Acetazolamide treatment of CME in patients with uveitis. - Rho, D. (Ophthalmology, 1996)
Keywords: Humans; Chronic Disease; Randomized Controlled Trials as Topic; Visual Acuity; Uveitis/*complications; Macular Edema/*drug therapy; Acetazolamide/adverse effects/*therapeutic use; Carbonic Anhydrase Inhibitors/adverse effects/*therapeutic use

Treatment of uveitic macular edema with acetazolamide. - Zierhut, M.; Thiel, H. J.; Schlote, T. (Documenta ophthalmologica. Advances in ophthalmology, 1999)
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Adolescent; Child; Ophthalmic Solutions; Uveitis/complications/*drug therapy; Visual Acuity/drug effects; Carbonic Anhydrase Inhibitors/*therapeutic use; Acetazolamide/*therapeutic use; Macular Edema/complications/*drug therapy

Neodymium: YAG laser iridolenticular synechiolysis in uveitis. - Kumar, H.; Ahuja, S.; Garg, S. P. (Ophthalmic surgery, 1994)
Fifteen patients with "bound down" pupil or ring synechiae associated with chronic granulomatous uveitis in whom dilatation could not be obtained pharmacologically underwent iris-lens synechiolysis using relatively low energies from a Q-switched Nd:YAG laser. Pupil size increased significantly in all of the treated eyes; visual acuity improved in 40%. Postlaser elevated intraocular pressure developed in a significant number, but there were no serious long-term complications associated with the procedure. Although acuity improved in less than half of the patients, because this laser treatment is relatively safe and offers some possibility of visual improvement, we recommend it for routine use, but only if performed by an experienced laser microsurgeon.
Keywords: Female; Humans; Male; Middle Aged; Adult; Visual Acuity; Intraocular Pressure; Uveitis/*complications; Postoperative Complications; Ocular Hypertension/etiology; *Laser Therapy; Iris Diseases/etiology/physiopathology/*surgery; Lens Diseases/etiology/physiopathology/*surgery; Pupil/physiology; Tissue Adhesions

[Parasitic uveitis in children]. - Bakunowicz-Lazarczyk, A.; Proniewska-Skretek, E.; Walkowiak, M.; Grochowski, J. (Klinika oczna, 1992)
Seven children with an atypical parasitic uveitis were treated in the Department of Ophthalmology in Bialystok in the period 1985-1989. Parasitic background had been discovered in all the children: toxocara in 3, lambliasis in 2 and nematodiasis also in 2. Specific treatment achieved an improvement of the visual acuity and the inflammatory process abated.
Keywords: Female; Humans; Male; Child; Visual Acuity/drug effects/physiology; Light Coagulation; Cryosurgery; Antinematodal Agents/therapeutic use; Antiprotozoal Agents/therapeutic use; Ascariasis/*diagnosis/therapy; Eye Infections, Parasitic/*diagnosis/etiology/therapy; Giardiasis/*diagnosis/therapy; Toxocariasis/*diagnosis/therapy; Uveitis/*diagnosis/etiology/therapy

Uveitis as a presenting feature of autoimmune hepatitis. - Romanelli, Roberto G.; Almerigogna, Fabio (American journal of ophthalmology, 2009)
Keywords: Humans; Drug Therapy, Combination; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity; Macular Edema/etiology; Cataract/etiology; Glaucoma/etiology; Hepatitis, Autoimmune/complications/*diagnosis/drug therapy; Uveitis/complications/*diagnosis/drug therapy

Use of the YAG laser with a seven-micron spot in pseudophakic eyes. - Buratto, L.; Ricci, A.; Vitali, D. (Journal - American Intra-Ocular Implant Society, 1985)
We report on 216 cases of posterior capsulotomy performed with a LASAG Microruptor II YAG laser in patients with posterior chamber intraocular lenses. In 108 cases, the YAG laser was used in multimode with a 70-micron spot and 3.5 mJ to 5.0 mJ of energy; in the other 108 cases, the laser was used in fundamental mode with a 7-micron spot and 0.7 mJ to 1.2 mJ of energy. In the first group, IOL damage was seen in 10.2% of cases, uveitis developed in 0.4% of patients, and transient eye pressure elevation was noted in 6.5% of patients. In the second group, neither IOL damage nor uveitis occurred, and only two cases (1.8%) developed transient pressure elevation.
Keywords: Female; Humans; Male; Middle Aged; Aged; Visual Acuity; Postoperative Period; Reoperation; Uveitis/etiology; *Lenses, Intraocular; *Laser Therapy; Methods; Intraocular Pressure/radiation effects; Lasers/adverse effects; Lens, Crystalline/*radiation effects; Yttrium

