scholarly journals An Eleven-Year Retrospective Study of Endogenous Bacterial Endophthalmitis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Takashi Nishida ◽  
Kyoko Ishida ◽  
Yoshiaki Niwa ◽  
Hideaki Kawakami ◽  
Kiyofumi Mochizuki ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Causative Organism ◽  
Ocular Involvement ◽  
Bacterial Endophthalmitis ◽  
Poor Visual Outcome ◽  
Ocular Symptoms ◽  
Good Visual Outcome ◽  
The Mean ◽  
Systemic Antibiotics ◽  
Endogenous Bacterial Endophthalmitis

Purpose. To determine the clinical features, microbial profiles, treatment outcomes, and prognostic factors for endogenous bacterial endophthalmitis (EBE).Methods. The medical records of 27 eyes of 21 patients diagnosed with EBE for 11 years were reviewed. Collected data included age, site of infection, visual acuities (VAs), microbial profiles, and treatment regimen.Results. The mean age was 68.5 years. Gram-positive organisms accounted for 76.2%, while gram-negative ones accounted for 19.0%.Staphylococcus aureuswas the most common causative organism (52.3%) of which 72.7% wasmethicillin-resistant S. aureus. A final VA of ≥20/40 was achieved in 44% and 20/200 or better was in 64%. Eyes with initial VA of ≥20/200 (P= 0.003) and focal involvements (P= 0.011) had significantly better final VA. Initial VA (P= 0.001) and the interval between onset of ocular symptoms and intravitreal antibiotic injection (P= 0.097) were associated with final VA in eyes receiving intravitreal antibiotics.Conclusions. EBE is generally associated with poor visual outcome; however the prognosis may depend on initial VA, extent of ocular involvement, and an interval between onset of ocular symptoms and intravitreal antibiotic injection. Early diagnosis and early intravitreal injection supplement to systemic antibiotics might lead to a relatively good visual outcome.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

scholarly journals Persistent Retinal Detachment in Retinoblastoma: The Challenges

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sophia El Hamichi ◽  
Dhariana Acon ◽  
Veronica Kon Graversen ◽  
Aaron S. Gold ◽  
Audina M. Berrocal ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Tumor Regression ◽  
Treatment Options ◽  
Local Treatment ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Age Of Diagnosis ◽  
The Mean ◽  
Ophthalmological Assessment ◽  
Complete Tumor

Introduction. Retinoblastoma (RB) is the most common eye tumor in children. There have been significant improvements in treatment options targeting killing the tumor while also conserving the eye and attempting to conserve functional vision. Retinal detachment (RD) is not an uncommon event and compromises the vision and sometimes RB treatment. Materials and Methods. Retrospective review of 62 patients over a period of 8 years between 2012 and 2019 with eyes treated for RB and having persistent RD that did not resolve after complete tumor regression. Results. Forty-two patients of these 62 cases developed RD (67%). The RD resolved in 35 patients (83% of RD), and 7 patients (16% of RD) developed a persistent RD. In all the persistent RD groups (7 patients/11 eyes), RB and RD were present simultaneously in the first ophthalmological assessment. Sex ratio was 2 females/5 males. The mean age of diagnosis was 11 months. All eyes had advanced RB stages. Eight eyes had local treatment with transpupillary laser, 6 eyes received IAC, and 3 patients received systemic chemotherapy. In 9 eyes, the RD had both exudative and tractional components. Only one eye had a pure tractional RD due to persistent fetal vasculature, and one eye had rhegmatogenous RD component with presence of a tear in addition to exudation. None of the eyes received RD surgical repair. Conclusion. Persistent RD occurs in eyes with advanced RB stages with complex RD with more than one component. The dilemma is performing a vitrectomy in eyes with cancer and poor visual outcome.

Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

2020 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Regina Lalramhluni ◽  
Soveeta Rath ◽  
Ankita Shrivastav ◽  
Prem Kumar Singh ◽  
Rahul Mayor ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Visual Outcome ◽  
Ectopia Lentis ◽  
Corrected Visual Acuity ◽  
Good Visual Outcome ◽  
Induced Astigmatism ◽  
The Mean ◽  
The Stability ◽  
Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

scholarly journals Clinical features and treatment outcomes of endogenous Klebsiella endophthalmitis: a 12-year review

