Search Results (20)

Among free-living amoebae (FLA), Acanthamoeba polyphaga is an important causal agent of Acanthamoeba keratitis (AK), a severe and potentially sight-threatening condition. The present study evaluated the “in vitro” efficiency of Melaleuca alternifolia Cheel (tea tree) (tea tree oil—TTO) and Eucalyptus globulus Labill. (Eucalyptus essential oil—EEO) essential oils against an Acanthamoeba strain isolated from human keratitis. The Minimum Inhibitory Concentration (MIC) of the EOs and the Fractional Inhibitory Concentration (FIC) Index were used to evaluate the decrease in viable cells of Acanthamoeba over time and at different concentrations of EOs, used alone or in association. A relevant amoebicidal effect emerged during the first hours of exposure for both compounds, and TTO was the most effective. The TTO/EEO association clearly indicated a synergistic effect in all tests, and at 2 days post-treatment, no viable A. polyphaga cells were observed at all tested concentrations. In conclusion, the potential therapeutic use of EOs represents a promising therapeutic strategy for the treatment of AK. Full article

Objective: Fungal corneal infections are challenging to treat due to delayed diagnostic procedures, bacterial co-infections, and limited antifungal efficacy. This study investigates the therapeutic potential of ultraviolet C (UVC) light alone and combined with antifungal drugs. Methods: A subsurface infection model was developed in semi-solid agar droplets, with Candida albicans cells or Aspergillus brasiliensis spores inoculated into 0.75% w/v yeast peptone dextrose (YPD) agar in a 96-well microplate (5 µL per well). Two treatment groups were tested: (1) UVC exposure (265 nm, 1.93 mW/cm²) for durations of 0 s, 5 s, 10 s, 15 s, 30 s, 60 s, or 120 s, and (2) UVC combined with antifungal drugs (Amphotericin B and Natamycin) at their minimum inhibitory concentrations (MICs), determined in YPD broth. After treatment, agar droplets were homogenized, diluted, and plated for microbial enumeration. The most effective UVC doses were further tested in an ex vivo C. albicans porcine keratitis model, where the corneal epithelium was debrided, infected with C. albicans, and exposed to UVC. Corneas were then homogenized and plated to evaluate treatment efficacy. Results: UVC exposure of ≥15 s inhibited C. albicans, and ≥10 s inhibited A. brasiliensis (all p < 0.05). The broth MICs were 0.1875 µg/mL for Amphotericin B against C. albicans, 6.25 µg/mL against A. brasiliensis, and 0.78125 µg/mL for Natamycin against C. albicans, 7.8125 µg/mL against A. brasiliensis. The broth MIC did not eradicate fungi in the subsurface model. Combined treatments enhanced inhibition (all p < 0.05), with 30 s UVC + amphotericin B for C. albicans (p = 0.0218) and 30 s UVC + natamycin for A. brasiliensis (p = 0.0017). Ex vivo, 15 s and 30 s UVC inhibited growth (p = 0.0476), but no differences were seen between groups (all p > 0.05). Conclusion: UVC demonstrated strong antifungal efficacy, with supplementary benefits from combining UVC with low doses of antifungal drugs. Full article

Background: Diseases in humans caused by amphizoic amoebae that can result in visual impairment and even blindness, have recently been identified more frequently worldwide. Etiologically complex incidents of keratitis, including those connected with Acanthamoeba strains detected in Poland, were evaluated in this study. Methods: Corneal samples from cases resistant to antimicrobial therapy assessed for epidemiological, microbiological and parasitological aspects were investigated by phase-contrast microscope, slit lamp and by confocal microscopy. In vitro techniques were applied for detection of bacteria and fungi, and corneal isolates cultured under axenic condition using BSC medium—for detection of Acanthamoeba spp.; molecular techniques were applied for amoeba species identification. Results: Most etiologically complicated keratitis cases, detected in ~84% of incidents, was due to exposure of contact lenses to tap water or pool water; trophozoites and cysts of Acanthamoeba, concomitant bacteriae, e.g., Pseudomonas aeruginosa, fungi and microfilariae were identified in contact lens users. Conclusions: In samples from contact lens wearers where microbial keratitis is identified along with some connection with the patient’s exposure to contaminated water environments, a risk of Acanthamoeba spp. infections should be considered. Understanding the complicated relationship between Acanthamoeba spp., co-occurring pathogens including associated endosymbionts is needed. In vivo confocal microscopy and in vitro cultivation were necessary to identify potentially contagious concomitant factors affecting the complex course of the keratitis. Full article