[Intravitreal injection of triamcinolone acetonide in non infectious uveitis]. - Benítez Del Castillo Sánchez, J. M.; García Sánchez, J. (Archivos de la Sociedad Espanola de Oftalmologia, 2001)
PURPOSE: Systemic immunosuppressants take more than two weeks before showing activity. Therefore corticosteroids remain the mainstay in the treatment of non infectious uveitis. The goal of this study is to assess results of the use of intravitreal triamcinolone acetonide in acute sight-threatening non-infectious uveitis. METHOD: Ten patients (4 idiopathic retinal vasculitis, 1 idiopathic panuveitis, 1 pars planitis and 4 Behçet disease) were treated. Triamcinolone acetonide 4 mg/0.1 ml was injected through pars plana. RESULTS: Pre-treatment visual acuity<0.1 and post-treatment visual acuity >0.6 after less than a week. Inflammation resolved completely in all cases. The only complications observed were transient ocular hypertension which was successfully treated in two patients with topical betablockers and a catact in one case. CONCLUSIONS: Intravitreal triamcinolone acetonide is effective in rapidly decreasing inflammation in acute sight threatening non infectious uveitis.
Keywords: Female; Humans; Male; Adult; Adolescent; Triamcinolone Acetonide/*administration & dosage; Uveitis/*drug therapy; Vitreous Body; Immunosuppressive Agents/*administration & dosage; Injections, Intralesional

Crohn's disease. Rifampin treatment of the ocular and gut disease. - Wirostko, E.; Johnson, L.; Wirostko, B. (Hepato-gastroenterology, 1987)
Idiopathic Uveitis (IU) may occur as either an isolated ocular disease or with other systemic diseases such as Crohn's Disease (CD). As many as 33% of CD patients demonstrate IU, and frequently their gut and IU course and severity are similar. Rifampin produces remissions of isolated IU, and Rifampin has been used to treat gut CD with varying success. In this investigation 4 CD patients, whose gut but not IU had partially responded to corticosteroids, the addition of Rifampin was associated with improvement in both their CD Activity Index and IU, allowing steroid discontinuation; Rifampin withdrawal was associated with exacerbations of both gut disease and IU; and re-institution of Rifampin was associated with another gut and IU disease remission. Since mouse ocular and systemic inflammatory disease producing non-cultivatable ultrastructurally unusual bacteria are commonly found within isolated chronic IU vitreous polymorphonuclear (PMN) leukocytes, a search for these bacteria in CD eye and gut disease seems justified, as the beneficial results of Rifampin in this study may have been an antimicrobial action on these bacteria.
Keywords: Female; Humans; Male; Adult; Drug Therapy, Combination; Drug Administration Schedule; Prednisone/administration & dosage/therapeutic use; Visual Acuity/drug effects; Uveitis/*drug therapy/etiology; Crohn Disease/complications/*drug therapy; Rifampin/*therapeutic use

[Retinal vascularization in sarcoidosis]. - Fajnkuchen, F.; Badelon, I.; Battesti, J. P.; Valeyre, D.; Chaine, G. (Presse medicale (Paris, France : 1983), 2000)
OBJECTIVES: To describe the characteristics of retinal vasculitis related to sarcoidosis, and to study the radio-clinical findings of sarcoidosis in case of retinal vasculitis. METHODS: We performed a retrospective study on 33 cases of retinal vasculitis associated with sarcoidosis. Our patients had a complete ophthalmological examination and a systematic fluorescein angiography was performed. Recorded data included clinical, biological and radiological evaluation of sarcoidosis. RESULTS: Retinal vasculitis were and remained asymptomatic in almost a third of the patients (n = 10). In 11 patients (33%) a decreased visual acuity of more than 3 lines was observed. Periphlebitis was observed in all cases, and 75.7% were of non ischemic forms. Thirty patients out of 33 (90.9%) were treated with systemic steroids in whom 17 were treated for ophthalmological reasons. The presence of anterior or posterior uveitis, more than one attack of vasculitis, and significant hyalitis were statistically associated with visual acuity decrease. Ninety percent of patients regained their initial visual acuity, only three patients at the end of the medical follow-up remained with a visual acuity below or equal to 2/10. Thirty one patients (91%) presented with mediastinal and pulmonary signs concordant with sarcoidosis on chest x-rays. Extrapulmonary localisations were common in case of retinal vasculitis (91% of patients). CONCLUSION: Retinal vasculitis associated with sarcoidosis are often asymptomatic. In most cases, there are bilateral, non ischaemic periphlebitis. They seem to have a relatively better prognosis than in other etiologies of vasculitis and they are part of an evolutive multisystemic sarcoidosis. Most of the time treatment with systemic steroids was indicated for ophthalmological or extra ophthalmological reasons.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Administration, Oral; Infusions, Intravenous; Fluorescein Angiography; Methylprednisolone/administration & dosage; Visual Acuity/drug effects; Uveitis, Anterior/diagnosis/drug therapy; Adrenal Cortex Hormones/administration & dosage; Retinitis/*diagnosis/drug therapy; Sarcoidosis/*diagnosis/drug therapy; Uveitis, Posterior/diagnosis/drug therapy

