Uveodermatologic syndrome in a rat terrier

A 4 yr old intact male rat terrier presented with severe bilateral nonresponsive panuveitis. Bilateral uveitis, blepharospasm, conjunctival hyperemia, diffuse corneal edema, peripheral bullous retinal detachment, and secondary ocular hypertension were noted. Ocular lesions progressed despite aggressive medical treatment and were followed by cutaneous depigmentation and crusting along the nasal planum. Intensive oral and topical anti-inflammatory and topical antiglaucoma medications were administered, but the ocular disease progressed. A bilateral enucleation was performed. Uveodermatologic syndrome was diagnosed from histopathologic examination of a skin biopsy as well as histopathology of both globes after bilateral enucleation. To maintain control of the dermatologic lesions, oral azathioprine was initiated, but it was not well tolerated by this patient. Immunosuppressive doses of oral cyclosporine and anti-inflammatory doses of oral prednisone were used to control the depigmentation and crusting skin lesions.

Development and in vitro characterization of paclitaxel and docetaxel loaded into hydrophobically derivatized hyperbranched polyglycerols

In this study we report the development and in vitro characterization of paclitaxel (PTX) and docetaxel (DTX) loaded into hydrophobically derivatized hyperbranched polyglycerols (HPGs). Several HPGs derivatized with hydrophobic groups (C(8/10) alkyl chains) (HPG-C(8/10)-OH) and/or methoxy polyethylene glycol (MePEG) chains (HPG-C(8/10)-MePEG) were synthesized. PTX or DTX were loaded into these polymers by a solvent evaporation method and the resulting nanoparticle formulations were characterized in terms of size, drug loading, stability, release profiles, cytotoxicity, and cellular uptake. PTX and DTX were found to be chemically unstable in unpurified HPGs and large fractions (∼80%) of the drugs were degraded during the preparation of the formulations. However, both PTX and DTX were found to be chemically stable in purified HPGs. HPGs possessed hydrodynamic radii of less than 10nm and incorporation of PTX or DTX did not affect their size. The release profiles for both PTX and DTX from HPG-C(8/10)-MePEG nanoparticles were characterized by a continuous controlled release with little or no burst phase of release. In vitro cytotoxicity evaluations of PTX and DTX formulations demonstrated a concentration-dependent inhibition of proliferation in KU7 cell line. Cellular uptake studies of rhodamine-labeled HPG (HPG-C(8/10)-MePEG(13)-TMRCA) showed that these nanoparticles were rapidly taken up into cells, and reside in the cytoplasm without entering the nuclear compartment and were highly biocompatible with the KU7 cells.

Calculation of the electrophoretic mobility of a particle bearing bound polyelectrolyte using the nonlinear poisson-boltzmann equation

A numerical method for determining the electrophoretic mobility of a polyelectrolyte-coated particle is presented. The particle surface is modeled as having a permeable layer of polyelectrolyte molecules anchored to its surface. Fluid flow within the polyelectrolyte layer is subject to Stokes drag arising from the polyelectrolyte segments. The method allows arbitrary distribution of polymer segments and charge density normal to the surface to be used. The hydrodynamic plane of shear may also be varied. The potential profile is determined by a numerical solution to the nonlinearized Poisson-Boltzmann equation. The potential profile is then used in a numerical solution to the Navier-Stokes equation to give the required mobility. The use of the nonlinearized Poisson-Boltzmann equation extends the results to higher charge density/lower ionic strength conditions than previous treatments. The surface potentials and mobilities for three limiting charge distributions are compared for both the linear and nonlinear treatments to delimit the range of validity of the linear treatment. The utility of the numerical, nonlinear treatment is demonstrated by an improved fit to the electrophoretic mobility of human erythrocytes as a function of ionic strength in the range 10 to 150 mM.

Iris abscesses with and without intralenticular fungal invasion in the horse

OBJECTIVE

To describe clinical and histologic findings in horses with iris abscesses. Design Retrospective medical records study.

ANIMALS STUDIED

Medical records of horses that had iris abscesses at the University of Florida Veterinary Medical Center, Peterson & Smith Equine Hospital, and Veterinary Eye Specialists of London, Ontario, from 2005 to 2008 were reviewed.

PROCEDURE

Data collected from the medical records included signalment, clinical and histologic descriptions of ocular lesions, therapy, complications, and visual outcomes.

