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Objective: This study aims to compare knowledge, attitude and regarding contact lens use between medical and non-medical students of Superior University, Lahore. Methodology: A cross-sectional analysis was conducted. The study included 127 medical students (M) and 127 nonmedical students who were contact lens users. A peer-reviewed questionnaire was used to determine their knowledge, attitude and practice regarding contact lens use. Results: The participants were all between the ages of 18 and 28 (both medical and non-medical). There were 50% medical students and 50% non-medical students among the 254 students. They used lenses for a variety of reasons, including cosmetic reasons (40.9%), refractive error correction (30.7%), and both (28.3%). The medical students had a high level of knowledge about contact lens use specially the duration of wearing contact lenses per day. The hygienic practices that participants in both groups had differed significantly according to instructions (Medical: 81.1 %, Non-medical: 68.5 %), removing lenses before swimming (Medical: 86.6 %, Non-medical: 74.8 %), removing lenses before sleeping (Medical: 90.6 %, Non-medical: 81.9 %), and cleaning contact lens case with toothbrush (Medical: 20.5 %, Non-medical: 29.9 %). In both groups, was the prevalent was the improper lens hygiene practices like changing lens storage solution daily, using tap water for cleaning lenses, not washing hands before handling lenses, and not storing contact lenses in fresh solution every night. Conclusion: Although medical students had better knowledge regarding contact lens usage than non-medical students. Whereas, non-medical students had a poor knowledge of the risks and consequences of wearing contact lenses. [ABSTRACT FROM AUTHOR]

The ability of mycoplasmas to persist on surfaces has been widely acknowledged, despite their fastidious nature. However, the organism's capability to form a recognisable biofilm structure has been identified more recently. In the current study Mycoplasma fermentans was found to adhere to the glass surface forming highly differentiated biofilm structures. The volumes of biofilm microcolonies were quantified and observed to be greater at late growth stage than those at early growth stage. The channel diameters within biofilms were measured with Scanning Electron Microscopy images and found to be consistent with the size observed in Confocal Laser Scanning Microscope images. The combination of imaging methods with 3D visualisation provides key findings that aid understanding of the mycoplasma biofilm formation and true biofilm architecture. The observations reported here provide better understanding of the persistence of these minimalist pathogens in nature and clinical settings. [ABSTRACT FROM AUTHOR]

Aims (1) To test the feasibility of simultaneous steadystate pattern electroretinogram (ssPERG) and intraocular pressure (IOP) measurements with an implanted IOP sensor. (2) To explore the scope of this approach for detecting PERG changes during IOP manipulation in a model of lateral decubitus positioning (LDP; lateral position). Methods 15 healthy controls and 15 treated glaucoma patients participated in the study. 8 patients had an IOP sensor (Eyemate-IO, Implandata Ophthalmic Products GmbH) in the right eye (GLAIMP) and 7 had no sensor and with glaucoma in the left eye. (1) We compared PERGs with and without simultaneous IOP read-out in GLAIMP. (2) All participants were positioned in the following order: sitting1 (S1), right LDP (LDR), sitting2 (S2), left LDP (LDL) and sitting3 (S3). For each position, PERG amplitudes and IOP were determined with rebound tonometry (Icare TA01i) in all participants without the IOP sensor. Results Electromagnetic intrusions of IOP sensor readout onto ssPERG recordings had, due to different frequency ranges, no relevant effect on PERG amplitudes. IOP and PERG measures were affected by LDP, for example, IOP was increased during LDR versus S1 in the lower eyes of GLAIMP and controls (5.1±0.6 mmHg, P0.025 =0.00004 and 1.6±0.6 mmHg, P0.025=0.02, respectively) and PERG amplitude was reversibly decreased (-25±10%, P0.025=0.02 and -17±5%, P0.025, respectively). Conclusions During LDP, both IOP and PERG changed predominantly in the lower eye. IOP changes induced by LDP may be a model for studying the interaction of IOP and ganglion-cell function. [ABSTRACT FROM AUTHOR]

To manage glaucoma, timolol is currently delivered via eye drop solution in high doses due to poor ocular bioavailability. The silicone contact lenses can be used to control the release of timolol by conventional soaking technology without changing or altering the swelling and optical transmittance of the contact lens. However, the soaking method showed limitations of low timolol uptake and high-burst release. In this research work, we have investigated the influence of microemulsion on timolol loading from the soaking solution and its ability to control the drug release kinetics. The contact lenses were soaked in the timolol-microemulsion soaking solution (TB-ME-SM) and compared with the timolol-soaking solution (TB-SM) without microemulsion. The loading of timolol laden-microemulsion in the contact lenses did not alter the swelling and transmittance properties. The two fold improvement in the timolol loading was noted from the TB-ME-SM soaking solution in comparison to TB-SM solution. The flux report showed improvement in the release rate profiles of TB-ME-SM lenses (up to 48–96 h) in comparison to TB-SM lenses (up to 24–36 h). The rabbit tear fluid data of TB-ME-SM lenses showed improvement in the timolol retention time in comparison to TB-SM lenses and eye drop solution. The efficacy study in the rabbit model showed a peak and valley profile with eye drop therapy, while TB-ME-SM-2 contact lenses showed prolong reduction in intra ocular pressure for 96 h. The study demonstrates the potential of microemulsion to improve the uptake of timolol and control release kinetics without altering the swelling and transmittance of the contact lens. [ABSTRACT FROM AUTHOR]

