Aqueous Tap Research Articles

Influence of cephalexin on cadmium adsorption onto microplastic particles in water: Human health risk evaluation

This paper explores the impact of environmental factors on the adsorption of cadmium (Cd) and cephalexin (CEX) onto polyethylene (PE) microplastics. The study focused on Cd adsorption behavior on microplastics (MPs) of various sizes, revealing that particles sized 30–63 μm exhibited the highest adsorption capacity compared to other sizes. Cd sorption was significantly influenced by initial pH and salinity levels. Experimental data closely matched both the Langmuir (R2 > 0.91) and Freundlich (R2 > 0.92) isotherms. Cd adsorption onto PE particles was greater than CEX adsorption, with the maximum Cd uptake capacity measured at 1.8 mg/g. FTIR analysis indicated that Cd and CEX adsorption onto MPs was likely governed by physical interactions, as no new functional groups were detected post-uptake. The desorption rates of Cd and CEX from PE microplastics were evaluated in various liquids, including aqueous solution, tap water, seawater, and synthetic gastric juice. The health risks associated with Cd, in combination with MPs and CEX, for both children and adults were assessed in groundwater and aqueous solutions. This study offers scientific insights and guidelines for examining the environmental behavior, migration, and transformation of microplastics and their related ecological risks in scenarios of combined pollution.

Outcomes of Postcataract Surgery Endophthalmitis Managed Without Microbial Cultures

To evaluate outcomes of eyes with post-cataract surgery endophthalmitis that were managed without microbial cultures. This retrospective, single-center comparative cohort study identified all cases of endophthalmitis after cataract surgery presenting between February 1, 2014, and November 1, 2022. All eyes presenting with presumed endophthalmitis requiring in-office treatment with intravitreal antibiotics and either a vitreous or aqueous tap were included. Endophthalmitis cases were divided into the "culture group" if the vitreous or aqueous specimens were sent for microbiologic sampling or into the "no culture group" if an aqueous or vitreous tap was performed but not sent for microbiologic sampling. Best corrected visual acuity (VA) 12 months following endophthalmitis presentation, incidence of retinal detachment, and need for subsequent procedures. Of the 232 endophthalmitis cases identified, 196 (85%) were in the "culture group" and 36 (15%) were in the "no culture group". At endophthalmitis presentation, eyes in the "culture group" had a mean (SD) logMAR VA [Snellen Equivalent] of 2.14 (0.8) [20/2760] and mean (SD) logMAR VA in the "no culture group" was 1.93 (0.8) [20/1702] (p=0.185). At 12-month follow up, mean (SD) logMAR VA for the "culture group" was 0.80 (1.0) [20/126] and 0.41 (0.5) [20/50] in the "no culture group" (adjusted difference = 0.41, 95% CI = -0.043 - 0.857, p=0.076). Twenty of 196 (10%) eyes in the "culture group" developed secondary retinal detachments within 12 months of presentation compared to 0 in the "no culture group" (p=0.045). Eyes with endophthalmitis following cataract surgery managed without microbiologic cultures have similar visual outcomes to eyes managed with microbiologic cultures and may be less likely to develop secondary retinal detachments. This may be an acceptable strategy to manage endophthalmitis after cataract surgery when prompt access to a microbiologic facility is unavailable.

Good Syndrome: Cytomegalovirus retinitis case challenge.