Ciliochoroidal effusions after neodymium:YAG posterior capsulotomy: association with pre-existing glaucoma and uveitis. - Schaeffer, A. R.; Ryll, D. L.; O'Donnell, F. E. Jr (Journal of cataract and refractive surgery, 1989)
Two patients with a history of glaucoma and a propensity for uveitis developed ciliochoroidal effusions following Nd:YAG laser posterior capsulotomy. Both patients experienced a waxing and waning course with eventual resolution of symptoms after a steroid regimen. The ciliochoroidal effusions were presumed to be secondary to uveitis induced by the YAG laser surgery. The role of glaucoma, previous surgeries, and an open posterior capsule is uncertain but may have predisposed these patients to ciliochoroidal detachment. We advise caution in performing YAG posterior capsulotomy in patients with glaucoma and a known propensity for uveitis.
Keywords: Female; Humans; Aged; Visual Acuity; Trabeculectomy; Cataract Extraction; Ciliary Body; Laser Therapy/*adverse effects; Glaucoma/*complications; Choroid Diseases/etiology; Lens Capsule, Crystalline/*surgery; Lens, Crystalline/*surgery; Uveal Diseases/*etiology; Uveitis/complications/*etiology

[Cataract surgery in adults and children with chronic uveitis]. - Turno-Krecicka, A.; Nizankowska, M. H.; Oficjalska-Młyńczak, J.; Koziorowska, M. (Klinika oczna, 2000)
PURPOSE: To present preoperative strategies and results of cataract surgery in patients with different types of uveitis. PATIENTS AND METHODS: The results of 18 cases of extracapsular cataract extraction with or without intraocular lens implantation were retrospectively analysed. Age of patients ranged from 10 to 71 years (mean age: 35 years). Etiology of uveitis was determined in 10 cases (63%). Preoperative management was determined by the diagnosis of uveitis. The postoperative observation time ranged from 3 years to 6 months (mean: 25 months). RESULTS: Visual acuity improved postoperatively in 17 eyes (96%), and was better than 0.5 in 10 eyes (63%). The reasons for lower visual acuity were: cystoid macular edema in 6 cases (33%), band keratopathy, amblyopia and floaters in the vitreous. CONCLUSIONS: Establishing the diagnosis and controlling the inflammation pre- and postoperatively are the basic conditions for the surgical outcomes in cataract surgery in patients with history of uveitis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Adolescent; Chronic Disease; Child; Visual Acuity; Uveitis/*complications; Postoperative Care; Macular Edema/etiology; Cataract/*etiology; Intraoperative Complications; *Lens Implantation, Intraocular; *Cataract Extraction/adverse effects

[Uveitis complicating posterior segment neovascularization. Six cases]. - Chevalley, G.; Brazitikos, P. D.; Paccolat, F.; Pournaras, C. J. (Klinische Monatsblatter fur Augenheilkunde, 1992)
Subretinal or preretinal neovascularisation may be occasionally observed during the evolution of certain forms of uveitis. Subretinal neovascularisation commonly begins at the level of the chorioretinal uveitic scars. Consequently, the alteration of the retinal pigment epithelium-Bruch's membrane-choriocapillaris complex is the apparent cause. Laser photocoagulation of the neovascular front, when indicated, is the treatment of choice. In contrast, preretinal neovascularisation is observed at the active stage of uveitis. Fluorescein angiography findings suggest that it is probably correlated with the importance of inflammation since in most of the cases there is no retinal ischemia. Therefore, in order to obtain a regression of the neovascular tufts the treatment should be directed against the inflammatory process. In this study the authors report five cases of subretinal neovascularisation which developed at the level of chorioretinal post-inflammatory scars and one case of papillary neovascularisation which occurred during the active stage of an unilateral intermediate uveitis and in which new vessels regressed completely following systemic steroid treatment.
Keywords: Female; Humans; Male; Middle Aged; Adult; Adolescent; Fluorescein Angiography; Visual Acuity; Light Coagulation; Retinal Neovascularization/*diagnosis/etiology/surgery; Uveitis/*diagnosis/etiology/surgery

