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Endophthalmitis is a serious eye infection that can occur after intravitreal injections. Topical antibiotics are frequently used as a preventative measure, but their impact on the conjunctival microbiome is not fully understood. Conjunctival swabs were collected from 33 eyes of 33 patients undergoing intravitreal injections, both before and after a 3-day course of prophylactic topical levofloxacin 0.5%. Conjunctival microbiome analysis was conducted using 16S rRNA sequencing on the Illumina MiSeq platform. Bioinformatics processing identified unique amplicon sequence variants (ASVs) to evaluate microbial diversity and community composition. Alpha and beta diversity indices were analyzed. Topical levofloxacin treatment resulted in no significant change in alpha diversity indices, including Shannon index, Chao1, Shannon, PD whole tree, and observed ASVs, indicating stable microbial richness and evenness. In contrast, beta diversity analysis, assessed through Bray-Curtis dissimilarity, revealed significant differences in microbial composition between pre- and post-treatment samples. These changes included a decrease in the abundance of Staphylococcus and Bacillus species and an increase in the abundance of Streptococcus, Haemophilus, and Neisseria. Although prophylactic topical levofloxacin was found to alter the conjunctival microbiome and showed inconsistent effects on the abundance of pathogenic bacteria, its clinical effectiveness as a preventative measure against endophthalmitis remains inconclusive. Further studies are needed to clarify its role in infection prevention.

Purpose: To evaluate diacerein (interleukin-1[beta] inhibitor) efficacy on ocular surface disease (OSD). Patients and Methods: This prospective observational study included patients who received diacerein for osteoarthritis and had dry eye (DE). The primary outcome was corneal staining score. Secondary outcomes were ocular surface disease index (OSDI) score, tear breakup time (TBUT), tear osmolarity (Osm), Schirmer's test results, interleukin-1[alpha] (IL-1[alpha]), interleukin- 1[beta] (IL-1[beta]), and interleukin-1 receptor antagonist (IL-1Ra) levels in tears. All measurements were done at baseline and 2-month follow-up visits. Linear mixed models were used to examine the effect of all parameters, and log-transformed models were used for IL-1[alpha], IL- 1[beta], and IL-1Ra analyses. Results: Thirty-four patients (31 females and 3 males) were enrolled. The corneal staining score improved by 1.29 points (P=0.022, 95% confidence interval [95% CI] 0.19 to 2.40) after 2 months, and the OSDI score improved by 17.2 points (P<0.001, 95% CI 10.82 to 23.58) but TUBT decreased by 0.66 seconds (P=0.021, 95% CI 0.10 to 1.22). No significant differences were observed in the tear Osm and Schirmer's test. IL-1Ra demonstrated no statistical difference, IL-1[alpha] was significantly increased by 80% (P=0.260), and IL-1[beta] was significantly decreased by 99.21% (P<0.001). Conclusion: Diacerein can improve corneal staining and decrease IL-1[beta] levels in tears, which reflects better DE symptoms. Diacerein may be a promising alternative treatment for patients with OSD and osteoarthritis. Keywords: diacerein, dry eye diseases, interleukin-1, ocular surface disease

To evaluate diacerein (interleukin-1β inhibitor) efficacy on ocular surface disease (OSD).PurposeTo evaluate diacerein (interleukin-1β inhibitor) efficacy on ocular surface disease (OSD).This prospective observational study included patients who received diacerein for osteoarthritis and had dry eye (DE). The primary outcome was corneal staining score. Secondary outcomes were ocular surface disease index (OSDI) score, tear breakup time (TBUT), tear osmolarity (Osm), Schirmer's test results, interleukin-1α (IL-1α), interleukin-1β (IL-1β), and interleukin-1 receptor antagonist (IL-1Ra) levels in tears. All measurements were done at baseline and 2-month follow-up visits. Linear mixed models were used to examine the effect of all parameters, and log-transformed models were used for IL-1α, IL-1β, and IL-1Ra analyses.Patients and MethodsThis prospective observational study included patients who received diacerein for osteoarthritis and had dry eye (DE). The primary outcome was corneal staining score. Secondary outcomes were ocular surface disease index (OSDI) score, tear breakup time (TBUT), tear osmolarity (Osm), Schirmer's test results, interleukin-1α (IL-1α), interleukin-1β (IL-1β), and interleukin-1 receptor antagonist (IL-1Ra) levels in tears. All measurements were done at baseline and 2-month follow-up visits. Linear mixed models were used to examine the effect of all parameters, and log-transformed models were used for IL-1α, IL-1β, and IL-1Ra analyses.Thirty-four patients (31 females and 3 males) were enrolled. The corneal staining score improved by 1.29 points (P=0.022, 95% confidence interval [95% CI] 0.19 to 2.40) after 2 months, and the OSDI score improved by 17.2 points (P<0.001, 95% CI 10.82 to 23.58) but TUBT decreased by 0.66 seconds (P=0.021, 95% CI 0.10 to 1.22). No significant differences were observed in the tear Osm and Schirmer's test. IL-1Ra demonstrated no statistical difference, IL-1α was significantly increased by 80% (P=0.260), and IL-1β was significantly decreased by 99.21% (P<0.001).ResultsThirty-four patients (31 females and 3 males) were enrolled. The corneal staining score improved by 1.29 points (P=0.022, 95% confidence interval [95% CI] 0.19 to 2.40) after 2 months, and the OSDI score improved by 17.2 points (P<0.001, 95% CI 10.82 to 23.58) but TUBT decreased by 0.66 seconds (P=0.021, 95% CI 0.10 to 1.22). No significant differences were observed in the tear Osm and Schirmer's test. IL-1Ra demonstrated no statistical difference, IL-1α was significantly increased by 80% (P=0.260), and IL-1β was significantly decreased by 99.21% (P<0.001).Diacerein can improve corneal staining and decrease IL-1β levels in tears, which reflects better DE symptoms. Diacerein may be a promising alternative treatment for patients with OSD and osteoarthritis.ConclusionDiacerein can improve corneal staining and decrease IL-1β levels in tears, which reflects better DE symptoms. Diacerein may be a promising alternative treatment for patients with OSD and osteoarthritis.