2020 ◽  
Vol 13 (12) ◽  
pp. 1933-1940
Author(s):  
Chun Yue Mak ◽  
Lawrence Pui-leung Iu ◽  
Helena Pui-yee Sin ◽  
Li Jia Chen ◽  
Grace Lui ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Treatment Outcomes ◽  
Clinical Features ◽  
Visual Outcome ◽  
Ophthalmological Examination ◽  
Poor Visual Outcome ◽  
Ocular Symptoms ◽  
Clinical Records ◽  
High Index Of Suspicion

AIM: To identify the clinical features and treatment outcomes of endogenous Klebsiella pneumoniae endophthalmitis and investigate prognostic factors of poor visual outcome. METHODS: The clinical records of all patients diagnosed with endogenous Klebsiella endophthalmitis between January 2007 to December 2018 in Prince of Wales Hospital, Hong Kong, China were retrospectively reviewed. Thorough ophthalmological examination findings were recorded in the case note, including visual acuity testing, slit-lamp examination, indirect ophthalmoscopy and B-scan ultrasonography if media opacity precluded fundus viewing. RESULTS: A total of 18 eyes in 14 patients were identified. Bilateral involvement was noted in 4 patients (28.6%). Hepatobiliary sepsis was the source in 9 patients (64.3%). Culture of intraocular fluid was positive in 5 out of 18 eyes (27.8%). Mortality was noted in 2 patients (14.3%). Mean final visual acuity was 20/1500. Six out of 16 eyes had total loss of sight (37.5%) and 3 eyes required evisceration (18.8%). Multivariate linear regression revealed poor presenting visual acuity (P=0.031) and lack of fundus view due to vitritis (P=0.02) as prognostic factors of poor visual outcome. CONCLUSION: Visual outcome of endogenous Klebsiella endophthalmitis is poor. Poor presenting visual acuity and lack of fundus view predict poor visual outcome. High index of suspicion for endophthalmitis is important in Klebsiella sepsis patients with complaints of ocular symptoms. Ophthalmological screening is recommended in non-communicable patients with Klebsiella sepsis.

scholarly journals Clinical profile and outcomes of descemetopexy in descemet membrane detachment (DMD) post-cataract surgery

2021 ◽  
Vol 7 (3) ◽  
pp. 482-485
Author(s):  
Harshika Chawla ◽  
Vishal Vohra ◽  
Asif Khan ◽  
Monika Bareja
Keyword(s):  
Risk Factors ◽  
Cataract Surgery ◽  
Sulfur Hexafluoride ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Preoperative Risk Factors ◽  
Good Visual Outcome ◽  
The Mean ◽  
Final Visual Outcome ◽  
Descemet Membrane Detachment

To identify the preoperative risk factors, type of cataract surgery, cataract grade, and final visual outcome in patients undergoing descemetopexy for DMD. This was a retrospective study in which records of patients who underwent descemetopexy with either air or 20% sulfur hexafluoride (SF6) between 1st July 2014 and 30th June 2017. Grade of cataract, type of surgery, visual outcomes, and site of DMD were recorded.The mean age of the patients was 63.21 ± 5.8 years. Of the total 23 cases undergoing descemetopexy, 20 cases (87%) were after manual small incision cataract surgery (MSICS) and three cases (13%) were post phacoemulsification. The mean duration of presentation with a detachment was 13.03± 10.9 days (1-40 days). The most common types of DMD were total (34.8%) followed by temporal (30.4%) and superior (26.1%). Two patients (8.6%) obtained LOGMAR visual acuity (VA) of 0.0 and 5 of 23 patients (21.7%) achieved LOGMAR VA 0.3 after descemetopexy. Reattachment rates were 87% and three cases had reintervention. : This study identifies mature cataract and pre-existing corneal pathology as major risk factors for DMD during cataract surgery. DMD can be treated effectively and good visual outcome after successful descemetopexy.

Long-Term Visual Outcomes in Children with Primary Congenital Glaucoma

2017 ◽  
Vol 27 (6) ◽  
pp. 705-710 ◽  
Author(s):  
Sanaa A. Yassin
Keyword(s):  
Visual Impairment ◽  
Visual Outcome ◽  
Glaucoma Surgery ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Visual Outcomes ◽  
Antiglaucoma Medication ◽  
Poor Visual Outcome ◽  
The Mean