To describe cytomegalovirus retinitis in a patient with Good syndrome (hypogammaglobulinemia and thymoma), ocular progression despite treatment, and fatal outcome. A 71-year-old woman with unilateral panuveitis of unknown cause and a history of thymoma resection was referred to our clinic. Visual acuity (VA) was 20/100 in her right eye (OD) and light perception in her left eye (OS). In slit-lamp examination, OD had inferior fine pigmented keratic precipitates, 2+ anterior chamber (AC) cells, cataract, and 2+ vitreous cells, no fundus detail, and normal ocular ultrasound. OS presented a white cataract, chronic hypotony, and increased choroidal thickness with calcifications. Laboratory evaluations were normal or negative for common causes of infection and inflammation. Prednisolone acetate eye drops were started, with improvement of AC inflammation. Cataract surgery was performed, reaching VA of 20/30. Two years later, VA had decreased and 2+ vitritis and retinitis were found. On clinical suspicion of masquerade syndrome, a vitrectomy biopsy was performed; pathology reported no data on ocular lymphoma. Leukopenia and lymphopenia were found: immunoglobulin levels, CD4 count, and viral load revealed systemic immunosuppression. The aqueous tap was positive for cytomegalovirus. Oral valganciclovir and intravitreal ganciclovir were initiated. In a patient with previous resection of thymoma and hypogammaglobulinemia, final diagnosis was Good syndrome, with CMVR being secondary to immunosuppression. Despite treatment, CMVR progressed and systemic deterioration resulted in mortal outcome. Good syndrome is an extremely rare disease and association with CMVR is uncommon. To our knowledge, only 14 cases exist in the literature.

Monodispersed AuNPs synthesized in a bio-based route for ultra selective colorimetric determination of Ni(II) ions

Nanoparticle (NP) systems with controllable and adjustable response sensor characteristics are promising for the colorimetric sensing of heavy metal ions in aqueous systems. In this article, uniform gold nanoparticles (AuNPs) with a mean diameter of 31.16 ± 6.67 nm have been achieved with the inexpensive and easily affordable differential centrifugation technique. Thereafter, they are deployed for Ni(II) ions colorimetric determination. Plant phytochemicals (mostly GC, EGC, CG and ECG polyphenols) that exist as natural reducing agents in mature green tea leaves were explored for the synthesized AuNPs. Subsequently, various spectroscopic and imaging methods such as UV–Vis spectroscopy, X-ray diffractometer (XRD), field emission transmission electron microscopy (FETEM), and X-ray photoelectron spectroscopy (XPS) have been applied for a greater insight into the morphological and structural characteristics of the green method synthesized AuNPs. The colorimetric sensing ability of the AuNPs for Ni(II) ionic identification in aqueous tap water system (0.001 to 1 mg/L) has been quantified in terms of the limit of detection (LOD) and limit of quantification (LOQ) values of 0.001 and 0.005 mg/L respectively. Furthermore, the metal-ligand interaction between AuNPs and Ni(II) ions resulted in a noticeable shift in color, and from the pink (λmax= 528 nm) to purple hue (λmax= 556 nm). The FETEM analysis assured clustering tendencies of AuNPs upon exposure to Ni(II) ions. The XPS analysis conveyed the coordination of positively charged Ni(II) ions with the surface-bound negative charged functional groups (–OH, C = O) of the AuNPs. These findings confirmed the practical relevance of the AuNPs for application as a potential colorimetric sensory system.

A new cysteamine-copper chemically modified screen-printed gold electrode for glyphosate determination

A chemically modified screen-printed gold electrode has been prepared by covering the electrode surface with a cysteamine-copper self-assembled monolayer (SAM). The sensor was effective for the voltammetric sensing of glyphosate. The method exploits the interaction of glyphosate with copper ions complexed by cysteamine, which results in a decrease in the intensity of copper redox current. Cyclic voltammetry was employed as a measuring technique. When dealing with voltammograms with numerous peaks changing in shape and size, it is difficult to define which signal is the most significant for the analyte determination; in these cases, a helpful approach is chemometrics. In this work, PLS (Partial Least Square regression) has been applied to build models to correlate the signal with the glyphosate concentration in standard aqueous solutions and tap water samples (matrix-matched calibration). The method's figures of merits were evaluated, obtaining a limit of quantification of about 5 μM. The reliability of the proposed sensor was verified by analyzing tap water spiked with glyphosate; recoveries higher than 90 % were achieved.

