Publications by authors named "Nattaporn Tesavibul"

29 Publications

  • Page 1 of 1

Visual outcome of endogenous endophthalmitis in Thailand.

Sci Rep 2021 Jul 12;11(1):14313. Epub 2021 Jul 12.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

To evaluate a 10-year visual outcome of endogenous endophthalmitis (EE) patients. A 10-year retrospective chart review of EE patients. Thirty-eight patients (40 eyes) were diagnosed with EE at the mean age of 42. Among the identifiable pathogens (71.1% culture positive), the causative agents were predominantly gram-negative bacteria (48.1%). The most common specie was Klebsiella pneumoniae (25.9%). About a quarter of the patients required surgical eye removal, and the remaining 45.7% had visual acuity (VA) worse than hand motion at one month after the infectious episode. The most common complication was ocular hypertension (52.5%). Poor initial VA was significantly associated with a worse visual outcome in the early post-treatment period (p 0.12, adjusted OR 10.20, 95% CI 1.65-62.96). Five patients continued to visit the clinic for at least ten years. One patient had gained his vision from hand motion to 6/7.5. Two patients had visual deterioration, one from corneal decompensation, and the other from chronic retinal re-detachment. Two patients developed phthisis bulbi, with either some VA perception of light or no light perception. Poor initial VA is the only prognostic factor of a poor early post-treatment visual outcome of EE.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-93730-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275623PMC
July 2021

Triggering factors associated with a new episode of recurrent acute anterior uveitis.

Sci Rep 2021 Jun 9;11(1):12156. Epub 2021 Jun 9.

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.

To identify triggering factors for the next inflammatory episode of recurrent acute anterior uveitis (RAAU), a 1:1 case-control study was conducted. We interviewed RAAU patients with recent acute anterior uveitis attack and quiescent controls for their information during a previous month using Srithanya Stress Test (ST-5) and questionnaires about potential triggering factors. Asymptomatic controls were matched for age (± 5 years), sex, and HLA-B27. There were 39 pairs of cases and controls. Patients who recently experienced a uveitis attack demonstrated higher mean ST-5 scores (3.7 ± 2.9 vs 0.7 ± 1.1) and shorter sleep time (6.3 ± 1.4 vs 7.4 ± 0.7 h per day) compared with their controls. In the multivariate conditional logistic regression analysis, ST-5 score ≥ 3 (OR 9.07, 95% CI 1.14-72.16, p = 0.037) and sleep time < 7 h per day (OR 12.12, 95% CI 1.37-107.17, p = 0.025) were more likely to trigger a uveitis attack in RAAU accounted for patients' age, sex, HLA- B27 positivity, and presence of concurrent anti-inflammatory drugs for co-existing diseases. Other suspected triggering factors were not found to have any significant association. In short, stress and inadequate sleep may lead to the future episode of acute anterior uveitis in RAAU. Both physical and emotional stress management should be advised to RAAU patients to minimize recurrences and further complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-91701-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190149PMC
June 2021

Epidemiology of keratitis/scleritis-related endophthalmitis in a university hospital in Thailand.

Sci Rep 2021 May 27;11(1):11217. Epub 2021 May 27.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Prannok, Bangkok-noi, Bangkok, 10700, Thailand.

To demonstrate the demographics, associated factors, clinical presentations, microbiology, management, visual outcome and complications of keratitis/scleritis-related endophthalmitis (KSE). A retrospective chart of all endophthalmitis patients diagnosed between September 2001 and August 2011 was reviewed. Only endophthalmitis cases with previous corneal or scleral infection were included in the study. The patients were followed until losing vision or eyeball, becoming phthisis, or the end of 2018. Eighty-seven patients with KSE were identified, all unilateral. The mean age was 56.4 ± 21.4 years. There was a slight male predilection (55 patients, 63.2%). The mean follow-up time was 50 ± 149 weeks. The causative pathogens were identified in 35 patients (40.2%), with the highest frequency being bacteria. The most common bacterium was Pseudomonas aeruginosa (n = 13), and the most common fungus was Aspergillus sp. (n = 5). Fifteen patients achieved (17.2%) final visual acuity (VA) of hand motion or better after treatment. Eyeball removal was performed in 61 (70.1%) patients. From multivariate analysis, the only prognostic factor for poor final VA (worse than hand motion, HM) was poor VA (worse than HM) at the initial visit (relative risk 1.97, 95% confidence interval 1.15-3.36, p = 0.013). KSE is uncommon but has a devastating outcome. We found that the patient's initial VA was the only predictor for their final vision. P. aeruginosa was the most common identifiable organism in this study. However, several fungal infections were recognised. These findings should raise awareness for treatment of KSE in the tropics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-90815-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160326PMC
May 2021

Extralesional microvascular and structural macular abnormalities in cytomegalovirus retinitis.

Sci Rep 2020 12 8;10(1):21432. Epub 2020 Dec 8.

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang-Lang Road, Siriraj Hospital, Bangkoknoi, Bangkok, 10700, Thailand.

