Darlene Miller | University of Miami (original) (raw)
Papers by Darlene Miller
Cornea, Apr 1, 2004
ABSTRACT To determine the in vitro efficacy of levofloxacin, ofloxacin, and ciprofloxacin against... more ABSTRACT To determine the in vitro efficacy of levofloxacin, ofloxacin, and ciprofloxacin against Streptococcus pneumoniae and Streptococcus viridans isolates recovered from clinical cases of keratitis and endophthalmitis. Streptococcal isolates recovered from keratitis and endophthalmitis cases between 1990 and 2001 were identified and extracted from the Microbiology Data Bank of the Bascom Palmer Eye Institute, Miami, FL. Comparative in vitro minimal inhibitory concentration (MIC90) susceptibility profiles for levofloxacin, ofloxacin, and ciprofloxacin against a select group (n = 65) of streptococcal isolates were documented using the E test methodology. Penicillin susceptibility profiles were also evaluated. chi 2 x 2 tables and McNemar's Paired-Sample Tests were used to established statistical significance. MIC90 values for levofloxacin, ofloxacin, and ciprofloxacin against pneumococcal isolates were 1.5, 6, and 3 microg/mL. The corresponding values for the S. viridans group were 2, 8, and 24 microg/mL. Levofloxacin was 4 times more active in vitro than ofloxacin and 2 times more active in vitro than ciprofloxacin against S. pneumoniae. Levofloxacin was 4 times more active in vitro than ofloxacin and 12 times more active than ciprofloxacin for S. viridans group. Sixty-three percent of the S. pneumoniae and 57.9% of the S. viridans group isolates were intermediate or resistant to penicillin. Levofloxacin provides 100% coverage for penicillin-intermediate and penicillin-resistant isolates versus 33.8% for ofloxacin and 29.2% for ciprofloxacin. Levofloxacin is highly active in vitro against streptococcal isolates recovered from keratitis and endophthalmitis patients, including penicillin-intermediate and penicillin-resistant strains.
Eye & Contact Lens-science and Clinical Practice, May 1, 2010
To describe a case of severe and drug-resistant Acanthamoeba keratitis in a contact lens wearer c... more To describe a case of severe and drug-resistant Acanthamoeba keratitis in a contact lens wearer caused by atypical T5 Acanthamoeba genotype (Acanthamoeba lenticulata). Methods: Report of a case, Acanthamoeba DNA amplification and sequencing. Results: A 61-year-old patient was referred to our clinic with a 2-week history of keratitis. Acanthamoeba keratitis (AK) was diagnosed using confocal microscopy and corneal scraping culture. Using polymerase chain reaction (PCR) and DNA sequencing, the organism was classified as a T5 genotype (A. lenticulata). The keratitis continued to progress despite topical antiamoebic therapy and ultimately led to enucleation of the affected eye. Conclusions: T5 genotype Acanthamoeba can cause severe AK. Atypical Acanthamoeba genotypes could be associated with worse prognosis and resistance to therapy.
Cornea, 2002
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Yoo, Sonia HMD; Dursun, Dilek MD; ...
Ophthalmology, Sep 1, 1998
This study aimed to review the clinical features, therapeutic response, and histopathology of cas... more This study aimed to review the clinical features, therapeutic response, and histopathology of cases of nontuberculous mycobacterial keratitis at the Bascom Palmer Eye Institute. Retrospective review of medical records, clinical photographs, histopathology, and microbiology of 24 cases of nontuberculous acid-fast keratitis over the past 15 years. Causal organisms included Mycobacterium chelonae (16), M. fortuitum (3), M. avium-intracellulare (2), M. nonchromogenicum (1), M. triviale (1), and M. asiaticum (1). Clinically, the keratitis had a superficial location except in those patients with a history of surgery. Amikacin was the most commonly used antibiotic (63%). Three patients were treated with Clarithromycin. In one patient, it was stopped because of toxicity; the other two had resolution of their infiltrates. Fifty-five percent did not respond to topical antimicrobial therapy. The organisms as a group were sensitive to amikacin and Clarithromycin and resistant to the fluoroquinolones. Sixty-four percent of the group that failed to respond to medical treatment were treated with steroids after the diagnosis was known, in comparison to 44% of the group treated successfully with medications. The histopathology of the patients treated with steroids showed minimal inflammation despite a large number of organisms, in contrast to the dense infiltrates seen in the specimens from patients not treated with topical steroids. Nontuberculous mycobacterial keratitis is a chronic insidious infection that is often unresponsive to medical therapy. The authors recommend that steroids be withheld. Based on the authors' experience of three patients, topical Clarithromycin may hold promise as a therapeutic agent. Lamellar keratectomy or penetrating keratoplasty should be considered in those patients who do not respond to medical therapy or those who have recurrent exacerbations on attempted weaning of topical antibiotic therapy.