929 Case Report -Post Cataract Surgery Fungal Infection Presenting as a Mass Lesion

Abstract Purpose Fungal endophthalmitis is rare and usually causes poor outcome in untreated patients. It is important to document and be aware of uncommon presentation of fungal endophthalmitis. Case report 68-year-old male presented with complaints of redness, pain, and blurry vision in the right eye for the past 5 months. He underwent an uneventful cataract surgery in the right eye 5 months ago elsewhere and in the post operative follow-up was found to have high intraocular pressure for which he was started on antiglaucoma medications. Aqueous tap did not reveal growth of any microorganism. On examination his vision in both the eyes were 20/20. Slit lamp examination revealed congested conjunctiva, corneal superficial punctate keratitis, anterior chamber 2+ cells and 1.2mm white mass over the iris which was encroaching towards the pupillary margin. Ultrasound bio microscopy revealed 0.8mm x 1.5mm mass in the iris at 11 -12 o’clock position. Since there was a diagnostic uncertainty, excision biopsy was done which revealed fungal filaments on KOH staining. The patient was started on tablet voriconazole and advised to review in 1 month. Conclusions Due to the rare frequency, there is a lack of understanding of presentation of fungal endophthalmitis. Many cases series analysis have suggested that the late fungal endophthalmitis presents as clumpy anterior chamber or posterior chamber inflammation [1], white plaque over the lens [2], peripheral vitreous lesion or as chorioretinitis. Our case report shows a rare presentation of fungal endophthalmitis in the form of mass lesion on the iris.

Epstein-Barr Virus Keratouveitis-Induced Malignant Glaucoma After Penetrating Keratoplasty: A Case Report and Literature Review

ABSTRACT Purpose To report a case of Epstein-Barr virus (EBV) keratouveitis-induced malignant glaucoma after repeat penetrating keratoplasty (PK). Methods Retrospective review of the patient’s medical records and review of literature on EBV corneal endotheliitis and/or anterior uveitis. Results A 78-year-old Thai female patient presented with a markedly edematous corneal graft, dense pigmented keratic precipitates, fibrinous anterior chamber reaction, uniformly flat anterior chamber, and ocular hypertension of 55 mmHg in the left eye on the first day after the third PK. An aqueous tap for polymerase chain reaction analysis was positive for EBV DNA but negative for other herpesviruses. The patient was diagnosed with EBV endotheliitis and anterior uveitis-induced malignant glaucoma; and successfully treated with oral valacyclovir and topical 2% ganciclovir eye drops. Conclusions EBV endotheliitis and anterior uveitis can induce malignant glaucoma following PK. A high index of suspicion is required when a patient has a history of unexplained multiple graft rejections.

Hypopyon uveitis as a presenting manifestation of biopsy-proven sarcoidosis – A case report

A 68-year-old lady was referred for evaluation of bilateral hypopyon uveitis by her ophthalmologist. She had a history of bilateral cataract surgery 8 months ago and had received intravitreal dexamethasone implants for recurrent bouts of anterior uveitis with cystoid macular edema (CME) in both eyes 4 months ago. Systemic history was significant for diabetes mellitus and recurrent skin lesions. Aqueous tap was negative for infection on culture and polymerase chain reaction (PCR). Skin biopsy showed non-necrotizing granulomas, negative for Mycobacterium tuberculosis and fungi, suggestive of sarcoidosis. She received oral steroids and methotrexate, which resulted in resolution of ocular and skin lesions. This case highlights a rare presentation of hypopyon in ocular sarcoidosis.

Herpetic Anterior Uveitis Multicentre Longitudinal Study (The UVHER Project). Baseline Characteristics

ABSTRACT Purpose The aim of the UVHER project is to evaluate the risk of development of optic nerve damage in patients with herpetic anterior uveitis (AU) prospectively followed over 2 years. Herein, we described the baseline characteristics. Methods This is a multicentre, prospective study. An aqueous humour tap was performed. Only patients with a positive PCR were included. Clinical characteristics, optical coherence tomography (OCT) parameters and visual field (VF) abnormalities were registered. Results 27 patients were included: 18 Herpes Simplex (HSV), one Varicella Zoster (VVZ), and 8Cytomegalovirus (CMV). Patients with HSV-AU had severe inflammation, iris atrophy and corneal involvement. In patients with CMV-AU, less inflammation and medium-to-large keratic precipitates were observed. OCT showed a thinner RNFL and GCL in CMV-AU patients in comparison to HSV patients. VF showed abnormalities in six cases. Conclusions Patients in the UVHER cohort showed the typical clinical manifestations of herpetic AU. In CMV patients, optic nerve damage was observed at baseline, and in HSV patients, inflammation was more severe.