To evaluate extralesional microvascular and structural changes of the macula using optical coherence tomography angiography (OCTA) and structural OCT in cytomegalovirus retinitis (CMVR). An observational study of CMVR patients were performed. Complete ophthalmic examination, serial color fundus photography, structural OCT and OCTA were performed at baseline and follow-up visits for up to 12 months. The structural OCT was analyzed to evaluate macular areas within, bordering and beyond the CMVR lesions. Extralesional retinal capillary plexus of the macula were evaluated by OCT angiography and compared with the unaffected fellow eyes. Thirteen eyes from 13 patients were enrolled. At baseline, macular areas without CMVR lesions showed decreased vessel density (VD) of both the superficial (P = 0.0002) and deep (P < 0.0001) retinal capillary plexus in eyes with CMVR as compared with the corresponding macular areas of the unaffected fellow eyes. The decrease of VD persisted through the follow-up period for up to 12 months after adjusting for degree of vitreous haze. Structural macular OCT characteristics at the borders and beyond the lesions included intraretinal hyperreflective dots, cystoid macular edema, subretinal fluid and selective ellipsoid zone (EZ) loss. The selective EZ loss found in 6 of 12 eyes showed recovery in 4 eyes after receiving anti-viral treatment. In CMVR eyes, there were microvascular and microstructural abnormalities in the macular area without clinically visible CMVR lesions. Our results provided interesting insights into CMV infection of the retina.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-78587-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722750PMC
December 2020

Nontuberculous mycobacterial endophthalmitis: case series and review of literature.

BMC Infect Dis 2020 Nov 23;20(1):877. Epub 2020 Nov 23.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.

Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.

Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.

Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients' age ranged from 13 to 89 years with mean of 60.5 ± 17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.

Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner's suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-020-05606-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685667PMC
November 2020

Recommendations for the management of ocular sarcoidosis from the International Workshop on Ocular Sarcoidosis.

Br J Ophthalmol 2020 Sep 15. Epub 2020 Sep 15.

Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

Aims: To establish expert recommendations for the management of ocular sarcoidosis (OS).

Methods: A question-based survey on the management of OS was circulated to international uveitis experts (members of the International Uveitis Study Group and the International Ocular Inflammation Society) electronically. Subsequently, a consensus workshop was conducted at the 7th International Workshop on Ocular Sarcoidosis (IWOS) in June 2019 in Sapporo, Japan as part of the Global Ocular Inflammation Workshops. Statements on the management of OS that were supported by a two-thirds majority of 10 international panel members of the workshop, after discussion and voting, were taken as consensus agreement.

Results: A total of 98 participants from 29 countries responded to the questionnaire survey. The subsequent consensus workshop established recommendations for the management of OS in five sections. The first section concerned evaluation and monitoring of inflammation. The second, third and fourth sections described ocular manifestations that were indications for treatment, and the management of anterior uveitis, intermediate uveitis and posterior uveitis. In the fifth section, the use of systemic corticosteroids and systemic immunosuppressive drugs were detailed.

Conclusions: Recommendations for management of OS were formulated through an IWOS consensus workshop.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bjophthalmol-2020-317354DOI Listing
September 2020

Features and outcomes of immunoglobulin therapy in patients with Good syndrome at Thailand's largest tertiary referral hospital.

Asian Pac J Allergy Immunol 2019 Jun;37(2):109-115

Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Good syndrome (GS) is an adult-onset immunodeficiency characterized by coexisting thymoma and hypogammaglobulinemia. Clinical course after treatment with intravenous immunoglobulin (IVIg) has rarely been reported.

Objective: To investigate and report the clinical course and outcomes of GS patients after treatment with IVIg at Thailand's largest national tertiary referral hospital METHODS: This retrospective chart review included patients diagnosed with GS and treated with IVIg during the 1 January 2005 to 31 December 2015 study period.

Results: Nine GS patients with a median age at diagnosis of 53 years were included. Pneumonia and sepsis were the most common clinical manifestations. Six infectious organisms suggestive of cell-mediated immunity defect occurred in six patients, including cytomegalovirus (CMV), Mycobacterium tuberculosis, Mycobacterium abscessus, Herpes simplex virus (HSV), Pneumocystis jirovecii, and Aspergillus. Mean serum IgG level was 317 mg/dL. Eight patients had very low to undetectable B-cells. Five patients had either low CD4 number or impaired T-cell function, and one patient had both. All patients received IVIg replacement therapy monthly at a dose of 0.4 g/kg. The mean trough IgG level was 881 mg/dL. After treatment with IVIg replacement, seven patients had favorable clinical outcomes. However, two patients expired due to septicemia.

Conclusion: Clinical outcomes of patients with GS are more dependent on the severity of infections and associated hematologic and autoimmune diseases than on the severity of thymoma itself. Therefore, early recognition and prompt IVIg replacement may change the natural course of this condition and may be successful in keeping the patient infections free.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12932/AP-131117-0196DOI Listing
June 2019

Late-onset postoperative Mycobacterium haemophilum endophthalmitis masquerading as inflammatory uveitis: a case report.

BMC Infect Dis 2018 02 7;18(1):70. Epub 2018 Feb 7.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.

Background: Although atypical mycobacteria had been increasingly found in various ocular infections in the past decades, a slow-growing Mycobacterium haemophilum (M. haemophilum) was scarcely reported. Similar to tuberculous infection, the presentation can masquerade as low-grade granulomatous intraocular inflammation with partial response to corticosteroids. Besides, the special requirements for culture make this pathogen difficult to diagnose. The study aims to report the clinical presentation and notify the awareness of NTM endophthalmitis among clinicians. This is the first case report of late-onset, postoperative M. haemophilum endophthalmitis in the literature.

