1
|
Baxter CR, Mccandless MG, Lin AL. Characteristics and Risk Factors for Rhegmatogenous Retinal Detachment Related to Endophthalmitis. JOURNAL OF VITREORETINAL DISEASES 2024; 8:138-143. [PMID: 38465361 PMCID: PMC10924589 DOI: 10.1177/24741264231218509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose: To evaluate the risk factors for the development of concurrent or delayed-onset rhegmatogenous retinal detachment (RRD) related to endophthalmitis as well as the anatomic and visual outcomes with subsequent RRD repair. Methods: In this retrospective case study, a 2-tailed t test (continuous) and Fisher exact test were used to determine statistical significance of the observed findings. The relative risk (RR) and 95% CIs were calculated to assess statistical significance. Results: Of the 170 patients included, 22 were found to have a concurrent or subsequent RRD. Initial treatment with pars plana vitrectomy (PPV) (RR, 3.544; 95% CI, 1.650-7.614), aphakia (RR, 4.150; 95% CI, 1.434-12.011), endogenous endophthalmitis (RR, 2.684; 95% CI, 1.065-6.764), and posterior synechiae (RR, 3.026; 95% CI, 1.408-6.505) were statistically significant risk factors for RRD. Anatomically successful repair was achieved in 77.7% of patients. Conclusions: In addition to preexisting risk factors, the initial treatment of endophthalmitis may be a significant risk factor for RRD development, with a higher incidence of subsequent RRD in patients who have PPV as the initial treatment for endophthalmitis.
Collapse
Affiliation(s)
- Cary R. Baxter
- Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Martin G. Mccandless
- Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Albert L. Lin
- Department of Ophthalmology, University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
2
|
Wei D, Pu N, Li SY, Wang YG, Tao Y. Application of iontophoresis in ophthalmic practice: an innovative strategy to deliver drugs into the eye. Drug Deliv 2023; 30:2165736. [PMID: 36628545 PMCID: PMC9851230 DOI: 10.1080/10717544.2023.2165736] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Delivery of drugs to special locations of ocular lesions, while minimizing systemic and local toxic effects, is recognized as a critical challenge in the ophthalmic practice. The special anatomy and physiology barriers within the eyeball entail effective drug delivery systems. Emerging attempts in drug delivery has led to developments in ocular iontophoresis, which acts as a noninvasive technology to enhance drug penetration using a small electric current. This technique offers greater flexibility to deliver desired drug dose in a controlled and tolerable manner. In previous studies, this technique has been testified to deliver antibiotics, corticoid, proteins and other gene drugs into the eye with the potency of treating or alleviating diverse ophthalmological diseases including uveitis, cataract, retinoblastoma, herpes simplex and cytomegalovirus retinitis (CMVR), etc. In this review, we will introduce the recent developments in iontophoresis device. We also summarize the latest progress in coulomb controlled iontophoresis (CCI), hydrogel ionic circuit (HIC) and EyeGate II delivery system (EGDS), as well as overview the potential toxicity of iontophoresis. We will discuss these factors that affect the efficacy of iontophoresis experiments, and focus on the latest progress in its clinical application in the treatment of eye diseases.
Collapse
Affiliation(s)
- Dong Wei
- Henan Eye Institute, Henan Eye Hospital, People’s Hospital of Zhengzhou University, Henan University School of Medicine, Henan Provincial People’s Hospital, Zhengzhou, China,College of Medicine, Zhengzhou University, Zhengzhou, China
| | - Ning Pu
- Henan Eye Institute, Henan Eye Hospital, People’s Hospital of Zhengzhou University, Henan University School of Medicine, Henan Provincial People’s Hospital, Zhengzhou, China,College of Medicine, Zhengzhou University, Zhengzhou, China
| | - Si-Yu Li
- College of Medicine, Zhengzhou University, Zhengzhou, China
| | - Yan-Ge Wang
- Henan Eye Institute, Henan Eye Hospital, People’s Hospital of Zhengzhou University, Henan University School of Medicine, Henan Provincial People’s Hospital, Zhengzhou, China,CONTACT Yan-Ge Wang
| | - Ye Tao
- Henan Eye Institute, Henan Eye Hospital, People’s Hospital of Zhengzhou University, Henan University School of Medicine, Henan Provincial People’s Hospital, Zhengzhou, China,Ye Tao Henan Eye Institute, Henan Eye Hospital, People’s Hospital of Zhengzhou University, Henan University School of Medicine, Henan Provincial People’s Hospital, Zhengzhou450003, China
| |
Collapse
|
3
|
Jandewerth T, Schmack I, Koch F, Kohnen T, Arad T. [Recurrent immunological intraocular inflammatory reaction after intravitreal operative drug administration]. DIE OPHTHALMOLOGIE 2023; 120:69-71. [PMID: 35294594 DOI: 10.1007/s00347-022-01600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/30/2022] [Accepted: 02/11/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Tyll Jandewerth
- Klinik für Augenheilkunde, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Main, Deutschland
| | - Ingo Schmack
- Klinik für Augenheilkunde, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Main, Deutschland
| | - Frank Koch
- Klinik für Augenheilkunde, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Main, Deutschland
| | - Thomas Kohnen
- Klinik für Augenheilkunde, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Main, Deutschland
| | - Tschingis Arad
- Klinik für Augenheilkunde, Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Main, Deutschland.
