Nanopore techniques as a potent tool in the diagnosis and treatment of endophthalmitis: a literature review

Abstract

Endophthalmitis is a serious ophthalmic disease characterized by changes in the eye’s posterior segment, such as hypopyon and intraocular inflammation, vitritis being a hallmark. Infection-caused endophthalmitis can lead to irreversible vision loss, accompanied by eye pain or eye distention, and in the most severe cases the removal of the eyeball. Microorganisms such as bacteria, fungi, viruses, and parasites typically account for the disease and the entry pathways of the microbial can be divided into either endogenous or exogenous approaches, according to the origin of the etiological agents. Exogenous endophthalmitis can be derived from various occasions (such as post-operative complications or trauma) while endogenous endophthalmitis results from the bloodstream which carries pathogens to the eye. This review aims to summarize the application of new technology in pathogen identification of endophthalmitis so as to prevent the disease and better guide clinical diagnosis and treatment.

Analysis of pathogenic factors and clinical features of infectious endophthalmitis

“…Staphylococcus epidermidis was the most common pathogen in traumatic endophthalmitis and intraocular post-operative endophthalmitis, which was consistent with previous reports. 19,20,21 Klebsiella pneumoniae was the main pathogen of endogenous endophthalmitis, which mainly occurred in patients with liver abscess, similar to domestic reports. Klebsiella pneumoniae is predominant in Asian countries, while fungal infections are predominant in Western countries .10,22 In the study, gram-positive bacteria were predominant in endophthalmitis due to corneal ulceration, while gramnegative bacteria were predominant in some reports, which may be caused by the different pathogenic bacteria and drug resistance in different countries or regions due to different geography and climate.…”

“…In previous literatures on pathogenic bacterial spectrum of infectious endophthalmitis, gram-positive bacteria were the main pathogenic bacteria, among which coagulase negative staphylococcus was the most common, followed by gram-negative bacteria, and fungal infection was rare. 19 In this study, coagulase negative staphylococcus was still the most common cause of infectious endophthalmitis. Staphylococcus epidermidis was the most common pathogen in traumatic endophthalmitis and intraocular post-operative endophthalmitis, which was consistent with previous reports.…”

“…25 Patients with corneal ulcers have complex conditions, and endophthalmitis caused by them is often di cult to detect, leading to delayed treatment. 19,26 The poor prognosis may be related to the long-term absence of effective eye therapy in both groups. How to perform timely and effective targeted eye therapy is key to improving the prognosis of both types of endophthalmitis.…”

Outcomes of Infectious Panuveitis Associated with Simultaneous Multi-Positive Ocular Fluid Polymerase Chain Reaction

“…Newer diagnostic tools such as metagenomic next-generation sequencing have demonstrated high sensitivity in identifying the presence of multiple concurrent pathogens and may be a powerful approach in the clinical setting, especially as newer technologies such as nanopore sequencing can acquire real-time genomic results within hours of sample submission. 30,31…”

A novel terminologic “naming-meshing” system using anterior chamber sedimentation for early diagnosis and prompt treatment of ocular or systemic diseases: is it hypopyon or pseudohypopyon?

“…Post-vitrectomy, management of retinal detachment 6. Color (hue) [1,[4][5][6][15][16][17][18][19][20][21][22][23][24][25][26] Hypopyon White (grayish-white)…”