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Jadhav V, Goyal J, Sahu S, Kelgaonkar A, Basu S, Pathengay A. Asymptomatic Ophthalmomyiasis Interna Posterior with Central Pigment Accumulation in the Inner Retina. Ocul Immunol Inflamm 2024:1-3. [PMID: 38995727 DOI: 10.1080/09273948.2024.2374433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE To report a case of ophthalmomyiasis interna posterior which was asymptomatic and had pigment clumps in the inner retina at the macula. METHODS Single-centre, observational, retrospective case report. RESULTS A routine refractive error check-up for an asymptomatic 52-year-old Asian Indian woman, who had relied on glasses for 8 years, unfolded a captivating narrative within her retina. This coloured fundus photo unveils mid-peripheral retinal disease with multiple outer retinal atrophic tracts, circumlinear patterns, and intricately intertwined RPE atrophic tracts. These were hyper-autofluorescent on blue autofluorescence. The inferonasal periphery had two-disc diameters of pigmented retinal-choroidal atrophic scar. The macula revealed a collection of black intraretinal pigments in parafoveal areas. The distinct clinical presentation, marked by multiple tracts and unilateral manifestation without disc pallor, hinted at the intriguing possibility of self-resolved "Ophthalmomyiasis interna posterior." CONCLUSION The course of disease in ophthalmomyiasis interna posterior can be self-limiting and asymptomatic. The presence of inner retinal pigments at foveal and parafoveal areas, possibly due to pigment migration from the peripheral outer retinal tracts, is a rare presentation.
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Affiliation(s)
- Vishal Jadhav
- Uveitis, Vitreous and Retina Services, LV Prasad Eye Institute, Bhubaneswar, India
| | - Jyoti Goyal
- Uveitis, Vitreous and Retina Services, LV Prasad Eye Institute, Bhubaneswar, India
| | - Suman Sahu
- Vitreous, Retina and ROP Services, LV Prasad Eye Institute, Bhubaneswar, India
| | - Anup Kelgaonkar
- Uveitis, Vitreous and Retina Services, LV Prasad Eye Institute, Bhubaneswar, India
| | - Soumyava Basu
- Saroja A Rao Centre of Uveitis, LV Prasad Eye Institute, Hyderabad, India
| | - Avinash Pathengay
- Uveitis, Vitreous and Retina Service, LV Prasad Eye Institute, Visakhapatnam, India
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Clare G, Kempen JH, Pavésio C. Infectious eye disease in the 21st century-an overview. Eye (Lond) 2024:10.1038/s41433-024-02966-w. [PMID: 38355671 DOI: 10.1038/s41433-024-02966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in aggregate, may account for a significant portion of the global visual burden. Diagnosis is frequently challenging even in specialist centres, and many disease presentations are highly regional. In an age of globalisation, an understanding of the various modes of transmission and the geographic distribution of infections can be instructive to clinicians. The impact of eye infections on global disability is currently not sufficiently captured in global prevalence studies on visual impairment and blindness, which focus on bilateral disease in the over-50s. Moreover, in many cases it is hard to differentiate between infectious and immune-mediated diseases. Since infectious eye diseases can be preventable and frequently affect younger people, we argue that in future prevalence studies they should be considered as a separate category, including estimates of disability-adjusted life years (DALY) as a measure of overall disease burden. Numbers of ocular infections are uniquely affected by outbreaks as well as endemic transmission, and their control frequently relies on collaborative partnerships that go well beyond the remit of ophthalmology, encompassing domains as various as vaccination, antibiotic development, individual healthcare, vector control, mass drug administration, food supplementation, environmental and food hygiene, epidemiological mapping, and many more. Moreover, the anticipated impacts of global warming, conflict, food poverty, urbanisation and environmental degradation are likely to magnify their importance. While remote telemedicine can be a useful aide in the diagnosis of these conditions in resource-poor areas, enhanced global reporting networks and artificial intelligence systems may ultimately be required for disease surveillance and monitoring.