Investigative Ophthalmology & Visual Science, Apr 22, 2011
Investigative Ophthalmology & Visual Science, Apr 28, 2009
Investigative Ophthalmology & Visual Science, Jun 16, 2013
Investigative Ophthalmology & Visual Science, May 1, 2005
Investigative Ophthalmology & Visual Science, May 1, 2003
Investigative Ophthalmology & Visual Science, May 1, 2005
Cornea, Jun 1, 2007
Purpose: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or... more Purpose: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or significantly improved without antifungal therapy. Methods: Observational case report of 5 patients with a history of contact lens wear who presented with infectious keratitis. Two patients had growth of fungal species on corneal microbiologic cultures, and of the remaining 3 patients, 2 showed fungal elements on confocal microscopy. All 5 patients exhibited growth of fungal species on contact lens microbiologic cultures. All patients received topical fluoroquinolone therapy as initial treatment. Results: In 3 cases, of whom 2 were treated with moxifloxacin 0.5%, the keratomycosis resolved completely on topical fluoroquinolone therapy. One case was switched to topical tobramycin 14 mg/mL and cefazolin 50 mg/mL with complete resolution of the infection. The final case showed marked initial improvement on fluoroquinolone therapy but was subsequently treated with natamycin 5%. Conclusions: Fungal keratitis associated with soft contact lens wear may occasionally present in a less aggressive form. Topical fluoroquinolone therapy may be an adjunct to the innate immune response in eradicating less fulminant keratomycosis.
Eye, Dec 9, 2011
Infectious keratitis represents a significant cause of ocular morbidity in the United States. The... more Infectious keratitis represents a significant cause of ocular morbidity in the United States. The work-up and treatment of presumed infectious keratitis (PIK) has changed in the past two decades. The development of newer topical antibiotics has enabled broad-spectrum antibiotic coverage with good tissue penetration. The majority of PIK cases respond well to this strategy. The small numbers of cases that do not respond to the treatment are the cases that offer a diagnostic and therapeutic challenge. This review will describe different algorithms that can be followed for the successful management of patients with difficult or progressive PIK. These algorithms are based on scientific work and on our empirical clinical experience. The review will also present three different clinical cases of PIK that were managed according to the algorithms presented in this review.
Ophthalmic surgery, lasers & imaging retina, 2006
A recent outbreak of fungal keratitis associated with contact lens use has been reported. During ... more A recent outbreak of fungal keratitis associated with contact lens use has been reported. During the past 4 months, a total of 36 patients with Fusarium keratitis have presented to one medical center. Two cases of Fusarium endophthalmitis resulting from this series of fungal keratitis associated with soft contact lens wear are described. [Ophthalmic Surg Lasers Imaging 2006;37:310-313.] AUTHORS From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida. Accepted for publication May 19, 2006. Supported in part by Research to Prevent Blindness, Inc., New York, New York. Address reprint requests to Harry W. Flynn, Jr., MD, 900 NW 17th Street, Miami, FL 33136.