Plasma exchange in the therapy of Behçet's disease. - Raizman, M. B.; Foster, C. S. (Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 1989)
Present therapies for Behçet's disease are unsatisfactory in many cases. We investigated the role of plasma exchange in four patients with severe Behçet's retinitis who were unresponsive to standard medical therapies. Plasma exchange induced a rapid reduction of ocular inflammation with improved visual acuity in all cases. In patients with severe Behçet's retinitis, plasma exchange is able to interrupt the acute inflammatory activity, but relapses may occur.
Keywords: Female; Humans; Male; Adult; Time Factors; Adolescent; Visual Acuity; Uveitis/complications; *Plasma Exchange; Behcet Syndrome/*therapy

Management of the posterior capsule before and after the YAG laser. - Harris, W. S.; Herman, W. K.; Fagadau, W. R. (Transactions of the ophthalmological societies of the United Kingdom, 1985)
A retrospective chart review of 2,514 consecutive posterior chamber implants was carried out to assess the management of the posterior capsule when vision loss dictated intervention. The capsulotomy technique used between May 1977 and March 1983 was pars plana posterior capsulotomy (227 eyes). All posterior capsulotomies performed after April 1, 1983 were with the YAG laser (342 eyes). Comparison of the complications with the two methods showed considerable differences. Anterior segment problems appear greater following YAG laser posterior capsulotomy than pars plana posterior capsulotomy, whereas posterior segment complications appear similar in both techniques. Comparison of CME following both techniques indicates that a delay of 6 months or more between cataract surgery and posterior capsulotomy is advisable.
Keywords: Humans; Time Factors; Visual Acuity; Intraocular Pressure; Uveitis/etiology; Postoperative Complications; Cataract Extraction; *Lenses, Intraocular; *Laser Therapy; Lens Capsule, Crystalline/surgery

Long-term results of ab externo neodymium:YAG cyclophotocoagulation. - Baez, K. A.; Ulbig, M. W.; McHugh, D.; Holz, F. W.; Spaeth, G. L. (German journal of ophthalmology, 1994)
Neodymium: YAG cyclophotocoagulation (CPC) was performed in 128 eyes of 123 patients with refractory glaucoma. In each eye, 40 burns delivered with energy of up to 7 J were placed 1.5 mm behind the limbus in a 360 degrees pattern. The minimal follow-up period was 24 months, with the mean being 36.9 (range, 24-84; SD, 5.8) months. The mean intraocular pressure was 35.0 (range 23-54; SD, 12.2) mmHg preoperatively, 20.6 (range 15-24; SD, 3.5) mmHg after 1 year, and 20.2 (range 12-24; SD, 8.1) mmHg after 2 years. A total of 25 eyes (19.5%) lost 2 or more lines in visual acuity. Success was defined as a lowering of intraocular pressure by > 30% and a decrease in visual acuity of < 2 Snellen lines. By this definition the success rate was 52.4%. There was no correlation with either the diagnosis, the stage of the disease, or the pigmentation of the trabecular meshwork, although patients with secondary traumatic or uveitic glaucoma tended to be less responsive to CPC. The most common acute complication of treatment was transient corneal edema. Phthisis bulbi developed in 1 eye (0.8%). In conclusion, CPC achieved satisfactory long-term control of intraocular pressure in the majority of patients with severe late-stage glaucoma.
Keywords: Female; Humans; Male; Middle Aged; Prognosis; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Retrospective Studies; Adolescent; Child; Visual Acuity; Intraocular Pressure; Ciliary Body/*surgery; Postoperative Complications; Sclera; Glaucoma/*surgery; *Laser Coagulation

CME and anterior uveitis with latanoprost use. - Thorne, J. E.; Maguire, A. M.; Lanciano, R. (Ophthalmology, 1998)
Keywords: Humans; Male; Aged; Visual Acuity; Intraocular Pressure/drug effects; Latanoprost; Macular Edema/*chemically induced; Prostaglandins F, Synthetic/*adverse effects/therapeutic use; Glaucoma, Open-Angle/drug therapy; Uveitis, Anterior/*chemically induced; Vision Disorders/chemically induced