Mycotic or fungal keratitis (FK) is a sight-threatening disease, caused by infection of the cornea by filamentous fungi or yeasts. In tropical, low and middle-income countries, it accounts for the majority of cases of microbial keratitis (MK). Filamentous fungi, in particular Fusarium spp., the aspergilli and dematiaceous fungi, are responsible for the greatest burden of disease. The predominant risk factor for filamentous fungal keratitis is trauma, typically with organic, plant-based material. In developed countries, contact lens wear and related products are frequently implicated as risk factors, and have been linked to global outbreaks of Fusarium keratitis in the recent past. In 2020, the incidence of FK was estimated to be over 1 million cases per year, and there is significant geographical variation; accounting for less than 1% of cases of MK in some European countries to over 80% in parts of south and south-east Asia. The proportion of MK cases is inversely correlated to distance from the equator and there is emerging evidence that the incidence of FK may be increasing. Diagnosing FK is challenging; accurate diagnosis relies on reliable microscopy and culture, aided by adjunctive tools such as in vivo confocal microscopy or PCR. Unfortunately, these facilities are infrequently available in areas most in need. Current topical antifungals are not very effective; infections can progress despite prompt treatment. Antifungal drops are often unavailable. When available, natamycin is usually first-line treatment. However, infections may progress to perforation in ~25% of cases. Future work needs to be directed at addressing these challenges and unmet needs. This review discusses the epidemiology, clinical features, diagnosis, management and aetiology of FK. [ABSTRACT FROM AUTHOR]

In the List of World Edible Insects, Cybister sp. (Dytiscidae) genus of species is known to be consumed by humans. Dried Cybister lateralimarginalis torquatus (Fischer von Waldheim, 1829) which has been collected in Turkey long before and compared to other edible insects having large body, belonging to the Dytiscidae family from the aquatic beetle fauna was aimed to determine microbiota (in digestive structure) of the insect species. In this study, Lelliottia amnigena (Enterobacter amnigenus) (male insect) and Citrobacter freundii (female insect) bacteria species were detected from insect digestion structures. Finally, the DNA sequences of the obtained bacteria were matched from the Gene Bank with the accessory numbers. Moreover, levels of some heavy elements (Al, Cr, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Hg, Pb) were evaluated in this study to observe whether Dytiscidae (Coleoptera) is a useful candidate for biomonitoring studies. The result of the study analyzes agricultural, ecological and health research, influence on the microbial flora and the effect of environment would be and how big the problem we would face in our future. Calculated analysis of the results will give a positive impetus and the fighting method to destroy it in the source. [ABSTRACT FROM AUTHOR]

Various bacterial pathogens are responsible for nosocomial infections resulting in critical pathophysiological conditions, mortality, and morbidity. Most of the bacterial infections are associated with biofilm formation, which is resistant to the available antimicrobial drugs. As a result, novel bactericidal agents need to be fabricated, which can effectively combat the biofilm-associated bacterial infections. Herein, for the first time we report the antimicrobial and antibiofilm properties of silver-platinum nanohybrids (AgPtNHs), silver nanoparticles (AgNPs), and platinum nanoparticles (PtNPs) against Escherichia coli, Pseudomonas aeruginosa , and Staphylococcus aureus. The AgPtNHs were synthesized by a green route using Dioscorea bulbifera tuber extract at 100°C for 5 h. The AgPtNHs ranged in size from 20 to 80 nm, with an average of ∼59 nm. AgNPs, PtNPs, and AgPtNHs showed a zeta potential of −14.46, −1.09, and −11.39 mV, respectively. High antimicrobial activity was observed against P. aeruginosa and S. aureus and AgPtNHs exhibited potent antimicrobial synergy in combination with antibiotics such as streptomycin, rifampicin, chloramphenicol, novobiocin, and ampicillin up to variable degrees. Interestingly, AgPtNHs could inhibit bacterial biofilm formation significantly. Hence, co-administration of AgPtNHs and antibiotics may serve as a powerful strategy to treat bacterial infections. [ABSTRACT FROM AUTHOR]

Copyright of Logopaedica Lodziensia is the property of Wydawnictwo Uniwersytetu Lodzkiego and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fetal-stage diseases, which may cause disabilities after birth, significantly decrease the quality of life of the fetuses. Improvements in imaging techniques enable early recognition of fetal-stage diseases. Reports indicate that some operable treatments during fetal development might improve physical function after birth. However, it is difficult to obtain follow-up biological information after fetal surgery because the fetus continues to develop in utero. Although implantable devices have been studied for measuring biological information, problems with biocompatibility, data communication, and power supply have been observed. To address these problems, we propose a method to measure biological information via pressure measurements using ultrasonic diagnostic equipment. The proposed method involves image analysis of a pressure-sensing membrane, whose deformation depends on the ambient pressure. In the proposed method, the deformation is imaged using ultrasonic diagnostic equipment and the displacement is calculated by image analysis. Finally, the calculated displacement is converted to biological information by focusing on its relationship with pressure. In this study, we prototyped a large-scale pressure-sensing module and evaluated the displacement of the pressure-sensing membrane within the module to confirm the working principle. The pressure-sensing module comprises a thin-film pressuresensing membrane that is sandwiched between the body of the prototype module and the protective parts, thus forming a diaphragm-like structure with the body of the prototype module and membrane. The pressure-sensing module was fabricated using silicone rubber, and its dimensions were 30× 30× 30 mm. Pressure was applied in the range of -22 to ＋22 kPa, and the displacement of the pressure-sensing membrane was calculated from ultrasonic images of the module. From the results, the displacement was confirmed to change linearly with the applied pressure, although the slope was non-linear in the pressure range of 0-10 kPa. These results indicate the feasibility of pressure estimation using the proposed method. [ABSTRACT FROM AUTHOR]