Investigative Ophthalmology & Visual Science, Apr 30, 2014
DOAJ (DOAJ: Directory of Open Access Journals), Sep 1, 2014
Investigative Ophthalmology & Visual Science, Jun 10, 2020
Investigative Ophthalmology & Visual Science, Jun 10, 2020
Investigative Ophthalmology & Visual Science, May 14, 2008
Investigative Ophthalmology & Visual Science, May 14, 2008
Cornea, Apr 1, 2004
ABSTRACT To determine the in vitro efficacy of levofloxacin, ofloxacin, and ciprofloxacin against... more ABSTRACT To determine the in vitro efficacy of levofloxacin, ofloxacin, and ciprofloxacin against Streptococcus pneumoniae and Streptococcus viridans isolates recovered from clinical cases of keratitis and endophthalmitis. Streptococcal isolates recovered from keratitis and endophthalmitis cases between 1990 and 2001 were identified and extracted from the Microbiology Data Bank of the Bascom Palmer Eye Institute, Miami, FL. Comparative in vitro minimal inhibitory concentration (MIC90) susceptibility profiles for levofloxacin, ofloxacin, and ciprofloxacin against a select group (n = 65) of streptococcal isolates were documented using the E test methodology. Penicillin susceptibility profiles were also evaluated. chi 2 x 2 tables and McNemar's Paired-Sample Tests were used to established statistical significance. MIC90 values for levofloxacin, ofloxacin, and ciprofloxacin against pneumococcal isolates were 1.5, 6, and 3 microg/mL. The corresponding values for the S. viridans group were 2, 8, and 24 microg/mL. Levofloxacin was 4 times more active in vitro than ofloxacin and 2 times more active in vitro than ciprofloxacin against S. pneumoniae. Levofloxacin was 4 times more active in vitro than ofloxacin and 12 times more active than ciprofloxacin for S. viridans group. Sixty-three percent of the S. pneumoniae and 57.9% of the S. viridans group isolates were intermediate or resistant to penicillin. Levofloxacin provides 100% coverage for penicillin-intermediate and penicillin-resistant isolates versus 33.8% for ofloxacin and 29.2% for ciprofloxacin. Levofloxacin is highly active in vitro against streptococcal isolates recovered from keratitis and endophthalmitis patients, including penicillin-intermediate and penicillin-resistant strains.
Eye & Contact Lens-science and Clinical Practice, May 1, 2010
To describe a case of severe and drug-resistant Acanthamoeba keratitis in a contact lens wearer c... more To describe a case of severe and drug-resistant Acanthamoeba keratitis in a contact lens wearer caused by atypical T5 Acanthamoeba genotype (Acanthamoeba lenticulata). Methods: Report of a case, Acanthamoeba DNA amplification and sequencing. Results: A 61-year-old patient was referred to our clinic with a 2-week history of keratitis. Acanthamoeba keratitis (AK) was diagnosed using confocal microscopy and corneal scraping culture. Using polymerase chain reaction (PCR) and DNA sequencing, the organism was classified as a T5 genotype (A. lenticulata). The keratitis continued to progress despite topical antiamoebic therapy and ultimately led to enucleation of the affected eye. Conclusions: T5 genotype Acanthamoeba can cause severe AK. Atypical Acanthamoeba genotypes could be associated with worse prognosis and resistance to therapy.
Cornea, 2002
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Yoo, Sonia HMD; Dursun, Dilek MD; ...
Ophthalmology, Sep 1, 1998
This study aimed to review the clinical features, therapeutic response, and histopathology of cas... more This study aimed to review the clinical features, therapeutic response, and histopathology of cases of nontuberculous mycobacterial keratitis at the Bascom Palmer Eye Institute. Retrospective review of medical records, clinical photographs, histopathology, and microbiology of 24 cases of nontuberculous acid-fast keratitis over the past 15 years. Causal organisms included Mycobacterium chelonae (16), M. fortuitum (3), M. avium-intracellulare (2), M. nonchromogenicum (1), M. triviale (1), and M. asiaticum (1). Clinically, the keratitis had a superficial location except in those patients with a history of surgery. Amikacin was the most commonly used antibiotic (63%). Three patients were treated with Clarithromycin. In one patient, it was stopped because of toxicity; the other two had resolution of their infiltrates. Fifty-five percent did not respond to topical antimicrobial therapy. The organisms as a group were sensitive to amikacin and Clarithromycin and resistant to the fluoroquinolones. Sixty-four percent of the group that failed to respond to medical treatment were treated with steroids after the diagnosis was known, in comparison to 44% of the group treated successfully with medications. The histopathology of the patients treated with steroids showed minimal inflammation despite a large number of organisms, in contrast to the dense infiltrates seen in the specimens from patients not treated with topical steroids. Nontuberculous mycobacterial keratitis is a chronic insidious infection that is often unresponsive to medical therapy. The authors recommend that steroids be withheld. Based on the authors' experience of three patients, topical Clarithromycin may hold promise as a therapeutic agent. Lamellar keratectomy or penetrating keratoplasty should be considered in those patients who do not respond to medical therapy or those who have recurrent exacerbations on attempted weaning of topical antibiotic therapy.