RESULTS

The medical records of two Quarterhorses, one pony, one warmblood, one Westphalian, and one Arab horse with unilateral iris abscesses were identified. Mild-to-severe clinical signs of iridocyclitis were present in all six eyes with iris abscesses. The eyes of two horses with iris abscesses were also associated with deep stromal abscesses and responded to medical therapy alone in one case, and medical therapy and corneal transplantation in the other. Iris abscesses in two horses were also associated with intralenticular invasion due to a Cladosporium and a Fusarium-type fungus respectively, and resulted in enucleations. Two horses with iris abscesses and no apparent lens involvement resolved with medical therapy in one case and surgical removal of the iris abscess and medical therapy in the other.

CONCLUSIONS

This is the first clinical report of iris abscesses in the horse, and the first histologic report of fungal invasion of the horse lens.

Metastatic intraocular chondrosarcoma in a dog

Chondrosarcoma accounts for about 10% of all canine bone tumors and is the second most common primary bone tumor in dogs. In veterinary medicine, chondrosarcomas are classified as skeletal and extraskeletal. Extraskeletal chondrosarcomas are mesenchymal neoplasms of soft tissues and visceral organs that produce neoplastic chondrocytes in a fibrillary matrix. There is no involvement of bone or periosteal tissues in extraskeletal chondrosarcomas. The aim of this report is to describe the first case of a metastatic intraocular extraskeletal chondrosarcoma in a dog.

The isolation of epithelial cells from the rat epididymis

Epithelial cells from the epididymis were released by digesting the chopped epididymis with pronase followed by collagenase plus hyaluronidase. The epithelial cells were further separated from contaminating cell types by differential centrifugation and sedimentation at unit gravity through a gradient of sucrose in Ringer. The isolated cells remained viable as judged by the exclusion of trypan blue. The cells respired in the presence of glucose and the rate of respiration was not altered by the subsequent addition of pyruvate.

Doxycycline levels in preocular tear film of horses following oral administration

OBJECTIVE

To determine the concentration of doxycycline in preocular tear film following oral administration in horses as a possible therapeutic modality for infectious and keratomalacic equine keratitis.

PROCEDURE

Eight broodmares without ocular disease from a Thoroughbred breeding facility were included in this study. Each mare received 20 mg/kg of doxycycline by mouth once daily in the morning for five consecutive days. Tears were collected 1 h after doxycycline administration starting on day one of administration and continuing for 10 consecutive days. Doxycycline levels in the tears were measured using liquid chromatography with tandem mass spectrometric detection (LC-MS/MS).

RESULTS

Doxycycline was present in the tears of each mare at low microg/mL levels with the highest concentration appearing on the third to fifth days (8.21-9.83 microg/mL). Doxycycline levels had fallen below quantifiable ranges by day 10. No systemic side-effects were noted in any of the horses included in this study.

CONCLUSIONS

Oral doxycycline is present in preocular tear film of normal horses with noninflamed eyes and may be useful as treatment in equine ulcerative keratomalacia. The oral dose listed was tolerated well by the horses in this study. The drug levels attained at 20 mg/kg once daily orally of doxycycline may aid in the treatment of corneal ulceration in horses, but further study is warranted.

Endothelin-1, nitric oxide, and glutamate in the normal and glaucomatous dog eye

PURPOSE

To document differences in the levels of the endothelin-1 peptide, nitric oxide, and glutamate in aqueous humor and vitreous in the dog eye with spontaneous glaucoma compared to the normal dog eye.

METHODS

Samples of aqueous humor and vitreous from enucleated normal eyes (n = 21) of 14 dogs and glaucomatous eyes (n = 8) of eight dogs were collected. Levels of endothelin-1, nitric oxide, and glutamate were measured by enzyme immunoassay.