The Boston Keratoprosthesis (KPro) is the most used artificial cornea. It restores vision in patients with a poor prognosis with penetrating keratoplasty. Significant improvements have occurred recently in terms of implant design and postoperative care. Nonetheless, glaucoma remains the primary reason for vision loss after KPro implantation. Management of inflammation and intraocular pressure (IOP) is challenging in KPro eyes. Progressive optic nerve damage often persists in spite of medical and surgical interventions. Significant efforts are being invested to determine the best management, even when IOP is controlled. Glaucoma drainage devices (GDD) implanted during KPro surgery could offer beneficial visual outcomes. Cyclophotocoagulation (CPC) may be reserved for end-staged glaucoma. This review highlights glaucoma mechanisms in KPro eyes, the need to better monitor and treat glaucoma in KPro patients, and the latest innovation strategies. Recent data on current options and timing for GDD and CPC are discussed. Implantation of GDD before or during KPro surgery reduces the risk of glaucoma progression compared to CPC. Future developments could offer KPro implants integrated with drainage devices and IOP sensors. Targeted control of inflammation will be the next novel strategy to reduce optic nerve damage occurring despite appropriate IOP control. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aims This study assessed the feasibility of a novel contact lens device for intraocular pressure (IOP) and ocular pulse amplitude (OPA) continuous measurements over 24 hours. Methods This prospective, open-label, single-centre, non-randomised study included glaucoma and healthy subjects. IOP and OPA values acquired by the pressuremeasuring contact lens (PMCL) device in one patient’s eye at the beginning of the measurement were compared with tonometry values (Goldman applanation tonometry (GAT) and dynamic contour tonometry (DCT)) in the same eye just before PMCL placement. Furthermore, IOP and OPA values measured with PMCL on the study eye during a water drinking test (WDT) were compared with DCT values in the fellow eye. Comparisons were performed using t-tests with 95% Confidence Intervals. Results Twenty-four-hour IOP and OPA curves were obtained for eight subjects. The mean IOP difference between PMCL and tonometry on the same eye was within ±5 mmHg in 75%(GAT) and 87.5%(DCT) of subjects. IOP variations due to WDT were detected by PMCL and DCT, showing an average increase of 2.43 and 1.85 mm Hg, respectively. Differences between PMCL and DCT for IOP variations in fellow eyes were within ±5 mm Hg for 97.2% of time points. The difference between OPA in fellow eyes was within ±5 mm Hg for 85.5% of the time points. Conclusions This first-in-human study is a proof-ofconcept for 24-hour continuous measurements of IOP and OPA with the PMCL. This device is non-invasive and has good comparability with standard tonometry. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the frequency, drug susceptibility, and drug resistance of pathogens causing microbial keratitis (a corneal inflammation) in the Clinical Department of Ophthalmology, Medical University of Silesia, Katowice. Despite intensive treatment, severe inflammation causes irreversible blindness in ∼7% of cases and eye loss (evisceration or enucleation of the eyeball) in ∼1% of cases at our hospital. The choice of a targeted drug depends on the culture result and drug resistance of the microorganism. This was a retrospective observation study. Conjunctival swabs and corneal scrapes were collected between January 1, 2013, and December 31, 2019, in the tertiary reference center for keratitis. The collected data included the type of material received, culture result, and antimicrobial susceptibilities. Of the 2482 samples analyzed, 679 were positive and 1803 were negative. Of the total pathogens isolated, 69.9% were Gram-positive bacteria, 20.8% were Gram-negative bacteria, and 7.1% were fungi. A significant increase in the number of Gram-positive methicillin-resistant Staphylococcus aureus and a partial increase in the number of Gram-negative beta-lactams-resistant bacteria were observed. All fungal species were sensitive to amphotericin B, 82.81% were sensitive to voriconazole, and 56.25% were sensitive to fluconazole. Dual drug therapy (levofloxacin and tobramycin) was the first-line treatment. Drug susceptibility testing of the cultured microorganisms is necessary to initiate targeted treatment. Increased drug resistance was observed in this study. In the present study, most bacteria were sensitive to fluoroquinolones. Ciprofloxacin therapy remains the recommended empirical treatment in microbial keratitis. According to our study, voriconazole remains a first-line antifungal drug, when a fungal infection is suspected. [ABSTRACT FROM AUTHOR]

Microbial biofilms are a natural adaptation of microorganisms, typically composed of multiple microbial species, exhibiting complex community organization and cooperation. Biofilm dynamics and their complex architecture are challenging for basic analyses, including the number of viable cells, biomass accumulation, biofilm morphology, among others. The methods used to study biofilms range from in vitro techniques to complex in vivo models. However, animal welfare has become a major concern, not only in society, but also in the academic and scientific field. Thus, the pursuit for alternatives to in vivo biofilm analyses presenting characteristics that mimic in vivo conditions has become essential. In this context, the present review proposes to provide an overview of strategies to study biofilms of medical interest, with emphasis on alternatives that approximate experimental conditions to host-associated environments, such as the use of medical devices as substrata for biofilm formation, microcosm and ex vivo models. [ABSTRACT FROM AUTHOR]

Copyright of Current Retina Journal / Güncel Retina Dergisi is the property of Anadolu Kitabevi Basim Yayim Medikal Turizm Kirtasiye Tic. Ltd. Sti. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Biofilms are microbial communities established in the self‐produced extracellular substances that include up to 80% of associated microbial infections. During biofilm formation, bacterial cells shift from the planktonic forms to aggregated forms surrounded by an extracellular polymeric substance. The bacterial biofilm shows resistance against immune reactions as well as antibiotics and is potentially able to cause disorders by both device‐related and nondevice‐related infections. The nondevice‐related bacterial biofilm infections include dental plaque, urinary tract infections, cystic fibrosis, otitis media, infective endocarditis, tonsillitis, periodontitis, necrotizing fasciitis, osteomyelitis, infectious kidney stones, and chronic inflammatory diseases. In this review, we will summarize and examine the literature about bacterial biofilm infections unrelated to indwelling devices. [ABSTRACT FROM AUTHOR]

Assessment of intraocular pressure (IOP) is a core diagnostic tool in management of glaucoma. All established ways to measure IOP use indirect approaches through ocular tissues, mainly the cornea or the sclera. Telemetric IOP measurement with an implantable device could eliminate bias caused by indirect techniques and could allow continuous monitoring. A favorable safety profile, high efficacy and good tolerability are key requirements. The Eyemate-IO™ system (Implandata Ophthalmic Products GmbH, Hannover, Germany) is a novel CE-marked implantable medical device for direct measurement of IOP. It consists of an intraocular sensor ring and an external reading device. This review presents the mechanism of telemetric IOP measurement and summarizes the available clinical data. Twelve months follow-up data of two clinical trials provide support for the efficacy and safety of this device. The implantable Eyemate-IO™ in keratoprosthesis was well tolerated; recorded adverse events were known complications of standalone surgery. The system had a good agreement with other IOP measuring modalities, including intraoperative manometry. In glaucoma patients, the Eyemate-IO™ could be implanted safely and showed a favorable efficacy and safety profile in the first twelve months postoperatively. The potential to achieve IOP monitoring with the Eyemate-IO™ seems promising. [ABSTRACT FROM AUTHOR]