Background: Pseudomonas aeruginosa (P. aeruginosa), is a diverse Gram-negative pathogen commonly associated with a wide spectrum of infections. It is indicated to be the most prevalent causative agent in the development of bacterial keratitis linked with the use of contact lens. Corneal infections attributed to P. aeruginosa frequently have poor clinical outcomes necessitating lengthy and costly therapies. Therefore, this review looks at the aetiology of P. aeruginosa bacterial keratitis as well as the bacterial drivers of its virulence and the potential therapeutics on the horizon. Method: A literature review with the articles used for the review searched for and retrieved from PubMed, Scopus, and Google Scholar (date last accessed 1 April 2024). The keywords used for the search criteria were “Pseudomonas and keratitis, biofilm and cornea as well as P. aeruginosa”. Results: P. aeruginosa is implicated in the pathogenesis of bacterial keratitis associated with contact lens usage. To reduce the potential seriousness of these infections, a variety of contact lens-cleaning options are available. However, continuous exposure to a range of antibiotics doses, from sub-inhibitory to inhibitory, has been shown to lead to the development of resistance to both antibiotics and disinfectant. Generally, there is a global public health concern regarding the rise of difficult-to-treat infections, particularly in the case of P. aeruginosa virulence in ocular infections. This study of the basic pathogenesis of a prevalent P. aeruginosa strain is therefore implicated in keratitis. To this effect, anti-virulence methods and phage therapy are being researched and developed in response to increasing antibiotic resistance. Conclusion: This review has shown P. aeruginosa to be a significant cause of bacterial keratitis, particularly among users of contact lens. It also revealed treatment options, their advantages, and their drawbacks, including prospective candidates. Full article

Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers whose lenses have become contaminated or who have a history of water exposure, and in those without contact lens wear who have experienced recent eye trauma involving contaminated soil or water. Infection usually results in severe eye pain, photophobia, inflammation, and corneal epithelial defects. The pathophysiology of this infection is multifactorial, including the production of cytotoxic proteases by Acanthamoeba that degrades the corneal epithelial basement membrane and induces the death of ocular surface cells, resulting in degradation of the collagen-rich corneal stroma. AK can be prevented by avoiding risk factors, which includes avoiding water contact, such as swimming or showering in contact lenses, and wearing protective goggles when working on the land. AK is mostly treated with an antimicrobial therapy of biguanides alone or in combination with diaminidines, although the commercial availability of these medicines is variable. Other than anti-amoeba therapies, targeting host immune pathways in Acanthamoeba disease may lead to the development of vaccines or antibody therapeutics which could transform the management of AK. Full article

Fungal keratitis is a relatively rare yet severe ocular infection that can lead to profound vision impairment and even permanent vision loss. Rapid and accurate diagnosis plays a crucial role in the effective management of the disease. A patient’s history establishes the initial clinical suspicion since it can provide valuable clues to potential predisposing factors and sources of fungal exposure. Regarding the evaluation of the observed symptoms, they are not exclusive to fungal keratitis, but their timeline can aid in distinguishing fungal keratitis from other conditions. Thorough clinical examination of the affected eye with a slit-lamp microscope guides diagnosis because some clinical features are valuable predictors of fungal keratitis. Definitive diagnosis is established through appropriate microbiological investigations. Direct microscopic examination of corneal scrapings or biopsy specimens can assist in the presumptive diagnosis of fungal keratitis, but culture remains the gold standard for diagnosing fungal keratitis. Advanced molecular techniques such as PCR and MALDI-ToF MS are explored for their rapid and sensitive diagnostic capabilities. Non-invasive techniques like in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT) are useful for real-time imaging. Every diagnostic technique has both advantages and drawbacks. Also, the selection of a diagnostic approach can depend on various factors, including the specific clinical context, the availability of resources, and the proficiency of healthcare personnel. Full article