Case Presentation: A 66-year-old man with non-insulin-dependent diabetes mellitus (NIDDM) manifested chronic granulomatous inflammation in the left eye after multiple glaucoma surgeries. With a diagnosis of noninfectious panuveitis, he was treated with systemic corticosteroids. The inflammation initially responded to therapy although it subsequently worsened and became purulent endophthalmitis. The vitreous cultures grew M. haemophilum. Intraocular and systemic antimicrobial treatments were administered early, but the patient eventually turned blind.

Conclusions: M. haemophilum endophthalmitis is a rare but serious intraocular complication leading to loss of vision or eyeball. Awareness of atypical mycobacterial infections is necessary especially in patients with impaired immune function, previous intraocular surgery, and corticosteroid resistance. Proper laboratory investigations and treatments should be performed. However, due to the rarity of the disease, the development of guidelines for its investigation and therapy is still challenging.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-018-2985-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804003PMC
February 2018

Intravitreal bevacizumab in treatment of retinal neovascularization from tuberculous retinal vasculitis.

Int J Ophthalmol 2017 18;10(10):1627-1629. Epub 2017 Oct 18.

Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18240/ijo.2017.10.25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638990PMC
October 2017

Rare presentation of intractable tuberculous panophthalmitis with intraocular and intraorbital abscesses: a case report.

J Med Case Rep 2017 Jul 4;11(1):180. Epub 2017 Jul 4.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

Background: We report a rare presentation of extrapulmonary tuberculosis.

Case Presentation: A 29-year-old Burmese woman with human immunodeficiency virus infection and known pulmonary tuberculosis who had been treated for 5 months presented to our hospital with unilateral progressive painful visual loss of 1 month's duration. She was diagnosed with tuberculous panophthalmitis with subretinal and intraorbital abscesses, conjunctival abscess, and extraocular muscle tuberculoma. The diagnosis was confirmed by a conjunctival pus swab with a positive result for acid-fast bacilli and a positive result for a mycobacterial culture. There was high suspicion of multidrug-resistant tuberculosis. Despite receiving ongoing aggressive treatment with conventional antituberculous medications, this patient required subtotal orbital exenteration to control her infection and prevent further progression. Second-line antituberculous medications were added to the first-line therapy, with satisfactory results achieved.

Conclusions: Tuberculous panophthalmitis with intraocular and intraorbital abscesses is a rare presentation of extrapulmonary tuberculosis. Patients who do not respond to first-line antituberculous therapy might be infected with either single-drug or multidrug-resistant Mycobacterium tuberculosis. Patient compliance is one of the key factors that can alter the course of treatment. Careful patient monitoring can improve disease progression, outcome, and prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13256-017-1353-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496312PMC
July 2017

Uveitis in Siriraj Hospital: pattern differences between immune-related uveitis and infectious uveitis in a university-based tertiary care hospital.

Int Ophthalmol 2018 Apr 20;38(2):673-678. Epub 2017 Apr 20.

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

Purpose: To describe a proportion of uveitis and to analyse differences between immune-related uveitis and infectious uveitis groups.

Methods: A retrospective study of 458 uveitis patients were categorized into immune-related uveitis, infectious uveitis, masquerade, and undetermined groups. The pattern of inflammation was described. Subgroup analysis was performed to compare pattern differences between immune-related uveitis and infectious uveitis groups.

Results: The most common location of inflammation was the anterior eye segment. Vogt-Koyanagi-Harada disease was the most common identifiable cause. From multivariate analysis, variables found to be significantly different between immune-related uveitis group and infectious uveitis group were age of onset, presence of systemic autoimmune diseases, HIV infection, and laterality.

Conclusions: Idiopathic anterior uveitis was the most prevalent diagnosis. Vogt-Koyanagi-Harada disease was the most common identifiable uveitis. Most immune-related uveitis patients were young and presented with chronic bilateral panuveitis, with most patients in the infectious uveitis group presenting with chronic unilateral posterior uveitis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10792-017-0515-5DOI Listing
April 2018

Long-term result of autologous cultivated oral mucosal epithelial transplantation for severe ocular surface disease.

Cell Tissue Bank 2016 Sep 9;17(3):491-503. Epub 2016 Aug 9.

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkoknoi District, Bangkok, 10700, Thailand.

The present study aimed to investigate the clinical outcomes of autologous cultivated oral mucosal epithelial transplantation (COMET) on human amniotic membrane (AM) for corneal limbal stem cell deficiency (LSCD). In this prospective, noncomparative case series, 20 eyes (18 patients) with bilateral severe ocular surface disease were chosen to undergo COMET on human AM. The primary outcome was clinical success, and the secondary outcomes were the best-corrected visual acuity difference, corneal opacification, symblepharon formation, and complications. The mean patient age was 48.2 ± 15.5 years. The mean follow-up time was 31.9 ± 12.1 months (range 8-50 months). All except one eye exhibited complete epithelialization within the first postoperative week. A successful clinical outcome, defined as a stable ocular surface without epithelial defects, a clear cornea without fibrovascular tissue invasion at the pupillary area, and no or mild ocular surface inflammation, was obtained in 15 of 20 eyes (75 %). The clinical success rate at 1 year was 79.3 %, and that at 4 years (end of follow-up) was 70.5 %. Fourteen of 20 (70 %) eyes exhibited improvement in visual acuity after COMET, and some required subsequent cataract surgery (2 eyes), penetrating keratoplasty (3 eyes), or keratoprosthesis implantation (1 eye). Preoperative symblepharon was eliminated in most eyes (8 of 13, 61.5 %) after COMET combined with eyelid reconstruction when needed. The only complication was corneal perforation (1 eye) induced by a severe eyelid abnormality; treatment with a tectonic corneal graft was successful. COMET can successfully restore ocular surface damage in most eyes with corneal LSCD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10561-016-9575-4DOI Listing
September 2016

Treatment outcomes of reduced-dose intravitreal ganciclovir for cytomegalovirus retinitis.