Corneal transplantation surgery faces several fundamental problems, including graft failure, especially in complicated cases, and a marked shortage of human donor corneas. The purpose of this review is to examine several developments in biosynthetic alternatives to donor corneal transplantation. In particular, we focus on the regulatory pathway and considerations needed to design an implant and take it to clinical application. We define biosynthetic implants as those that combine synthetic and natural components, as well as those that mimic materials found in nature. This is a non-comprehensive review of the topic that discusses examples of implants ranging from cell-free devices to those containing cells. We provide a guide to designing implants for clinical application as medical devices, highlighting aspects for consideration at the design and manufacturing stages. Biosynthetic implants developed as alternatives to conventional corneal transplantation afford customization, particularly for patients at high risk for graft failure. A range of these implants exist, but there appears to be a bottleneck to clinical entry. Implants should be designed with clinical application in mind from the outset to allow for an efficient bench to bedside translation. [ABSTRACT FROM AUTHOR]

Introduction: Recognizing fungal keratitis based on the clinical presentation is challenging. Topical therapy may be initiated with antibacterial agents and corticosteroids, thus delaying the fungal diagnosis. As a consequence, the fungal infection may progress ultimately leading to more severe infection and blindness. We noticed an increase of fungal keratitis cases in the Netherlands, especially caused by Fusarium species, which prompted us to conduct a retrospective cohort study, aiming to describe the epidemiology, clinical management, and outcome. Materials and Methods: As fungi are commonly sent to the Dutch mycology reference laboratory for identification and in vitro susceptibility testing, the fungal culture collection was searched for Fusarium isolates from corneal scrapings, corneal swabs, and from contact lens (CL) fluid, between 2005 and 2016. All Fusarium isolates had been identified up to species level through sequencing of the ITS1-5.8S-ITS2 region of the rDNA and TEF1 gene. Antifungal susceptibility testing was performed according to the EUCAST microbroth dilution reference method. Antifungal agents tested included amphotericin B, voriconazole, and natamycin. In addition, susceptibility to the antisepticum chlorhexidine was tested. Ophthalmologists were approached to provide demographic and clinical data of patients identified through a positive culture. Results: Between 2005 and 2016, 89 cases of Fusarium keratitis from 16 different hospitals were identified. The number of cases of Fusarium keratitis showed a significant increase over time (R 2 = 0.9199), with one case in the first 5 years (2005–2009) and multiple cases from 2010 and onwards. The male to female ratio was 1:3 (p = 0.014). Voriconazole was the most frequently used antifungal agent, but treatment strategies differed greatly between cases including five patients that were treated with chlorhexidine 0.02% monotherapy. Keratitis management was not successful in 27 (30%) patients, with 20 (22%) patients requiring corneal transplantation and seven (8%) requiring enucleation or evisceration. The mean visual acuity (VA) was moderately impaired with a logMAR of 0.8 (95% CI 0.6–1, Snellen equivalent 0.16) at the time of Fusarium culture. Final average VA was within the range of normal vision [logMAR 0.2 (95% CI 0.1–0.3), Snellen equivalent 0.63]. CL wear was reported in 92.9% of patients with Fusarium keratitis. The time between start of symptoms and diagnosis of fungal keratitis was significantly longer in patients with poor outcome as opposed to those with (partially) restored vision; 22 vs. 15 days, respectively (mean, p = 0.024). Enucleation/evisceration occurred in patients with delayed fungal diagnosis of more than 14 days after initial presentation of symptoms. The most frequently isolated species was F. oxysporum (24.7%) followed by F. solani sensu stricto (18%) and F. petroliphilum (9%). The lowest MICs were obtained with amphotericin B followed by natamycin, voriconazole, and chlorhexidine. Conclusion: Although Fusarium keratitis remains a rare complication of CL wear, we found a significant increase of cases in the Netherlands. The course of infection may be severe and fungal diagnosis was often delayed. Antifungal treatment strategies varied widely and the treatment failure rate was high, requiring transplantation or even enucleation. Our study underscores the need for systematic surveillance of fungal keratitis and a consensus management protocol. [ABSTRACT FROM AUTHOR]

Purpose: To determine the causative organisms and associated risk factors for infectious keratitis in South Texas. Methods: This retrospective study was performed at a tertiary teaching hospital system in South Texas. Medical records of all patients who presented with infectious keratitis from 2012 to 2018 were reviewed. Only patients with culture-proven bacterial, fungal, and Acanthamoeba keratitis were included. Results: In total, 182 eyes of 181 patients had culture-proven bacterial, fungal, or Acanthamoeba keratitis. The age of patients ranged from 3 to 93 years, with a mean of 48.3 ± 20.8 years. The most common etiologic agent was bacteria, with 173 bacterial cultures (95.1%) recovered, followed by 13 fungal cultures (7.1%), and 3 Acanthamoeba cultures (1.6%).Of the 218 bacterial isolates, coagulase-negative Staphylococcus was the most common (25.7%), followed by Pseudomonas aeruginosa (23.4%), Staphylococcus aureus (11.0%), and Moraxella (7.8%). Fusarium was the most common fungal isolate (46.2%). The most common risk factors for infectious keratitis included contact lens wear (32.4%), underlying corneal disease (17.6%), trauma (14.3%), and ocular surface disease (13.7%). Conclusions: Bacteria are the most common cause of infectious keratitis in this patient population, with coagulase-negative Staphylococcus and Pseudomonas as the most common isolates. The prevalence of culture-positive fungal keratitis is significantly lower than that of bacterial keratitis. Contact lens wear is the most common risk factor associated with infectious keratitis in South Texas. [ABSTRACT FROM AUTHOR]