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Affiliation(s)
| | - John H Kempen
- Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Sight for Souls, Bellevue, WA, USA
- MCM Eye Unit; MyungSung Christian Medical Center (MCM) Comprehensive Specialized Hospital and MyungSung Medical College, Addis Ababa, Ethiopia
- Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
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Visioli G, Zeppieri M, Iannucci V, Manni P, Albanese GM, Salati C, Spadea L, Pirraglia MP. From Bedside to Diagnosis: The Role of Ocular Fundus in Systemic Infections. J Clin Med 2023; 12:7216. [PMID: 38068267 PMCID: PMC10707096 DOI: 10.3390/jcm12237216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 01/23/2024] Open
Abstract
In this comprehensive review, we delve into the significance of the ocular fundus examination in diagnosing and managing systemic infections at the bedside. While the utilization of advanced ophthalmological diagnostic technologies can present challenges in bedside care, especially for hospitalized patients confined to their beds or during infection outbreaks, the ocular fundus examination often emerges as an essential, and sometimes the only practical, diagnostic tool. Recent discussions have highlighted that the role of an ocular fundus examination might not always be advocated as a routine diagnostic procedure. With this context, we introduce a decision tree tailored for assessing the ocular fundus in inpatients with systemic infections. We also present an overview of systemic infections that impact the eye and elucidate key signs detectable through a bedside ocular fundus examination. Targeted primarily at non-ophthalmology clinicians, this review seeks to offer a comprehensive insight into a multifaceted approach and the enhancement of patient clinical outcomes.
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Affiliation(s)
- Giacomo Visioli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Valeria Iannucci
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Priscilla Manni
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Giuseppe Maria Albanese
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Leopoldo Spadea
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (G.V.)
- Eye Clinic, Policlinico Umberto I University Hospital, 00161 Rome, Italy
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Amin RH, Abdullatif AM. Management of presumed trematode-induced granulomatous intermediate uveitis. Eye (Lond) 2023; 37:2299-2304. [PMID: 36477731 PMCID: PMC10366116 DOI: 10.1038/s41433-022-02336-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/16/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To describe the surgical management of presumed trematode-induced granulomatous intermediate uveitis (PTIGIU) not responding to medical treatment in controlling the inflammation. METHODS A prospective, interventional, single-center study in which patients with a history of fresh canal water contact and PTIGIU were enrolled. All patients underwent lensectomy-pars plana vitrectomy (PPV) and post-operative control of inflammation, functional and anatomical outcomes were assessed. RESULTS Fifteen eyes of 12 patients were included in the study with median age of 11.6 ± 4 yrs. Six months following lensectomy-PPV, inflammation was well controlled in all patients. The eyes were divided into two groups: Group A: 10 patients with an attached retina while Group B: 5 patients who were in the cicatricial stage with tractional retinal detachment. All patients in group A had CDVA of 20/40 or better, unlike patients in group B who failed to achieve a CDVA better than 20/70 throughout their follow-up. In group B, final anatomical success was achieved in only 40% with hypotony occurring in 20%. CONCLUSION PTIGIU is associated with the presence of ciliary body granuloma which, if left untreated, can lead to drastic outcomes. Early lensectomy-PPV represents a viable management option in cases resistant to medical treatment, with a favorable outcome.
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Das D, Rehman O, Bhattacharjee K, Bhattacharjee H, Jyoti Barman M, Choudhury A, Deka A, Islam S. Parasitic Eye Diseases: Nuances in Rapid Identification and Advanced Microscopy. Ocul Immunol Inflamm 2023:1-4. [PMID: 37364062 DOI: 10.1080/09273948.2023.2226218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/18/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
AIM To study parasitic eye diseases in a tertiary institute of North-east India by live examination of parasites, rapid staining, and scanning electron microscopy (SEM). METHODS A 12-year retrospective analysis was performed and all patients diagnosed with ocular parasitic diseases were identified. Examination under a compound microscope, fluorescein staining, and scanning electron microscopy were done. RESULTS A total of 160 ocular parasitosis cases were identified. The cases for which rapid staining and SEM studies were done included Cysticercosis (n = 18, 11.25%), Hydatidosis (n = 5, 3.13%), Dirofilariasis (n = 5, 3.13%), Thelaziasis (n = 3, 1.87%), and Gnathostomiasis (n = 2, 1.25%). Live examination was performed in 11 cases (6.63%) and 8 cases (4.82%) underwent scanning electron microscopy. . CONCLUSION Fluorescein staining for identification of parasites and SEM study helped in detailing microscopic and ultrastructural findings.