BMC Infect Dis 2016 Apr 18;16:164. Epub 2016 Apr 18.

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.

Background: Cytomegalovirus retinitis (CMVR) is one of the most common opportunistic infection in immunocompromised individuals. Intravitreal ganciclovir injection has been used successfully but no standard regimen was established. Risks of drug toxicity, endophthalmitis, and injection-related complications increased with number and frequency of injection. The aim of this study is to evaluate the outcomes of reduced-dose intravitreal ganciclovir (2 mg/0.04 mL) for the treatment of CMVR.

Methods: A prospective observational cohort study involving 67 eyes of 49 patients with CMVR was performed. Induction therapy involved intravenous ganciclovir (10 mg/kg/day) for 2 weeks unless contraindicated or patients refused. Patients were then treated with reduced-dose intravitreal ganciclovir every week for 4 weeks, and then every other week until the lesion healed. The patients' demographic data were recorded, and vision parameters were examined every visit.

Results: Twenty eyes (29.9 %) presented with initial visual acuities less than 6/60. The majority of patients were diagnosed with CMVR in zones 1 or 2 (63 eyes, 94 %), and, at least, one quadrant of the retina was involved (56 eyes, 83.6 %). Forty-one eyes (61.2 %) completely resolved after treatment within the 6-month follow-up. There was no significant difference in healing time, whether or not patients received induction treatment with intravenous ganciclovir (111.00 ± 12.96 vs 105.00 ± 28.32 days, p = 0.8). Five eyes (12.2 %) of patients with healed CMVR had visual acuities less than 6/60.

Conclusions: Reduced-dose intravitreal ganciclovir is a safe and effective treatment option. It provides comparable results to other weekly regimens. Induction with intravenous ganciclovir is not crucial in a resolution of retinitis, although it may be necessary to reduce systemic cytomegalovirus loads and mortality rates.

Trial Registration: The trial was registered with Thai Clinical Trials Registry (TCTR) on 16 March 2016 - TCTR20160316001 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-016-1490-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836083PMC
April 2016

Microbiology of primary acquired nasolacrimal duct obstruction: simple epiphora, acute dacryocystitis, and chronic dacryocystitis.

Clin Ophthalmol 2016 22;10:337-42. Epub 2016 Feb 22.

Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: The aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO) and its antimicrobial susceptibilities.

Methods: Ninety-three patients (100 eyes) diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria.

Results: Seventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples), whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%), 24 (30.4%), and four samples (5.1%), respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%), followed by nonspore-forming Gram-positive rods (anaerobe) (17.7%) and Pseudomonas aeruginosa (15.2%). Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012). Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms.

Conclusion: Patients with PANDO, with or without clinical signs of lacrimal infection, were culture positive. Gram-negative organisms were frequently isolated, which were different from previous studies. Ciprofloxacin was the most effective agent against all Gram-positive and Gram-negative organisms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/OPTH.S100280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768895PMC
March 2016

Effect of 0.3% Hydroxypropyl Methylcellulose/Dextran Versus 0.18% Sodium Hyaluronate in the Treatment of Ocular Surface Disease in Glaucoma Patients: A Randomized, Double-Blind, and Controlled Study.

J Ocul Pharmacol Ther 2015 Jul-Aug;31(6):323-9. Epub 2015 Jun 19.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand .

Purpose: To compare the efficacy and safety of 0.3% hydroxypropyl methylcellulose/dextran (HPMC/dextran) and 0.18% sodium hyaluronate (SH) in the treatment of ocular surface disease in patients using antiglaucoma drugs containing preservatives.

Methods: This was a double-blind, randomized, parallel-group study in 70 glaucoma patients with Ocular Surface Disease Index (OSDI) score greater than 20 points and/or presence of ocular signs. Patients were randomized to receive either preservative-free 0.3% HPMC/dextran (n=35) or preservative-free 0.18% SH (n=35). Treatment was 1 drop in each eye, 4 times a day. Data were collected at baseline, at day 7 and day 28.

Results: The groups were homogeneous at baseline. At day 28, both treatments showed significant improvements (P<0.05) in the mean OSDI score, lid skin and lid margin inflammation, conjunctival injection, and expressibility of meibomian glands, corneal staining score, fluorescein tear breakup time (FBUT), and Schirmer I test. However, the mean OSDI score, lid margin inflammation and conjunctival injection showed significant improvements (P<0.05) in the SH group at days 7 and 28, compared to the HPMC/dextran group. FBUT and the Schirmer I test also showed significant improvements (P<0.05) in the SH group compared to the HPMC/dextran group, at day 28. No adverse reactions were observed in either group.