The use of Boston type 1 keratoprosthesis (BKPro) has significantly increased worldwide. It is no longer considered a procedure of last resort but a reasonable option for patients with otherwise poor prognosis for a traditional penetrating keratoplasty. BKPro was approved by the Food and Drug Administration in 1992 for bilateral severe corneal blindness due to multiple corneal transplant failure. Over the years, indications have extended beyond recurrent immunologic rejection to include other conditions such as chemical injury and other causes of bilateral limbal stem cell deficiency, extensive corneal neovascularization, neurotrophic corneas and hypotony, among others. Numerous advances in the design of the BKPro, improvement of preoperative, intraoperative and postoperative management have resulted in favorable outcomes and a reduction in postoperative complications. Accordingly, many studies have shown that implantation of this device is highly effective in restoring vision with very good short-term outcomes. However, due to the lifetime risk of sight-threatening complications after BKPro implantation, a longer follow-up period should provide outcomes that are more realistic. In this review, the authors examined only the results of publications with an average of at least 2 years of follow-up. The overall intermediate to long-term visual outcomes and retention rate in BKPro seem to be favorable. However, autoimmune diseases and cicatrizing conditions continue to show a higher incidence of postoperative complications that require further management. [ABSTRACT FROM AUTHOR]

Bimatoprost is widely used for the management of glaucoma. Currently, it is delivered via eye drop solution, which is highly inefficient due to low bioavailability. To control the release of ocular drugs, contact lenses are used by scientists. However, the conventional soaking method showed high burst release due to absence of any efficient controlling membrane. The objective of the paper was to apply molecular imprinting technology to improve the loading of bimatoprost from the soaking solution and to sustain the release of drug from the contact lens. The bimatoprost was loaded by conventional soaking method (BT-SM) and compared with the molecular imprinted contact lenses (BT-MP). The loading of bimatoprost by molecular imprinting technology affect the swelling of the contact lens; however, the batch BT-MP-10 did not showed significant alterations. The uptake study showed improvement in the bimatoprost loading by molecular imprinting technology in comparison to the conventional soaking technology. The in vitro bimatoprost release data showed improvement in the bimatoprost release rate profiles with BT-MP contact lenses (up to 36–60 h) lenses in comparison to BT-SM contact lenses (up to 24–36 h). The in vivo rabbit tear fluid data with BT-MP batch showed improvement in the bimatoprost retention time in comparison to BT-SM contact lens and eye drop solution. The rabbit model failed to respond bimatoprost; thus, the efficacy studies need to be conducted on canines or human primates. The paper revealed the potential of using molecular imprinting technology to improve the uptake of bimatoprost and to achieve sustain release kinetics without altering the swelling, transmittance and folding endurance properties of the contact lens. [ABSTRACT FROM AUTHOR]

Purpose: This study was aimed at identifying differentially expressed genes (DEGs) in bacterial and fungal keratitis. The candidate genes can be selected and quantified to distinguish between causative agents of infectious keratitis to improve therapeutic outcomes.Methods: The expression profile of bacterial or fungal infection, and normal corneal tissues were downloaded from the Gene Expression Omnibus. The limma package in R was used to screen DEGs in bacterial and fungal keratitis. The Co-Express tool was used to calculate correlation coefficients of co-expressed genes. The "Advanced network merge" function of Cytoscape tool was applied to obtain a fusional co-expression network based on bacterial and fungal keratitis DEGs. Finally, functional enrichment analysis by DAVID software and KEGG analysis by KOBAS of DEGs in fusion network were performed.Results: In total, 451 DEGs in bacterial keratitis and 353 DEGs in fungal keratitis were screened, among which 148 DEGs were found only in bacterial keratitis and 50 DEGs only in fungal keratitis. Besides, 117 co-expressed gene pairs were identified among bacterial keratitis DEGs and 87 pairs among fungal keratitis DEGs. In total, nine biological pathways and seven KEGG pathways were screened by analyzing DEGs in the fusional co-expression network.Conclusion: TLR4 is the representative DEG specific to bacterial keratitis, and SOD2 is the representative DEG specific to fungal keratitis, both of which are promising candidate genes to distinguish between bacterial and fungal keratitis. [ABSTRACT FROM AUTHOR]

Glaucoma is a group of neurodegenerative disease linked with imbalance in the aqueous humor flow due to resistance in the aqueous drainage system. This increases the intraocular pressure (IOP), which causes damage to the optic nerve head and leads to irreversible blindness. As IOP is the only treatable risk factor for glaucoma, its 24 hours biorhythm need to be understood before managing it. Monitoring IOP is a critically important part in the management of glaucoma. Various approach and technology have been initiated and on-going for a frequent, round-the-clock IOP measurement to determine the IOP peaks and fluctuations. We review the current innovative approach and its importance as well as discussing the shortcomings of each method to obtain the 24 hour IOP profile. [ABSTRACT FROM AUTHOR]

Introduction: If intraocular pressure (IOP) is the sole modifiable risk factor for glaucoma progression, glaucoma management should not rely on a vague estimation of its value measured over seconds, out of the 31,536,000 seconds in a year. A technology that would allow continuous and accurate IOP measurement in any situation could drastically enhance the diagnosis, treatment, follow-up and advice we give glaucoma patients. Areas covered: This review covers the development history of IOP telemetry devices, from Green and Gilman's first 24-hour telemetry concept in 1974 to the two devices commercially available today: Sensimed's TriggerFish contact lens sensor and Implandata's implantable monitoring device. Through a systematic review of the articles indexed by the US National Library of Medicine National Institute of Health between November 1969 and July 2019 with the keywords 'telemetry', 'continuous iop' and '24 hour iop', it details the ongoing contribution of telemetry to glaucoma knowledge. Expert opinion: The usage and purpose of the currently available telemetry devices remain specific and targeted. However, we foresee that this is likely to change in the upcoming years, with the advent of new, more versatile devices and ergonomic modules. The future of telemetry may lie in miniaturization, connectivity and new organic measures. [ABSTRACT FROM AUTHOR]

