The incidence of nosocomial infections, as well as the high mortality and drug resistance expressed by nosocomial pathogens, especially in immunocompromised patients, poses significant medical ...challenges. Currently, the efficacy of plant compounds with antimicrobial potential has been reported as a promising alternative therapy to traditional methods. Isoespintanol (ISO) is a monoterpene with high biological activity. Using the broth microdilution method, the antibacterial activity of ISO was examined in 90 clinical isolates, which included 14 different species: (Escherichia coli (38), Pseudomonas aeruginosa (12), Klebsiella pneumoniae (13), Acinetobacter baumannii (3), Proteus mirabilis (7), Staphylococcus epidermidis (3), Staphylococcus aureus (5), Enterococcus faecium (1), Enterococcus faecalis (1), Stenotrophomonas maltophilia (2), Citrobacter koseri (2), Serratia marcescens (1), Aeromonas hydrophila (1), and Providencia rettgeri (1). MIC90 minimum inhibitory concentration values ranged from 694.3 to 916.5 µg/mL and MIC50 values from 154.2 to 457.3 µg/mL. The eradication of mature biofilms in P. aeruginosa after 1 h of exposure to ISO was between 6.6 and 77.4%, being higher in all cases than the percentage of biofilm eradication in cells treated with ciprofloxacin, which was between 4.3 and 67.5%. ISO has antibacterial and antibiofilm potential against nosocomial bacteria and could serve as an adjuvant in the control of these pathogens.
The growing increase in infections by Candida spp., non-albicans, coupled with expressed drug resistance and high mortality, especially in immunocompromised patients, have made candidemia a great ...challenge. The efficacy of compounds of plant origin with antifungal potential has recently been reported as an alternative to be used. Our objective was to evaluate the mechanism of the antifungal action of isoespintanol (ISO) against clinical isolates of Candida tropicalis. Microdilution assays revealed fungal growth inhibition, showing minimum inhibitory concentration (MIC) values between 326.6 and 500 µg/mL. The eradication of mature biofilms by ISO was between 20.3 and 25.8% after 1 h of exposure, being in all cases higher than the effect caused by amphotericin B (AFB), with values between 7.2 and 12.4%. Flow cytometry showed changes in the permeability of the plasma membrane, causing loss of intracellular material and osmotic balance; transmission electron microscopy (TEM) confirmed the damage to the integrity of the plasma membrane. Furthermore, ISO induced the production of intracellular reactive oxygen species (iROS). This indicates that the antifungal action of ISO is associated with damage to membrane integrity and the induction of iROS production, causing cell death.
The aim of this study was to evaluate the antifungal activity of isoespintanol (ISO) extracted from Oxandra xylopioides Diels (Annonaceae) against clinical isolates of Candida spp. Isoespintanol was ...obtained from the petroleum benzine extract of the leaves and was identified by nuclear magnetic resonance (NMR) and mass spectrometry (MS). For antifungal activity experiments, the broth microdilution method was used. The results show an inhibitory effect against Candida spp., with minimum inhibitory concentration (MIC) values between 450.4–503.3 μg/mL. Furthermore, the inhibitory effect of ISO against fungal biofilms is highlighted, even in some cases, greater than the effect shown by amphotericin B (AFB) and in others, where AFB showed no effect. Assays with fluorescent staining with acridine orange (AO) and ethidium bromide (EB), transmission electron microscopy (TEM), Evans blue, measurement of extracellular pH and leakage of intracellular material, evidenced damage at the level of fungal membranes and general cell damage, when cells were exposed to ISO, compared to untreated cells. The results of this research, serve as the basis for future studies in the establishment of the mechanisms of antifungal action of ISO, which could serve as an adjunct in the treatment of infections by these yeasts.
Isoespintanol; Oxandra xylopioides; Candida spp.; Antifungal.
To study the characteristics of nonarteritic anterior ischemic optic neuropathy (NAION) as measured with optical coherence tomography (OCT) at diagnosis and during the first year after the episode.
...Cohort study.
Twenty-seven patients diagnosed with NAION in our center between April 1, 2004 and March 31, 2006.
Patients diagnosed with NAION underwent at the time of diagnosis and 6 weeks and 3, 6, and 12 months after presentation a complete ophthalmologic evaluation, including determination of Snellen visual acuity (VA), visual fields (VFs) (standard automated perimetry, Swedish Interactive Threshold Algorithm strategy 24-2), and optic nerve head (ONH) scanning with StratusOCT.