Conclusions: Preservative-free artificial tear, 0.3% HPMC/dextran, and 0.18% SH, caused a significant relief of the ocular surface disease in glaucoma patients. However, 0.18% SH led to a greater improvement in ocular signs and symptoms than 0.3% HPMC/dextran.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jop.2014.0115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507088PMC
April 2016

Frosted branch angiitis as a result of immune recovery uveitis in a patient with cytomegalovirus retinitis.

J Ophthalmic Inflamm Infect 2013 Jun 22;3(1):52. Epub 2013 Jun 22.

Department of Ophthalmology, Thammasat University Hospital, Pathumthani, Thailand.

Background: Since the introduction of Highly Active Antiretroviral Therapy (HAART), AIDs related morbidity and mortality have declined. However, the advent of HAART brought the new problem of immune recovery inflammatory syndrome. Cytomegalovirus retinitis remains the most common cause of visual loss in AIDs patients. Some patients with cytomegalovirus retinitis who experienced immune recovery as a consequence of HAART develop worsening of visual symptoms from immune recovery uveitis (IRU).

Findings: We report a case of cytomegalovirus retinitis and AIDs who developed an unusual presentation of IRU after the initiation of HAART. A 40-year-old woman presented with a history of blurry vision in the right eye. She was diagnosed with human immunodeficiency virus infection and cytomegalovirus retinitis, treated with intravitreal injections of ganciclovir. The retinitis improved. One week after HAART initiation, she developed IRU, characterized by increased intraocular inflammation, extensive frosted branch angiitis and cystoid macular edema. The CD4+ T lymphocyte count increased from 53 to 107 cells/mm3. Systemic prednisolone with continuation of HAART and intravitreal injections of ganciclovir were given with significant improvement.

Conclusion: Atypical presentation of IRU, characterized by extensive frosted branch angiitis and increased intraocular inflammation may occur in immunocompromised patients with cytomegalovirus retinitis who experienced immune recovery. The time from HAART initiation to develop IRU may vary from days to months. This case demonstrated a very rapidly developed IRU which should be recognized and appropriately managed to avoid permanent damage of the eye.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1869-5760-3-52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707756PMC
June 2013

Clinical manifestations of cytomegalovirus-associated posterior uveitis and panuveitis in patients without human immunodeficiency virus infection.

JAMA Ophthalmol 2013 May;131(5):638-45

Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Importance: Little attention has been paid to clinical features of cytomegalovirus (CMV) infections in individuals without human immunodeficiency virus (HIV).

Objective: To describe the clinical manifestations and comorbidities of patients without HIV infection who have CMV-associated posterior uveitis or panuveitis.

Design And Setting: Retrospective observational case series in an academic research setting.

Participants: The medical records were reviewed of 18 patients (22 affected eyes) diagnosed as having posterior uveitis or panuveitis who had aqueous positive for CMV by polymerase chain reaction techniques.

Main Outcome Measures: Demographic data, clinical manifestations, and associated systemic diseases were recorded.

Results: Ocular features included focal hemorrhagic retinitis (n = 13) and peripheral retinal necrosis (n = 7). Two eyes had no focal retinal lesions but manifested vasculitis and vitritis. All patients exhibited vitreous inflammation. Inflammatory reactions in anterior segments developed in 14 of 22 eyes (64%). Retinal vasculitis was observed in 16 of 22 eyes (73%) and included mostly arteries (in 13 of 16 eyes [81%]). Eleven of 18 patients were taking immunosuppressive medications (5 for hematologic malignant diseases, 4 for systemic autoimmune diseases, and 2 following organ transplants). One additional patient was diagnosed as having non-Hodgkin lymphoma 3 months after the onset of CMV-associated panuveitis, and another patient had primary immunodeficiency disorder. Of the remaining 5 patients, 2 had diabetes mellitus, and 3 had no associated systemic diseases and exhibited no evidence of immune deficiency.

Conclusions And Relevance: Cytomegalovirus-associated infections of posterior eye segments can develop in patients without HIV infection who have compromised immune function of variable severity but may occur also in individuals who have no evidence of immune insufficiency. Cytomegalovirus infections located in posterior eye segments in patients without HIV infection caused intraocular inflammatory reaction in all cases and demonstrated more variable clinical presentation than classic CMV retinitis observed in patients with HIV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaophthalmol.2013.2860DOI Listing
May 2013

Efficacy of cyclosporine 0.05% eye drops in Stevens Johnson syndrome with chronic dry eye.

J Ocul Pharmacol Ther 2013 Apr 5;29(3):372-7. Epub 2013 Jan 5.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To evaluate the efficacy of cyclosporine 0.05% (CsA) eye drops in patients with Stevens Johnson syndrome (SJS) who had chronic dry eye.

Design: Prospective noncomparative interventional case series.

Methods: Thirty cases of SJS patients who developed dry eye defined by symptoms and signs, including the Schirmer I test, the fluorescein clearance test (FCT), and corneal staining (fluorescein and Rose Bengal staining) were treated with CsA 0.05% eye drops twice daily for 6 months. Dry eye symptoms, eye injection, tear break up time (TBUT), and corneal staining were evaluated before and after the treatment at 0, 2, 4, and 6 months. The Shirmer I test and FCT were evaluated at 0 and 6 months.

