scholarly journals Complicated corneal ulceration in cats: diagnosis and treatment outcomes of 80 cases (2014-2018)

2021 ◽  
Vol 72 (3) ◽  
pp. 3041
Author(s):  
KM ALI ◽  
AA MOSTAFA ◽  
S SOLIMAN
Keyword(s):  
Corneal Ulcer ◽  
Endoscopic Examination ◽  
Etiologic Factor ◽  
Corneal Ulceration ◽  
Short Term ◽  
Surgical Interventions ◽  
Corneal Scarring ◽  
Corneal Ulcers ◽  
Superficial Ulcer ◽  
Peripheral Iridectomy

The study describes the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats and evaluates the short-term outcomes after surgical interventions. Eighty client-owned cats of different breeds with corneal ulcers were included. Cats were clinically evaluated to initially determine corneal abnormalities. Endoscopic examination of the corneas was performed to determine anterior and posterior segments’ abnormalities. Non-healing superficial ulcer was treated by superficial keratectomy and deep stromal ulcers were treated using conjunctival flaps. Corneal sequestrum were treated by partial keratectomies and conjunctival flaps. Anterior synechiae were treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon were treated by removal of the adhered conjunctival membrane from the cornea. Unresponsive endophthalmitis was treated surgically by exenteration. Outcomes after surgical managements of selected corneal abnormalities were assessed clinically and endoscopically. Non-healing superficial ulcer, deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechiae with secondary glaucoma and corneal scarring were the recorded complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechiae, and corneal sequestration. Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats was noticed.

scholarly journals A Prospective Study of Corneal Ulcers and Their Microbiological Profile among Patients in a Government Hospital in Ajmer, Rajasthan

2021 ◽  
Vol 8 (13) ◽  
pp. 790-795
Author(s):  
Prateek Jain ◽  
Sushma Kumari Singhal ◽  
Pankaj Sharma ◽  
Kalika Gupta
Keyword(s):  
Prospective Study ◽  
Corneal Ulcer ◽  
Bacterial Species ◽  
Specific Treatment ◽  
Corneal Ulceration ◽  
Predisposing Factor ◽  
Ocular Surgery ◽  
Corneal Ulcers ◽  
A Prospective Study

BACKGROUND Significant causes of corneal blindness worldwide are ocular trauma and corneal ulceration that are often under reported. They may be responsible for 1.5 - 2.0 million new cases of monocular blindness every year. Corneal ulceration in developing countries has only recently been recognised as a silent epidemic. Infectious keratitis is one of the leading causes of blindness but in most cases these infections represent preventable or treatable ophthalmic diseases. Important predisposing factors related to corneal ulcers are trauma, chronic ocular surface disease, contact lens usage, ocular surgery, corneal anaesthetics abuse, diabetes mellitus, vitamin deficiency and immuno-deficiencies. This work is proposed to study the prevalence, clinical and lab diagnosis and management of suppurative corneal ulcer. We wanted to study the socio-demographic profile, microbiological investigation and treatment outcome of patients with corneal ulcer. METHODS This is a prospective study conducted among patients presenting with corneal ulcer at a tertiary level Government Medical College, Ajmer, Rajasthan. RESULTS Trauma comes out as a major predisposing factor for the development of corneal ulcer. 18.1 % of the study subjects had bacterial corneal ulcer and 37.7 % had fungal ulcer. More than half of the patients showed good prognosis on follow up. There was good response in most of patients, 51.2 % improved in first week which increased to 57.4 % at the time of second follow up. The most common bacterial species responsible for corneal ulcer was found to be staphylococcus followed by pseudomonas. CONCLUSIONS Bacteria and fungi are a frequent cause of ulcerative keratitis. Microbiological work up is an essential tool in the diagnosis of these infections which should not be under-rated. Timely administration of species-specific treatment certainly results in early resolution of keratitis followed by satisfactory visual outcome. Late or inappropriate treatment worsens the condition resulting in corneal perforation and increased morbidity. KEYWORDS Prospective, Corneal Ulcer, Bacterial, Fungal, Infectious

scholarly journals A Study on Microbial Profile of Corneal Ulcer Cases in a Tertiary Health Care Centre of Southern Assam

2021 ◽  
Vol 8 (7) ◽  
pp. 228-235
Author(s):  
Barnamoy Bhattacharjee ◽  
Atanu Chakravarty
Keyword(s):  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Agricultural Practice ◽  
Care Hospital ◽  
Corneal Ulceration ◽  
Penicillium Species ◽  
Direct Microscopy ◽  
Corneal Ulcers ◽  
Microbial Profile

