Acanthamoeba Keratitis: The Emerging Vision-Threatening Corneal Disease

Some Acanthamoeba species are distributed in natural and man-made environments, in a wide range of soil and aquatic habitats, also in clinical settings. The amphizoic organisms can exist as facultative parasites - causative agents of serious human disease, Acanthamoeba keratitis. The vision-threatening eye disease occurring particularly in contact lens wearers is reported with increasing prevalence in different regions of the world. The amoebic keratitis is difficult to diagnose as clinical symptoms are similar to those observed in other eye diseases. Moreover, bacterial, viral, fungal, and amoebic co-infections frequently occur; also amoebae act as carriers for ~ 20 species pathogenic for humans, e.g. from Pseudomonas, Legionella, Mycobacterium and Escherichia genera; thus the corneal disease is frequently misdiagnosed. Complex etiology, late proper recognition of amoebic infections, and the exceptional resistance of Acanthamoeba cysts to chemicals are important factors influencing diagnostic and therapeutic difficulties. Surgical interventions are needed as an alternative treatment in refractory Acanthamoeba keratitis. It should be taken into consideration that the knowledge and awareness of increasing threat generated by the amphizoic amoebae are still insufficient. This compilation presents selected aspects of eye disease that is becoming the increasingly significant for human health worldwide

Polymorphism of the flap endonuclease 1 gene in keratoconus and Fuchs endothelial corneal dystrophy

Oxidative stress is implicated in the pathogenesis of many diseases, including serious ocular diseases, keratoconus (KC) and Fuchs endothelial corneal dystrophy (FECD). Flap endonuclease 1 (FEN1) plays an important role in the repair of oxidative DNA damage in the base excision repair pathway. We determined the association between two single nucleotide polymorphisms (SNPs), c.-441G>A (rs174538) and g.61564299G>T (rs4246215), in the FEN1 gene and the occurrence of KC and FECD. This study involved 279 patients with KC, 225 patients with FECD and 322 control individuals. Polymerase chain reaction (PCR) and length polymorphism restriction fragment analysis (RFLP) were applied. The T/T genotype of the g.61564299G>T polymorphism was associated with an increased occurrence of KC and FECD. There was no association between the c.-441G>A polymorphism and either disease. However, the GG haplotype of both polymorphisms was observed more frequently and the GT haplotype less frequently in the KC group than the control. The AG haplotype was associated with increased FECD occurrence. Our findings suggest that the g.61564299G>T and c.-441G>A polymorphisms in the FEN1 gene may modulate the risk of keratoconus and Fuchs endothelial corneal dystrophy.peer-reviewe

Racjonalna terapia bakteryjnych zakażeń powierzchni oka z zastosowaniem fluorochinolonów

There are many mechanisms, that protect healthy ocular surface from invasion of pathogenic bacteria. Infection and inflammation develop on the ocular surface in case of damaging natural defensive barrier. One of the most common ocular surface infections are bacterial conjunctivitis and keratitis. Rational therapy of these diseases should be based on antibiotics that have broad antimicrobial spectrum, good efficacy and safety. All these qualities have fluoroquinolones: ofloxacin, levofloxacin and moxifloxacin.Prawidłowa powierzchnia oka ma szereg mechanizmów chroniących ją przed inwazją bakterii chorobotwórczych. W przypadku przełamania fizjologicznej bariery dochodzi do rozwoju zakażenia i stanu zapalnego. Jednymi z częstszych chorób zakaźnych powierzchni oka są bakteryjne zapalenia spojówek i rogówki. Terapia tych schorzeń powinna bazować na racjonalnym stosowaniu antybiotyków o szerokim spektrum działania przeciwbakteryjnego, wysoce skutecznych i bezpiecznych. Wszystkie powyższe cechy maja fluorochinolony: ofloksacyna, lewofloksacyna i moksyfloksacyna

The impact of inflammatory flares in dry eye disease

Dry eye disease is a condition treated commonly by most of the ophthalmologists. The current understanding of the disease puts impact on its newly discovered components – ‘flares’. Flares are defined as exacerbations of dry eye disease. They take place in response to the triggers, which may be environmental or internal factors. During the ‘flare’ the immunological response is being activated and the patients experience the worsening of the symptoms. The introduction of the anti-inflammatory treatment (e.g. topical hydrocortisone solution) is the effective treatment in the cases of inflammatory state exacerbations

Polymorphism of the DNA Base Excision Repair Genes in Keratoconus

Keratoconus (KC) is a degenerative corneal disorder for which the exact pathogenesis is not yet known. Oxidative stress is reported to be associated with this disease. The stress may damage corneal biomolecules, including DNA, and such damage is primarily removed by base excision repair (BER). Variation in genes encoding BER components may influence the effectiveness of corneal cells to cope with oxidative stress. In the present work we genotyped 5 polymorphisms of 4 BER genes in 284 patients and 353 controls. The A/A genotype of the c.–1370T>A polymorphism of the DNA polymerase γ (POLG) gene was associated with increased occurrence of KC, while the A/T genotype was associated with decreased occurrence of KC. The A/G genotype and the A allele of the c.1196A>G polymorphism of the X-ray repair cross-complementing group 1 (XRCC1) were associated with increased, and the G/G genotype and the G allele, with decreased KC occurrence. Also, the C/T and T as well as C/C genotypes and alleles of the c.580C>T polymorphism of the same gene displayed relationship with KC occurrence. Neither the g.46438521G>C polymorphism of the Nei endonuclease VIII-like 1 (NEIL1) nor the c.2285T>C polymorphism of the poly(ADP-ribose) polymerase-1 (PARP-1) was associated with KC. In conclusion, the variability of the XRCC1 and POLG genes may play a role in KC pathogenesis and determine the risk of this disease

First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS