A. L. Hofling-Lima

Twenty years of acanthamoeba keratitis

Purpose: We described the rate of Acanthamoeba keratitis (AK) in a referral eye center in São Paulo, Brazil, through a retrospective review of clinical and laboratorial records of patients over 2 decades. Methods: From 1987 to 2006, a total of 581 requests for amoebic laboratory workup in cases of infectious keratitis were investigated. Statistical analyses were applied to analyze a tendency of AK cases. Results: Acanthamoeba species were cultured from corneal scrapings of 185 patients, 5 of them with bilateral infection. Eighty-three percent of those patients were related with contact lens wear. Conclusions: The results suggested that patients with AK have persisted and increased over time at our ophthalmology center. Contact lenses showed to be a potential risk factor. Amoebic corneal infection can be considered as a new but well-established disease in Brazilian ophthalmology and visual sciences.

Aerobic bacterial conjunctival flora in diabetic patients.

Objective To study the aerobic conjunctival flora of diabetic patients and its relation to the presence and level of diabetic retinopathy and the duration of the disease. Methods One hundred three patients from the diabetic retinopathy screening program of the Federal University of São Paulo with no evidence of ocular surface disease were included. The diabetic patient cohort was compared with 60 nondiabetic subjects. All patients underwent slit-lamp evaluation, conjunctival scrapings, and indirect ophthalmoscopy. Results The frequency of positive conjunctival cultures was significantly higher in the diabetic group (94.18%) than in the nondiabetic group (73.33%). Among diabetic patients, a significantly higher frequency of positive cultures was detected in those with diabetic retinopathy than in those without retinopathy. Neither the duration of the diabetes nor the hypoglycemic therapy correlated with the culture results. Coagulase-negative Staphylococcus was the most common microorganism isolated, and its identification was more frequent in patients with retinopathy than in those without diabetic retinopathy. Conclusion Diabetic patients have a significantly higher number of positive conjunctival cultures. The presence of diabetic retinopathy was correlated with an increase in positive cultures and a higher proportion of coagulase-negative Staphylococcus.

Avaliação da contaminação microbiana da membrana amniótica e líquido amniótico

PURPOSE: To verify and compare the possible microbiological contamination of amniotic fluid, and amniotic membranes at time zero and at different times after delivery. METHODS: Nine amniotic fluid samples were collected by intrauterine aspiration and nine amniotic membranes were collected after cesarean deliveries of patients with negative serology (HIV, syphilis, hepatitis B and C). Samples were collected at different times after delivery (zero, thirty, sixty minutes). The samples were inoculated in culture media for bacteria and fungi. RESULTS: Bacteria were retrieved from four amniotic fluid samples, as well as from all nine amniotic membranes. Coagulase-negative Staphylococcus was the most prevalent bacteria. At time zero, coagulase-negative Staphylococcus was revealed in all nine amniotic membranes, Staphylococcus aureus in two, Neisseria sp., Enterobacter and Streptococcus viridans in one. Thirty minutes after delivery, coagulase negative Staphylococcus grew in all nine amniotic membranes and Streptococcus viridans in one. Sixty minutes after delivery, coagulase-negative Staphylococcus was shown in eight, Staphylococcus aureus in two and Streptococcus viridans in one sample. Coagulase-negative Staphylococcus was found in three amniotic fluids and corresponding membranes. CONCLUSION: Amniotic membrane contamination was a problem in all samples, and the processing protocol used at the Federal University of Sao Paulo was efficient to decontaminate the AM. Care must be taken before the use of AM. Further studies are necessary to establish the accurate variation of AM contamination at different times after delivery.

Análise clínica, cirúrgica e laboratorial de pacientes com conjuntivocálase

OBJETIVO: Avaliacao clinica, cirurgica e laboratorial de pacientes com conjuntivocalase. METODOS: Foi realizado exame oftalmologico antes e apos tratamento cirurgico em dez pacientes com conjuntivocalase avaliando os seguintes dados: acuidade visual, biomicroscopia do segmento anterior, padrao de coloracao pela rosa bengala, teste de Schirmer e citologia de impressao. RESULTADOS: Apos a cirurgia todos os pacientes apresentaram melhora na sintomatologia e no padrao de rosa bengala. A citologia de impressao revelou metaplasia escamosa em oito pacientes. CONCLUSAO: A cirurgia pode ser eficaz na melhora da sintomatologia dos pacientes com conjuntivocalase. Metaplasia escamosa foi achado frequente nesses pacientes.