Navegando por Palavras-chave "keratitis"

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    Bilateral deep keratitis caused by systemic lupus erythematosus
    (Lippincott Williams & Wilkins, 2004-03-01) Adan, CBD; Trevisani, VFM; Vasconcellos, M.; Freitas, D. de; Souza, L. B. de; Mannis, M.; Universidade Federal de São Paulo (UNIFESP); Univ Santo Amaro; Univ Calif Davis
    We report the optical and ultrasonic biomicroscopy and confocal microscopy findings in bilateral stromal keratitis (keratoendotheliitis), a rare ocular manifestation of systemic lupus erythematosus (SLE). Examination revealed deposits with polyrefringent crystals. Topical corticosteroid produced regression of the corneal edema, but there was an increase in corneal opacity. Ultrasound biomicroscopy images confirmed the deep location of the corneal opacities, and confocal microscopy showed a disruption of the corneal stroma and crystal-like bodies.
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    Corneal infections after implantation of intracorneal ring segments
    (Lippincott Williams & Wilkins, 2004-08-01) Hofling-Lima, A. L.; Branco, B. C.; Romano, A. C.; Campos, MQS; Moreira, H.; Miranda, D.; Kwitko, S.; Freitas, D. de; Casanova, F.; Sartori, M.; Schor, P.; Souza, L. B.; Universidade Federal de São Paulo (UNIFESP); Univ Fed Parana; Univ Fed Rio Grande Sul
    Purpose: To report risk factors, clinical course, and outcome in patients with infectious keratitis following implantation of intracorneal ring segments (ICRS).Methods: the records of 8 patients with culture-proven infectious keratitis after ICRS (Ferrara(R) or Intacs(R)) implantation were retrospectively reviewed. Age, gender, corneal findings, ocular abnormalities, the condition that led to ICRS implantation, immediate prior use of a contact lens, elapsed time between implantation and the onset of symptoms, previous medications, and systemic disorders were noted.Results: Culture-positive infectious keratitis developed in 7 eyes of 7 patients (2 men and 5 women) with a mean age of 35 years who underwent Ferrara implantantion for the treatment of keratoconus and in a 29-year-old man who underwent Intacs implantation for correction of low myopia. Contact lens use, diabetes, and trauma were factors possibly associated with the risk of infection in three cases. Microorganisms, identified in all cases, included Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Pseudomonas sp, Nocardia sp, Klebsiella sp, and Paecylomices sp. Onset of symptoms of infection varied from less than 1 week to 22 months postoperatively, depending on the infecting organism.Conclusions: infectious keratitis following ICRS implantation is a sight-threatening complication for which early recognition and rapid institution of appropriate treatment may result in a better visual outcome.
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    First report of presumed parasitic keratitis in Indians from the Brazilian Amazon
    (Lippincott Williams & Wilkins, 2000-11-01) Garrido, C.; Campos, M.; Universidade Federal de São Paulo (UNIFESP)
    Purpose. To describe corneal disorders in patients with systemic parasitic disease. Methods. Cross-sectional study consisted of ophthalmologic examinations, peripheral blood tests and skin biopsies in 496 subjects (395 Indians and 101 non-indians) from the upper Negro River, Brazilian Amazon. Results. Mansonella ozzardi was detected in the blood of 140 (28.23%) subjects. Seventy-six (55.07%) of them also presented multiple nummular opaque superficial lesions in the cornea. None of the examined patients presented onchocercal-related skin lesions or positive skin biopsies for filaria. Conclusion. There was a significant association between mansonelliasis and keratitis.