RESULTS

Endothelin-1 aqueous humor levels (mean +/- SD) increased significantly from 3.05 (+/- 1.66) pg/mL for the normal eyes to 6.22 (+/- 2.83) pg/mL for the glaucomatous eyes (P = 0.0054). The increase in vitreous from 1.83 (+/- 1.66) pg/mL for the normal eyes to 2.86 (+/- 1.31) pg/mL for the glaucomatous eyes was not significant (P = 0.0840). Nitric oxide levels (mean +/- SD) increased significantly in aqueous humor from 4.12 (+/- 2.64) microM for the normal eyes to 12.95 (+/- 14.42) microM for the glaucomatous eyes (P = 0.0141). The vitreous levels increased from 4.86 (+/- 3.92) microM for the normal eyes to 15.33 (+/- 16.22) microM for the glaucomatous eyes (P = 0.0179). Glutamate levels (mean +/- SD) decreased nonsignificantly in aqueous humor from 2.35 (+/- 3.84) microM for the normal eyes to 1.61 (+/- 0.74) microM for the glaucomatous eyes (P = 0.9377) and in vitreous from 1.37 (+/- 1.89) microM for the normal eyes to 1.02 (+/- 1.11) microM for the glaucomatous eyes (P = 0.3303).

CONCLUSION

Endothelin-1 and nitric oxide increased in aqueous humor and vitreous of dogs with spontaneous glaucoma while the changes in glutamate varied.

Measurement of retinal nerve fiber layer thickness in normal and glaucomatous Cocker Spaniels by scanning laser polarimetry

OBJECTIVE

To measure changes in the thickness of the retinal nerve fiber layer in normal and early glaucomatous dogs with scanning laser polarimetry.

ANIMALS STUDIED

A total of 45 eyes, 32 normal and 13 glaucomatous eyes, of American Cocker Spaniels with primary glaucoma were used. All eyes were evaluated through a complete neuro-ophthalmic examination, tonometry, gonioscopy, slit-lamp biomicroscopy, and indirect ophthalmoscopy prior to enucleation.

METHODS

The retinal nerve fiber layer thickness was measured in anesthetized animals with scanning laser polarimetry (Nerve fiber analyzer, GDx; Laser Diagnostic Technologies, LTD, San Diego, CA, USA). Glaucomatous eyes retained some vision at the time of this study.

RESULTS

The mean +/- SD of the retinal nerve fiber layer thickness was 141.69 +/- 18 microm for normal dogs and 105.08 +/- 23.86 microm for visual glaucomatous dogs. The average retinal nerve fiber layer thickness in the superior and inferior retinal quadrants was 148.03 +/- 8.5 and 141.06 +/- 8.73 microm, respectively, for normal dogs, and 106.61 +/- 25.77 and 107.08 +/- 24.99 microm in the superior and inferior retinal quadrants, respectively, for glaucomatous dogs. The superior to nasal retinal nerve fiber layer thickness ratio was 1.45 for normal dogs and 1.26 for visual glaucomatous dogs.

CONCLUSIONS

Using scanning laser polarimetry it was possible to detect changes in retinal nerve fiber layer thickness in glaucomatous dogs at early stages of the disease. Therefore, this instrument has the potential to improve the clinical management of canine glaucoma by detecting progressive changes to the retinal nerve fiber layer.

Lithium toxicity from an Internet dietary supplement

INTRODUCTION

The widespread availability of medications and herbal products on the Internet has increased the potential for poisonings. We are reporting a case of mild, acute lithium toxicity occurring after the intentional misuse of a lithium-containing "dietary supplement" (Find Serenity Now) obtained over the Internet.

CASE REPORT

An 18-year-old woman presented to our emergency department (ED) after ingesting 18 tablets of Find Serenity Now; each tablet contained, according to the listing, 120 mg of lithium orotate [3.83 mg of elemental lithium per 100 mg of (organic) lithium orotate compared to 18.8 mg of elemental lithium per 100 mg of (inorganic) lithium carbonate]. The patient complained of nausea and reported one episode of emesis. Her examination revealed normal vital signs. The only finding was a mild tremor without rigidity. Almost 90 minutes after the ingestion, her serum lithium level was 0.31 mEq/L, a urine drug screen was negative, and an electrocardiogram (ECG) showed a normal sinus rhythm. The patient received intravenous fluids and an anti-emetic; one hour later, her repeat serum lithium level was 0.40 mEq/L. After 3 hours of observation, nausea and tremor were resolved, and she was subsequently transferred to a psychiatric hospital for further care. Prior human and animal data have shown similar pharmacokinetics and shared clinical effects of these lithium salts.

DISCUSSION

Over-the-Internet dietary supplements may contain ingredients capable of causing toxicity in overdose. Chronic lithium toxicity from ingestion of this product is also of theoretical concern.