Background-Visual impairment due to corneal ulceration has for long been acknowledged as leading cause of blindness both worldwide and in India only next to Cataract. The aetiology for infective corneal ulcer varies considerably with occupation of patients in different regions of India. Thus, continuing with empirical management without lab diagnosis leads to protracted clinical course. So, understanding the microbial profile of corneal ulcers in agriculture dependent population of Southern Assam helps in improved management of this morbidity. Aims- To 1) Find the prevalence of infected corneal ulcers in untreated patients attending Ophthalmology department of a tertiary care hospital of Southern Assam. 2) Study the pattern of microbial aetiology in the infected corneal ulcer cases. 3) Find the association of infected corneal ulcers with various attributing factors. Method-Corneal scrapings from 86 routine untreated cases of corneal ulceration from Ophthalmology Department were studied prospectively from Dec2017 to Jan2019 and subjected to Gram staining and direct examination with 10%KOH. Culture on SDA and Blood Agar were incubated at 25°C and 37°C respectively and followed up for 3 weeks before declaring sterile. Antimicrobial sensitivity was performed for bacterial isolate and yeast-like species. Slide culture and LPCB tease mount were done for identification of moulds. Result- Out of the 86 cases, 58 were positive in direct microscopy, of which 44 were culture positive. Of the 28 samples negative in direct microscopy, 2 were positive by Culture. Bacterial isolates were found in 5 cases and fungal aetiology in 41 cases. Conclusion- The prevalence of infected corneal ulcer as per standard of Culture positivity is 53.5% (46/86). Mycotic involvement was found in 90% cases. Important fungal isolates identified were Aspergillus species, Penicillium species, Curvularia species, Fusarium species, Sarocladium species. Higher prevalence was significantly associated with harvesting season, agricultural practice and history of trauma while diabetes and steroid intake were not significantly associated with mycotic ulcers. Keywords: Corneal ulcer, Assam, Fungal, Fusarium, Sarocladium, Pseudomonas.

scholarly journals Use of Plasma Rich in Growth Factors and ReGeneraTing Agent Matrix for the Treatment of Corneal Diseases

Vision ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
Ronald M. Sánchez-Ávila ◽  
Edmar Uribe-Badillo ◽  
Carlos Fernández-Vega González ◽  
Francisco Muruzabal ◽  
Borja de la Sen-Corcuera ◽  
...  
Keyword(s):  
Growth Factors ◽  
Corneal Ulcer ◽  
Disease Index ◽  
Eye Drops ◽  
Analog Scale ◽  
Ocular Surface Disease Index ◽  
Corneal Ulcers ◽  
Corrected Visual Acuity ◽  
The Mean

This study aimed to investigate the use of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers. RGTA treatment was applied (one drop every two days); however, if ulcer closure was not achieved, PRGF eye drops treatment was added (four times/day). The time taken to reach the ulcer closure, the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in terms of frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. Seventy-four patients (79 eyes) were included, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder (n = 27, 34.2%), mainly for herpes virus (n = 15, 19.0%). The time of PRGF eye drops treatment associated with the RGTA matrix was 4.2 ± 2.2 (1.5–9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved from the baseline (p < 0.001), and IOP remained unchanged (p = 0.665). RGTA and PRGF in noninfectious ulcers were effective and could be a therapeutic alternative for this type of corneal disease.

scholarly journals Loss of FOXC1 contributes to the corneal epithelial fate switch and pathogenesis

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Mingsen Li ◽  
Liqiong Zhu ◽  
Jiafeng Liu ◽  
Huaxing Huang ◽  
Huizhen Guo ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Corneal Epithelium ◽  
Corneal Ulcer ◽  
Corneal Epithelial ◽  
Ocular Development ◽  
Rieger Syndrome ◽  
Corneal Ulcers ◽  
Epithelial Homeostasis ◽  
Forkhead Box ◽  
Interferon Regulatory Factor 1