Characteristics of the ONH and their relationship with VA and VFs.
Initial mean retinal nerve fiber layer (RNFL) thickness in the affected eye was 200.9 microm (standard deviation SD, 52.3 microm); this represented a 96.4% increase relative to the fellow eye. Percentages of RNFL loss 3, 6, and 12 months after onset were 38.9%, 42.3%, and 43.9%, respectively. At the 6-month visit, RNFL percentage decreases for the superior, nasal, inferior, and temporal quadrants were 51.5%, 28.5%, 41.2%, and 38.2%, respectively. Reduction in the superior quadrant RNFL thickness was statistically higher. Using regression analysis, it was found that for every micrometer of mean RNFL thickness lost there was a 2-decibel decrease in VF mean deviation (MD) and that there was a 1-line drop in Snellen VA for every 1.6 microm lost. The mean ONH area was 2.6 mm2 (SD, 0.4) in the unaffected eye; there was no correlation with VA, VF MD, or RNFL thickness of the affected eye at the last follow-up visit.
Optical coherence tomography can diagnose optic disc edema and monitor RNFL loss over time. It is most useful at onset and 6 months after NAION, when RNFL loss has reached a plateau and is correlated with visual function. Future studies that aim to determine if a drug or intervention is useful for treating NAION may include OCT assessment of the RNFL thickness, because it provides an objective outcome measure correlated with visual performance.
Abstract Objective To report macular structure on optical coherence tomography (OCT) after lamellar macular hole surgery and its relationship with visual outcome. Design Retrospective interventional ...case series; private practice setting. Participants Twelve patients diagnosed with a lamellar hole who had undergone vitrectomy and who had OCT scanning before and after surgery and at least 6 months follow-up were included. Methods Surgery consisted of 25 g vitrectomy, peeling of epiretinal and internal limiting membrane, fluid/air/gas exchange, and 2 weeks of face-down positioning. Results OCT showed an epiretinal membrane in all cases. After a mean follow-up of 16.7 months, VA improved by ≥2 lines in nine patients and remained stable in three. There was a complete closure of the lamellar hole in ten patients; in four a retinal pseudocyst was found during the healing process, resolving spontaneously in two and persisting in the other two after 8 and 9 months, respectively. Two patients developed a full-thickness macular hole that closed successfully after surgical repair. All patients had a VA ≥ 20/32 at the end of follow-up. Conclusion Epiretinal membranes appear to have a role in the pathogenesis of lamellar macular holes. Vitrectomy is a useful technique to obtain closure of the lamellar hole and visual improvement. The presence of a retinal pseudocyst is a common feature during the healing process and is compatible with a favorable visual outcome. A full-thickness macular hole is a severe and not uncommon complication of this procedure.
Bilateral acute iris depigmentation (BADI) and transillumination (BATI) syndromes have been linked with the use of antibiotics, especially fluoroquinolones. They are characterized by acute onset of ...pigment dispersion in the anterior chamber, depigmentation of the iris and pigment deposition in the angle and in the posterior surface of the cornea (BADI), with iris transillumination defects and atonic pupil with sphincter paralysis (BATI). The purpose of this paper is to report the development of clinical depigmentation and iris damage similar to BADI and BATI in patients who had undergone uneventful glaucoma surgery with intracameral moxifloxacin as prophylaxis for endophthalmitis.
Four patients who had undergone Ex-Press implantation (cases 1 and 2) or non-penetrating deep sclerotomy (cases 3 and 4) developed asymptomatic pigment dispersion in the anterior chamber, which cleared after treatment with topical corticosteroids and NSAIDS. However, pupillary damage ensued, with mid-midriasis and pigment deposition under the filtration bleb.
This is, to the best of our knowledge, the first report of acute unilateral iris depigmentation and transillumination after intracameral use of moxifloxacin. Moxifloxacin's toxic effect may have been promoted by the subconjuntival mitomycin employed to prevent scarring at the filtration bleb. Surgeons should be aware of these potential side-effects of drugs used as widely as moxifloxacin and mitomycin.
•Moxifloxacin is widely used as prophylaxis for endophthalmitis after cataract surgery.•Bilateral acute iris depigmentation and transillumination syndromes have been reported after the use of antibiotics.•We report four cases of similar syndromes in patients undergoing glaucoma surgery after intracameral moxifloxacin.