Blood flow velocity response of the ophthalmic artery and anterior optic nerve head capillaries to carbogen gas in the rhesus monkey model of optic nerve head ischemia

PURPOSE

To determine the effect on blood flow velocity of the ophthalmic artery and anterior superficial optic nerve head (ONH) capillaries by changing inhaled gas from 100% oxygen to carbogen (95% oxygen, 5% CO(2)) in rhesus monkeys receiving chronic unilateral orbital endothelin-1 administration.

METHODS

The right eye of six young male rhesus monkeys (Macaca mulatta) received endothelin-1 (ET-1) by osmotic minipumps to the perineural optic nerve (0.3 microg/day) for 8 months. Three additional monkeys (control group) received the ET-1 vehicle (Sham) solution to the right optic nerve for the same period of time. The left eye served as a nontreated control in both groups. The blood flow velocities of the anterior ONH capillaries and ophthalmic artery were assessed in both eyes using confocal laser scanning flowmetry (CSLF) and color Doppler imaging (CDI), respectively.

RESULTS

A slight increase in the CDI blood flow velocities and a small decrease in the resistive index of the ophthalmic artery, and increased flow of the ONH capillaries in rhesus monkeys were detected when inhaled gas was changed from 100% oxygen to carbogen. The difference in CSLF blood flow in the nasal ONH between the endothelin-1 (ET-1) treated right eye and the normal left eye of the same individual monkeys was significantly greater than the difference in blood flow between the Sham-treated right eye and the normal left eye in control animals under the conditions of carbogen and oxygen inhalation.

CONCLUSION

Carbogen inhalation slightly influences the microcirculation of the globe and ONH in rhesus monkeys. These data suggest that low dose ET-1 administration has a subtle vasorelaxing effect in the ONH microcirculation in this animal model of ONH ischemia.

Proteinases of the cornea and preocular tear film

Maintenance and repair of corneal stromal extracellular matrix (ECM) requires a tightly coordinated balance of ECM synthesis, degradation and remodeling in which proteolytic enzymes (proteinases) perform important functions. There are natural proteinase inhibitors present in preocular tear film (PTF) and cornea simultaneously with proteinases that prevent excessive degradation of normal healthy tissue. Disorders occur when there is an imbalance between proteinases and proteinase inhibitors in favor of the proteinases, causing pathologic degradation of stromal collagen and proteoglycans in the cornea. Two matrix metalloproteinases (MMPs), MMP-2 and MMP-9, are of major importance in terms of remodeling and degradation of the corneal stromal collagen. Immunohistochemical studies have shown different origins of MMP-2 and -9. MMP-2 is synthesized by corneal keratocytes and performs a surveillance function in the normal cornea, becoming locally activated to degrade collagen molecules that occasionally become damaged. Alternatively, MMP-9 may be produced by epithelial cells and polymorphonuclear neutrophils following corneal wounding. Because the cornea is in close contact with the preocular tear film (PTF), proteinases have been evaluated in the PTF. In damaged corneas, total proteolytic activity in the tear fluid was found to be significantly increased compared to normal eyes and contralateral eyes. Studies analyzing the proteolytic activity in serial PTF samples during corneal healing led to the following conclusions: ulcerative keratitis in animals is associated with initially high levels of tear film proteolytic activity, which decrease as ulcers heal; proteinase levels in melting ulcers remain elevated leading to rapid progression of the ulcers. The success of medical and surgical treatment of the corneal ulcers is reflected by the proteolytic activity in tears. In animals, successful treatment leads to a rapid reduction in tear film proteolytic activity that corresponds with the improvement in the clinical signs of corneal ulceration. The in vitro effects of various compounds on proteolytic activity in the tear fluid of animals with ulcerative keratitis have been evaluated and their important inhibitory effects have been confirmed. Because these various compounds utilize different mechanisms to inhibit various families of proteinases, a combination of these proteinase inhibitors may be beneficial.

Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990-2002): 38 horses

OBJECTIVE

The purpose of this study was to evaluate the effectiveness of postoperative beta-irradiation with strontium-90 as an adjunctive treatment to superficial keratectomy and permanent bulbar conjunctival graft for removal of equine corneolimbal squamous cell carcinoma (SCC), in decreasing recurrence rate.

