What is causing the corneal ulcer? Management strategies for unresponsive corneal ulceration

Abstract

Infectious keratitis represents a significant cause of ocular morbidity in the United States. The work-up and treatment of presumed infectious keratitis (PIK) has changed in the past two decades. The development of newer topical antibiotics has enabled broad-spectrum antibiotic coverage with good tissue penetration. The majority of PIK cases respond well to this strategy. The small numbers of cases that do not respond to the treatment are the cases that offer a diagnostic and therapeutic challenge. This review will describe different algorithms that can be followed for the successful management of patients with difficult or progressive PIK. These algorithms are based on scientific work and on our empirical clinical experience. The review will also present three different clinical cases of PIK that were managed according to the algorithms presented in this review.

Characterization of Ocular Methicillin-Resistant Staphylococcus epidermidis Isolates Belonging Predominantly to Clonal Complex 2 Subcluster II

“…Patients presenting with corneal ulcer are immediately started on eye drop antibiotics, usually a new 8-methoxyfluoroquinolone, including moxifloxacin and gatifloxacin, whereas patients submitted to intraocular procedures are commonly subjected to a 7-day regimen (or more) of topical fluoroquinolone for prophylaxis of endophthalmitis (43,44). The impact of biofilm formation on ocular infections is well known and undoubtedly plays a major role in the pathogenesis of such infections (45).…”

Molecular Fingerprint-Based Artificial Neural Networks QSAR for Ligand Biological Activity Predictions

“…17–23 ANN have several unique attributes which make them robust for non linear generalization problems with multidimensional inputs. For instance, the networks have adaptive learning behaviors in which they learn from previous examples and adapt to changes in input parameters.…”

Early Addition of Topical Corticosteroids in the Treatment of Bacterial Keratitis

“…13 It is important to recognize that in SCUT, all cases of bacterial keratitis were confirmed by positive cultures, and these results are not relevant if the diagnosis is uncertain. 14 Corticosteroid use has been shown to be associated with worse outcomes in keratitis caused by fungus and Acanthamoeba . 15,16 This report demonstrates that microbiology culture results can be obtained early enough to gain visual benefit from topical corticosteroids.…”