Purpose To determine the long-term visual outcomes and risk factors for visual loss in children with primary congenital glaucoma (PCG) who underwent angle surgery over a 21-year period. Methods This was a retrospective study of patients who underwent trabeculotomy, trabeculectomy, or combined trabeculotomy-trabeculectomy for PCG. Visual acuity (VA), surgeries, and underlying cause of visual impairment were recorded and compared. Main outcome measures were final best-corrected good VA (20/20 to 20/50), moderate VA (<20/50 to 20/200), or poor VA (<20/200); age at surgery, sex, laterality, type of initial glaucoma surgery, and number of surgeries were recorded. Results Fifty-three eyes were eligible to be included in the study. The mean logMAR VA was 0.61 ± 0.57. A good VA was attained in 51%, moderate VA in 30%, and poor VA in 19%. The main cause of visual impairment with VA <20/50 was deprivation amblyopia (64%). There was no association between VA level and status of success (controlled with or without medications) (p = 0.202). The mean spherical equivalent of refraction was -4.47 ± 5.66; myopia was the predominant refractive error (74%) and astigmatism >2 D (40%). A statistically significant high myopic shift was more frequent in the visually impaired group. None of the studied factors was statistically associated with moderate to poor visual outcome (all p>0.05). Conclusions A favorable VA outcome was achieved. Topical antiglaucoma medication has an adjuvant role in maintaining the success rate of surgery without risking the visual outcome. Corneal opacification and anisometropia were the cause of amblyopia.

Epidemiological Features and Prognosis of Retinoblastoma in Fars southern Iran, 2010-2018

2021 ◽  
Author(s):  
Maryam Sherafat ◽  
Alireza Salehi ◽  
Hossein Molavi Vardanjani ◽  
Masoomeh Eghtedari ◽  
Naser Owji
Keyword(s):  
Survival Rates ◽  
Interquartile Range ◽  
Time Interval ◽  
Ocular Involvement ◽  
Symptom Presentation ◽  
Ocular Symptoms ◽  
Epidemiological Features ◽  
Tumor Stages ◽  
The Mean ◽  
Southwestern Iran

Background: Retinoblastoma (RB) is the most common intraocular malignancy in childhood. The aim of this study was to investigate the epidemiological features and survival rates of patients with RB in southwestern Iran. Materials and Methods: This retrospective study was conducted on patients with RB referred to the only referral center of southwestern Iran from 2010 to 2018. Demographic characteristics at first symptom presentation, the time interval between the symptom presenting and the treatment, educational level, socioeconomic status, type of ocular symptoms, extra-ocular involvement, types of treatments, outcomes and follow-up, the treatment interval until death and the survival rate of the patient, and pathology reports were recorded and analyzed. Results: This study included 46 new patients with RB (25 boys and 21 girls) including 65.2% unilateral, 26.1% bilateral, and 8.7% trilateral involvements. The mean age at first symptom presentation was 18.98±16.16 months. The mean delay time was 2.48 (Interquartile range: 5.16) for boys and 3.02 (Interquartile range: 5.37) for girls (P = 0.265); death rate was significantly different for boys and girls (12.0 % versus 430%; P = 0.039). E-nucleation was done in 95.3% of cases. In 29% of patients the tumor was well-differentiated, and about 64.5% of the cases were pathologically graded at pathological tumor stages 3 or 4. At the time of the study, 54.3% of the patients were alive.  The mean survival time was 44.0 months. Conclusion: Almost all cases were diagnosed in the advanced stages of the disease in Southwestern Iran. The disease is not preventable but early diagnosis improves the prognosis so we recommend that an eye examination at birth and designing and implementing prevention programs through parenting and child care personnel be performed in order to pay attention to early symptoms of the condition and in the absence of symptoms, screening should be done every six months.

scholarly journals Clinical Features and Surgical Outcomes of Posterior Segment Intraocular Foreign Bodies in Children in East China

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Ting Zhang ◽  
Hong Zhuang ◽  
Keyan Wang ◽  
Gezhi Xu
Keyword(s):  
Clinical Features ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Poor Visual Outcome ◽  
Long Term Follow Up ◽  
The Mean