STUDY

The retrospective case study included 38 horses diagnosed and treated for SCC of the eye that involved the limbus and/or cornea. The patients were treated between 1990 and 2002, with strontium-90 irradiation immediately after corneal and conjunctival graft surgery. Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe that was previously treated.

RESULTS

The Appaloosa was the most commonly represented breed and horses that had more than one base coat color represented the majority of the cases (53%). The coat colors of white, chestnut/sorrel and gray were the most commonly represented colors of the horses treated. Eight horses (21%) could not be assessed for tumor recurrence due to lack of two or more post-treatment examinations, and another horse was enucleated 6 days postoperatively due to progressive corneal ulceration. Twenty-four horses (63% of the entire study population; 83% of the followed cases) had a mean +/- SD of 1754 +/- 1319 days without tumor recurrence, ranging from 14 days to 5110 days. Five horses (13% of the entire study population; 17% of the assessed horses) had tumor recurrence at a mean +/- SD of 449 +/- 339 days with a range of 29 days to 900 days. For the five recurrences, treatment included local excision (n = 1), enucleation (n = 2), and additional strontium-90 therapy (n = 3).

CONCLUSIONS

The combination of superficial keratectomy, beta-irradiation and permanent bulbar conjunctival grafts for limbal, corneal or corneolimbal SCC in horses is effective in at least 83% of the horses. Recurrence occurred in about 17% of the horses. Multiple biannual re-examinations are recommended to observe for tumor recurrence.

Amniotic membrane transplantation for corneal surface reconstruction after excision of corneolimbal squamous cell carcinomas in nine horses

OBJECTIVE

The purpose of this study was to evaluate the usefulness and effectiveness of permanent amniotic membrane transplantation as an adjunctive treatment to superficial keratectomy alone or combined with strontium-90 irradiation for treatment of equine corneolimbal squamous cell carcinoma (SCC) to decrease corneal scarring and recurrence rate.

STUDY

The retrospective case study included 11 horses (n = 12 eyes) diagnosed and treated for ocular SCC that involved the limbus and cornea. Nine of those horses (n = 9 eyes) were treated between 2002 and 2006, with superficial lamellar keratectomy alone or combined with strontium-90 irradiation and followed by placement of a permanent amniotic membrane graft in the surgical defect. The level of scarring (i.e. the clarity of the cornea) resulting with the use of amniotic membrane was subjectively compared to cases where a permanent bulbar conjunctival graft was performed following keratectomy combined with strontium-90 irradiation or cryotherapy (n = 3 eyes). Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe.

RESULTS

The nine horses that received an amniotic membrane graft after keratectomy alone or combined with irradiation showed a minimal level of scarring in a cornea that regained a greater transparency in comparison to the horses that were treated with a bulbar conjunctival graft. All of the horses that received an amniotic membrane graft had 226 +/- 218 days of follow-up without tumor recurrence (mean +/- SD), ranging from 21 days to 778 days.

CONCLUSIONS

The combination of superficial keratectomy alone or associated with beta-irradiation and permanent amniotic membrane transplantation is an effective treatment of corneal or corneolimbal SCC in horses. The placement of an amniotic membrane material represents an alternative surgical procedure to bulbar conjunctival grafts, especially if there is a lack of bulbar conjunctiva tissue available after tumor resection or if a particularly large corneal resection is necessary. The amniotic membrane is incorporated into the corneal defect and seems to create noticeably much less scarring than a corneal defect covered by bulbar conjunctiva.

Effectiveness of commercially-available antibiotic-impregnated implants

The aim of this study was to determine the effectiveness of antibiotic-impregnated implants in the prevention of bone infection. We used a model of contaminated fracture in goats to evaluate four treatment groups: no treatment, hand-made tobramycin-impregnated polymethylmethacrylate beads, commercially-available tobramycin-impregnated calcium sulphate pellets and commercially-available tobramycin-impregnated polymethylmethacrylate beads. Three weeks after intraosseous inoculation with streptomycin-resistant Staphylococcus aureus tissue cultures showed no evidence of infection in any of the antibiotic-treated groups. All of the cultures were positive in the untreated group. These results show that effective local antibiotic delivery can be obtained with both commercially-available products and with hand-made polymethylmethacrylate beads. The calcium sulphate pellets have the advantage of being bioabsorbable, thereby obviating the need for a second procedure to remove them.