AbstractForkhead box C1 (FOXC1) is required for neural crest and ocular development, and mutations in FOXC1 lead to inherited Axenfeld–Rieger syndrome. Here, we find that FOXC1 and paired box 6 (PAX6) are co-expressed in the human limbus and central corneal epithelium. Deficiency of FOXC1 and alternation in epithelial features occur in patients with corneal ulcers. FOXC1 governs the fate of the corneal epithelium by directly binding to lineage-specific open promoters or enhancers marked by H3K4me2. FOXC1 depletion not only activates the keratinization pathway and reprograms corneal epithelial cells into skin-like epithelial cells, but also disrupts the collagen metabolic process and interferon signaling pathways. Loss of interferon regulatory factor 1 and PAX6 induced by FOXC1 dysfunction is linked to the corneal ulcer. Collectively, our results reveal a FOXC1-mediated regulatory network responsible for corneal epithelial homeostasis and provide a potential therapeutic target for corneal ulcer.

scholarly journals Various factors affecting the bacterial corneal ulcer healing: a 4-years study in referral tertiary eye hospital in Indonesia

2015 ◽  
Vol 24 (3) ◽  
pp. 150-5 ◽  
Author(s):  
Muhammad Asroruddin ◽  
Rina L.D. Nora ◽  
Lukman Edwar ◽  
Soedarman Sjamsoe ◽  
Made Susiyanti
Keyword(s):  
Corneal Ulcer ◽  
Ocular Trauma ◽  
Antibiotic Sensitivity ◽  
Pseudomonas Sp ◽  
Chi Square ◽  
Factors Affecting ◽  
Corneal Ulcers ◽  
Time Required ◽  
Mean Time ◽  
Epithelial Healing

Background: Corneal ulcer is one of the most common causes of visual acuity impairment and blindness all over the world. The aim of the study was to evaluate various factors affecting the bacterial corneal ulcers healing, including the predisposing factors, causative organisms, antibiotic sensitivity, as well as the treatment outcomes.Methods: All data were taken retrospectively from medical records of patients who underwent corneal scraping for Gram examination and/or culture over a-4-year period (2008-2011) at the Cipto Mangunkusumo Hospital Jakarta. Treatment outcome were analyzed using Chi-square test, one-way ANOVA, and post-hoc analysis. Mean time required for complete epithelial healing was also investigated.Results: 220 cases of bacterial corneal ulcers in 216 patients were included. The most common risk factors were ocular trauma (45.8%). Gram-positive coccus were found in 65.7% cases other than other microbes. Pseudomonas sp. (25,0%) and Staphylococcus epidermidis (18.4%) were the most common isolates, sensitive to almost all kinds of antibiotics. About 83.0% (106 cases) were improved with antibiotics only, the rest were not improved and worsened. Mean time for complete epithelial healing was 17.5 ± 8.9 days with mild ulcer had the most rapid recovery. Eyes treated with fluoroquinolone eyedrops were healed in 14 days, faster than other regiments.Conclusion: Ocular trauma was the most common risk factor for corneal ulcer, and the most commonly isolated organism was Pseudomonas sp. Most cases were improved with antibiotics, and fluoroquinolone showed faster healing. Complete epithelial healing occurred in about 17.5 days.

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

scholarly journals Clinical Aspects of Bacterial Corneal Ulcer Prolonged Course, the Role of Herpes Viruses in Its Pathogenesis, Treatment

2019 ◽  
Vol 16 (1S) ◽  
pp. 40-44
Author(s):  
V. V. Neroev ◽  
L. A. Katargina ◽  
L. A. Kovaleva ◽  
G. I. Krichevskaya ◽  
N. V. Balatskaya
Keyword(s):  
Corneal Ulcer ◽  
Human Herpesvirus ◽  
Clinical Aspects ◽  
Herpesvirus Type ◽  
Corneal Ulcers ◽  
Barr Virus ◽  
Human Herpesvirus Type ◽  
Epstein Barr ◽  
Simplex Virus

Purpose: to study the role of human herpesviruses (HHV) in the pathogenesis of prolonged bacterial corneal ulcers. Patients and methods. 117 patients with bacterial corneal ulcer were examined. Two groups were identified: a favorable course-with duration of bacterial corneal ulcer epithelialization for 17 days (62 people) and a prolonged course with a persistent ulcer more than 17 days (55 people). Blood samples (n = 117) and scrapes from corneal ulcer (n = 117) were investigated in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Herpes simplex virus (HSV1, 2), Epstein-Barr virus (EBV), Human herpesvirus type 6, 7 (HHV-6, HSV-7). Results. The HSV1, 2 and EBV genomes were detected in the cornea significantly more often in BCU of prolonged course compared with a favorable course (HSV1, 2 p = 0.012; EBV p = 0.012), and HHV-6 was detected not only in the cornea (p = 0.000), but also and in blood (p = 0.007). In patients with HHV DNA in corneal scarps and/or blood, after resorption of purulent infiltrate, corneal epithelialization was absent, and the use of antiherpetic drugs allowed to reduce the completion time of BCU epithelialization. Conclusion. The role of HHV-6, EBV, HSV 1, 2 in the pathogenesis of bacterial corneal ulcer of protracted course was revealed. The expediency of examination of patients with bacterial corneal ulcer on HHV is shown, a method of treatment is proposed, including antiherpetic therapy, which makes it possible to prevent the development of a protracted course.