Intravitreal triamcinolone acetonide for treatment of sympathetic ophthalmia. - Jonas, Jost B. (American journal of ophthalmology, 2004)
PURPOSE: To report on the treatment of long-standing sympathetic ophthalmia by intravitreal triamcinolone acetonide. DESIGN: Clinical interventional case report. METHODS: A 47-year-old patient who suffered from sympathetic ophthalmia and who was treated with intensive systemic immunosuppressive therapy received an intravitreal injection of 25 mg of triamcinolone acetonide. Before injection, intraocular pressure ranged between 5 and 8 mm Hg; visual acuity measured 6/20. RESULTS: Within the first 4 weeks after the injection, visual acuity improved from 6/20 to 6/12, intraocular pressure increased to values between 10 mm Hg and 13 mm Hg, and intraocular flare measurements decreased by approximately 50%. Systemic immunosuppressive treatment was reduced to 10 mg prednisolone/day at the first postoperative day and could not be stopped due to an adrenal insufficiency. Three months after the injection, visual acuity regressed to 6/20, intraocular pressure was reduced to values between 5 mm Hg and 10 mm Hg, and anterior chamber flare increased. The patient received a second intravitreal injection of 25 mg of triamcinolone acetonide after which intraocular pressure increased again to values between 10 mm and 13 mm Hg, and anterior chamber flare decreased. After the injection, perimetry revealed a marked enlargement of the originally constricted visual field with a decrease in mean visual field defect from approximately 11 dB to values lower than 7 dB. CONCLUSIONS: Intravitreal injections of triamcinolone acetonide may be an additional tool in the treatment for sympathetic ophthalmia.
Keywords: Humans; Male; Middle Aged; Visual Fields/drug effects; Immunosuppressive Agents/*therapeutic use; Injections; Vitreous Body; Visual Acuity/drug effects; Intraocular Pressure/drug effects; Triamcinolone Acetonide/*therapeutic use; Ophthalmia, Sympathetic/*drug therapy

[Disseminated choroiditis, papillitis and vasculitis retinae as main findings in lues II-III]. - Bialasiewicz, A. A.; Dommer, S. (Klinische Monatsblatter fur Augenheilkunde, 1991)
Intraocular inflammations as chief manifestation of a T. pallidum infection associated with stage II syphilis are rarely documented in the recent literature. We report on a 35 year old patient with bilateral choroiditis, retinal vasculitis and papillitis persisting retrospectively since he had received some medication for syphilis 8 years previously. This patient was at high risk for other sexually transmitted diseases, however, he did not show HIV-seroconversion. General symptoms like uneasiness, fatigue, depressions and intermittent weight loss were mentioned. Reduction of visual acuity with topical corticosteroid therapy led to another medical work-up, and a systemic therapy with Ceftriaxone for 14 days resulted in better vision, better perimetric results and less inflammatory cell in the vitreous but evident optic atrophy.
Keywords: Humans; Male; Adult; Drug Therapy, Combination; Follow-Up Studies; Visual Fields/drug effects; Ceftriaxone/therapeutic use; Visual Acuity/drug effects; Syphilis Serodiagnosis; Methylprednisolone/therapeutic use; Chorioretinitis/*diagnosis/drug therapy; Neurosyphilis/*diagnosis/drug therapy; Papilledema/*diagnosis/drug therapy; Retinal Detachment/diagnosis/drug therapy

[Central serous chorioretinitis. Therapy experience over 20 years with and without laser coagulation]. - Makabe, R.; Gümbel, H. (Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 1995)
Since 1969, 1,179 eyes with central serous chorioretinopathy have been examined with fluorescein fundus angiography. The classic form with fluorescein leakage (type I) decreased in incidence from 86.4% to 55.4%, while an atypical form with frequent serous pigment epithelial detachment (type II) increased from 12.6% to 33.0%, and the mixed form (type I + II) increased from 1 to 11.6%. In type I with delayed healing laser coagulation of the leakage was performed, which improved the visual acuity from 0.64 to 0.92 an average (n = 122), while in cases without laser coagulation the percentage improved only from 0.66 to 0.84 on average (n = 34) with a statistically significant difference (t = 2.64, P < 0.01). Laser coagulation was especially beneficial in the mixed form (n = 16), in which the visual acuity improved from 0.42 to 0.86 on average. The proportion of women increased from 10.7 to 17.9%. The patient age tended to be higher in women more than in men.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Treatment Outcome; Fluorescein Angiography; Visual Acuity/physiology; *Laser Coagulation; Chorioretinitis/classification/diagnosis/*surgery

Low-dose methotrexate treatment in noninfectious uveitis resistant to corticosteroids. - Holz, F. G.; Krastel, H.; Breitbart, A.; Schwarz-Eywill, M.; Pezzutto, A.; Völcker, H. E. (German journal of ophthalmology, 1992)
A total of 14 patients (10 women and 4 men) ranging in age from 18 to 56 years who presented with active chronic noninfectious uveitis were treated with low-dose methotrexate (MTX). All patients had failed to respond to previous systemic corticosteroid therapy. MTX therapy was initiated in 8 patients at a dose of 40 mg given intravenously once weekly for 4 weeks followed by 15 mg/week given orally; 6 subjects were started on the oral regimen of 15 mg/week. During a follow-up period of 3-24 months, intraocular inflammation improved in all subjects under immunosuppressive therapy with MTX. A concomitant improvement in visual acuity was observed in 11 patients. Side effects included slight elevations in transaminases in 4 patients, transient mucositis in 1 case, partial alopecia in 2 subjects, and nausea in 3 patients. Our initial results suggest that low-dose MTX therapy may be considered as a therapeutic modality in noninfectious, steroid-refractory uveitis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Treatment Outcome; Adolescent; Administration, Oral; Drug Resistance; Injections, Intravenous; Prednisolone/*therapeutic use; Visual Acuity; Uveitis/*drug therapy; Methotrexate/*administration & dosage/adverse effects/therapeutic use