Diagnostic virologique des atteintes oculaires herpétiques antérieures sur prélèvement lacrymal : une technique simple et non invasive

Virological diagnosis of anterior ocular herpetic disease (AOHD) is essential for the management of these often-chronic pathologies that may require long-term therapy. PCR has become the gold standard, but the type of sampling (tears, corneal scraping, aqueous tap) has not been standardized. In this study, we studied the technique of tear sampling for the diagnosis of AOHD. We retrospectively analyzed the medical files of patients with a positive tear sample (Schirmer strip) for herpes simplex 1 virus (HSV-1) in the Department of Ophthalmology of Paris-Saclay Bicêtre Hospital between January 2018 and December 2020. We studied the clinical and virological characteristics (viral loads) of these cases of proven AOHD. Thirty-six samples (33 patients) were included: 12 epithelial keratitis, 9 stromal HSK with ulceration, 5 uveitis, 4 stromal HSK without ulceration, 3 blepharitis, 1 endothelial HSK, 1 neurotrophic keratitis, and 1 conjunctivitis. The mean viral load was 3.9×105 copies/mL. Viral load was higher in cases of corneal ulceration (5.2×105±9.4×105 versus 1.2×102±1.7×102 copies/mL, P<1×10-4). There was no significant difference between primary episodes and relapses. Tear sampling using Schirmer strips is a simple, non-invasive method that can be useful for the virological diagnosis of various clinical forms of AOHD.

Endophthalmitis After Intravitreal Anti-Vascular Endothelial Factor Injections: Outcomes of Eyes Managed Without Microbiologic Cultures

To evaluate outcomes of eyes that developed endophthalmitis after intravitreal anti-vascular endothelial growth factor injections that were managed without microbiologic cultures. Retrospective, single-center, comparative cohort study. We included all eyes with postinjection endophthalmitis from July 1, 2013, to September 1, 2019. Endophthalmitis cases were divided into the culture group if treated with intravitreal antibiotics and a vitreous or aqueous tap sent for microbiologic sampling or into the no culture group if treated with immediate injection of intravitreal antibiotics with an anterior chamber paracentesis that was not sent for microbiologic sampling. The main outcome measures were visual acuity, the incidence of retinal detachment, and the need for additional procedures. Of 165 endophthalmitis cases identified, 119 (72%) were in the culture group and 46 (28%) were in the no culture group. At endophthalmitis presentation, eyes in the culture group had a mean logMAR VA of 1.98 (∼20/1900) compared with 1.90 (∼20/1600) for eyes in the no culture group (P=.589). At the 6-month follow-up, the mean vision loss was 5.5 lines lost from baseline for the culture group compared with 2.5 lines lost for the no culture group (P=.017). Eyes in the culture group required a subsequent pars plana vitrectomy in 29 of 119 cases (24%) compared with 7 of 46 cases (15%) in the no culture group (P=.29). Six of 119 eyes (5%) in the culture group developed secondary retinal detachments compared with none in the no culture group (P=.143). When access to microbiologic facility is not available, the management of postinjection endophthalmitis using intravitreal antibiotics without microbiologic cultures may be an acceptable treatment strategy.

Evaluating the presence of SARS-CoV-2 in the intraocular fluid of COVID-19 patients.

Purpose:To detect the presence of SARS-CoV-2 in aqueous and vitreous humor of COVID-19 patients in a pilot study.Methods:Consecutive patients planned for emergency ophthalmic surgeries after ocular trauma were subjected to naso-oropharyngeal RT-PCR test for SARS-CoV-2. Laboratory-confirmed cases were enrolled for the study. During surgery, 0.1 mL aqueous and vitreous each was aspirated. The vitreous tap was collected on clinical suspicion of endophthalmitis. RT-PCR test was used to detect SARS-COV-2 nucleotide in the samples. Cycle threshold (Ct) for E gene of ≤35 along with confirmatory results on one of the two target genes (RdRp or ORF1b) was considered as positive.Results:One hundred and thirty two patients were found positive on naso-oropharyngeal RT-PCR test for SARS-CoV-2 preoperatively. Seven patients with ocular trauma were studied. The mean age was 31.8 years. There were six male and one female patient. Two patients had symptoms of mild COVID-19 disease and the rest were asymptomatic. The mean Ct value of the E gene on naso-oropharyngeal RT-PCR was 23.14 ± 4.7. Corneal and corneoscleral laceration repair was done in five patients, intracorneal wooden foreign body was removed in one patient, and injection of intravitreal antibiotics was done in one patient. Aqueous and vitreous tap was collected in 7 and 5 patients, respectively. None of the aqueous or vitreous samples was found positive for SARS-CoV-2.Conclusion:SARS-CoV-2 was not detected by RT-PCR in aqueous or vitreous humor in this pilot study. Future studies with a larger sample size are needed to further explore the presence of SARS-CoV-2 in intraocular fluids.

Influence of pressure and Mg2+ ions on crystalline properties of calcium carbonate

This paper examines the influence of pressure on the crystalline properties of CaCO3 precipitate from drinking water and model aqueous solutions. Seven different evaporation models were examined. Evaporation was performed with a rotary evaporator, pressure vessel, and evaporation at atmospheric pressure at 373 K. Evaporation was also performed with a pressure vessel using a model aqueous solution in the presence of Mg2+ ions, which are CaCO3 inhibitors. Measurements of absorbency, turbidity, pH value, zeta potential and particle size were performed at different time units after the precipitation of CaCO3 from a model aqueous solution and tap water. The precipitated crystals were determined by XRD and SEM. It can be concluded that pressure affects the properties of CaCO3, but not immediately after CaCO3 precipitation. The changes began after 15 min of model sample processing. Calcite was precipitated in all experiments, except in one with Mg2+ ions when aragonite was found. The treatment of tap water in a pressure vessel favoured aragonite precipitation, although later the aragonite modified into calcite.

Diagnostic value of culture results from aqueous tap versus vitreous tap in cases of bacterial endophthalmitis

ObjectiveTo investigate the concordance between aqueous and vitreous tap culture results among different types of bacterial endophthalmitis.Methods and analysisThis retrospective cohort analysis included all cases diagnosed with endophthalmitis at Moorfields...

Treatment of cytomegalovirus anterior segment infection with intravitreal injection of ganciclovir in adjunction with or without oral valganciclovir: a long-term results

We evaluated the therapeutic outcome of intravitreal injection (IVI) of ganciclovir with/without oral valganciclovir for cytomegalovirus (CMV) anterior segment infection. We enrolled 61 patients (61 eyes) with PCR-proven CMV anterior segment infection. IVI of ganciclovir (2 mg/0.05 mL) was given as a loading dose; subsequent use of oral valganciclovir (900 mg twice daily) was determined according to the severity of anterior chamber inflammation after injection. All eyes had IVI of ganciclovir, and 53 patients received oral valganciclovir as adjunctive therapy with a mean duration of 1.9 months to achieve disease remission. Repeated diagnostic aqueous taps were performed in 37 eyes with suspected recurrence, and CMV DNA was positive in 24 eyes. This therapeutic strategy afforded a median 50% recurrence-free survival time of 47.0 ± 8.12 months. The patients’ mean best corrected visual acuity, intraocular pressure and corneal endothelial cell counts stabilized or improved. Corneal transplantation before CMV infection diagnosis was identified as an independent risk factor for recurrence (hazard ratio 6.81, 95% confidence interval 1.21–38.23, P = 0.029). In patients with CMV anterior segment infection, the relative short-term therapeutic strategy, IVI of ganciclovir in adjunction with/without oral valganciclovir, effectively achieved a median recurrence-free survival time of nearly 4 years.