Wastewaters from a treatment plant discharging into a canal harboring fish may present sources of microbiological hazard for wild fish. Such fish, inhabiting microbiologically polluted bodies of water, can be contaminated by human pathogens and, if used for human consumption, may pose a risk to public health. Hence, in this work the aim was to identify tested strains from tissues of wild fish living in the receiving water bodies, captured from locations up to 12 km from the point of discharge of treated water of town Virovitica in order to assess the bacterial threat of the WWTP on fish and potentially on public health. A rather rich diversity of bacterial genera was isolated from gill tissues and internal organs. The most frequent isolate was Aeromonas hydrophila which has gained public health recognition as an opportunistic pathogen. Vibrio cholerae, an indicator bacterium for aquatic contamination, was retrieved from all investigated tissues. Opportunistic human pathogens as well as some zoonotic agents were also retrieved from fish tissues (Enterobacter amnigenus, Acinetobacter spp., Ochrobactrum anthropi, Pseudomonas aeruginosa, Flavimonas (Pseudomonas) oryzihabitans, Shewanellaputrefaciens and others). Public health hazard is particularly pronounced regarding local recreational fishermen who fish out, handle and consume fish from respective waters. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance in Neisseria gonorrhoeae is a major issue of public health, and there is a critical need for the development of new antigonococcal strategies. In this study, we investigated the effectiveness of antimicrobial blue light (aBL; wavelength, 405 nm), an innovative nonpharmacological approach, for the inactivation of N. gonorrhoeae. Our findings indicated that aBL preferentially inactivated N. gonorrhoeae, including antibiotic-resistant strains, over human vaginal epithelial cells in vitro. Furthermore, no aBL-induced genotoxicity to the vaginal epithelial cells was observed at the radiant exposure used to inactivate N. gonorrhoeae. aBL also effectively inactivated N. gonorrhoeae that had attached to and invaded into the vaginal epithelial cells in their cocultures. No gonococcal resistance to aBL developed after 15 successive cycles of inactivation induced by subtherapeutic exposure to aBL. Endogenous aBL-activatable photosensitizing porphyrins in N. gonorrhoeae were identified and quantified using ultraperformance liquid chromatography, with coproporphyrin being the most abundant species in all N. gonorrhoeae strains studied. Singlet oxygen was involved in aBL inactivation of N. gonorrhoeae. Together, these findings show that aBL represents a potential potent treatment for antibiotic-resistant gonococcal infection. [ABSTRACT FROM AUTHOR]

Salmonella species can infect a diverse range of birds, reptiles, and mammals, including humans. The type III protein secretion system (T3SS) encoded by Salmonella pathogenicity island 1 (SPI-1) delivers effector proteins required for intestinal invasion and the production of enteritis. The T3SS is regarded as the most important virulence factor of Salmonella. SPI-1 encodes transcription factors that regulate the expression of some virulence factors of Salmonella , while other transcription factors encoded outside SPI-1 participate in the expression of SPI-1-encoded genes. SPI-1 genes are responsible for the invasion of host cells, regulation of the host immune response, e.g., the host inflammatory response, immune cell recruitment and apoptosis, and biofilm formation. The regulatory network of SPI-1 is very complex and crucial. Here, we review the function, effectors, and regulation of SPI-1 genes and their contribution to the pathogenicity of Salmonella. [ABSTRACT FROM AUTHOR]

Wastewaters from a treatment plant discharging into a canal harboring fish may present sources of microbiological hazard for wild fish. Such fish, inhabiting microbiologically polluted bodies of water, can be contaminated by human pathogens and, if used for human consumption, may pose a risk to public health. Hence, in this work the aim was to identify tested strains from tissues of wild fish living in the receiving water bodies, captured from locations up to 12 km from the point of discharge of treated water of town Virovitica in order to assess the bacterial threat of the WWTP on fish and potentially on public health. A rather rich diversity of bacterial genera was isolated from gill tissues and internal organs. The most frequent isolate was Aeromonas hydrophila which has gained public health recognition as an opportunistic pathogen. Vibrio cholerae, an indicator bacterium for aquatic contamination, was retrieved from all investigated tissues. Opportunistic human pathogens as well as some zoonotic agents were also retrieved from fish tissues (Enterobacter amnigenus, Acinetobacter spp., Ochrobactrum anthropi, Pseudomonas aeruginosa, Flavimonas (Pseudomonas) oryzihabitans, Shewanella putrefaciens and others). Public health hazard is particularly pronounced regarding local recreational fishermen who fish out, handle and consume fish from respective waters. [ABSTRACT FROM AUTHOR]

Purpose: Boston keratoprosthesis (KPro) patients are prone to glaucoma even with well-controlled intraocular pressure (IOP). Recent experimental data have shown that soluble tumor necrosis factor alpha (TNF-α) after ocular injury may contribute to progressive retinal damage and subsequent glaucoma. This study evaluates the blood plasma levels of soluble TNF-α, TNF receptors 1 (TNFR1) and 2 (TNFR2), and leptin in patients with Boston type I KPro. Methods: Venous blood samples were collected from KPro patients with glaucoma (KPro G, n = 19), KPro patients without glaucoma (KPro NoG, n = 12), primary angle closure glaucoma without KPro (PACG, n = 13), and narrow angles without glaucoma or KPro (NA, n = 21). TNF-α, TNFR1, TNFR2, and leptin levels were quantified using the enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate (ESR) was assessed using the Westergren test. Patients with underlying autoimmune conditions or diabetes were excluded from the study. Results: All groups had similar age, body mass index (BMI), IOP, and ESR (p ≥ 0.11). The mean time from KPro surgery to blood draw was 5.3 ± 3.7 years. Compared to NA patients (0.72 ± 0.3 pg/ml), KPro G and KPro NoG patients had higher blood plasma levels of TNF-α (1.18 ± 0.58 pg/ml, p = 0.006; 1.16 ± 0.50 pg/ml, p = 0.04, respectively). Similarly, KPro G patients had higher blood plasma levels of TNFR2 (2768 ± 1368 pg/ml) than NA patients (2020 ± 435 pg/ml, p = 0.048). In multivariate analysis, KPro status remained positively associated with TNF-α levels (β = 0.36; 95% confidence intervals [CI]: 0.14–0.58; p = 0.002) and TNFR2 levels (β = 458.3; 95% CI: 32.8–883.7; p = 0.035) after adjusting for age, gender, BMI, glaucoma status, and ESR. TNFR1 and leptin levels were not significantly different in the study groups. Conclusions: We detected elevated serum levels of TNF-α and TNFR2 in KPro patients. Longitudinal studies are needed to establish TNF-α and TNFR2 as serum biomarkers related to KPro surgery. Abbreviations: BCVA: best corrected visual acuity; BMI: body mass index; CDR: cup-to-disc ratio; EDTA: ethylenediaminetetraacetic acid; ELISA: enzyme-linked immunosorbent assay; ESR: erythrocyte sedimentation rate; HVF: Humphrey visual field; IOP: intraocular pressure; KPro G: keratoprosthesis with glaucoma; KPro NoG: keratoprosthesis without glaucoma; KPro: keratoprosthesis; MD: mean deviation; NA: narrow angle; non-KPro: without keratoprosthesis; PACG: primary angle closure glaucoma; RNFL: retinal nerve fiber layer; TNF-α: tumor necrosis factor alpha; TNFR1: tumor necrosis factor receptor 1; TNFR2: tumor necrosis factor receptor 2 [ABSTRACT FROM AUTHOR]