[Modification of the course of chronic intraocular inflammations by sunlight (Israel study)]. - Manthey, K. F.; Danielmeyer, F. (Klinische Monatsblatter fur Augenheilkunde, 1988)
Natural treatment methods are currently becoming more and more interesting, in part due to recent results of experimental and clinical research. It has been shown that light of certain wavelengths has a systemic immunosuppressive effect. It therefore seemed logical to expose patients suffering from chronic iridocyclitis or intermediate (peripheral) uveitis to high doses of solar radiation. Following a stay in Israel (Dead Sea), a transient increase in visual acuity was observed. Inflammatory activity and the number of inflammatory attacks decreased. This could be the first step toward a more "physiological" method of immunosuppression in the treatment of chronic uveitis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Adolescent; Chronic Disease; Child; Visual Acuity; *Heliotherapy; *Phototherapy; Israel; Uveitis, Anterior/*therapy; Uveitis/*therapy

Two non-infectious forms of endophthalmitis after intravitreal triamcinolone and cataract extraction. - Rauen, M.; Oetting, T. A.; Boldt, H. C.; Kwon, Y. H. (Eye (London, England), 2009)
Keywords: Humans; Male; Middle Aged; Cataract Extraction/*adverse effects; Visual Acuity; Intravitreal Injections; Macular Edema/drug therapy; Triamcinolone/*adverse effects; Anti-Inflammatory Agents/*adverse effects; Endophthalmitis/*chemically induced; Uveitis/surgery

Acetazolamide treatment of CME in patients with uveitis. - Flach, A. (Ophthalmology, 1996)
Keywords: Humans; Chronic Disease; Randomized Controlled Trials as Topic; Visual Acuity; Uveitis/*complications; Macular Edema/*drug therapy; Acetazolamide/adverse effects/*therapeutic use; Carbonic Anhydrase Inhibitors/adverse effects/*therapeutic use

[Endogenous uveitis. Retrospective clinical study]. - Todea, V.; Rusu, M. (Oftalmologia (Bucharest, Romania : 1990), 1997)
The paper proposes one retrospective study of cases with endogenous uveitis hospitalized and treated in Ophthalmological Clinic from Cluj, between 1983-1992. It underlines clinical, therapeutic features. The examination of the group of the patients depending on the treatment underlines the existence of two great therapeutical subgroups: other with nonsteroid antiinflammatory treatment and another with steroid antiinflammatory treatment. Are examined the characteristics of patients, disease and treatment as well its efficiency. Because approximately 25% from patients had a constant functional evolution and 18-20% had low visual acuity, it required the necessity of search some new therapeutical alternative and diversifying of the etiologic exams.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Adolescent; Glucocorticoids/*therapeutic use; Infant, Newborn; Child; Child, Preschool; Infant; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Prednisone/*therapeutic use; Visual Acuity/drug effects; Uveitis/classification/*drug therapy/etiology/pathology

Macular grid laser photocoagulation in uveitis. - Suttorp-Schulten, M. S.; Feron, E.; Postema, F.; Kijlstra, A.; Rothova, A. (The British journal of ophthalmology, 1995)
AIMS/BACKGROUND: The aim of this study was to evaluate whether grid laser photocoagulation of the macula is beneficial in the treatment of cystoid macular oedema in patients with uveitis. METHODS: Six eyes of five patients with long standing cystoid macular oedema due to chronic uveitis were treated by grid laser photocoagulation of the macula. RESULTS: In the first weeks after treatment a temporary increase of oedema and paracentral scotomas were observed. At the long term follow up of more than 18 months in all patients, macular oedema had been reduced significantly or disappeared in all eyes treated. One eye had a significant increase in Snellen acuity, three eyes more or less stabilised, and two eyes deteriorated. CONCLUSION: The beneficial effect of laser treatment on visual acuity in patients with uveitis might be more favourable if performed at an earlier stage of the disease.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Retrospective Studies; Chronic Disease; Fluorescein Angiography; Visual Acuity; Laser Coagulation/*methods; Macular Edema/etiology/surgery; Uveitis/complications/physiopathology/*surgery

