Management of phaeniciatic ophthalmomyiasis externa

Ophthalmomyiasis Externa and Importance of Risk Factors, Clinical Manifestations, and Diagnosis: Review of the Medical Literature

OBJECTIVE

This review aims to describe and compare the risk factors, clinical course, diagnosis, and parasitologic features of external ophthalmomyiasis. We also discuss the different preventive measures and the effect of global warming in a large case series reported from January 2000 to December 2022.

METHODS

We perform a literature review of reported cases of external ophthalmomyiasis to determine the clinical characteristics, therapeutic management, and information on the organisms that most commonly cause external ophthalmomyiasis.

RESULTS

A total of 312 cases of external ophthalmomyiasis were recorded. The most common causative organism was Oestrus ovis (Linnaeus) (Diptera: Oestridae), accounting for 72.1% of cases, followed by Dermatobia hominis (Linnaeus Jr. in Pallas, 1781) (Diptera: Oestridae) at 5.4%, Lucilia sericata (Meigen) (Diptera: Calliphoridae) at 0.96%, and Chrysomyia bezziana (Villeneuve) (Diptera: Calliphoridae) at 0.96%. Before experiencing symptoms, 43.6% of cases reported having direct contact with flies or being hit in the eye, 33% reported no associated risk factors, 9.3% reported living with sheep and goats, and 7.7% reported a history of foreign objects entering the eye. The most common symptoms for those affected by O. ovis were sudden onset, including a foreign body sensation and movement, redness, tearing, itching, swelling, irritation, photophobia, burning, and ocular secretion. In cases caused by D. hominis, symptoms included eyelid edema, pain, redness, itching, movement within the lesion, ocular irritation, and discharge. Regarding occupational or recreational activity, agriculture, and livestock had the highest incidence, followed by trades and technical activities, being a student, and having traveled to an endemic region for work or recreation.

CONCLUSION

Patients with red eyes may suffer from external ophthalmomyiasis, which requires a thorough examination to diagnose and treat it early. Moreover, as the temperature increases due to climate change, it is essential to consider how this will affect the spread of different pathogens.

Insecticidal Activity of Hyoscyamus niger L. on Lucilia sericata Causing Myiasis

Background: Hyoscyamus niger L. (Solanaceae) generally known as henbane, is commonly distributed in Europe and Asia. In Turkey, henbane seeds have been used in folk medicine to remove worms from the eyes. The present study aimed to investigate the insecticidal activity of H. niger seeds. Methods: n-hexane, ethyl acetate, methanol and alkaloid extracts were prepared from the seeds of the plant and their insecticidal activities on Lucilia sericata larvae were evaluated. EC₅₀ and EC₉₀ values of the alkaloid extract were calculated and morphological abnormalities were investigated. Results: Alkaloid extract prepared from the seeds of this plant displayed significant insecticidal activity. EC₅₀ values of H. niger seeds alkaloid extract were found to be 8.04, 8.49, 7.96 μg/mL against first, second and third instar, respectively. It was determined that malformations of larvae included damaged larvae with small size, contraction and weak cuticle. Furthermore, HPLC analysis was performed on alkaloid extract of H. niger seeds and main components of the extract were determined. It was determined that alkaloid extract mainly contain hyoscyamine and scopolamine. Conclusions: These results confirm the folkloric usage of the plant and suggest that the alkaloid content of the plant could be responsible for the insecticidal activity.

Orbital myiasis in eviscerated socket and review of literature

Orbital myiasis is a potentially destructive infestation of the orbital tissues. It is uncommon in clinical practice and is seen in patients with poor hygiene with debilitated or immunocompromised state. We report a case of orbital myiasis in an empty socket of an immunocompetent individual. A 65-year-old immunocompetent patient was found to have orbital myiasis in an empty socket status postevisceration, for which he underwent treatment by manual removal of the larvae after application of a suffocating agent, turpentine oil. A total of 12 larvae were removed over the ensuing week. The tissues healed with secondary intention leaving an irregular healthy scar. It was noteworthy that once eviscerated the eye was neglected by the patient. Empty orbital sockets are potential sites for infestations.

Myiasis

Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. In mammals (including humans), dipterous larvae can feed on the host's living or dead tissue, liquid body substance, or ingested food and cause a broad range of infestations depending on the body location and the relationship of the larvae with the host. In this review, we deeply discuss myiasis as a worldwide infestation with different agents and with its broad scenario of clinical manifestations as well as diagnosis techniques and treatment.

External ophthalmomyiasis manifesting with keratouveitis

PURPOSE

To report a case of external ophthalmomyiasis manifesting with keratouveitis.

CASE REPORT

A 77-year-old man, presented with keratouveitis secondary to external ophthalmomyiasis. Slit-lamp examination of the affected eye disclosed subepithelial linear opacities, stromal keratitis, and anterior uveitis. There were also some moving maggots identified as Oestrus ovis larvae. Following removal of the maggots and instillation of tobramycin, the symptoms completely resolved within 2 days and visual acuity improved.

CONCLUSIONS

Although external ophthalmomyiasis usually manifests with ocular surface involvement, this uncommon condition must be considered in the differential diagnosis of keratouveitis, especially in rural areas.

MacroH2A1 knockdown effects on the Peg3 imprinted domain

Background

MacroH2A1 is a histone variant that is closely associated with the repressed regions of chromosomes. A recent study revealed that this histone variant is highly enriched in the inactive alleles of Imprinting Control Regions (ICRs).

Results

The current study investigates the potential roles of macroH2A1 in genomic imprinting by lowering the cellular levels of the macroH2A1 protein. RNAi-based macroH2A1 knockdown experiments in Neuro2A cells changed the expression levels of a subset of genes, including Peg3 and Usp29 of the Peg3 domain. The expression of these genes was down-regulated, rather than up-regulated, in response to reduced protein levels of the potential repressor macroH2A1. This down-regulation was not accompanied with changes in the DNA methylation status of the Peg3 domain.

Conclusion

MacroH2A1 may not function as a transcriptional repressor for this domain, but that macroH2A1 may participate in the heterochromatin formation with functions yet to be discovered.