fibrin and Keratitis

Endothelial plaque is an important sign of fungal keratitis and is related to diagnosis, surgical indications, and prognosis. However, bacterial keratitis sometimes involves fibrin formation on the back corneal surface, similar to endothelial plaques. Because corneal infiltration interferes with precise observation of the posterior corneal plaque, distinguishing pathogens with a slitlamp is difficult. We hope to assist clinicians in early diagnosis and timely treatment by observing the connection state of endothelial plaques and the corneal endothelium through anterior segment optical coherence tomography (AS-OCT) and the different forms of endothelial plaques in infectious keratopathy through in vivo confocal microscopy (IVCM).. We analyzed 52 patients in the Eye Hospital of the First Affiliated Hospital of Harbin Medical University who were clearly diagnosed with fungal or bacterial keratitis with endothelial plaques. All patients underwent AS-OCT and IVCM on admission.. According to the smear, IVCM, or fungal and bacterial culture results, the patients were diagnosed with fungal (28 patients) or bacterial keratitis (24 patients). AS-OCT in 25 patients diagnosed with fungal keratitis revealed that the corneal endothelium-endothelial plaque boundary was unclear and wavy, and 24 patients had unclear cell boundaries and a large number of compactly distributed inflammatory cells in the endothelial layer according to IVCM. AS-OCT in 23 patients diagnosed with bacterial keratitis revealed clear corneal endothelium-endothelial plaque boundaries, and insufficient endothelial cell boundaries with a large number of visible and scattered inflammatory cell structures were observed through IVCM in 22 patients.. Corneal endothelial plaque detection by AS-OCT and IVCM can be used for early diagnosis of infectious keratitis.

Topics: Corneal Diseases; Corneal Ulcer; Eye Infections, Bacterial; Eye Infections, Fungal; Fibrin; Humans; Keratitis; Microscopy, Confocal; Tomography, Optical Coherence; Vision Disorders

To develop a contact lens capable of releasing antibiotics for a minimum of 8 hours for the treatment of bacterial keratitis.. Fibrin gel was loaded with vancomycin or gentamicin and then shaped into a curved disc. The disc was then used to coat the surface of a commercial contact lens or was sealed between two lenses. Separate contact lenses were soaked in solutions of vancomycin or gentamicin. The in vitro release kinetics for each system was determined using PBS at 37°C and a particle-enhanced turbidimetric inhibition immunoassay. The bioactivity of the antibiotics released from the fibrin was confirmed by using a microbiological assay.. Vancomycin and gentamicin were released at similar rates from soaked contact lenses and a coating of fibrin gel; however, the amounts of antibiotic delivered by the two systems differed considerably. The fibrin coating released over three times more gentamicin but less than one-fifth that of the lenses soaked in vancomycin. When fibrin was encapsulated between two contact lenses, significantly more controlled release was observed. For all systems, bactericidal amounts of vancomycin and gentamicin were released throughout the three-day testing period.. As a delivery system, fibrin gel loaded with gentamicin performs better than contact lenses soaked in gentamicin. The opposite is true for vancomycin, where soaked lenses outperform fibrin gel. These systems could potentially be used as a treatment for bacterial keratitis.

Topics: Anti-Bacterial Agents; Coated Materials, Biocompatible; Contact Lenses, Hydrophilic; Equipment Design; Eye Infections, Bacterial; Fibrin; Gentamicins; Humans; Keratitis; Vancomycin