ObjectiveTo observe and analyze the clinical features and prognosis of endogenous klebsiella pneumoniae endophthalmitis (EKPE).MethodsThis is a retrospective case series study. Seven patients (8 eyes) with EKPE were enrolled in this study. There were 3 males (4 eyes) and 4 females (4 eyes). The ages were from 39 to 76 years, the mean age was 57.29 years. All these cases had no history of trauma and surgery. Meanwhile, they all had some risk factors, such as infection, diabetes mellitus, systemic lupus erythematosus, liver abscess, renal insufficiency undergoing dialysis treatment, Hodgkin lymphoma and so on. All the eyes were undertaken visual acuity, slit lamp and fundus examination to observe the eye conditions. Seven eyes were undertaken pars plana vitrectomy with intravitreal injection of antibiotics from 2 days to 2 weeks after onset. And only one eye was undertaken intravitreal injection of antibiotics without surgery. Microbial stains and culture were performed for 7 eyes using vitreous and aqueous fluid samples from the procedures of vitrectomy. Meanwhile, culture and drug sensitive tests were performed from blood samples. According to the result of the drug sensitive tests, carbapenems such as imipenem and meropenem were used in each patient through intravenous injection from 1 to 2 weeks. During the follow up period from 3 days to 1 year, prognosis was observed at each office visit.ResultsFrom these eight eyes, presenting visual acuity was light perception (4 eyes), hand motion (3 eyes), 0.1 (1 eye). Hypopyon (6 eyes), aqueous fluid opacity (2 eyes) and diffuse vitreous opacity (8 eyes) were found. Changes in fundus like optic disc, macular edema and retinal vascular occlusion could be observed. Cultures of the vitreous and aqueous fluid samples from vitrectomy were all point out to klebsiella pneumoniae. At last office visit, the visual acuity of patients with hypopyon was no light perception (1 eye), light perception (1 eye), hand motion (1 eye). The visual acuity of patients without hypopyon was 0.05 (1 eye) and 0.5(1 eye). Finally, 1 eye was underwent enucleation and one patient with binocular disease was died of multiple organ failure.ConclusionsEKPE is almost unilateral attacked. Changes in fundus like optic disc, macular edema and retinal vascular occlusion can be observed. EKPE is commonly associated with poor visual outcomes. It is useful to save patients’ visual acuity by performing vitrectomy before hypopyon happened.
Alzheimer's disease is a common neuro-degenerative disease. The clinical diagnosis mainly depends on the patient's complaint, the score of mini-mental state examination and Montreal cognitive assessment scale, and the comprehensive judgment of MRI and other imaging examinations. Retina is homologous to brain tissue, and their vascular systems have similar physiological characteristics to small blood vessels in the brain. Numerous studies found that the thickness of retinal nerve fiber layer, visual function, retinal blood vessels and retinal oxygen saturation were changed in AD patients to different degrees. To explore the formation mechanism and significance of ocular fundus changes in AD patients will be helpful to select specific, sensitive and simple methods for early observation and evaluation of AD.
Ischemic retinopathy, resulting in multiple lesions like microvasculature damage, inflammation and neovascularization, is a major contributor of vision damage. In these pathological changes, retinal glia cannot be ignored in the development of retinopathy. They constitute a highly versatile population that interacts with various cells to maintain homeostasis and limit disease. Therefore, glial activation and gliosis are strikingly ubiquitous responses to almost every form of retinal disease. Both of microglial cells and Müller cells are major intrinsic retinal glial cells and they are in close relationship, which means they can influence each other, make joint action or even become interdependent. They exhibit morphological and functional changes to have an impact on degree of retinal injury through different responses, which mediated by glial cells are important not only for course of disease progression, but also for the maintenance of neuronal and photoreceptor survival. Thus, defining the mechanisms that underlie communications between microglial cells and Müller cells could enable the development of more selective therapeutic targets, with great potential clinical applications.