{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:21:01Z","timestamp":1787775661546,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n This study highlights the clinical presentation of ring infiltrates (RI) in\n Pythium<\/jats:italic>\n keratitis, typically associated with fungal or\n Acanthamoeba<\/jats:italic>\n keratitis, emphasizing diagnostic and therapeutic challenges. We present a retrospective case series of seven patients diagnosed with\n Pythium<\/jats:italic>\n keratitis who developed RI, either at presentation or during the disease course. Diagnosis was confirmed by microbiological examination, and all patients received antipythium therapy within 1 week of presentation. Among the seven patients, all exhibited RI, leading to diagnostic confusion due to its common association with fungal and\n Acanthamoeba<\/jats:italic>\n keratitis. Prompt microbiological confirmation enabled targeted therapy, but initial presentation caused diagnostic challenges, especially in settings without routine microbiological support. RI is not uncommon in\n Pythium<\/jats:italic>\n keratitis and can result in misdiagnosis as fungal keratitis, particularly in resource-limited settings. Recognizing RI as a feature of\n Pythium<\/jats:italic>\n keratitis and ensuring early microbiological confirmation can enhance diagnostic accuracy and improve patient outcomes.\n <\/jats:p>","DOI":"10.4103\/ojo.ojo_1_25","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T19:00:19Z","timestamp":1772218819000},"page":"100-102","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ring infiltrates in Pythium keratitis"],"prefix":"10.4103","volume":"19","author":[{"given":"Amanjot","family":"Kaur","sequence":"first","affiliation":[{"name":"Cornea and Anterior Segment, Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrita","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment, Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Das","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment, Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smruti Rekha","family":"Priyadarshini","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment, Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikant Kumar","family":"Sahu","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment, Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"R1-20260302","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/bjophthalmol-2017-310604","article-title":"Clinical profile of Pythium keratitis: Perioperative measures to reduce risk of recurrence","volume":"102","author":"Agarwal","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"R2-20260302","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1136\/bjophthalmol-2017-311360","article-title":"Leap forward in the treatment of Pythium insidiosum keratitis","volume":"102","author":"Bagga","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"R3-20260302","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.4103\/ijo.IJO_2356_20","article-title":"Pythium keratitis: Clinical profile, laboratory diagnosis, treatment, and histopathology features post-treatment at a tertiary eye care center in Eastern India","volume":"69","author":"Vishwakarma","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"R4-20260302","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1136\/bjophthalmol-2017-311804","article-title":"Clinical profile, risk factors and outcome of medical, surgical and adjunct interventions in patients with Pythiuminsidiosum keratitis","volume":"103","author":"Agarwal","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"R5-20260302","doi-asserted-by":"crossref","first-page":"100498","DOI":"10.1016\/j.ajoc.2019.100498","article-title":"Successful medical management of Pythium insidiosum keratitis using a combination of minocycline, linezolid, and chloramphenicol","volume":"15","author":"Maeno","year":"2019","journal-title":"Am J Ophthalmol Case Rep"},{"key":"R6-20260302","doi-asserted-by":"crossref","first-page":"3515","DOI":"10.4103\/ijo.IJO_870_22","article-title":"Clinical differentiation of Pythium keratitis from fungal keratitis and development of a scoring system","volume":"70","author":"Chatterjee","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"R7-20260302","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijid.2019.06.011","article-title":"Pythiosis: Case report leading to new features in clinical and diagnostic management of this fungal-like infection","volume":"86","author":"Bernheim","year":"2019","journal-title":"Int J Infect Dis"},{"key":"R8-20260302","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1186\/s13256-021-03189-3","article-title":"Pythium insidiosum keratitis reported in China, raising the alertness to this fungus-like infection: A case series","volume":"15","author":"Hou","year":"2021","journal-title":"J Med Case Rep"},{"key":"R9-20260302","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1080\/02713683.2019.1676911","article-title":"Clinical and histopathological evaluation of a rabbit model for Pythium insidiosum keratitis","volume":"45","author":"Kalra","year":"2020","journal-title":"Curr Eye Res"}],"container-title":["Oman Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_1_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:38:06Z","timestamp":1787773086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ojo.ojo_1_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ojo.ojo_1_25","relation":{},"ISSN":["0974-620X","0974-7842"],"issn-type":[{"value":"0974-620X","type":"print"},{"value":"0974-7842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-01-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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