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    Fusarium Keratitis: Genotyping, in Vitro Susceptibility and Clinical Outcomes
    (Lippincott Williams & Wilkins, 2013-05-01) Oechsler, Rafael Allan [UNIFESP]; Feilmeier, Michael R.; Miller, Darlene; Shi, Wei; Hofling-Lima, Ana Luisa [UNIFESP]; Alfonso, Eduardo C.; Univ Miami; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To determine differences in the clinical characteristics and antifungal susceptibility patterns among molecularly characterized ocular Fusarium sp isolates.Methods: Fifty-eight isolates of Fusarium sp obtained from 52 eyes of 52 patients were retrieved from the Ocular Microbiology Laboratory of the Bascom Palmer Eye Institute and grown in pure culture. These isolates were characterized based on DNA sequence analysis of the ITS1/2 and ribosomal deoxyribonucleic acid regions. Antifungal susceptibilities were determined for each isolate using broth microdilution methods, and the corresponding medical records were reviewed to determine the clinical outcomes.Results: Fusarium solani isolates had significantly higher values of minimum inhibitory concentration for 90% isolates (MIC90) with voriconazole than F. non-solani organisms (16 and 4 mu g/mL, respectively). Isolates of F. solani also exhibited a significantly longer time to cure (65 vs. 40.5 days), a worse follow-up best-corrected visual acuity (20/118 vs. 20/36), and an increased need for urgent surgical management (7 vs. 0 penetrating keratoplasties) when compared with those of F. non-solani.Conclusions: This is the first report to examine the correlation between ocular genotyped Fusarium sp and clinical outcomes. It supports the overall worse prognosis of F. solani versus F. non-solani isolates, including higher voriconazole resistance by the former. the clinical implementation of molecular-based diagnostics and antifungal efficacy testing may yield important prognostic and therapeutic information that could improve the management of fungal ocular infections.
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    In vitro activity of fluoroquinolones against ocular bacterial isolates in São Paulo, Brazil
    (Lippincott Williams & Wilkins, 2007-02-01) Dourado Oliveira, Adalia Dias; Alves d'Azevedo, Pedro; Francisco, Waldemar; Hoefling-Lima, Ana Luisa; Universidade Federal de São Paulo (UNIFESP); Fdn Fac Fed Ciencias Med Porto Alegre; Fac Ciencias Med Santa Casa
    Purpose: To compare the in vitro susceptibility profiles of bacterial ocular isolates and to determine minimum inhibitory concentrations (MICs) of gatifloxacin and moxifloxacin (fourth-generation fluoroquinolones) versus ciprofloxacin and ofloxacin (second-generation fluoroquinolones).Methods: Gram-positive and gram-negative isolates were recovered from cases of keratitis, conjunctivitis, and endophthalmitis between 2002 and 2004 and were identified and extracted from the Microbiology Data Bank of the Federal University of São Paulo, São Paulo, Brazil. the comparison of in vitro MIC and susceptibility profiles for ofloxacin, ciprofloxacin, gatifloxacin, and moxifloxacin in gram-positive and gram-negative (n = 219) isolates was performed using the E test method.Results: the fourth-generation fluoroquinol ones were statistically more potent than the second generations for gram-positive bacteria. the MIC90 level was lower for moxifloxacin than that for gatifloxacin against Staphylococcus aureus, methicillin-susceptible coagulase-negative Staphylococcus (CoNS), and S. pneumoniae, whereas the levels were equal against S. viridans and the gatifloxacin MIC90 was lower in methicillin-resistant CoNS. There was no statistically significant difference between moxifloxacin and gatifloxacin when the permutation method from the MULTTEST procedure (SAS proc multtest) was used to obtain the adjusted P value. MIC90 for ciprofloxacin was lower in gram-negative bacteria. MIC90 for ofloxacin was higher against Haemophilus spp. and Moraxella spp. Ciprofloxacin was the most statistically potent fluoroquinolone for Pseudomonas spp. Ciprofloxacin was statistically just as potent as gatifloxacin for the other gram-negative isolates.Conclusion: From susceptibility profiles achieved with in vitro testing, the fourth-generation fluoroquitiolones may offer some advantages over the currently available fluoroquinolones; however, a combination of the pharmacodynamics and pharmacokinetics of the drug, infection site, and the MIC is needed to predict the in vivo efficacy and best clinical applicability.