Results: Seventeen patients (56.67%) completed the study. Eight patients (26.67%) withdrew from the study as a result of intolerable side effects of CsA, which included pain, redness, and eyelid swelling. Five cases were lost in follow up. All 17 cases demonstrated significant improvement in dry eye symptoms, conjunctival injection, corneal staining, Schirmer I test, and FCT (P<0.05).

Conclusions: CsA 0.05% eye drops might be beneficial in the treatment of chronic dry eye associated with SJS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jop.2012.0009DOI Listing
April 2013

Chronic recalcitrant bacterial infection in steroid modified interstitial (stromal) keratitis: presentation and management.

J Med Assoc Thai 2012 Nov;95(11):1425-32

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To report histopathologically proven bacterial infection manifested multifocal interstitial (stromal) keratitis (IK) with definite previous history of prolong topical steroid use. Standard managements of bacterial keratitis did not provoke enough benefit.

Material And Method: A retrospective analysis of 19 eyes in 15 patients referred to Siriraj Hospital between 2004 and 2010.

Results: Multifocal intrastromal infiltration, with relatively quiet ocular reaction and mild inflammation were initially presented in all eyes. They all previously had been diagnosed of presumed viral keratitis, and had been given topical corticosteroid treatment for a prolonged period of time without healing. Autoimmune disease workups were all negative. Corneal scrapings showed negative culture results in all eyes. However, bacteria within stromal lamellae with absent or minimal inflammatory cells were demonstrated in all eyes by corneal biopsies. In addition, cytology results obtained from 16S rDNA sequencing revealed Stenotrophomonas maltophilia in one eye and coagulase-negative staphylococci in two eyes. No case responded well to intensive topical and systemic antibiotics. However they were successfully treated with penetrating keratoplasty (11 eyes, 57.9%) or intrastromal antibiotic injections (8 eyes, 42.1%).

Conclusion: Bacterial infection should be a concern in prolonged chronic IK. This was considered as primary bacterial IK or bacterial superinfection in immunocompromised cornea. Early recognition and appropriately aggressive managements contribute to successful outcome. Corneal biopsy is always essential and 16S rDNA sequencing is useful in this distinct clinical entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2012

A randomized double-masked study of 0.05% cyclosporine ophthalmic emulsion in the treatment of meibomian gland dysfunction.

Cornea 2012 Dec;31(12):1386-93

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: To compare the efficacy of topical cyclosporine [0.05% cyclosporine A (CsA)] and preservative-free artificial tears in the treatment of meibomian gland dysfunction (MGD).

Methods: A 3-month prospective, randomized, double-masked, parallel-group controlled trial enrolled 70 patients with symptomatic MGD and unstable tear film [tear breakup time (TBUT) <8 seconds]. Patients were randomized to topical CsA (0.05%; group A) and 0.5% carboxymethylcellulose (control; group B) instilled twice daily for 3 months. Ocular Surface Disease Index (OSDI), lid margin inflammation, meibomian gland expression, conjunctival injection, corneal and interpalpebral dye staining, noninvasive tear breakup time (NIBUT) using the Tearscope Plus and invasive fluorescein tear breakup time (FBUT), and Schirmer I test were performed.

Results: At the 3-month evaluation, mean OSDI, NIBUT and FBUT, lid margin inflammation, meibomian gland expressibility, and tarsal injection showed significant improvement from baseline in group A (P<0.01, P<0.01, P<0.001, P<0.05, and P<0.001, respectively). In group B, only the OSDI improved significantly from baseline at 3 months (P=0.003). TBUTs (NIBUT and FBUT) were significantly longer in group A at all visits, and the mean change of TBUTs from baseline was also significantly greater in group A at 3 months (P<0.001).

Conclusions: Topical CsA 0.05% twice daily may be helpful in the treatment of MGD mainly by improving tear film stability.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICO.0b013e31823cc098DOI Listing
December 2012

Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction.

Clin Ophthalmol 2012 11;6:1483-92. Epub 2012 Sep 11.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET) using human amniotic membrane for corneal limbal stem-cell deficiency.

Methods: Prospective, noncomparative case series. Eighteen patients (19 eyes) with severe ocular surface diseases were chosen to undergo CLET using human amniotic membrane. Twelve eyes received auto-CLET, and seven eyes received allo-CLET. Clinical outcomes of corneal surface epithelialization, conjunctivalization, inflammation, visual acuity, graft status, and complications were observed.

Results: Corneal epithelium cultivated on amniotic membrane (two to four layers) was positive for molecular markers p63, ABCG2, CK3, and CK12. The mean patient age was 44.7 ± 15.2 years. A successful clinical outcome, defined as corneal epithelialization without central conjunctivalization or severe inflammation, was obtained in 14 (73.7%) of 19 eyes (mean follow-up 26.1 ± 13.5 months; range 6-47). A histopathologic success, defined as absence of goblet cells at the central cornea, was achieved in 12 (63.2%) eyes. Clinical failures occurred in five (26.3%) of 19 eyes, and histopathologic failures occurred in seven (36.8%) of 19 eyes. Survival analysis at 1 year showed that the clinical success rate was 77.9% and the pathological success rate was 72.3%. Fourteen of 19 (73.7%) eyes had visual acuity improvements after CLET. Six cases underwent penetrating keratoplasty; five of these grafts remained clear after 20.4 ± 6.9 months (range, 12-31) of follow-up. Complications included infectious keratitis (three cases) and recurrent symblepharon (one case). All complicated cases had lid abnormalities. Factors affecting the final clinical outcomes were lid abnormalities, abnormal corneal stromal beds, and complications.