| |
Collapse
|
4
|
Herwig-Carl MC, Holz F, Löffler KU. [Ophthalmopathologic Aspects of Endophthalmitis]. Klin Monbl Augenheilkd 2022; 239:867-875. [PMID: 35858597 DOI: 10.1055/a-1782-8061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Endophthalmitis is one of the most severe ophthalmic emergencies. Most patients experience a permanent decrease in visual acuity after the event, but the eye can be preserved in most cases. However, when the eye is enucleated after endophthalmitis, ophthalmopathologic investigation of the globe with respect to the clinical history can provide valuable information regarding the ultimately frustrating course of the disease that can be helpful for the treatment of future patients. Often, valuable aspects also emerge with regard to the therapeutic approach. For example, in therapy-resistant fungal endophthalmitis the necessity of penetrating keratoplasty with a large graft diameter and possibly even removal of the lens including the capsular bag should be stressed. In the following, five enucleated eyes with a different spectrum of endophthalmitis, as well as different potential pathways of exogenous and endogenous endophthalmitis, are illustrated clinically and ophthalmopathologically. In summary, endophthalmitis requires urgent intervention; however, various differential diagnoses must be excluded. Histopathologic examination of enucleated eyes is helpful for understanding the course of the disease and may also have forensic significance.
Collapse
Affiliation(s)
| | - Frank Holz
- Universitäts-Augenklinik, Universitätsklinikum Bonn, Deutschland
| | - Karin U Löffler
- Universitäts-Augenklinik, Universitätsklinikum Bonn, Deutschland
| |
Collapse
|
5
|
Peng KL, Kung YH, Tsai HS, Wu TT. Treatment outcomes of acute poptoperative infectious endophthalmitis. BMC Ophthalmol 2021; 21:384. [PMID: 34715824 PMCID: PMC8555216 DOI: 10.1186/s12886-021-02144-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/07/2021] [Indexed: 12/04/2022] Open
Abstract
Background Acute postoperative endophthalmitis is one of the most severe complications of modern ophthalmic procedures including cataract surgeries, vitrectomy and intravitreal injection (IVI). We evaluated the treatment outcomes of acute postoperative infectious endophthalmitis. Methods In this retrospective study, we collected data from 82 patients with acute infectious endophthalmitis within 6 weeks after intraocular surgeries, including cataract surgeries, vitreoretinal surgeries, and IVI, from January 2010 to December 2019. We analyzed the pre-treatment, treatment-related and post-treatment factors that affected visual outcomes. Results The mean age was 67.65 ± 9.52 years, the proportion of male patients was 56.1%. The mean baseline vision was 1.92 (Snellen Equivalent SE], counting finger [CF]) ± 0.54 logarithm of the minimum angle of resolution (log MAR) and the mean final vision was 0.71 (SE, 39/200) ± 0.80 logMAR. Visual improvement was significant (P < 0.001). The pre-treatment factors affecting final visual outcomes were diabetes, hemodialysis, baseline vision, signs of vitreous opacity, and different surgeries before endophthalmitis; the treatment-related factors affecting visual outcomes were the choice factors between IVI of antibiotics alone and vitrectomy combined with IVI of antibiotics, and the injection numbers of antibiotics; post-treatment factors affecting visual outcomes were complications such as retinal detachment (RD), glaucoma and macular pucker. Furthermore, prior cataract surgery was associated with a better mean final vision of 0.57 (SE, 54/200) ± 0.67 logMAR while prior vitrectomy resulted in the worst mean final vision of 1.38 (SE, 21/500) ± 0.75 logMAR. Conclusions The important factors that affected the final visual prognosis, included diabetes, hemodialysis, baseline vision, severity of vitritis, treatment strategies and complications. The treatment outcomes revealed better final vision in prior cataract surgery than vitrectomy.
Collapse
Affiliation(s)
- Kai-Ling Peng
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, R.O.C.,Shu-Zen Junior College of Medicine and Management, Kaohsiung,, Taiwan, R.O.C
| | - Ya-Hsin Kung
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, R.O.C.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C
| | - Hui-Shuang Tsai
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, R.O.C
| | - Tsung-Tien Wu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, R.O.C.. .,Shu-Zen Junior College of Medicine and Management, Kaohsiung,, Taiwan, R.O.C.. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C..
| |
Collapse
|