Rationale: Nocardia farcinica is an opportunistic pathogen that rarely causes ocular infections. This study reviewed a case of N. farcinica-mediated scleritis involving the corneal limbus. Patient concerns: A 56-year-old man was admitted to the Department of Keratology of Jinan Second People’s Hospital due to “a red and swollen right eye accompanied with severe pain for >1 month.” He denied any history of hypertension, diabetes, systemic immune diseases and eye surgery. Diagnoses: Corneal defect and scleral necrosis were observed by slit lamp. Combination of anterior segment optical coherence tomography and ophthalmic ultrasound biomicroscopy was used for diagnosis and evaluation of corneal and scleral conditions. Culture and metagenomic sequencing verified that the pathogen of scleritis was N. farcinica. Interventions: The patient was treated by sulfacetamide sodium eye drops, oral administration of sulfamethoxazole tablets, amikacin anterior chamber flushing, scleral debridement, and allogeneic scleral transplantation. Outcomes: The disease was successfully controlled. Lessons: Infectious scleritis caused by N. farcinica is extremely rare. Culture of pathogenic microorganisms remains to be the gold standard for the diagnosis of infectious eye diseases. Metagenomic sequencing shows potential promise in the diagnosis of infectious eye diseases. N. farcinica is sensitive to sulfonamides and amikacin.
Objective. To investigate the clinical characteristics and pathogenic genetic mutations of a Chinese family with anterior segment mesenchymal dysgenesis and congenital posterior polar cataract. Methods. Through family investigation, the family members were examined via slit lamp anterior segment imaging and screened for eye and other diseases by eye B-ultrasound. Genetic test was performed on the blood samples of the fourth family generation (23 people) via whole exome sequencing (trio-WES) and Sanger sequencing. Results. Among the 36 members in four family generations, there were 11 living cases with different degrees of ocular abnormalities, such as cataracts, leukoplakia, and small cornea. All patients who received the genetic test had the heterozygous frameshift mutation c.640_656dup (p.G220Pfs ∗ 95) on exon 4 of the PITX3 gene. This mutation was cosegregated with the clinical phenotypes in the family and thus might be one of the genetic factors that cause the corresponding ocular abnormalities in this family. Conclusion. The congenital posterior polar cataract with or without anterior interstitial dysplasia (ASMD) of this family was inherited in an autosomal dominant manner, and the frameshift mutation (c.640_656dup) in the PITX3 gene was the cause of ocular abnormalities observed in this family. This study is of great significance for guiding prenatal diagnosis and disease treatment.
The hyperbaric oxygen therapy is often used in the management of acid and base burns of the eyes. However, oxygen is rarely supplied locally through goggles or face mask in ophthalmology. Therefore, in this study, we aim to investigate how oxygen delivery affects eye recovery after injury. We used a rabbit model with corneal epithelial injury to examine the effects of local oxygen supply via goggles or face mask on the recovery of cornea. A total of 75 healthy New Zealand white rabbits were randomly divided into three groups, A, B, and C, with 25 rabbits in each group. Then, on each rabbit eye (150 eyes in total), a circle of corneal epithelium with 5 mm in diameter was scraped off from the center of the cornea with a corneal epithelial scraper. Group A was given oxygen goggles every day (the oxygen flow rate was 3 L/min, once a day, 2 hours each time); group B was given nasal inhalation of oxygen every day (the oxygen flow rate was 3 L/min, once a day, 2 hours each time); and group C did not receive any treatment and was healed naturally. We found that the group A, which received oxygen supply via goggles, showed the best eye recovery. Transmission electron microscopy showed that the cornea with local oxygen supply via goggles or face mask exhibited intact capillary structure and obvious desmosome/hemidesmosome connections between cells. Moreover, the protein and RNA levels of hypoxia-related genes were lower in group A and B, suggesting that the hypoxia factor is a sensitive and early regulator in the low oxygen environment.
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