Conclusion: CLET can successfully restore ocular surface damage in most cases with corneal limbal stem cell deficiency.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/OPTH.S33951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460717PMC
October 2012

Crystallization after intravitreal ganciclovir injection.

Clin Ophthalmol 2010 Jul 30;4:709-11. Epub 2010 Jul 30.

Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: To report crystal formation as a complication of intravitreal ganciclovir injection.

Patients And Methods: A 73-year-old female patient with unilateral cytomegalovirus retinitis was treated with intravitreous ganciclovir (4 mg/0.04 mL).

Results: After the intravitreal injection, sudden crystallization was observed in the vitreous humor. The patient experienced marked reduction in visual acuity and increased intraocular pressure. Despite aqueous paracenthesis and pars plana vitrectomy, optic atrophy was observed and her visual acuity remained unimproved after 12 months.

Conclusion: Crystal formation can occur as a complication of intravitreal ganciclovir injection. Associated retinal and optic nerve damage was found which results in permanent visual morbidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915856PMC
http://dx.doi.org/10.2147/opth.s10949DOI Listing
July 2010

Efficacy of amniotic membrane patching for acute chemical and thermal ocular burns.

J Med Assoc Thai 2007 Feb;90(2):319-26

Department of Ophthalmology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkoknoi, Bangkok, Thailand.

Objective: To study the efficacy of amniotic membrane patching (AMP) for acute chemical and thermal ocular burns and compare the results with a control group.

Material And Method: Fifteen patients (21 eyes) with acute ocular burn severity grading of II to IV were retrospectively reviewed. Thirteen eyes were treated with preserved AMP while eight eyes were treated with conventional treatment. Outcomes and complications were evaluated and compared between eyes in the AMP group and the control group with the same severity of burn.

Results: In the AMP group, the mean age was 36.9 +/- 11.7 years (range, 20-58). The mean follow-up time was 8.0 +/- 6.8 months (range, 1-20). Complete epithelialization was achieved in 69.2% (9/13 eyes) in total, 100% (5/5 eyes), 100% (3/3 eyes) and 20% (1/5 eyes) in grade II, III and IV respectively. Mean epithelial healing time in the AMP group was 10.4 +/- 5.8 days (range, 4-20). Comparison of grade 2 and 3 burns showed that the AMP group in which patching was performed within 5 days resulted in faster epithelial healing, less corneal haze and limbal deficiency than in the group in which patching was performed after 5 days, and the control group (mean epithelial defect 7.0 +/- 2.0, 19.5 +/- 0.7, 9.9 +/- 10.8 days respectively).

Conclusion: Adjunctive treatment of ocular burns with AMP promoted rapid epithelial healing and reduced corneal complication. Surgery performed in the early stage tended to yield a better outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
February 2007

Efficacy of subconjunctival 5-fluorouracil and triamcinolone injection in impending recurrent pterygium.

Ophthalmology 2006 Jul 26;113(7):1102-9. Epub 2006 May 26.

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To study the efficacy of subconjunctival 5-fluorouracil (5-FU) and triamcinolone injection in halting the progression of impending recurrent pterygium.

Design: Randomized, prospective, controlled clinical trial.

Participants: One hundred nine patients who had undergone pterygium excision within the previous 6 months and developed grade 3 characteristics (impending recurrent pterygium).

Methods: A total of 109 eyes with impending recurrent pterygium were stratified randomly into 3 groups by treatment: 35 eyes served as the control group, 39 eyes received a 5-mg intralesional injection of 5-FU weekly for 2 weeks, and 35 eyes received one 20-mg intralesional injection of triamcinolone. All groups received 1% prednisolone acetate eye drops 4 times daily for 8 weeks.

Main Outcome Measures: Recurrence rate, success rate, and survival analysis were compared among the groups.

Results: With a mean follow-up time of 10.9+/-5.5 months (range, 6-26 months), the success rates of the 5-fluorouracil and triamcinolone groups were higher than the control group (87.2%, 71.4%, and 48.6%, respectively). 5-fluorouracil was significantly (P = 0.001) more effective in inhibiting the recurrence of pterygium compared with the control group at all time points during follow-up. Kaplan-Meier survival analysis showed that the recurrence-free period of pterygium in the 5-FU group was significantly (P = 0.005) longer than that of the control group but not in the triamcinolone group compared with the controls (P = 0.063). There was no significant difference between the 5-FU group and the triamcinolone group (P = 0.362). Minimal reversible complications such as steroid-induced glaucoma and superficial punctate epitheliopathy developed during the study.

Conclusions: Intralesional injection of 5-FU and triamcinolone was more effective in inhibiting the recurrence of pterygium than topical steroid alone, with the results in the 5-FU group reaching statistical significance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ophtha.2006.02.026DOI Listing
July 2006

Vogt-Koyanagi-Harada disease in Thai patients.

J Med Assoc Thai 2005 Nov;88 Suppl 9:S26-30

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objectives: To study the demographic, clinical manifestations, treatment and visual outcome of Vogt-Koyanagi-Harada disease (VKH) in a group of Thai patients.

Design: Retrospective case series.

Material And Method: Patients with VKH disease in Pramongkutklao Hospital from January 1998 to December 2002 were identified. Demographic data, clinical manifestations, treatment, and outcome were analyzed.

