Non-contact in vivo scanning laser microscopy of blebitis

Sbeity, Zaher; Radcliffe, Nathan M.; Pm, Palmiero; Tello, Celso; Liebmann, J. M.; Ritch, Robert

doi:10.1038/eye.2008.246

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…This predisposes to thin walled, avascular blebs which lead to frank bleb leaks and have a decreased capacity for healing, possibly related to a limited blood supply causing ischemia 6,26–29. Neither anti-fibrotic agent was found to confer a greater risk for BRI (Tables 2 and 3), which concurs with other studies 5,8,12,13.…”

Section: Discussionsupporting

confidence: 87%

“…Almost half of our patients with BRIs were culture negative. While a few studies have reported similar rates of negative cultures,4,18 the overwhelming majority have yielded larger numbers of culture positive subjects 4,13,14,24,29. When positive, the vitreous and conjunctival cultures were correlated.…”

Section: Discussionmentioning

confidence: 99%

“…Unsurprisingly, given the greater severity of inflammation, BRE subjects were more likely to present with a purulent bleb than their blebitis counterparts (90.0% vs 20.7%, P <0.001). This suggests that pus is a harbinger of poor outcome and is a strong indicator of blebitis being an antecedent to BRE 21,29…”

Section: Discussionmentioning

confidence: 99%

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Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population

Yap¹,

Chin²,

Ku³

et al. 2016

OPTH

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PurposeComparison of the demographic, ocular, systemic and microbiological characteristics of eyes with bleb related infection (BRI) and bleb related endophthalmitis (BRE).MethodsRetrospective chart review of patients with BRI from January 1996–July 2013. Identification done via the center’s longstanding endophthalmitis audit, BRI audit and laboratory database identifying all conjunctival swabs from blebs. Blebitis was defined as anterior segment inflammation with mucopurulent material in or around the bleb, with anterior chamber cells but no hypopyon. BRE was defined by the presence of hypopyon or vitreous inflammation.ResultsTwenty-nine patients with blebitis and 10 with BRE were identified. Mean age of subjects (n=39) was 68.4 (±13.3) with a preponderance of men (74.4%) and Chinese ethnicity (74.4%). BRE patients were 10.7 years older than blebitis patients (P=0.026). 28 (71.8%) subjects had primary open angle glaucoma. The presenting intraocular pressure (IOP) dropped in blebitis but almost doubled in BRE (P=0.011) compared to average preinfective IOP. Two weeks after treatment, IOPs in both groups returned to close to preinfective levels. Subjects with blebitis more often had an avascular bleb (88.0%) while those with BRE trended toward a moderately vascular bleb (50%). The distribution of causative microorganisms between the groups was similar.ConclusionOur study indicates that risk factors are similar in both groups even though the visual outcome and clinical course, in the form of IOP findings and bleb vascularity, can diverge significantly. The decreased IOP in blebitis subjects represents objective evidence of subclinical leaks or bleb sweating.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population

Yap¹,

Chin²,

Ku³

et al. 2016

OPTH

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“…The white, hyperreflective dots in the anterior chamber and capsule likely corresponded to inflammatory cells found histologically. In fact these dots were similar in size, reflectivity and structure to presumed inflammatory cells reported in other ocular tissues such as conjunctiva, cornea and blebs 4,5 . In our case, vitreous hyperechogenicity and capsular hyperreflectivity as imaged by the RCM may represent signs of endocapsular inflammation.…”

supporting

confidence: 80%

“…However, this requires surgical intervention with the risk of complications. The Rostock Cornea Module (RCM), Heidelberg Retina Tomograph, was used to image in vivo microstructural changes in keratitis and blebitis 3,4 . We used a non‐contact RCM lens prototype to assist in the diagnosis of chronic endophthalmitis after cataract surgery.…”

mentioning

confidence: 99%