Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ciprofloxacin 0.3% ophthalmic solution has been shown to be effective in the treatment of bacterial keratitis and conjunctivitis, and many physicians use ciprofloxacin as sole therapy in these conditions. In this retrospective study, we found seven of 84 isolates from corneal and conjunctival cultures that were resistant to ciprofloxacin. All of the resistant organisms were gram positive. Six of the isolates (Staphylococcus aureus, Staphylococcus hominis, and four isolates of the Streptococcus viridans group) were from corneal cultures, and one (Staphylococcus aureus) was from a conjunctival culture. Yearly records of systemic isolates from 1988 to 1993 (n = 35,308) demonstrated a statistically significant decrease in susceptibility for several organisms that are common pathogens in the conjunctiva and cornea: Pseudomonas aeruginosa (95-90%, p = 0.001); Staphylococcus aureus (96-87%, p < 0.0001); Staphylococcus spp., coagulase negative (97-81%, p < 0.0001); Enterococcus spp. (92-79%, p < 0.0001); Acinetobacter anitratus (97-77%, p = 0.0006); and Enterobacter cloacae (100-96%, p = 0.03). Although the susceptibility of corneal and conjunctival isolates in this series remained relatively high (91.7%), a much larger series of systemic isolates that are common ocular pathogens revealed a statistically significant increase in resistance to ciprofloxacin over the preceding 5 years.
Cornea 1996 Jan
PMID:Susceptibility of corneal and conjunctival pathogens to ciprofloxacin. 890 83

Although Streptococcus pneumoniae is usually extremely sensitive to penicillin, recent reports in the nonophthalmic literature indicate a rise in the prevalence of penicillin-resistant pneumococci. We report a case of penicillin-resistant S. pneumoniae keratitis in a 51-year-old woman with severe rheumatoid arthritis. This report is only the second such case in the ophthalmic literature and may indicate the emergence of penicillin-resistant strains of S. pneumoniae as ocular pathogens.
Cornea 1996 Jan
PMID:Penicillin-resistant Streptococcus pneumoniae keratitis. 890 89

The purpose of this study was to determine whether corneal epithelial defects and epitheliopathy in patients with unilateral dysfunction of the ophthalmic division of the trigeminal nerve (neurotrophic keratitis) is associated with reduced aqueous tear production. Sensation of the skin, cornea, and nasal mucosa, aqueous tear production by Schirmer 1 testing, nasal-lacrimal reflex, and exposure zone rose bengal staining were evaluated in the affected and fellow eyes of subjects with neurotrophic keratitis (n = 5), eyes of subjects who had recent herpes zoster ophthalmicus (HZO) and who did not develop neurotrophic keratitis (n = 4), and normal controls (n = 10). Sensation in the brow and upper lid skin and nasal mucosa was absent on the affected side of patients with neurotrophic keratitis, but was intact in all other groups. Corneal sensation and Schirmer 1 test values were significantly reduced (p < or = 0.05) in eyes with neurotrophic keratitis compared with the other groups. The nasal-lacrimal reflex was absent on the involved side of subjects with neurotrophic keratitis but was intact in subjects with HZO without keratopathy, and in normal controls (p < 0.008). Rose bengal keratitis staining scores were significantly increased in eyes with neurotrophic keratitis compared with the other groups (p < 0.05). We conclude that neurotrophic keratitis is associated with reduced cutaneous, nasal mucosal, and corneal sensation on the affected side, as well as marked reduction in aqueous tear production with loss of the nasal-lacrimal reflex. It is possible that the corneal epithelial pathology in neurotrophic keratitis is due in part to aqueous tear deficiency.
Cornea 1996 Mar
PMID:Aqueous tear production in patients with neurotrophic keratitis. 892 60

A 36-year-old man sustained an indolent keratitis following a minor corneal trauma. Nocardia brasiliensis was isolated from cultures of the corneal scrapings. Fortified topical antibiotics, based on in vitro drug sensitivity testing, were intensively applied for weeks without clinical improvement. The patient underwent therapeutic lamellar keratectomy, which led to a rapid and complete resolution. The site of the keratectomy reepithelialized within 2 days and became a faint subepithelial haze thereafter. The visual acuity improved to 20/20 and there was no evidence of recurrence during the subsequent follow-up. It appears that lamellar keratectomy is a valuable treatment alternative for localized chronic nocardial keratitis.
Cornea 1996 Mar
PMID:Nocardia brasiliensis keratitis successfully treated with therapeutic lamellar keratectomy. 892 64

We sought to identify the types of, prevalence of, and predisposing factors for the development of surface keratopathy after penetrating keratoplasty. We reviewed the records of 120 corneal grafts performed over a 15-month period. Twenty patients were excluded from the study. Fifty-three men and 47 women composed the group studied. All transplants were performed by the same surgeon. Retrospective data from patients' records were gathered preoperatively and from postoperative visits at 1 week and at 1, 2, 3, and 4 months. Data included preoperative medical and demographic data, operative time, postoperative medication regimens, assessment of the presence and degree, if present, of punctate epithelial keratopathy (PEK), hurricane keratopathy, macroepithelial defects, microcystic edema, bullous edema, and filamentary keratitis. In addition, information on the donor material was recorded. Surface disease and normal groups were compared to identify risk factors for the occurrence of surface abnormalities. Thirty-three of the patients demonstrated persistent surface abnormalities. Coarse PEK was the most common surface abnormality in the sample studied and was most prominent in the first week after surgery. Postoperative surface keratopathy was not statistically associated with preoperative diagnosis, donor age, death-to-preservation time, preservation-to-surgery time, or donor epithelial status. However, corneal recipients in the group with surface keratopathy were significantly older (mean, 68.7 years) than patients in the group with no surface abnormalities (mean, 52.6 years; Mann-Whitney U test, p < 0.001). Although many factors may contribute to the normal integrity of the corneal surface after keratoplasty, recipient age is of key importance in the development of surface disease.
Cornea 1997 Jan
PMID:Preoperative risk factors for surface disease after penetrating keratoplasty. 898 26