Investigative Ophthalmology & Visual Science, Apr 22, 2011
Investigative Ophthalmology & Visual Science, Apr 28, 2009
Investigative Ophthalmology & Visual Science, Jun 16, 2013
Investigative Ophthalmology & Visual Science, May 1, 2005
Investigative Ophthalmology & Visual Science, May 1, 2003
Investigative Ophthalmology & Visual Science, May 1, 2005
Cornea, Jun 1, 2007
Purpose: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or... more Purpose: To report 5 cases of fungal keratitis associated with contact lens wear that resolved or significantly improved without antifungal therapy. Methods: Observational case report of 5 patients with a history of contact lens wear who presented with infectious keratitis. Two patients had growth of fungal species on corneal microbiologic cultures, and of the remaining 3 patients, 2 showed fungal elements on confocal microscopy. All 5 patients exhibited growth of fungal species on contact lens microbiologic cultures. All patients received topical fluoroquinolone therapy as initial treatment. Results: In 3 cases, of whom 2 were treated with moxifloxacin 0.5%, the keratomycosis resolved completely on topical fluoroquinolone therapy. One case was switched to topical tobramycin 14 mg/mL and cefazolin 50 mg/mL with complete resolution of the infection. The final case showed marked initial improvement on fluoroquinolone therapy but was subsequently treated with natamycin 5%. Conclusions: Fungal keratitis associated with soft contact lens wear may occasionally present in a less aggressive form. Topical fluoroquinolone therapy may be an adjunct to the innate immune response in eradicating less fulminant keratomycosis.
Eye, Dec 9, 2011
Infectious keratitis represents a significant cause of ocular morbidity in the United States. The... more Infectious keratitis represents a significant cause of ocular morbidity in the United States. The work-up and treatment of presumed infectious keratitis (PIK) has changed in the past two decades. The development of newer topical antibiotics has enabled broad-spectrum antibiotic coverage with good tissue penetration. The majority of PIK cases respond well to this strategy. The small numbers of cases that do not respond to the treatment are the cases that offer a diagnostic and therapeutic challenge. This review will describe different algorithms that can be followed for the successful management of patients with difficult or progressive PIK. These algorithms are based on scientific work and on our empirical clinical experience. The review will also present three different clinical cases of PIK that were managed according to the algorithms presented in this review.
Ophthalmic surgery, lasers & imaging retina, 2006
A recent outbreak of fungal keratitis associated with contact lens use has been reported. During ... more A recent outbreak of fungal keratitis associated with contact lens use has been reported. During the past 4 months, a total of 36 patients with Fusarium keratitis have presented to one medical center. Two cases of Fusarium endophthalmitis resulting from this series of fungal keratitis associated with soft contact lens wear are described. [Ophthalmic Surg Lasers Imaging 2006;37:310-313.] AUTHORS From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida. Accepted for publication May 19, 2006. Supported in part by Research to Prevent Blindness, Inc., New York, New York. Address reprint requests to Harry W. Flynn, Jr., MD, 900 NW 17th Street, Miami, FL 33136.
Investigative Ophthalmology & Visual Science, Apr 30, 2014
DOAJ (DOAJ: Directory of Open Access Journals), Sep 1, 2014
Investigative Ophthalmology & Visual Science, Jun 10, 2020
Investigative Ophthalmology & Visual Science, Jun 10, 2020
Investigative Ophthalmology & Visual Science, May 14, 2008
Investigative Ophthalmology & Visual Science, May 14, 2008