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    In vitro amoebicidal activity of S-nitrosoglutathione and S-nitroso-N-acetylcysteine against trophozoites of Acanthamoeba castellanii
    (Oxford Univ Press, 2010-03-01) Cariello, Angelino Julio [UNIFESP]; Pereira de Souza, Gabriela Freitas; Foronda, Annette Silva [UNIFESP]; Zorat Yu, Maria Cecilia [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Oliveira, Marcelo Ganzarolli de; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
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    Microbiota Evaluation of Patients With a Boston Type I Keratoprosthesis Treated With Topical 0.5% Moxifloxacin and 5% Povidone-Iodine
    (Lippincott Williams & Wilkins, 2013-04-01) Magalhaes, Fernanda Pedreira [UNIFESP]; Nascimento, Heloisa Moraes do [UNIFESP]; Ecker, David J.; Sannes-Lowery, Kristin A.; Sampath, Rangarajan; Rosenblatt, Mark I.; Sousa, Luciene Barbosa de [UNIFESP]; Oliveira, Lauro Augusto de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Ibis Biosci Inc; Weill Cornell Med Coll
    Purpose: To evaluate the efficacy of a prophylactic regimen of daily topical 0.5% moxifloxacin and 5% povidone-iodine (PI) in patients with Boston type I keratoprosthesis (KPro) and to assess the applicability of a novel molecular diagnostic technique to analyze the ocular surface microbiota in these patients.Methods: Ten patients had their inferior conjunctival fornix sampled for standard culture methods before the addition of topical 5% PI to the prophylactic regimen and were considered the control group (group 1). the inferior conjunctival fornix and the KPro-donor cornea interface of 10 patients treated with the mentioned prophylactic regimen were sampled and analyzed by standard culture methods and using a polymerase chain reaction/electrospray ionization mass spectrometry assay (group 2).Results: Samples from the inferior conjunctival fornix were positive for coagulase-negative staphylococcus in 3 patients and for Aerobasidium pullulans in 1 patient in group 1. the inferior conjunctival fornix and the KPro-donor cornea interface scrapings were positive for coagulase-negative staphylococcus in 2 patients and 1 patient, respectively, in group 2. No bacteria and fungi growth were detected in any patient from group 2 with the molecular diagnostic approach. None of the patients with culture-positive results developed keratitis or endophthalmitis during the study.Conclusions: Topical 0.5% moxifloxacin associated with topical 5% PI is an effective prophylactic regimen in patients with Boston type I KPro. the molecular diagnostic approach using serial polymerase chain reaction and mass spectrometry was comparable with standard microbiologic techniques as a surveillance tool in these patients.
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    Ocular rosacea
    (Ethis Communicatins, Inc, 2005-01-01) Alvarenga, Lênio Souza [UNIFESP]; Mannis, Mark J. [UNIFESP]; Univ Calif Davis; Universidade Federal de São Paulo (UNIFESP)
    Rosacea is a common skin disease that frequently involves the eye. Although the pathogenesis of the disease remains undefined, recent findings suggest that an altered inflammatory response plays an important role in both cutaneous and ocular rosacea. Ocular manifestations include lid and ocular surface alterations. Chronic inflammation can lead to corneal vascularization, which may compromise vision. Treatment of ocular rosacea is aimed at preventing irritation of the ocular surface (e.g., lubricants, lid hygiene) and controlling inflammation with topical and systemic anti-inflammatory drugs. Systemic tetracyclines are the mainstay of treatment. These drugs act multifactorially by decreasing bacterial flora and the expression of matrix metalloproteinases, altering meibum secretion, inhibiting the production of bacterial lipases, and providing an immunomodulatory effect.
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    Ocular wavefront aberrations in patients after diffuse lamellar keratitis
    (Lippincott Williams & Wilkins, 2007-01-01) Beer, Sandra Maria Canelas; Campos, Mauro; Lopes, Paraguassu Tibirica; Andre, Jose Armando; Schor, Paulo; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To study ocular wavefront aberrations after laser in situ keratomileusis (LASIK) in patients who developed diffuse lamellar keratitis (DLK).Methods: A case-control evaluation of 47 patients with DLK and 30 uneventful LASIK-operated controls. Measurements of visual acuities, cycloplegic refraction, eye's wave aberrations using a LADARWAVE aberrometer (up to eighth order), and corneal topography were obtained after LASIK treatment. All of the surgeries were performed using the Hansatome or the Moria microkeratome and the LadarVision excimer laser system.Results: Mean follow-up interval from the day of the operative procedure to the examination day was 6.26 (DLK group; range, 2-13 months) and 6.23 months (control group; range, 3-9 months). Mean preoperative spherical equivalent was -3.7 D in patients with DLK and -3.7 D in controls. High-order aberration S7+7 (P = 0.015) was statistically different in the DLK group from that in controls. High-order aberrations S3+3 (P = 0.091) and S8+4 (chi(2) = 8.014, P = 0.046) showed a tendency to be different from controls. Loss of best-corrected visual acuity was greater in patients with DLK.Conclusions: the occurrence of DLK after LASIK surgery may not significantly affect the visual outcome.