[The surgical treatment of uveal glaucoma]. - Pen'kov, M. A.; Zubarev, S. F.; Avrushchenko, N. M.; Butkevich, Z. I.; Panchenko, N. V. (Oftalmologicheskii zhurnal, 1990)
The paper describes results after surgical treatment of 17 eyes with uveal glaucoma. Since conservative treatment could not achieve normalization of intraocular pressure, the following surgical interventions were made; peripheral intralamellar iridencleisis (7 eyes), sinusotrabeculectomy with basal iridectomy (4 eyes), iridocycloretraction (2 eyes), diathermocoagulation of the ciliary body (2 eyes), drainage by a silicon tube (2 eyes). Surgical complications were hyphema in 2 eyes, injury of the lens capsule in 1 eye; in 4 eyes a slight aggravation of the uveal process after the surgery was arrested by antiinflammatory therapy. Intraocular pressure normalized in 15 eyes. Visual functions increased in patients with early diagnosed and operated glaucoma; in far-advanced cases the operation removed pains, but no functional effect was achieved.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Adolescent; Chronic Disease; Child; Visual Acuity; Intraocular Pressure; Postoperative Care; Glaucoma/diagnosis/etiology/*surgery; Uveitis/complications/diagnosis/*surgery

Intravitreal injections of triamcinolone acetonide for severe vitritis in patients with incomplete Behcet's disease. - Kramer, Michal; Ehrlich, Rita; Snir, Moshe; Friling, Ronit; Mukamel, Masha; Weinberger, Dov; Axer-Siegel, Ruth (American journal of ophthalmology, 2004)
PURPOSE: To report our experience with intravitreal triamcinolone acetonide (IVTA) injections for the treatment of sight-threatening vitritis. DESIGN: Interventional case series. METHODS: Three patients with acute severe exacerbations of noninfectious panuveitis and vitritis were treated with IVTA injections alone or as an adjunct to systemic immunosuppressive agents. RESULTS: Rapid clearance of the vitreous inflammation with improvement in visual acuity was observed 1 to 2 weeks after injection. The effect lasted 2 to 6 months, with the shortest duration in the vitrectomized eye of Patient 1. Repeated injections were required in all patients. CONCLUSION: Intravitreal triamcinolone acetonide may be beneficial in selected cases of vitritis. This treatment modality has a rapid effect and may lower the use of systemic agents.
Keywords: Female; Humans; Male; Middle Aged; Adolescent; Glucocorticoids/*therapeutic use; Recurrence; Injections; Visual Acuity; Acute Disease; Triamcinolone Acetonide/*therapeutic use; Behcet Syndrome/complications/*drug therapy; Eye Diseases/*drug therapy/etiology; Vitreous Body/*drug effects/pathology

Ruby laser photocoagulation therapy of central serous retinopathy. I. A controlled clinical study. II. Factors affecting prognosis. - Watzke, R. C.; Burton, T. C.; Leaverton, P. E. (Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology, 1974)
Keywords: Humans; Prognosis; Time Factors; Follow-Up Studies; Recurrence; Fluorescein Angiography; Visual Fields; Fundus Oculi; Visual Acuity; Ophthalmoscopy; *Laser Therapy; Remission, Spontaneous; *Lasers; Age Factors; Chorioretinitis/complications/diagnosis/physiopathology/*surgery

[Experience with the dispensary observation of uveitis patients]. - Pen'kov, M. A.; Avrushchenko, N. M. (Oftalmologicheskii zhurnal, 1982)
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Adolescent; *Ambulatory Care; Child; Visual Acuity; Ophthalmology; Uveitis/*therapy; Hospitals, Special; Ukraine

[The enhanced efficacy of specific hyposensitization in patients with recurrent uveitis]. - Savko, V. V.; Safronenkova, I. A. (Oftalmologicheskii zhurnal, 1989)
The purpose of a new method elaborated for treatment of allergic inflammation of the eye is to rise effectiveness of treatment and to prevent exacerbation of allergic inflammation by means of increasing the accuracy of determining the therapeutic allergen dilution when conducting specific hyposensitization. This is achieved in the following way: in addition to control, when conducting allergometric titration, the syringe needle is introduced intracutaneously without subsequent administration of the allergen. In respective terms, the thermometry of skin is made in the sites of administration of different allergen dilutions and in the control site. Considering the minimum hyperthermia in the site of administration of the highest allergen dilution as compared with the control site, the therapeutic allergen dilution is chosen. This method of treatment was used in 38 patients (54 eyes) with recurrent uveitis and proved to be highly effective in 34 patients (50 eyes), i.e. in 92%. In remote terms of observation, no further recurrences were recorded in 65% of cases.
Keywords: Female; Humans; Male; Middle Aged; Adult; Recurrence; Chronic Disease; Uveitis/physiopathology/*therapy; Visual Acuity/physiology; Allergens/administration & dosage; Desensitization, Immunologic/*methods; Hypersensitivity, Delayed/physiopathology/*therapy