Acanthamoeba keratitis (AK) is a rare cornea disease caused by species of the Acanthamoeba genus. The antifungal voriconazole blocks the ergosterol synthesis in the protozoan membrane and is active against the cysts and trophozoites of Acanthamoeba spp. Due to the low stability of voriconazole, its options for eye drops are scarce. This study aimed to investigate the stability of the biological activity of voriconazole against two strains of Acanthamoeba castellanii and one clinical isolate from a patient with AK. To evaluate the stability of the biological activity of voriconazole, strains of A. castellanii (ATCC 50492) were exposed to different periods and voriconazole concentrations stored at 4 °C for 7, 15, and 30 days. The cytotoxicity assays were performed using SIRC (ATCC CCL-60™) cell line. The results indicated the amoebicidal effect of voriconazole against Acanthamoeba spp. within 24 h and 48 h of exposure, and the voriconazole solution was stable and retained antiamoebic activity when stored at 4 °C for up to 30 days. In the cytotoxicity test, the result demonstrated low cytotoxicity of the drug to the corneal rabbit cell line. However, there is a need to carry out further synergistic effects with other antiamoebic drugs and then in vivo experiments in the AK animal model. Full article

Graves’ orbitopathy (GO) is an extrathyroidal manifestation of Graves’ disease (GD), which can be associated with corneal ulcerations or optic neuropathy in severe forms. Transnasal endoscopic orbital decompression (TEOD) is a surgical procedure performed in order to decrease the intraorbital pressure by removing part of its bony borders in cases with excessive mass in orbit. The aim of this study was to present the results and evaluate the efficacy of TEOD for GO. The retrospective study included 28 orbits (16 patients) who underwent TEOD from 2017 to 2020. Outcome was evaluated based on visual acuity improvement, clinical activity score (CAS) decrease, proptosis, and intraocular pressure (IOP) reduction. A preoperative best-corrected visual acuity (BCVA) increased from 0.69 ± 0.385 (mean ± standard deviation) to 0.74 ± 0.332 (p = 0.17) postoperatively. CAS decreased in 15 orbits postoperatively. Proptosis decreased from 22.89 ± 1.873 mm to 21.25 ± 2.053 mm (p < 0.05). IOP decreased from a preoperative 16.11 ± 3.93 mmHg to 14.40 ± 3.27 mmHg (p < 0.05) postoperatively. In addition, postoperative relief of exposure keratitis was observed. The analysis of development of iatrogenic diplopia revealed increasing in degree of diplopia. TEOD shows rare complications, but significant improvements in BCVA, CAS, proptosis, and IOP. Full article

Climate change has contributed to changes in disease transmission. In particular, zoonoses such as tick-borne diseases are occurring in areas previously unsuitable for tick survival, with spread to non-endemic areas rising. Ophthalmic manifestations of tick-borne diseases are rare. Often overlooked, diagnosis requires awareness and a high level of suspicion, which may delay treatment. This review provides a comprehensive overview of ocular disease associated with ticks so that management protocols for patients can be designed and implemented. A narrative literature review was conducted. The current literature includes case series, case reports, and literature reviews. Ocular manifestations of tick-borne diseases include adnexal manifestations, conjunctivitis, keratitis, cranial nerve palsies, optic nerve disease, uveitis, exudative retinal detachment, and panophthalmitis, which may occur in isolation or as part of a systemic process. As there is no one constellation of ocular symptoms and signs diagnostic of tick-borne eye diseases, a systematic approach is recommended with particular attention to significant travel and exposure history. In this review, we identify significant risk factors and propose management strategies for afflicted patients to improve treatment outcomes while maintaining cost-effectiveness. Ophthalmologists and generalists will benefit from increased awareness of ocular manifestations of tick-borne diseases in the age of modern travel and climate change. Full article