Ascorbic acid levels of aqueous humor of dogs after experimental phacoemulsification

Phacoemulsification has been successfully employed in humans and animals for lens extraction. This ultrasonic extracapsular surgical technique induces hydroxyl radical formation in the anterior chamber, which accumulates despite irrigation and aspiration. In this paper we determined the total antioxidant status of aqueous humor after phacoemulsification by measuring aqueous humor ascorbic acid levels. Mixed-breed dogs (n = 11; weighing about 10 kg) with normal eyes as determined by slit-lamp biomicroscopy, applanation tonometry, and indirect ophthalmoscopy had phacoemulsification performed in one eye with the other eye used as a control. Samples of aqueous humor were obtained by anterior chamber paracentesis before surgery and at days 1, 2, 3, 7, and 15 after surgery. Total aqueous humor antioxidant status was inferred from the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis (2-amidopropane) chlorine. Ascorbic acid concentrations were measured by high-pressure liquid chromatography with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by anova followed by the paired t-test. Total antioxidant capacity was reduced from 48 to 27 min during the first 24 h with a gradual increase thereafter, remaining statistically lower than the control eye until 7 days postoperatively. Reduced levels of ascorbic acid followed this reduction in antioxidant capacity (from 211 to 99 microm after 24 h), remaining lower than the control eye until 15 days postoperatively. Protein concentration in aqueous humor increased from 0.62 mg/mL to 30.8 mg/mL 24 h after surgery, remaining statistically lower than the control eye until 15 days postoperatively. Paracentesis alone did not significantly alter the parameters measured. These results indicate that after phacoemulsification, the aqueous humor ascorbic acid levels and antioxidant defenses in aqueous humor are reduced, indirectly corroborating free radical production in the anterior chamber as a result of phacoemulsification. The inflammatory process consequent to the surgical procedure demonstrated by increased protein content in aqueous humor can also contribute to free radical production and ascorbic acid consumption.

Pars plana vitrectomy for the treatment of ophthalmomyiasis interna posterior in a dog

Unilateral chorioretinitis caused by ophthalmomyiasis interna posterior in a 5-month-old, female spayed Dachshund is reported. Larva removal by pars plana vitrectomy was performed after an unsuccessful photocoagulation of the organism. The larva was intact after surgical removal and was identified as a first stage instar Cuterebra spp. larva. The eye remains visual and comfortable with no signs of residual or recurrent inflammation postoperatively. This report describes, for the first time, the successful surgical retrieval of an intravitreal fly larva in a dog using vitrectomy techniques without sacrificing either the globe or vision, and taxonomic identification of the parasite.

Evaluation of clinical characteristics and bacterial isolates in dogs with bacterial keratitis: 97 cases (1993-2003)

OBJECTIVE

To evaluate clinical characteristics and breeds affected with bacterial keratitis and compare patterns of resistance in bacterial isolates over time in dogs.

DESIGN

Retrospective cross-sectional study.

ANIMALS

97 dogs with bacterial keratitis.

PROCEDURE

Dogs with bacterial keratitis were identified from teaching hospital medical records at the Universities of Tennessee and Florida during the years 1993 to 2003. Data were collected pertaining to breed, Schirmer tear test results, treatments administered at the time of initial examination, bacterial species isolated, and resistance to selected antimicrobials.

RESULTS

66% of the dogs were brachycephalic, 54% had tear production < 15 mm/min, and 29% were receiving a corticosteroid at the time of initial examination. The most common bacteria isolated were Staphylococcus intermedius (29%), beta-hemolytic Streptococcus spp (17%), and Pseudomonas aeruginosa (21%). Staphylococcus intermedius isolates had limited resistance to certain antimicrobials. More than 80% of beta-hemolytic Streptococcus spp isolates were resistant to neomycin, polymyxin B, and tobramycin. Isolates of P aeruginosa were susceptible to tobramycin and gentamicin and had limited resistance to ciprofloxacin and enrofloxacin. Among bacterial species isolated, there was no evidence of development of antimicrobial resistance over time.

CONCLUSIONS AND CLINICAL RELEVANCE

Data suggested that administration of ciprofloxacin or a combination of a first-generation cephalosporin and tobramycin may be used in the treatment of bacterial keratitis while awaiting results of bacterial culture and susceptibility testing. Evidence suggests that current methods of medical management of bacterial keratitis are not associated with increased antimicrobial resistance.