We report a case of severe pigmented keratitis with poor prognosis, caused by Cladorrhinum bulbillosum. Antifungal treatment with topical natamycin and fluconazole eye drops and oral tablet fluconazole failed to heal the ulcer and resulted in perforation. The causative fungus, C. bulbillosum, was identified on the basis of its typical microscopic features and 98% sequence homology to ex-type isolate CBS 304.90 (accession no. FM955448). The results of an in vitro antifungal susceptibility test indicated that the isolate was susceptible to natamycin, amphotericin B, fluconazole and itraconazole. The present case is the third case of keratitis and the second case of human keratitis. Compromised immunity due to liver cirrhosis could lead to a failed prognosis even when the fungal isolate is highly susceptible to antifungal treatment.
Background:Congenital cataract and microphthalmia are highly heterogeneous congenital eye disorders that affect normal vision. Although mutation in several genes has been shown to cause congenital cataract and microphthalmia, genetic studies associating single-nucleotide polymorphisms with these conditions is scarce. Hence, the present study aims to investigate the association of bone morphogenetic protein 4 (BMP4)-V152A (rs17563), and SIX homeobox 6 (SIX6)-H141N (rs33912345) polymorphisms with congenital cataract and microphthalmia in Western Indian cohorts.Materials and Methods:BMP4-V152A and SIX6-H141N were genotyped in 561 participants comprising of 242 congenital cataracts, 52 microphthalmia, and 267 controls using polymerase chain reaction (PCR) and allele specific oligonucleotide (ASO)-PCR method, respectively.Results:The frequency of BMP4- 152A was found to be significantly different between the cases and controls (Odds ratio (OR) 95% confidence interval [CI] = 1.4 [1.03–1.76], P = 0.0275). The frequency of BMP4- 152AA genotype was found to be significantly higher in congenital cataract cases as compared to controls (OR [95% CI] = 2.1 [1.14–3.67], P = 0.0154. The V-N haplotype of BMP4-V152A and SIX6-H141N was found to have a protective effect toward congenital cataract (OR [95% CI] = 0.72 [0.56–0.94], P = 0.0163) and microphthalmia (OR [95% CI] = 0.63 [0.40–1.01, P = 0.0541).Conclusions:The BMP4- 152AA genotype might play role in the causation of congenital cataract, whereas BMP4-SIX6 V-N haplotype might play a protective role toward the development of congenital cataract and microphthalmia.
Background:Corticocapsular adhesions (CCA) are frequently seen between lens capsule and adjacent cortical
layer. During cataract surgery, in the presence of CCA, excessive efforts to rotate the nucleus can result in
zonular damage. To reduce morbidity, identification of associations with CCA can be helpful in appropriately
modifying the surgical procedure.Aim:To investigate probable associations with CCA in patients undergoing cataract surgery.Setting and Design:Iladevi Cataract and IOL research center. Case-control study.Materials and Methods:A single eye of 600 patients, 200 patients with CCA (cases) and 400 patients without
CCA (controls) were considered. A CCA diagnosis was based on: (i) preoperative presence of CCA on slit-
lamp examination with visualization of furry surface of cortex during surgery; (ii) preoperative absence of
CCA on slit-lamp examination but intraoperative visualization of furry surface of cortex. Variables such
as age, gender, type of cataract, grade of cataract, high myopia, diabetes mellitus and hypertension were
studied.Statistical Analysis:Multivariate logistic regression was done. Results were presented as odds ratio (OR)
with 95% CI.Results:Mean age was 64.71 ± 9.10 years in cases and 59.27 ± 8.79 years in controls. Presence of CCA
increased with age from 22% (n = 59) in 45 to 49 years to 70% (n = 110) in 70 to 79 years. An increase in age was
associated with CCA by 3.3% (OR = 3.3%, P = 0.028). The odds of CCA for females were 83% higher
(P = 0.027).
Presence of anterior cortical cataract increased odds of CCA by 9.5 times (P = 0.001), while posterior cortical
cataract increased odds by 3.3 times (P = 0.001).Conclusion:Corticocapsular adhesions were strongly associated with cortical cataracts, increased age and
female gender.
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