Chronic superficial keratitis (CSK) is a progressive inflammatory condition of the eye (cornea) that can cause discomfort and blindness. Differential disease risk across dog breeds strongly suggests that CSK has a genetic basis. In addition to genetic risk, the occurrence of CSK is exacerbated by exposure to ultraviolet light. Genome-wide association analysis considered 109 greyhounds, 70 with CSK and the remainder with normal phenotype at an age over four years. Three co-located variants on CFA18 near the 5′ region of the Epidermal Growth Factor Receptor (EGFR) gene were associated with genome-wide significance after multiple-test correction (BICF2P579527, CFA18: 6,068,508, p_raw = 1.77 × 10⁻⁷, p_genome = 0.017; BICF2P1310662, CFA18: 6,077,388, p_raw = 4.09 × 10⁻⁷, p_genome = 0.040; BICF2P160719, CFA18: 6,087,347, p_raw = 4.09 × 10⁻⁷, p_genome = 0.040) (canFam4)). Of the top 10 associated markers, eight were co-located with the significantly associated markers on CFA18. The associated haplotype on CFA18 is protective for the CSK condition. EGFR is known to play a role in corneal healing, where it initiates differentiation and proliferation of epithelial cells that in turn signal the involvement of stromal keratocytes to commence apoptosis. Further validation of the putative functional variants is required prior to their use in genetic testing for breeding programs. Full article

Background: Rhizobium (Agrobacterium) species are plant aerobic bacteria, which in some cases can produce endophthalmitis in humans after corneal trauma. Case presentation: A 42-year-old female patient presented in the Emergency Department of the Emergency County Hospital of Craiova, Romania, reporting pain, epiphora, and blurry vision in her right eye for about five days. This initial infectious keratitis episode was successfully resolved, but after 20 days she presented again after trauma with a leaf with corneal abscess. In the conjunctival secretion, R. radiobacter was identified. Despite antibiotherapy, the patient’s state did not improve, and ultimately the eye was eviscerated. Methods: A search was performed in the ProQuest, PubMed, and ScienceDirect databases for the terms Agrobacterium, Rhizobium, radiobacter, and eye. We eliminated non-human studies, editorials and commentaries, and non-relevant content, and excluded the duplicates. Results: In total, 138 studies were initially obtained, and then we selected 26 studies for retrieval. After the selection process, we ended up including 17 studies in our analysis. Most studies reported R. radiobacter endophthalmitis after ocular surgical procedures or outdoor activities that involve exposure to soil. Conclusion: R. radiobacter is a rare cause of endophthalmitis after eye trauma that generally responds well to usual antibiotherapy, but occasionally can evolve to severe, leading to the loss of the eye. Full article

The purpose of the study was to assess the antimicrobial activity of an ultraviolet-C (UVC) device against microorganisms implicated in contact lens related adverse events. An UVC device with an emitting 4.5 mm diameter Light Emitting Diode (LED; 265 nm; 1.93 mJ/cm²) was used. Pseudomonas aeruginosa, Staphylococcus aureus, Fusarium solani, and Candida albicans agar plate lawns were exposed to the device beams for 15 and 30 s at 8 mm distance. Following the exposure, the diameter of the growth inhibition zone was recorded. Contact lenses made of Delfilicon-A, Senofilicon-A, Comfilicon-A, Balafilicon-A, Samfilicon-A and Omafilicon-A and a commercially available contact storage case was used. They were exposed to bacterial and fungal strains for 18 h at 37 °C and 25 °C respectively. After this, the samples were exposed to UVC for 30 s at 8 mm distance to determine the antimicrobial efficacy. Samples were then gently washed and plated on appropriate agar for enumeration of colonies. The UVC exposure reduced microbial growth by 100% in agar lawns, and significantly (p < 0.05) reduced microbial contamination to contact lenses and cases, ranging between 0.90 to 4.6 log. Very short UVC exposure has high antimicrobial efficacy against most of the predominant causative microorganisms implicated in contact lens related keratitis. UVC could be readily used as a broad-spectrum antimicrobial treatment for lens disinfection. Full article