Purpose. To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. Methods. The number and type of emergencies attended in the ...emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into “clusters,” which include those conditions that affect the same ocular tissue and that have similar clinical expression. Results. The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (−65.4%), cornea (−35.8%), uveitis (−3.6%), eyelid and orbital and lacrimal (−35.5%), strabismus (−60%), neuro-ophthalmology (−11.8%), retina (−10.6%), cataract (+16.4%), glaucoma (−37%), and miscellaneous (−45.1%). The number of people seen with viral conjunctivitis decreased by −87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. Conclusions. Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.
Today, patients often expect to achieve spectacle independance after cataract surgery. New trifocal intraocular lenses have been developed to try and fullfill this demand. The purpose of this study ...is to report the short-term visual outcomes of a new trifocal intraocular lens (AcrySof PanOptix™).
Consecutive adult patients undergoing cataract surgery with bilateral implantation of the study intraocular lens in a private practice clinic were considered for inclusion. Exclusion criteria were the presence of other ocular pathologies or preoperative astigmatism >1.5 diopters (D). Patients with intraoperative complications were excluded from analysis. One month after surgery patients underwent: monocular defocus curve; monocular and binocular uncorrected visual acuity in photopic and mesopic conditions, for far (4 m), intermediate (60 cm) and near (33 cm) distances and binocular contrast sensitivity. Patients completed a visual satisfaction questionnaire between 9 and 12 months after surgery.
One hundred and sixteen eyes of fifty-eight patients receiving bilateral implantation of the study intraocular lens were analysed. Mean binocular uncorrected visual acuity in photopic conditions was 0.03 LogMAR for far, 0.12 for intermediate and 0.02 for near distances. All patients achieved a binocular uncorrected visual acuity better than 0.3 LogMAR (20/40 Snellen equivalent) for distance and near vision and 94.8% of patients for intermediate vision. Mesopic binocular uncorrected visual acuity values were similar to photopic values. The monocular defocus curves showed that the best visual acuity was reached at a vergence of 0.00D. Visual acuity dropped slightly at -1.00D and peaked again at -2.00D. Visual acuities better than 0.2 LogMAR were maintained between -2.50D and +0.50D. Contrast sensitivity was high and similar in photopic and mesopic conditions. As regards patient-evaluated outcomes, only 2 patients (3.4%) were fairly dissatisfied with their sight after surgery. Three patients (5.1%) reported the need for spectacle correction for certain activities. All other patients (94.8%) reported never using spectacle correction.
The PanOptix trifocal IOL provides good short-term visual outcomes, with good intermediate performance and excellent patient-reported satisfaction. The similar values achieved in mesopic and photopic conditions in binocular uncorrected visual acuity and contrast sensitivity suggest low pupillary dependence for light distribution.
ISRCTN60143265 , retrospectively registered on the 24th of April 2017.
To assess and compare the visual quality and subjective outcomes of a trifocal spherical intraocular lens (IOL) and its new toric version.
Clínica Rementería, Madrid, Spain.
Prospective case series.
...Patients had bilateral implantation of the AcrySof IQ PanOptix spherical or toric IOL. Three months postoperatively, monocular and the binocular uncorrected and corrected distance, intermediate, and near visual acuities; binocular defocus curves; and binocular contrast sensitivity function (CSF) were assessed. Patient satisfaction was evaluated with the Catquest 9SF questionnaire.
The study comprised 250 eyes (166 with spherical IOL; 84 with toric IOL) of 125 patients. Both groups had good monocular visual acuity at all distances with no statistically significant differences between groups. The mean monocular uncorrected acuity in the spherical group was 0.06 logarithm of the minimum angle of resolution (logMAR) ± 0.07 (SD), 0.20 ± 0.10 logMAR, and 0.05 ± 0.07 logMAR for far, intermediate, and near, respectively, and in the toric group, 0.07 ± 0.10 logMAR, 0.23 ± 0.20 logMAR, and 0.07 ± 0.12 logMAR, respectively. Defocus curves showed a visual acuity of 0.1 logMAR or better between −2.5 diopters (D) and +0.5 D with no differences between groups. The CSF values were within normal ranges with both IOLs. The questionnaire showed high rates of patient satisfaction with no differences between groups.
The visual outcomes with the 2 IOLs were similar. With optimum implantation and alignment, the trifocal toric IOL seems to provide visual quality and patient satisfaction that is equivalent to that with the nontoric version with the same platform.
PDF