scholarly journals The prevalence of characteristic corneal ulcer patients in sanglah general hospital, in indonesia

2021 ◽  
pp. 81-84
Author(s):  
Sinta Wiranata ◽  
I Wayan Eka Sutyawan ◽  
I Putu Budhiastra
Keyword(s):  
General Hospital ◽  
Corneal Ulcer ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Corneal Ulcers ◽  
Analytical Research ◽  
Epidemiological Trends ◽  
The Relationship

Purpose: The purpose of the study was to perceive epidemiology, predisposing and varied risk factors, age, gender, profession, ulcus location, lateralization, visus category, medication. It also determines the relationship between each factor with infection and non-infection in Sanglah General Hospital, Bali. Methods: This is a cross-sectional study with method was used with 44 patients conferred in the Ophthalmology Department. The purposive sampling technique was also used in this study by considering exclusion and inclusion criteria. Then, the data were analyzed and assessed for medication and surgery for treatment between January 2017 and October 2018 using SPSS 25 version. Results: The mean age at diagnosis was 49.16±2.58 years, where samples of corneal ulcer infection made up 56.8%, and most of the cases occurred within the age group 30 - 60 years. Meanwhile, the infection mostly occurred in males, at a proportion of 77.3%, and based on the profession, 43.2% of the corneal ulcer were farmers. The most predisposing factor for infectious corneal ulcers was trauma, at 36.4%, as 39 patients had a central ulcus, where 47.7% were infectious, and 36.4% were non-infectious. However, not all the study variables were statistically significant (p > 0.05) with the patient's corneal. Conclusion: The findings of this study showed that corneal ulcer is common and mostly affects male. Furthermore, the epidemiological trends from developing countries with a predominance of infectious corneal ulcers were additional or less common. Therefore, more analysis with larger and specific sample sizes is required to be developed for resultant analytical research

scholarly journals Profile of fungal keratitis in a Sub-Himalayan territory of north India

2021 ◽  
Vol 17 (4) ◽  
pp. 356-364
Author(s):  
Anil Kumar Verma ◽  
Anuradha Sood ◽  
Anil Chauhan ◽  
Rajeev Tuli ◽  
Subhash Chand Jaryal
Keyword(s):  
Corneal Ulcer ◽  
Diagnostic Value ◽  
Fungal Species ◽  
Fungal Keratitis ◽  
North India ◽  
Mycotic Keratitis ◽  
Predisposing Factor ◽  
Direct Microscopy ◽  
Corneal Ulcers ◽  
Wet Mount

Aim: To study the microbiological and epidemiological profile of patients with suppurative corneal ulcer presenting in a rural referral center situated in a Sub-Himalayan territory of north India. The study was conducted to evaluate the epidemiology and frequency of mycotic keratitis among the patients of suppurative corneal ulcer and to identify various fungal species as etiological agents. Methods: Corneal scrapings from 56 patients of suppurative corneal ulcers were subjected to direct microscopy and culture. Results: Of the 56 cases of suppurative corneal ulcer investigated, fungal etiology was identified in 18 (32%) cases. Most of the patients (82.1%) worked in agriculture. Trivial trauma with vegetative matter was the most common predisposing factor. Fusarium and Acremonium species were the most common fungi isolated, followed by Aspergillus. Four cases of rare mycotic keratitis caused by Paecilomyces lilacinus, Scedosporium apiospermum, Monilia sitophila, and Ulocladium species were detected. Four cases were smear positive (10% KOH wet mount) but culture negative. Analysis of KOH wet mount was done using culture as gold standard. The sensitivity and specificity of KOH wet mount was 71.43% and 90.48%, respectively. Conclusion: Direct microscopy and culture has a greater diagnostic value in the management of suppurative corneal ulcer. The authors have observed changes in the pattern of organisms identified as cause of fungal keratitis in the region. Rare species of fungi may also be detected if corneal scrapings are collected for direct microscopy and culture from all the cases of suppurative corneal ulcers greater than 2 mm.

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