Retinal involvement and ocular findings in COVID-19 pneumonia patients

Changes in immune and coagulation systems and possible viral spread through the blood–brain barrier have been described in SARS-CoV-2 infection. In this study, we evaluated the possible retinal involvement and ocular findings in severe COVID-19 pneumonia patients. A cross-sectional study was conducted on 46 patients affected by severe COVID-19 who were hospitalized in one intensive care unit (ICU) and in two infectious disease wards, including bedside eye screening, corneal sensitivity assessment and retinography. A total of 43 SARS-CoV-2-positive pneumonia patients affected with COVID-19 pneumonia were included, including 25 males and 18 females, with a median age of 70 years [IQR 59–78]. Except for one patient with unilateral posterior chorioretinitis of opportunistic origin, of whom aqueous tap was negative for SARS-CoV-2, no further retinal manifestation related to COVID-19 infection was found in our cohort. We found 3 patients (7%) with bilateral conjunctivitis in whom PCR analysis on conjunctival swabs provided negative results for SARS-CoV-2. No alterations in corneal sensitivity were found. We demonstrated the absence of retinal involvement in SARS-CoV-2 pneumonia patients. Ophthalmologic evaluation in COVID-19, particularly in patients hospitalized in an ICU setting, may be useful to reveal systemic co-infections by opportunistic pathogens.

Endophthalmitis After Descemet Stripping Endothelial Keratoplasty: Microbiological Yield and Visual Outcomes

To describe the clinical presentation, management, and visual outcomes of 6 eyes with endophthalmitis after Descemet stripping endothelial keratoplasty (DSEK). Retrospective case series. Setting: Tertiary, academic eye center. StudyPopulation: Individuals developing endophthalmitis after DSEK at the Duke Eye Center from January 1, 2009, to January 1, 2018, with at least 6months of follow-up. ObservationProcedure: Retrospective chart review. OutcomeMeasures: Diagnostic procedures, microbiological yield, and visual outcomes. Six eyes of 6 patients were identified. Mean time from surgery to presentation was 51days (range, 4-137days). Dense vitreous opacities were present in all cases. Five of 6 cases (83%) had culture-proven infectious endophthalmitis (2 Candida glabrata, 2 coagulase-negative Staphylococcus, 1 Streptococcus pneumoniae). Aqueous tap yielded positive culture in 2 of 2 cases with adequate sample (100%); needle vitreous tap yielded positive culture in 0 of 3 cases. One eye underwent vitrectomy on presentation, and 3 eyes (50%) underwent subsequent vitrectomy for persistent endophthalmitis after a mean of 37days. Mean pre-endophthalmitis visual acuity (VA) was 20/64; mean VA at 6months was 20/2069 (average 15 ETDRS lines lost). VA at 6months was light perception or no light perception in 3 of 6 cases (50%). One eye underwent enucleation at 6months, and 1 eye became phthisical 1 year after endophthalmitis. DSEK-related endophthalmitis may lead to severe vision loss, even with prompt and appropriate treatment. Aqueous tap had a higher culture yield than needle vitreous tap in our series.

A Nine-Year Analysis of Practice Patterns, Microbiologic Yield, and Clinical Outcomes in Cases of Presumed Infectious Endophthalmitis