The purpose of the current study was to investigate the effects of two commonly used sedation protocols in dogs, acepromazine (ACP) and acepromazine–methadone (ACP–MET) combination, on tear production measured by the Schirmer Tear Test (STT) 1. We hypothesized that both sedation protocols cause a reduction in canine tear production for a variable time. Fifteen client-owned dogs were recruited for the study. Each dog was subjected to sedation twice, 2–3 weeks apart, and they were randomly allocated to one of two groups receiving ACP (0.015 mg kg⁻¹) or ACP–MET (0.010 mg kg⁻¹ and 0.2 mg kg⁻¹) intramuscularly. In both eyes, tear production was measured 15 min before sedation (T0) and 20 min (T20 m), 40 min (T40 m), 1 h (T1), 2 h (T2), 4 h (T4) and 8 h (T8), after drug administration. Two-way repeated measures ANOVA, followed by the Bonferroni post hoc test (p < 0.05), showed a significant effect of time (p < 0.0001) and treatment (p < 0.0001). A significant decrease in tear production at T20 m, T40 m, T1 and T2 compared to T0 was observed in the ACP experimental protocol, while in the ACP + MET protocol, this reduction persisted until T8. Comparing the two experimental protocols, no statistically significant differences were observed at T0 or T20 m, and STT 1 values were statistically lower in the ACP + MET than the ACP protocol at the other data points. In the ACP + MET group, at T40 m, 100% of dogs showed STT 1 readings lower than 15 mm/min. This finding is clinically relevant as it can predispose dogs to corneal injuries. The major reduction in tear production due to the ACP + MET protocol proves the need for adequate corneal hydration, particularly to discourage its use in animals with altered tear production. The data obtained provide important information helping clinicians to better manage the drug’s effects on tear production. Full article

Air pollutants, especially ambient fine particulate matter2.5, may contribute to various ocular surface disorders, including dry eye disease, keratitis and conjunctivitis. A natural polyamine spermidine has a protective effect on the retina and optic nerve; however, no study has been conducted on the application of spermidine in particulate matter2.5-induced dry eye disease. In the present study, we investigated the effect of spermidine eye drops in topically exposed particulate matter2.5-induced dry eye models of Sprague-Dawley rats, by hematological, biochemical and histological evaluation. Spermidine eye drops attenuated the particulate matter2.5 exposure-induced reduction of tear secretion and corneal epithelial damage. Furthermore, spermidine protected against conjunctival goblet cell loss and retinal ganglion cell loss induced by particulate matter2.5. Additionally, spermidine markedly prevented particulate matter2.5-induced infiltration of cluster of differentiation3⁺ and cluster of differentiation4⁺ T lymphocytes and F4/80⁺ macrophages on lacrimal gland. Moreover, over expression of pro-inflammatory cytokines, including tumor necrosis factor-α, interleukin-6 and interleukin-17 in the lacrimal gland and cornea. Meanwhile, the levels of serum total cholesterol and low-density lipoprotein cholesterol were markedly increased by topical exposure to particulate matter2.5, but this change in the lipid profile was decreased by spermidine. Taken together, spermidine may have protective effects against particulate matter2.5-induced dry eye symptoms via stabilization of the tear film and suppression of inflammation and may in part contribute to improving retinal function and lipid metabolism disorder. Full article

Tear film provides lubrication and protection to the ocular surface. The sedation reduces tear production, often leading to perioperative exposure keratopathy. The aim of the present study was to report the effects of intramuscular dexmedetomidine on canine tear production, measured by STT-1, for an experimental period of 8 h after sedation. Ten dogs who underwent sedation for routine radiologic assessment were recruited for the study. In all animals, tear production in right and left eyes was measured 15 min before sedation (T0: basal values) and 20 min (T20), 1 h (T1), 2 h (T2), 4 h (T4) and 8 h (T8) after drug administration. Analysis of variance and post hoc Bonferroni test (p < 0.05) were performed. A significant effect of time on canine tear production was found. The tear production returned to basal values at T8. So, it is recommended to treat the canine eyes with tear substitutes during and up to 12 h after sedation. Full article