Purpose. To report the long-term follow-up results of posterior segment intraocular foreign body (IOFB) removal in children and to determine the prognostic factors for visual outcome. Methods. Design: retrospective, noncomparative, interventional case series; a single tertiary care center study. Participants or samples: eleven eyes (11 patients) under 16 years of age with posterior segment IOFB injuries from May 2014 to November 2017. Main outcome measures: clinical features of injury, visual acuity, and complications. Results. The mean age was 6.8 years, and the mean follow-up was 20.2 months. The main IOFB sources were accidental penetration of the eye by materials in the playground (6 cases) or by pencil lead at school (4 cases). The mean IOFB size was 3.8 (range 1–6) mm. At the last visit, the visual acuities were 20/40 or better in 40.0% of patients and better than 20/200 in 70.0%. Poor visual outcome was correlated with intraoperative rhegmatogenous retinal detachment (P=0.0083). Postoperative complications included elevated transient intraocular pressure, retinal redetachment, and secondary glaucoma. Conclusions. The clinical features of pediatric posterior segment IOFBs suggest insufficient awareness of such injuries both on the playground and at school. Visual outcomes from surgical treatment were relatively favorable in this series.

scholarly journals Outcomes of Late-Onset Bleb-Related Endophthalmitis Treated with Pars Plana Vitrectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Kazuyoshi Ohtomo ◽  
Chihiro Mayama ◽  
Takashi Ueta ◽  
Miyuki Nagahara
Keyword(s):  
Pars Plana Vitrectomy ◽  
Pathogenic Bacteria ◽  
Late Onset ◽  
Influence Factors ◽  
Visual Outcome ◽  
Careful Consideration ◽  
Visual Prognosis ◽  
Poor Visual Outcome ◽  
Pars Plana ◽  
The Mean

Purpose. To investigate clinical results on bleb-related endophthalmitis (BRE) after trabeculectomy treated with pars plana vitrectomy (PPV) and to evaluate influence factors for visual prognosis. Methods. Investigating medical records retrospectively, BRE was defined as an endophthalmitis induced by bleb infection. A total of 2018 eyes of 1225 patients who had trabeculectomy between December 2000 and July 2013 were included in this study. Eleven eyes of 11 patients with BRE were performed with PPV. Results. The mean age was 56.6 years. The mean period between trabeculectomy and BRE onset was 7.4 years. The mean period from starting symptom to initiation of treatment for endophthalmitis (PSITE) was 2.3 days. Bleb leakages were observed in 7 eyes (64%). On culture examinations, highly pathogenic bacteria (HPB) were identified in 6 cases (55%). HPB infection was influence factors on visual disturbance (P=.0337). Number of HPB infections is significantly higher in poor visual outcome than without poor visual outcome (P=.0310). Conclusion. Visual prognosis of BRE treated by PPV is significantly better when the pathogenic bacteria are not HPB. Severe visual loss occurred with HPB infection even though patients had appropriate treatments. Physicians need to have careful consideration to prevent bleb infection after trabeculectomy with MMC.

scholarly journals Clear Corneal Phacovitrectomy with Posterior Capsulorhexis and IOL Implantation in Management of Selective Vitreoretinal Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Ernest V. Boiko ◽  
Sergey V. Churashov ◽  
Alexei N. Kulikov ◽  
Dmitrii S. Maltsev
Keyword(s):  
Case Series ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Anterior Capsule ◽  
Epiretinal Membranes ◽  
Good Visual Outcome ◽  
The Mean ◽  
Capsular Bag ◽  
Anterior Proliferative Vitreoretinopathy

Purpose. To describe our technique, clear corneal phacovitrectomy with posterior capsulorhexis (CCPV), for the management of selected posterior segment intraocular foreign body (IOFB), posteriorly dislocated lens fragments (PDLF), and proliferative diabetic retinopathy (PDR) cases.Methods. This was a single-center retrospective interventional case series. In 21 patients (21 eyes) we performed phacovitrectomy through three clear corneal tunnel incisions (CCTI) and posterior capsulorhexis to remove IOFB (n=8), PDLF from the vitreous cavity after complicated phacoemulsification (n=6), and vitreous hemorrhage and epiretinal membranes in PDR (n=7). The procedure was completed with implantation of a hydrophobic acrylic IOL through the CCTI.Results. The mean visual acuity (logMAR) was 0.90 preoperative and improved to 0.26 over a mean follow-up of 8.7 months (range, 6–12 months). The intraocular lens was implanted into the capsular bag (n=12) or onto the anterior capsule (n=9). One PDR patient experienced an intraprocedural complication, hemorrhage from isolated fibrovascular adhesions. One IOFB patient developed apparent anterior proliferative vitreoretinopathy and required a repeat intervention.Conclusion. Selected vitreoretinal IOFB, PDLF, and PDR cases can be successfully managed by a combined surgical approach involving clear corneal phacovitrectomy with posterior capsulorhexis and implantation of an IOL, with good visual outcome and a low complication rate.

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