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    Random amplified polymorphic DNA profiles as a tool for the characterization of Brazilian keratitis isolates of the genus Acanthamoeba
    (Associação Brasileira de Divulgação Científica, 2000-01-01) Alves, J.m.p.; Gusmão, C.x.; Teixeira, M.m.g.; Freitas, Denise de [UNIFESP]; Foronda, A.s.; Affonso, H.t.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    The genus Acanthamoeba comprises free-living amebae identified as opportunistic pathogens of humans and other animal species. Morphological, biochemical and molecular approaches have shown wide genetic diversity within the genus. In an attempt to determine the genetic relatedness among isolates of Acanthamoeba we analyzed randomly amplified polymorphic DNA (RAPD) profiles of 11 Brazilian isolates from cases of human keratitis and 8 American type culture collection (ATCC) reference strains. We found that ATCC strains belonging to the same species present polymorphic RAPD profiles whereas strains of different species show very similar profiles. Although most Brazilian isolates could not be assigned with certainty to any of the reference species, they could be clustered according to pattern similarities. The results show that RAPD analysis is a useful tool for the rapid characterization of new isolates and the assessment of genetic relatedness of Acanthamoeba spp. A comparison between RAPD analyses and morphological characteristics of cyst stages is also discussed.
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    Síndrome de Cogan: relato de caso
    (Conselho Brasileiro de Oftalmologia, 2005-12-01) Medeiros, Fabricio Witzel De; Altieri, Rosana Aparecida Soares [UNIFESP]; Souza, Murilo Barreto; Milani, José Antonio De Almeida; Alves, Milton Ruiz; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Faculdade de Tecnologia e Ciências Faculdade de Medicina
    Non-luetic interstitial keratitis, deafness and vertigo characterize Cogan's syndrome. The most common ocular findings in early Cogan's syndrome are bilateral, peripheral, subepithelial numular corneal opacities. The report presents a patient with the evolution of the classic form of Cogan's syndrome.
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    Twenty Years of Acanthamoeba Keratitis
    (Lippincott Williams & Wilkins, 2009-06-01) Carvalho, Fabio Ramos de Souza [UNIFESP]; Foronda, Annette Silva [UNIFESP]; Mannis, M. J.; Hoefling-Lima, Ana Luisa [UNIFESP]; Belfort, R. [UNIFESP]; Freitas, Denise de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Univ Calif Davis
    Purpose: We described the rate of Acanthamoeba keratitis (AK) in a referral eye center in Sao Paulo, Brazil, through a retrospective review of clinical and laboratorial records of patients over 2 decades.Methods: From 1987 to 2006, a total of 581 requests for amoebic laboratory workup in cases of infections keratitis were investigated. Statistical analyses were applied to analyze a tendency of AK cases.Results: Acanthamoeba species were cultured from corneal scrapings of 185 patients, 5 of them with bilateral infection. Eighty-three percent of those patients were related with contact lens wear.Conclusions: The results suggested that patients with AK have persisted and increased over time at our ophthalmology center. Contact lenses showed to be a potential risk factor. Amoebic corneal infection can be considered as a new but well-established disease ill Brazilian ophthalmology and visual sciences.
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    Use of oral voriconazole as adjunctive treatment of severe cornea fungal infection: case report
    (Conselho Brasileiro de Oftalmologia, 2006-06-01) Freda, Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Banco de Olhos de Porto Alegre Setor de Córnea e Doenças Externas
    A case of Aspergillus flavus keratitis was successfully treated with oral voriconazole and penetrating keratoplasty after conventional antifungal medical therapy failure.