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Affiliation(s)
- Dipankar Das
- Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Obaidur Rehman
- Department of Ophthalmic Plastic & Reconstructive Surgery and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Kasturi Bhattacharjee
- Department of Ophthalmic Plastic & Reconstructive Surgery and Facial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
| | | | - Manab Jyoti Barman
- Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Amit Choudhury
- Department of Parasitology, Veterinary Science College, Guwahati, India
| | - Apurba Deka
- Department of Statistics, Gauhati University, Guwahati, India
| | - Saidul Islam
- Department of Ocular Pathology, Sri Sankaradeva Nethralaya, Guwahati, India
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Ravaynia PS, Lombardo FC, Biendl S, Dupuch MA, Keiser J, Hierlemann A, Modena MM. Parallelized Impedance-Based Platform for Continuous Dose-Response Characterization of Antischistosomal Drugs. ACTA ACUST UNITED AC 2020; 4:e1900304. [PMID: 32510834 DOI: 10.1002/adbi.201900304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/19/2020] [Indexed: 11/11/2022]
Abstract
Schistosomiasis is an acute and chronic disease caused by tropical parasitic worms of the genus Schistosoma, which parasitizes annually over 200 million people worldwide. Screening of antischistosomal compounds is hampered by the low throughput and potential subjectivity of the visual evaluation of the parasite phenotypes, which affects the current drug assays. Here, an impedance-based platform, capable of assessing the viability of Schistosoma mansoni schistosomula exposed to drugs, is presented. This automated and parallelized platform enables unbiased and continuous measurements of dose-response relationships for more than 48 h. The platform performance is established by exposure of schistosomula to three test compounds, praziquantel, oxethazaine, and mefloquine, which are known to affect the larvae phenotypes. The system is thereafter used to investigate the response of schistosomula to methiothepine, an antipsychotic compound, which causes complex drug-induced effects. Continuous monitoring of the parasites reveals transient behavioral phenotypes and allows for extracting temporal characteristics of dose-response curves, which are essential for selecting drugs that feature high activity and fast kinetics of action. These measurements demonstrate that impedance-based detection provides a wealth of information for the in vitro characterization of candidate antischistosomals and, represents a promising tool for the identification of new lead compounds.
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Affiliation(s)
- Paolo S Ravaynia
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
| | - Flavio C Lombardo
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Stefan Biendl
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Matthias A Dupuch
- Micro and Nanosystems, Department of Mechanical and Process Engineering, ETH Zürich, Tannenstrasse 3, Zurich, 8092, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Department of Medical Parasitology and Infection Biology, University of Basel, Socinstrasse 57, Basel, 4051, Switzerland
| | - Andreas Hierlemann
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
| | - Mario M Modena
- Bioengineering Laboratory, Department of Biosystems Science and Engineering, ETH Zürich, Mattenstrasse 26, Basel, 4058, Switzerland
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Ciuca L, Meomartino L, Piantedosi D, Cortese L, Cringoli G, Rinaldi L, Lamagna B. Irreversible Ocular Lesions in a Dog With Angiostrongylus Vasorum Infection. Top Companion Anim Med 2019; 36:4-8. [PMID: 31472726 DOI: 10.1053/j.tcam.2019.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 11/11/2022]
Abstract
This report describes a 10-month-old dog with a sudden loss of vision and severe dyspnoea. The ocular examination revealed bilateral panuveitis, lens subluxation, secondary glaucoma, and retinal detachment. In addition, the ocular ultrasound showed in the vitreous body of the right eye, a small doubled-lined foreign body compatible with an intraocular parasite. Radiographs of the thorax revealed an increased opacity with mixed lung pattern (alveolar and bronchial) and thoracic ultrasonography showed several subpleural nodules. The presence of Angiostrongylus vasorum first stage larvae was confirmed with 324 larvae per gram of feces and an antigen test for the parasite (AngioDetect, IDEXX) also yielded a positive result. The severe and irreversible ocular lesions described in this case enhanced the complexity of the clinical picture of canine angiostrongylosis. Infection with the parasite should be included in the list of differential diagnoses for ocular uveitis to avoid potentially serious complications related to a missed or delayed diagnosis.
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Affiliation(s)
- Lavinia Ciuca
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Leonardo Meomartino
- Interdepartmental Centre of Veterinary Radiology, University of Naples Federico II, Naples, Italy
| | - Diego Piantedosi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Laura Cortese
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Giuseppe Cringoli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Laura Rinaldi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Barbara Lamagna
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy.
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