Management of Infectious Endophthalmitis

Forster, Richard K.; Abbott, Richard L.; Gelender, Henry

doi:10.1016/s0161-6420(80)35241-x

Cited by 265 publications

(90 citation statements)

References 14 publications

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“…The postoperative endophthalmitis incidence can be in the early phase following the operation (early-onset endophthalmitis) or subsequent stage over a six year period after the surgery (delayedonset endophthalmitis) [2][3][4]. It has been reported that the most common form of post-operative endophthalmitis, corresponding for 70% of infectious cases, was endophthalmitis following cataract extraction [5]. The inflammation and infectious lesions as consequences of endophthalmitis lead to incidence of late-onset bleb-related complications in 11% [4] to 57% [6] of cases as well as panophthalmitis and corneal perforation.…”

Section: Introductionmentioning

confidence: 99%

PCR Detection and Identification of Bacterial Contaminants in Ocular Samples from Post- Operative Endophthalmitis

Abrishami

Hashemi

Abrishami

et al. 2015

JCDR

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Section: Introductionmentioning

confidence: 99%

PCR Detection and Identification of Bacterial Contaminants in Ocular Samples from Post- Operative Endophthalmitis

Abrishami

Hashemi

Abrishami

et al. 2015

JCDR

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“…Bacterial detection by PCR was positive for three aqueous samples and one vitreous sample; one of these was negative by culture. Amplification of ITS2/5.8S rDNA and molecular typing shows potential as a rapid technique for identifying fungi in ocular samples.The microbiological spectrum of infectious endophthalmitis shows that the percentage of isolates that are fungi is 8 to 18.5% (2,7,12,22,23) and in keratitis the rate is 16 to 35.9% (8,42). Clinical diagnosis of these ocular infections is confirmed by obtaining intraocular (aqueous or vitreous) specimens or corneal scrapings.…”

mentioning

confidence: 99%

Detection and Identification of Fungal Pathogens by PCR and by ITS2 and 5.8S Ribosomal DNA Typing in Ocular Infections

Ferrer

Colom²,

Frasés³

et al. 2001

J Clin Microbiol

311

197

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The goal of this study was to determine whether sequence analysis of internal transcribed spacer/5.8S ribosomal DNA (rDNA) can be used to detect fungal pathogens in patients with ocular infections (endophthalmitis and keratitis). Internal transcribed spacer 1 (ITS1) and ITS2 and 5.8S rDNA were amplified by PCR and seminested PCR to detect fungal DNA. Fifty strains of 12 fungal species (yeasts and molds) were used to test the selected primers and conditions of the PCR. PCR and seminested PCR of this region were carried out to evaluate the sensitivity and specificity of the method. It proved possible to amplify the ITS2/5.8S region of all the fungal strains by this PCR method. All negative controls (human and bacterial DNA) were PCR negative. The sensitivity of the seminested PCR amplification reaction by DNA dilutions was 1 organism per PCR, and the sensitivity by cell dilutions was fewer than 10 organisms per PCR. Intraocular sampling or corneal scraping was undertaken for all patients with suspected infectious endophthalmitis or keratitis (nonherpetic), respectively, between November 1999 and February 2001. PCRs were subsequently performed with 11 ocular samples. The amplified DNA was sequenced, and aligned against sequences in GenBank at the National Institutes of Health. The results were PCR positive for fungal primers for three corneal scrapings, one aqueous sample, and one vitreous sample; one of them was negative by culture. Molecular fungal identification was successful in all cases. Bacterial detection by PCR was positive for three aqueous samples and one vitreous sample; one of these was negative by culture. Amplification of ITS2/5.8S rDNA and molecular typing shows potential as a rapid technique for identifying fungi in ocular samples.The microbiological spectrum of infectious endophthalmitis shows that the percentage of isolates that are fungi is 8 to 18.5% (2,7,12,22,23) and in keratitis the rate is 16 to 35.9% (8,42). Clinical diagnosis of these ocular infections is confirmed by obtaining intraocular (aqueous or vitreous) specimens or corneal scrapings. However, standard microbiological tests are positive in only 54 to 69% of endophthalmitis cases (13,22,23) (by culture) and 80% (8) of keratitis cases (by Gram and Giemsa stains and culture). In fungal infections, even when positive, results usually take longer than a week because these organisms are difficult to identify and/or are slow-growing. Early diagnosis and rapid intervention is a critical element for an effective treatment of ocular infections. This has led to the development of culture-independent diagnostic tests such as PCR. PCR-based detection methods with universal primers for bacterial DNA in ocular samples (5,16,20,21,26,27,34,36,40) have recently been developed. For detection of fungal pathogens, multicopy gene targets have been evaluated for increasing the sensitivity (33, 39) and universal fungal PCR primers have been developed for broadening the range of detectable fungi (9,14,18,31,37). Studies on fungal DNA detection in ocular ...

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“…Up to 13% of the endophthalmitis cases are caused by fungi (Forster et al 1980). Systemic antifungal agents are useful if they can penetrate the intact blood retinal barrier in sufficient concentrations to inhibit active proliferation of the fungi.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of fluconazole and liposome entrapped fluconazole for C. albicans induced experimental mycotic endophthalmitis in rabbit eyes

Gupta

Dhingra

Velpandian

et al. 2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To study the efficacy of intravitreally injected plain and liposome encapsulated fluconazole in the doses of 100 and 200 mg in Candidal endophthalmitis in rabbit eyes. Method: Endophthalmitis was induced by injecting Candida albicans (1000 CFU/0.1 ml). Seventy two hours after inoculation, plain and liposome encapsulated fluconazole (REVs) were injected. At day 16 sterility was studied using vitreous culture. Results: In the 100 & 200 mg plain fluconazole group, vitreous sterility was seen in 62.5% and 75%, respectively. In the liposome entrapped fluconazole a culture sterility of 25% and 50% for 100 mg and 200 mg, respectively, was seen. Conclusion: Plain fluconazole in the dose of 100 and 200 mg was equally effective against Candidal endophthalmitis in rabbits, but a failure of 25-37.5% of the eyes to respond, discourages one from using fluconazole as a sole therapy. Liposome entrapped fluconazole was found to be inferior to plain fluconazole in this model.

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Management of Infectious Endophthalmitis

Cited by 265 publications

References 14 publications

PCR Detection and Identification of Bacterial Contaminants in Ocular Samples from Post- Operative Endophthalmitis

PCR Detection and Identification of Bacterial Contaminants in Ocular Samples from Post- Operative Endophthalmitis

Detection and Identification of Fungal Pathogens by PCR and by ITS2 and 5.8S Ribosomal DNA Typing in Ocular Infections

Efficacy of fluconazole and liposome entrapped fluconazole for C. albicans induced experimental mycotic endophthalmitis in rabbit eyes

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