report of N. haematococca infection in human. METHODS: We reviewed 46 patients who underwent PKP due to FK in our hospital from July 2021 to December 2021, and there were three patients who had relapsed. The next-generation sequencing revealed that all three corneas were infected with N. haematococca. RESULTS: Based on the ocular manifestation and treatment course of three cases, we summarize the characteristics of N. haematococca FK: the scope of corneal infection was widespread with severe hypopyon. The effect of local use of fluconazole and voriconazole was not ideal, and PKP was the main treatment. Even after a large-scale corneal lesion resection, the lesion may recur. The recurrence occurred primarily in the second week after PKP. CONCLUSION: This is the first clinical report of N. haematococca infection in humans. Compared with the other currently known FK caused by the Fusarium solani species complex, N. haematococca keratitis is more severe and more likely to recur.

The anterior scleral thickness in eyes with primary open-angle glaucoma.

PURPOSE: To investigate the anterior scleral thickness (AST) and its associations with Schlemm's canal (SC) area, trabecular meshwork (TM) thickness and length, and scleral spur (SS) length in healthy and primary open-angle glaucoma (POAG) groups. METHODS: Thirty-five eyes of 35 healthy subjects and 23 eyes of 23 patients with POAG were included. The AST, SC area, TM thickness and length, and SS length were measured using swept-source optical coherence tomography. AST was measured at 0 mm (AST0), 1 mm (AST1), 2 mm (AST2), and 3 mm (AST3) from SS. Associations between AST and SC area, TM thickness and length, and SS length were also estimated. RESULTS: AST0 (728.84 ± 99.33 vs. 657.39 ± 67.02 µm, p < 0.001), AST1 (537.79 ± 79.55 vs. 506.83 ± 57.37 µm, p = 0.038), AST3 (571.09 ± 79.15 vs. 532.13 ± 59.84 µm, p = 0.009), SC area (6304.26 ± 1238.72 vs. 4755.64 ± 1122.71 µm2, p < 0.001), TM thickness (107.21 ± 31.26 vs. 94.51 ± 24.18 µm, p = 0.035), TM length (736.20 ± 141.85 vs. 656.43 ± 127.03 µm, p = 0.004), and SS length (219.89 ± 50.29 vs. 174.54 ± 35.58 µm, p < 0.001) were significantly greater in healthy group than in POAG group. In addition, SC area, TM thickness, and SS length were significantly and positively associated with AST0 in the healthy group, whereas no similar associations were observed in the POAG group. CONCLUSIONS: Compared with the healthy group, AST was significantly thinner in the POAG group, which also had smaller SC and TM dimensions. Moreover, the SC area, TM thickness, and SS length were significantly and positively associated with AST in the healthy group. Thus, AST might play an important role in maintaining TM and SC morphology and further in the pathogenesis of POAG.

Morphology of the Trabecular Meshwork and Schlemm's Canal in Posner-Schlossman Syndrome.

Purpose: The purpose of this study was to investigate trabecular meshwork (TM) and Schlemm's canal (SC) morphology in Posner-Schlossman syndrome (PSS). Methods: Forty-five patients with PSS were recruited. TM thickness and length as well as SC area and diameter of both affected and fellow eyes were assessed using swept-source optical coherence tomography. Results: TM thickness (108.24 ± 28.29 µm vs. 89.36 ± 25.82 µm, P = 0.014), SC area (6010.90 ± 1287.54 µm2 vs. 5445.69 ± 1368.89 µm2, P = 0.003), and SC diameter (239.38 ± 60.17 µm vs. 217.76 ± 60.79 µm, P = 0.010) were significantly greater in the affected eyes. Furthermore, TM thickness (113.32 ± 30.03 µm vs. 89.00 ± 26.99 µm, P = 0.046), SC area (6216.32 ± 1267.87 µm2 vs. 5476.40 ± 1390.15 µm2, P = 0.001), and SC diameter (246.82 ± 64.12 vs. 212.53 ± 64.29 µm, P = 0.001) were significantly greater in the affected eyes than in the fellow eyes in the ocular hypertension (OHT) subgroup (affected eye with intraocular pressure [IOP] > 21 mm Hg). However, those differences were not noted in the ocular normal tension (ONT) subgroup (affected eye with IOP ≤ 21 mm Hg, all P > 0.05). Conclusions: TM edema might play a role in the IOP elevation in PSS. The edematous TM could make controlling IOP of the affected eyes difficult. When TM edema is relieved, IOP of the affected eyes can reduce to normal spontaneously or with IOP-lowing medications.

Multiple layers lens capsule true exfoliation in patient with primary angle closure glaucoma.

INTRODUCTION: True exfoliation of lens capsule is a relatively rare disorder that has a thin, fluttering membrane in the anterior chamber, mainly located in the pupil area, which is believed to have split from the anterior lens capsule. CASE REPORT: The authors present here a patient with true exfoliation and primary angle closure glaucoma in both eyes, the ultrastructure of one eye revealed that the delaminated membrane was composed of more than two layers in itself. CONCLUSION: Lens capsule true exfoliation could happen in patient with primary angle closure glaucoma, with more than two layers in itself.

Ultramicrostructure and clinical implications of satellite foci in front of the head of pterygium.

In our previous studies, grey satellite foci were found in the front of heads of pterygia. This research was designed to investigate the ultramicrostructure and clinical implications of these satellite foci. The satellite foci were observed and counted under slit lamp biomicroscope. The patients with eye pterygia were divided into groups in terms of occupation, sex, age, length of history, grade of congestion, and size of the heads. The SPSS 13.0 software was used for statistical analysis. The cap areas and satellite foci were ultramicrostructurally examined. Among the total 62 eyes with pterygium, satellite foci were found in 34. The overall incidence of satellite foci was 54.8%. There were no significant differences in incidence among the subjects of different sex, age, and length of history. There were significant differences in incidence among the patients of different occupation, grades of congestion, and size of heads. Higher grades of congestion, outdoor occupations and larger pterygium heads were associated with higher incidence of satellite foci. High grades of congestion and bigger heads were also correlated with the number of satellite foci. Length of history bore no correlation with number of satellite foci. Histologically, the components of the cap areas and the foci were identical, with both consisting of mass of active fibroblasts. The activated fibroblasts existed in the natural tissue planes between Bowman's layer and basal cell layer. The fibroblasts in the satellite foci and the cap areas of a pterygium show some features of tumor cells and may play a vital role in the development and progression of a pterygium. The presence and amount of satellite foci around a pterygium can be used as an indicator for the speed of its growth.

[Effect of interleukin-1alpha on the phagocytic function in cultured human trabecular meshwork cells].

OBJECTIVE: To investigate the effect of interleukin-1alpha (IL-1alpha) on the phagocytic function in cultured human trabecular meshwork (HTM) cells. METHODS: HTM Cells were cultured and subcultured in vitro. The third to fifth passage of HTM cells were treated with different concentrations of IL-1alpha or vehicle in DMEM/F12 medium. 1000 of 0.85 microm microsphere/per cell were added to each well. The morphological changes of HTM cells were observed by an inverted phase-contrast microscope and electron microscope. The cellular phagocytic function of HTM cells was evaluated by counting the numbers of microsphere in 20 HTM cells using a light microscope. RESULTS: The break of HTM cell membrane was found under the electron microscope. The numbers of microsphere in HTM cells was significantly (P = 0.005) reduced in a dose- and incubation time-dependent manner (F = 3.603, P = 0.046, F = 15.846, P = 0.005, respectively). CONCLUSIONS: IL-1alpha affects the phagocytic function of HTM cells that is correlated to the concentration and the incubation time.