Results: Among the 33 patients, there were 12 males and 21 females with a mean age of onset of 35 +/- 13.4 year-old (range 17-67). Serous retinal detachment was detected in 48%. Transient hearing loss, vitiligo, poliosis and alopecia occurred in 18%, 24%, 15% and 33% respectively. Forty two percent of the patients were treated with systemic corticosteroids alone and 58% with a combination of steroids and immunosuppressive drugs. At the end of the follow-up, visual acuity (VA) improved in 55%, remained unchanged in 36% and worsened in 9% of the eyes. Final VA of equal or better than 20/40 was obtained in 76%. The mean follow-up time was 21.6 +/- 14.9 months (range 2-64).

Conclusion: Demographic data, clinical manifestations, and treatment outcome of this group of Thai patients are comparable with studies from other countries.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2005

Topical 0.002% mitomycin C for the treatment of conjunctival-corneal intraepithelial neoplasia and squamous cell carcinoma.

Cornea 2005 May;24(4):443-8

Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: To demonstrate the efficacy of topical 0.002% mitomycin C (MMC) as an adjunctive and alternative treatment in primary and recurrent conjunctival-corneal intraepithelial neoplasia (CCIN) and squamous cell carcinoma (SCC).

Methods: The medical records of 7 patients with histopathologically confirmed CCIN and conjunctival SCC were retrospectively reviewed. All cases were treated with topical 0.002% MMC 4 times daily. The tumor size pre- and post-treatment, clinical response, and ocular complications were evaluated.

Results: The mean age of the patients was 56 +/- 13.4 years. The most common presenting symptom was foreign body sensation (57.1%) with a mean duration of 2.3 +/- 3.8 months. Six patients had pathologically proven CCIN (85.7%) and 1 had SCC (14.3%). Before MMC treatment, 6 eyes (85.7%) had recurrences after surgical excision. The tumor-free period ranged from 2 to 19 months. Two patients had multiple recurrences. MMC 0.002% 4 times daily was applied for a period of 5.4 +/- 4.4 weeks (range, 2-14). All had complete tumor regression as observed clinically and confirmed by impression cytology. Side effects of MMC therapy included ocular irritation, mild conjunctival hyperemia, and punctate keratopathy. There were no serious complications detected. The mean follow-up time was 30.7 +/- 15 months (range, 2-52) with no evidence of clinical recurrence in any case.

Conclusions: Topical 0.002% MMC showed a favorable outcome as an adjunctive and alternative treatment of CCIN and SCC with regression of primary and recurrent tumors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.ico.0000148314.86557.6aDOI Listing
May 2005

Preserved Amniotic Membrane Transplantation for Conjunctival Surface Reconstruction.

Cell Tissue Bank 2001 ;2(1):31-39

Department of Ophthalmology, The Bangkok Biomaterial Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkoknoi, Bangkok 10700, Thailand; Author for correspondence: (Tel.: 662-411-2006; Fax: 662-411-1906; e-mail:

Objective. To study the efficacy of preserved human amniotic membrane in the reconstruction of conjunctival defect created during surgical removal of conjunctival lesions or symblepharon lysis.Methods. Preserved human amniotic membrane transplantation was performed in 93 eyes of 85 patients for reconstruction of various conjunctival surface problems. The indications for surgery were (1) pterygium excision (54 eyes), (2) conjunctival tumors excision (23 eyes), lysis of symblepharon (13 eyes), and covering a scleral graft (three eyes).Results. Success was noted in 69.9% (65/93) eyes, partially success in 22.6% (21/93) eyes, and failure in 7.5% (7/93) eyes with a mean follow-up of 8.9 months (1-28 months). In pterygium, conjunctival tumor, symblepharon, and scleral graft group, the success rate in each group was 70.3%, 78.3%, 53.8%, and 66.7% respectively. No serious immediate post-operative complications or graft rejection occurred.Conclusion. Amniotic membrane transplantation can be considered an alternative treatment for difficult ocular surface problems, and is effective in promoting epithelial healing, and reducing inflammation and scarring.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1023/A:1011597332277DOI Listing
January 2001

Corneal lattice dystrophy, a concealed ophthalmic problem in Thailand.

J Med Assoc Thai 2003 Aug;86(8):727-36

Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

One single family of corneal lattice dystrophy was examined and interviewed to elucidate the variety of clinical manifestations, factors associated with visual impairment, and the impact on the patient's quality of life. Forty-three out of 88 family members (48.9%) were affected. The inheritance pattern was autosomal dominant. Corneal haze grading from 1 to 4 was 5.3 per cent, 26.3 per cent, 43.4 per cent, and 25 per cent respectively. Surface irregularity grading from 1 to 4 was 18.4 per cent, 39.5 per cent, 32.9 per cent, and 9.2 per cent respectively. Forty-five per cent of the patients had VA < or = 20/200. Corneal haziness, irregularity, corneal erosion and disease duration were significantly related to visual impairment (p < 0.05). This disturbed the patient's activities such as reading (79.1%), working (62.8%) and daily life (69.8%). Corneal lattice dystrophy within the same family may present with different manifestations depending on the severity and duration of the disease and might be misdiagnosed. Inadequate knowledge among patients was susceptible to the high prevalence of the disease leading to impaired quality of life.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2003
-->