To analyze practice patterns, microbiologic yield, and clinical outcomes in cases of presumed infectious endophthalmitis at a single tertiary academic referral center. Retrospective chart review. Eyes diagnosed with endophthalmitis at the Duke Eye Center between January 1, 2009, and January 1, 2018, that underwent aqueous tap, needle vitreous tap, or mechanical vitreous biopsy with pars plana vitrectomy (PPV) in conjunction with intravitreal antimicrobials. Charts of 133 eyes of 130 consecutive patients were identified and reviewed for etiology of endophthalmitis, ocular history, interventions, visual outcomes, complication rates, and microbiologic culture results. Microbiologic yield and corrected visual acuity (VA) at initial presentation and last follow-up (up to 1 year) were the primary outcome measures. Secondary outcome measures included need for subsequent intervention, retinal detachment (RD) rate, and antimicrobial sensitivities. Of the 133 cases of presumed infectious endophthalmitis, 74% were unrelated to cataract surgery. Initial management included intravitreal antimicrobials with aqueous tap in 46% of eyes, needle vitreous tap in 59% of eyes, and mechanical vitreous biopsy with PPV in 14% of eyes. Twenty-seven percent of cases that underwent initial aqueous or needle vitreous tap required subsequent intervention with PPV. Overall, 45% of endophthalmitis cases were culture proven. Needle vitreous tap and mechanical vitreous biopsy with PPV were more likely to yield culture growth compared with aqueous tap (P= 0.042, P= 0.004, respectively). All isolated bacteria were sensitive to the combination of intravitreal vancomycin and ceftazidime. Eyes that underwent initial mechanical vitreous biopsy with PPV had worse VA at presentation (P= 0.024) and at last follow up (P= 0.011) compared with eyes that underwent initial aqueous tap or needle vitreous tap. An RD occurred within 3-12 months in 13% (17/133) of cases, and of these, 41% had an endogenous etiology. Needle vitreous tap and mechanical vitreous biopsy were more effective in yielding positive cultures compared with aqueous tap; however, culture results may not influence initial intravitreal antimicrobial choice. Eyes with presenting VA between counting fingers and hand motion at 1 foot were more likely to undergo initial PPV.

Factors Associated With Positive Microbial Culture in Patients With Endophthalmitis Based on Clinical Presentation and Multimodal Intraocular Sampling.

Purpose:The aim of this study was to identify the factors associated with positive culture sample in patients with endophthalmitis based on clinical presentation and multimodal intraocular sampling.Design:Retrospective review.Methods:A total of 259 subjects with a diagnosis of endophthalmitis presented to a tertiary ophthalmic referral center between 2006 and 2018. Patient demographics, presenting clinical findings and the results of aqueous and vitreous sampling were analyzed.Results:Mean age was 64.2 (± 22.6) years with 52.9% female. Endophthalmitis followed cataract surgery in 84 eyes (32.4%) and was the most common precipitant; intravitreal injections were the next common cause involving 60 eyes (23.2%). Mean visual acuity on presentation was hand movements with a hypopyon present 134 eyes (52%). In total, 135 cases (52.1%) were culture positive. Aqueous sampling was performed in 112 eyes [culture positive 36 (32.1%)]; vitreous sample in 122 eyes [positive in 56 (45.3%)]. Vitrectomy was performed in 169 eyes with 149 sent for culture [70 (47.0%) positive]. A positive vitrectomy culture was observed in 14 eyes (36.9%) of 38, despite initial treatment with intravitreal antibiotics. Factors associated with positive culture were aqueous tap [odds ratio (OR) 2.06, P = 0.02], vitrectomy (OR 2.86, P = 0.001), and absent red reflex (OR 2.73, P = 0.001).Conclusions:A multimodal approach to intraocular sampling should be considered in those presenting with endophthalmitis, with both aqueous tap and vitrectomy associated with an increased probability of achieving a positive culture.

Intraocular biopsy in uveitis.

An intraocular biopsy is performed for diagnostic, prognostic and investigational purposes. Biopsies help to confirm or exclude malignancies and differentiate inflammatory from infectious processes. Histopathological analysis is the final verdict in unresponsive uveitis, atypical inflammation, metastases and masquerade syndromes. Advances and refinement of techniques in cytopathology, immunohistochemistry, microbiological and molecular biologic study offer much more than just diagnosis. They provide prognosis based on cell characteristics and are helpful in planning treatment and intervention. Many biopsy procedures have evolved to provide more safety and minimise complications thus improving the quality of specimens or samples available for analysis. The type of biopsy and technique adopted varies based on the clinical suspicion, size and location of lesions. In uveitis, a working diagnosis of intraocular inflammation is made on clinical examination and laboratory investigations and ancillary tests. Malignancy and uveitis is interlinked and masquerade syndromes are among the commonest indications for biopsy and analysis of specimen. The various types of intraocular biopsies include aqueous tap, fine needle aspiration biopsy, vitreous biopsy, iris and ciliary body, and retinochoroidal biopsy. They will be reviewed in this article with respect to current perspective