We sought to determine whether there are unique findings in infections crystalline keratitis (ICK) examined by confocal microscopy and if confocal microscopy is predictive for bacteriology in ICK. A retrospective review of consecutive patients with a presumed diagnosis of ICK by slit-lamp examination was performed. These patients were then examined with confocal microscope and cultured. Sixteen patients were identified by biomicroscopy. Average age was 71 years; 12 of 16 patients were women; 10 of 16 had prior penetrating keratoplasty; and 12 of 16 were taking topical steroids. Confocal microscopy revealed a variable appearance to the crystals in the corneal stroma. Eight of 16 patients had distinct needle-like deposits at varying depths in the stroma, and eight had amorphous deposits grouped at different levels of the stroma. The results of confocal microscopic examination resembled the reported histopathology with clusters of deposits, but its current resolution does not allow identification of bacterial morphology. There was no correlation of morphology with culture results. Organisms were recovered in 12 of 16 patients by culture. In 10 of 16 patients, the infection was successfully treated with topical antibiotics, usually cefazolin. Crystal morphology of ICK can be observed by confocal microscopy. No pathognomonic, single pattern for this disease is seen with the confocal microscope. The latter may be an aid in determining the clinical response to treatment.
Cornea 1997 Jan
PMID:Evaluation of infectious crystalline keratitis with confocal microscopy in a case series. 898 29

Confocal microscopy provides a new, noninvasive way of imaging the human cornea in vivo. One of its most important clinical uses is the diagnosis and management of infectious keratitis. The authors used tandem scanning confocal microscopy to image the corneas in two culture-proven cases of Aspergillus keratitis. Fungal hyphae were imaged as high-contrast filaments 6 microns in diameter from 60 to 400 microns in length. Confocal microscopy may be a fast and safe diagnostic tool in determining the presence of fungal hyphae in vivo within the human cornea.
Cornea 1997 Jan
PMID:Diagnosis of Aspergillus keratitis in vivo with confocal microscopy. 898 30

Synthetic peptides, ranging from 12 to 18 residues, containing partial sequences from natural cecropin A and melittin were tested for activity in an experimental pseudomonas keratitis model in rabbits. In separate experiments, two Pseudomonas aeruginosa strains: (a) a clinical isolated strain, and (b) an American Type Culture Collection (ATCC) strain, were inoculated into the stroma of one cornea of each rabbit. Peptides were topically applied at 0.1% in phosphate-buffered saline (PBS) and compared with PBS alone and 0.3% gentamicin eye drops. Clinical evaluation, based on the McDonald-Shadduck scale, was performed during a > 48-h period after the bacterial inoculation. The peptide-treated animals showed significantly lower (p < 0.05) inflammatory signs and lower anterior-segment bacterial damage compared with PBS-treated animals, after the first 6 h. The antiinflammatory/antimicrobial activity was non significantly differnt (p > 0.05) from that in animals treated with gentamicin. We conclude that peptides keeping the sequence KWKLFKK from cecropin A and at least the sequence VLKVL from melittin show promise as novel agents in topical ocular therapy of bacterial keratitis.
Cornea 1997 Jan
PMID:Effect of hybrid peptides of cecropin A and melittin in an experimental model of bacterial keratitis. 898 41

The literature is reviewed concerning the pathophysiologic effects of contact-lens wear, the microbiology of contact-lens wear, the change in microflora with contact-lens wear, the contamination of contact lenses and contact-lens products, patient compliance, and corneal interaction with the contact lens. Hypoxia and hypercapnia are the most significant changes in the cornea as a result of contact-lens wear. Changes take place in the conjunctival flora in patients with contact lenses. Compliance of patients and contamination of contact lenses and contact-lens products are significant risk factors. The corneal interaction with the contact lens can overwhelm the protective mechanisms of the cornea, increasing the ability of microbes to adhere to the cornea and progress to microbial keratitis. Some of the factors associated with microbial keratitis are modifiable and should stimulate the contact-lens industry to develop better contact lenses and contact lens products and also permit ophthalmologists to obtain better informed consent from their patients.
Cornea 1997 May
PMID:Contact lens-related microbial keratitis: Part II: Pathophysiology. 914 96

The editors of this Festschrift asked us to review the use of antibiotics for the treatment of bacterial conjunctivitis and keratitis over the past 25 years, a period coinciding with the life of the Castroviejo Corneal Society. We believe it is more appropriate to begin our review in the late 1960s. about the time that experimental and clinical studies and algorithms for the clinical care derived from these studies helped shape a more rigorous approach to therapy. Those years saw the introduction of antibiotics that were adapted for ophthalmic use, many of which are still being used today. We will give more weight to our review of keratitis than conjunctivitis.
Cornea 2000 Sep
PMID:The evolution of antibiotic therapy for bacterial conjunctivitis and keratitis: 1970-2000. 1100 18


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