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Penelope J Allen

Publications and source records attributed to Penelope J Allen.

3 recordsLinked to original sources
PubMed2004

Post-traumatic endophthalmitis.

OBJECTIVE: To establish risk factors for the occurrence of post-traumatic endophthalmitis, to observe the efficacy of prophylaxis, and to describe the clinical features of post-traumatic endophthalmitis. DESIGN: Partially prospective consecutive case-control study. PARTICIPANTS: A total of 250 consecutive patients admitted to a single ophthalmic hospital with open globe injuries during a 3-year period were included. METHODS: Patients with post-traumatic endophthalmitis were identified prospectively and added to an endophthalmitis database. All open globe injuries during the same time period were identified through a retrospective search of inpatient admissions, and their charts were reviewed. Information collected from all patient files included patient age; gender; injury setting (indoor/outdoor); wound contamination; nature of injury (site on eye, lens involvement, retained intraocular foreign body); mechanism of injury (penetration/perforation/rupture/ruptured surgical wound); prophylactic antibiotic administration, including route and timing; timing of primary repair; lensectomy at the time of primary repair; and depot corticosteroid at the time of primary repair. Any association between these parameters and the subsequent development of endophthalmitis was investigated. Any association between endophthalmitis and final visual acuity (VA) and also enucleation was evaluated. MAIN OUTCOME MEASURE: Development of endophthalmitis. RESULTS: The frequency of endophthalmitis after open globe injury was 6.8%. The following factors were associated with the subsequent development of endophthalmitis by univariate analysis: dirty wound (14.3% vs. 4.1%, P = 0.01), retained intraocular foreign body (13.0% vs. 4.4%, P = 0.02), lens capsule breach (12.8% vs. 3.2%, P = 0.01), delayed primary repair (> or =12 hours) (11.3% vs. 2.9%, P = 0.02), and rural address (10.1% vs. 4.3%, P = 0.07). Risk factors identified after multivariate analysis were dirty injury (odds ratio [OR], 5.3; 95% confidence interval [CI)], 1.5-18.7), breach of lens capsule (OR, 4.4; 95% CI, 1.2-15.6), and delay in primary repair (per hour: OR, 1.013; 95% CI, 1.002-1.024). None of the following factors was found to be associated with post-traumatic endophthalmitis: patient age, gender, injury setting, site of injury on eye, mechanism of injury, antibiotic administration, lensectomy at the time of primary repair, and depot corticosteroid at the time of primary repair. Final VA tended to be worse in eyes with endophthalmitis (P = 0.08). Endophthalmitis did not significantly influence the frequency of enucleation/evisceration (5.9% vs. 4.3%, P = 0.55). CONCLUSIONS: Delay in primary repair, ruptured lens capsule, and dirty wound were each independently associated with the development of post-traumatic endophthalmitis. Patients with > or =2 of these 3 risk factors had a particularly high frequency of infection.

Adolescent↗
PubMed2004

Three cases of post-traumatic endophthalmitis caused by unusual bacteria.

Three cases of post-traumatic endophthalmitis caused by unusual bacteria are presented. The pathogens identified were: (i) Bacillus cereus and Citrobacter freundii; (ii) Pseudomonas fluorescens; and (iii) Chryseobacterium meningosepticum and Stenotrophomonas maltophilia. Two of these pathogens have not previously been reported to cause endophthalmitis. The available literature regarding the individual cases is summarized and a brief discussion of post-traumatic endophthalmitis is presented, with reference to a recently published large series at the authors' institution.

Adult↗
PubMed2002

Analysis of the Arg345Trp disease-associated allele of the EFEMP1 gene in individuals with early onset drusen or familial age-related macular degeneration.

BACKGROUND: A single base change within the EFEMP1 gene has been associated with malattia leventinese and Doyne honeycomb retinal dystrophy, two dominantly inherited macular diseases with early onset drusen. The aim of this study was to determine whether the same disease allele was also associated with other forms of early onset drusen or familial cases of age-related macular degeneration. METHODS: Thirteen index cases of early onset drusen together with 15 other family members were examined. In addition, 54 familial cases of age-related macular degeneration were examined. Blood was taken for DNA analysis and screened for the Arg345Trp disease-associated allele of the EFEMP1 gene. Twenty-four cases of malattia leventinese or Doyne honeycomb retinal dystrophy were also screened as positive controls. Another 150 ethnicity- and age-matched individuals acted as controls. RESULTS: The Arg345Trp disease-associated allele in the EFEMP1 gene was confirmed in individuals with malattia leventinese and Doyne honeycomb retinal dystrophy. However, involvement of this allele was not evident in either early onset drusen or familial age-related macular degeneration. CONCLUSIONS: The Arg345Trp disease-associated allele of the EFEMP1 gene does not appear to be associated with cases of early onset drusen that fall outside the diagnosis of malattia leventinese or Doyne honeycomb retinal dystrophy, nor does it appear to play a role in familial age-related macular degeneration. These findings do not exclude the involvement of other alleles of the EFEMP1 gene in either phenotype. The genetic mechanisms involved in the heterogeneous group of early onset drusen remain to be elucidated but should lead to insights into the genetic causes of macular diseases.

Adult↗