Purpose: To report on a wearer of rigid gas-permeable contact lenses with a keratomycosis due to Tintelnotia—a new genus of Phaeosphaeriaceae—treated with terbinafine and polyhexamethylene biguanide. Methods: Chart review of a patient with fungal keratitis treated additionally with systemic and topical terbinafine 0.25% after symptoms increased under conventional antimycotic therapy with voriconazole. Antifungal susceptibility had been tested in vitro. Results: After starting an additional treatment with systemic and topical terbinafine, the severe corneal infection was sufficiently resolved. The drug was well tolerated without any neurological, dermatological or gastroenterological problems. Terbinafine revealed a marked in vitro antifungal activity of 0.12 µg/ml. The fungus was identified as Tintelnotia destructans. Conclusions: Terbinafine might be considered as a therapeutic option in severe cases of fungal keratitis refractory to common antifungal therapy. [ABSTRACT FROM AUTHOR]

The bicontinuous microemulsion contact lens (BMCL) has nanoporous biphasic structures (100–250 nm) that are interconnected via multiple nano‐channels, providing suitable retention of various drugs for glaucoma. Timolol maleate (TM)‐carried thermosensitive poly(N‐isopropylacrylamide) (PNIPAM) nanogel (30–50 nm) was incorporated into BMCLs by soaking or by centrifuging plus soaking. Here, we present drug‐loading and release in silicon‐ or polyethylene oxide‐microemulsion BMCLs under various conditions. Nanoporous BMCLs containing thermosensitive TM‐laden nanogel were capable of potent body‐temperature‐triggered release of TM. Daily drug release was controllable according to the initial volume of drug‐loaded (VDL) and loading method for sustained drug release, making them reduce drug‐loss during transportation or storage. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1159–1169, 2019. [ABSTRACT FROM AUTHOR]

Biodegradable silk catheters for the delivery of therapeutics are designed with a focus on creating porous gradients that can direct the release of molecules away from the implantation site. Though suitable for a range of applications, these catheters are designed for drug delivery to transplanted adipose tissue in patients having undergone a fat grafting procedure. A common complication for fat grafts is the rapid reabsorption of large volume adipose transplants. In order to prolong volume retention, biodegradable catheters can be embedded into transplanted tissue to deliver nutrients, growth factors or therapeutics to improve adipocyte viability, proliferation, and ultimately extend volume retention. Two fabrication methods are developed: a silk gel‐spinning technique, which uses a novel flash‐freezing step to induce high porosity throughout the bulk of the tube, and a dip‐coating process using silk protein solutions doped with a water soluble porogen. Increased porosity aids in the diffusion of drug through the silk tube in a controllable way. Additionally, we interface the porous tubes with ALZET osmotic pumps for implantation into a subcutaneous nude mouse model. The work described herein will discuss the processing parameters as well as the interfacing between pump and cargo therapeutic and the resulting release profiles. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 501–510, 2019. [ABSTRACT FROM AUTHOR]

The relentless rise of antibiotic resistance is considered one of the most serious problems facing mankind. This mini‐review will cover three cutting‐edge approaches that use light‐based techniques to kill antibiotic‐resistant microbial species, and treat localized infections. First, we will discuss antimicrobial photodynamic inactivation using rationally designed photosensitizes combined with visible light, with the added possibility of strong potentiation by inorganic salts such as potassium iodide. Second, the use of blue and violet light alone that activates endogenous photoactive porphyrins within the microbial cells. Third, it is used for "safe UVC" at wavelengths between 200 nm and 230 nm that can kill microbial cells without damaging host mammalian cells. We have gained evidence that all these approaches can kill multidrug resistant bacteria in vitro, and they do not induce themselves any resistance, and moreover can treat animal models of localized infections caused by resistant species that can be monitored by noninvasive bioluminescence imaging. Light‐based antimicrobial approaches are becoming a growing translational part of anti‐infective treatments in the current age of resistance. [ABSTRACT FROM AUTHOR]

Purpose: To assess safety and tolerability of a subconjunctival penciclovir implant in cats infected with feline herpesvirus type 1 (FHV-1).Methods: Subconjunctival blank (n = 4 cats) or penciclovir-impregnated (n = 6) silicone implants were placed bilaterally in 10 normal, FHV-1-naive cats 7-8 days before viral inoculation. Outcomes included disease score, FHV-1 serology, conjunctival viral load, Schirmer tear tests (STT), tear film break-up times (TFBUTs), conjunctival histology, goblet cell density (GCD), body weight, tear and plasma penciclovir concentration, and corneal ulcer evaluation.Results: Both groups had similar clinical and histologic disease scores, STT values, TFBUTs, GCD, FHV-1 titers, viral loads, and body weight changes. No ocular or systemic signs of toxicity were noted. Tear penciclovir concentration varied widely among cats and across time points. Tear penciclovir concentrations exceeded the lowest published half maximal inhibitory concentration (IC50) in 5/6 treated cats. Plasma penciclovir concentrations remained below 10 ng/mL. Cats with higher tear penciclovir concentrations at inoculation and/or time of peak disease had fewer corneal ulcers than cats in which tear penciclovir concentrations were inconsistent, low, or unrecordable.Conclusions: Subconjunctival blank and penciclovir-impregnated implants were well tolerated at the ocular surface and not associated with systemic toxicity, adverse effect, or appreciable plasma penciclovir concentrations. Tear penciclovir concentrations >IC50 were sometimes achieved, especially during burst release soon after implant placement. Further study is necessary to determine efficacy of locally delivered penciclovir when penciclovir concentration is consistently maintained above IC50. This will be especially useful in patients unable to receive systemic therapy. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role of interleukin-17 in ocular surface and corneal disease. Ocular surface and corneal disease is a leading cause of blindness and is an ongoing challenge for the public health sector to implement effective therapies. The majority of cells in corneal lesions are derived primarily from neutrophils that induce inflammatory events that lead to tissue damage. One of the key pro-inflammatory cytokines is IL-17, and it has been investigated in order to facilitate the understanding of the pathogenesis of ocular surface lesion development. Method: A review of the literature was performed through a systematic approach. Results: IL-17 has been shown to exacerbate dry eye disease, viral and bacterial keratitis lesion severity, although it was found to be protective for Acanthamoeba. Antibodies developed to neutralize IL-17 have shown some promise in reducing the severity of some diseases. Conclusion: IL-17 plays a role in the pathogenesis of ocular surface and corneal disease and targeting this cytokine may provide a useful treatment option in the future. [ABSTRACT FROM AUTHOR]

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Purpose. Reliable and regular assessment of intraocular pressure (IOP) is important for the monitoring of patients with glaucoma. The purpose of this study was to evaluate the feasibility of a novel system for the automated, noncontact measurement of IOP. Patients and Methods. A first-generation telemetric IOP sensor was previously implanted in the ciliary sulcus of six patients with open-angle glaucoma during cataract surgery. Using this technology, automated noninvasive tonometry may be performed in a home setting. In the present study, a modified sleep mask and a modified eyepatch with incorporated coil antennae for measurements during nighttime and daytime, respectively, were tested on a single patient. Results. In this feasibility study, the 24 h wear of the prototype measuring apparatus was well tolerated. Three sequences of 24 h IOP measurements with at least 200 IOP measurements per day were performed (Sequence 1: mean 19.6 ± 2.7 mmHg, range 13.4–28.7 mmHg; Sequence 2: mean 21.0 ± 3.0 mmHg, range 13.1–30.5 mmHg; Sequence 3: mean 19.9 ± 2.4 mmHg, range 12.6–27 mmHg). Conclusions. For the first time, repeated and automated 24-hour measurements are possible using a prototype noncontact reading system after implantation of a novel telemetric IOP sensor in patients with glaucoma. [ABSTRACT FROM AUTHOR]

Summary: Mycotic keratitis or keratomycosis is a fungal infection with global distribution. The dominant aetiology of this disease varies based on geographical origin, socioeconomic status, and climatic condition. Generally, Aspergillus spp. and Fusarium spp. are common in tropical and subtropical regions and Candida spp. are dominant in temperate areas. Demonstration of fungal elements in microscopic examination besides the isolation of fungi in culture is the gold standard of laboratory diagnosis. As the culture is a time‐consuming procedure, other approaches such as in vivo confocal microscopy which produces real‐time imaging of corneal tissue and molecular techniques have been developed to facilitate rapid diagnosis of fungal keratitis. The first choice of treatment is topical natamycin, although topical amphotericin B is the best choice for Aspergillus and Candida keratitis. Regarding the diversity of fungal aetiology and the emergence of drug resistance in some genera and species, proper identification using molecular methods and antifungal susceptibility testing could provide useful data. Furthermore, as the better efficacy of combination therapy in comparison to monotherapy is reported, in vitro determination of interactions between various drugs seem informative. This review aims to provide a general and updated view on the aetiology, risk factors, epidemiology, clinical and laboratory diagnosis, and management of fungal keratitis. [ABSTRACT FROM AUTHOR]

The present review casts a critical eye on intraocular pressure (IOP) monitoring and its value in current and future glaucoma care. Crucially, IOP is not fixed, but varies considerably during the 24-h cycle and between one visit and another. Consequently, a single IOP measurement during so-called office hours is insufficient to characterize the real IOP pathology of a patient with glaucoma. To date IOP remains the principal and only modifiable risk factor for the development and progression of glaucoma. Only by evaluating IOP characteristics (mean, peak and fluctuation of IOP) at diagnosis and after IOP-lowering interventions can we appreciate the true efficacy of therapy. Unfortunately, a major limiting factor in glaucoma management is lack of robust IOP data collection. Treatment decisions, advancement of therapy and even surgery are often reached on the basis of limited IOP evidence. Clearly, there is much room to enhance our decision-making and to develop new algorithms for everyday practice. The precise way in which daytime IOP readings can be used as predictors of night-time or 24-h IOP characteristics remains to be determined. In practice it is important to identify those at-risk glaucoma patients for whom a complete 24-h curve is necessary and to distinguish them from those for whom a daytime curve consisting of three IOP measurements (at 10:00, 14:00 and 18:00) would suffice. By employing a staged approach in determining the amount of IOP evidence needed and the rigour required for our monitoring approach for the individual patient, our decisions will be based on more comprehensive data, while at the same time this will optimize use of resources. The patient's clinical picture should be the main factor that determines which method of IOP monitoring is most appropriate. A diurnal or ideally a 24-h IOP curve will positively impact the management of glaucoma patients who show functional/anatomical progression, despite an apparently acceptable IOP in the clinic. The potential impact of nocturnal IOP elevation remains poorly investigated. The ideal solution in the future is the development of non-invasive methods for obtaining continuous, Goldmann equivalent IOP data on all patients prior to key treatment decisions. Moreover, an important area of future research is to establish the precise relationship between 24-h IOP characteristics and glaucoma progression. [ABSTRACT FROM AUTHOR]