Gaucoma following keratoplasty. - Thoft, R. A.; Gordon, J. M.; Dohlman, C. H. (Transactions - American Academy of Ophthalmology and Otolaryngology. American Academy of Ophthalmology and Otolaryngology, 1974)
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Visual Fields; Intraocular Pressure; Dexamethasone/therapeutic use; Carbonic Anhydrase Inhibitors/therapeutic use; *Corneal Transplantation; *Postoperative Complications; Uveitis/complications; Cryosurgery; Glaucoma/complications/drug therapy/*etiology/therapy; Hyphema/complications; Retinal Detachment/complications; Transplantation, Homologous

Sympathetic uveitis after giant tear repair. - Maisel, J. M.; Vorwerk, P. A. (Retina (Philadelphia, Pa.), 1989)
A 33-year-old Hispanic man developed sympathetic ophthalmia 4.5 months after vitrectomy and repeat scleral buckling for a giant retinal tear in an aphakic previously traumatized eye. The patient had gray-white, subretinal nodules with characteristic changes of sympathetic uveitis detected by fluorescein angiography. The fluorescein angiographic and clinical findings revealed a dramatic response to steroid treatment: visual acuity returned to the previous 20/20 level within 5 weeks of therapy.
Keywords: Humans; Male; Adult; Time Factors; Fluorescein Angiography; Prednisone/therapeutic use; Visual Acuity; Vitrectomy; Laser Therapy; Ophthalmia, Sympathetic/drug therapy/*etiology; Retinal Perforations/*complications/surgery; Scleral Buckling

[Exchange plasmapheresis in combined treatment of severe uveitis]. - Chentsova, O. B.; Grechanyĭ, M. P.; Kil'diushevskiĭ, A. V. (Vestnik oftalmologii, 1989)
Exchange plasmapheresis (EP) has been employed in multiple-modality therapy of 15 patients suffering from severe uveitis. The traditional therapy has yielded but a short-term effect and failed to stabilize the process in these patients. EP has resulted in improvement in all the patients: the injection has reduced, as well as the number of precipitates and oracities in the vitreous body; hemorrhages in the fundus oculi have resolved, and the vision acuity has considerably improved in 11 of the 15 patients; no cases of the deterioration of the vision acuity have been recorded. The relapses have ceased in 10 patients. EP has been well tolerated and yielded no complications; it has normalized the levels of the blood serum immunoglobulins and circulating immune complexes and activized phagocytosis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Visual Acuity; *Plasmapheresis; Antigen-Antibody Complex/analysis; Immunoglobulins/analysis; Phagocytosis; Uveitis/immunology/*therapy

[The results of intracapsular extraction in uveal cataracts]. - Savinykh, V. I. (Oftalmologicheskii zhurnal, 1990)
Remote results (from 10 to 20 years) after operation in 36 patients with uveal cataracts and adhesion and obliteration of the pupil have shown a slight rise of visual acuity to 0.09-0.1 in 24 eyes, this being connected with lesion of the choroid, retina, atrophy of the optic nerve, cornea, vitreous body, atrophy of the optic nerve. In 19 eyes uveitis recurred. Surgical technique and the choice for the terms of operation are pointed out. A conclusion is made that massive antiinflammatory therapy with prescription of corticosteroids should be carried out in the postoperative period.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Adolescent; Visual Acuity; Postoperative Complications/epidemiology; Cataract/*complications; Postoperative Care; Cataract Extraction/*methods; Uveitis/complications/*surgery; Cryosurgery

Adult cytomegalic inclusion retinitis. - Merritt, J. C.; Callender, C. O. (Annals of ophthalmology, 1978)
Two cases of adult cytomegalic inclusion retinitis are described in renal transplant patients. The areas of initial involvement by the retinitis were left atrophic and demarcated from normal retina by a hypopigmented area in the retina. Both cases were complicated by the development of a secondary glaucoma with open angles. The glaucoma in each patient was successfully managed by carbonic anhydrase inhibitors, epinephrine drops, and cycloplegias. One patient still retains normal visual acuity in the eye which had active retinitis.
Keywords: Female; Humans; Male; Adult; Fluorescein Angiography; Uveitis/etiology; Glaucoma/etiology; *Postoperative Complications; Transplantation, Homologous; Cytomegalovirus Infections/diagnosis/*etiology; Kidney Transplantation; Retinitis/diagnosis/*etiology; Transplantation, Isogeneic

[Plasmapheresis and acute attacks of uveitis]. - Malecaze, F.; Mathis, A.; Goudable, C.; Maillard, P.; Fabre, L.; Bec, P. (Ophtalmologie : organe de la Societe francaise d'ophtalmologie, 1989)
Our study concerns the effects of plasma exchange in acute attacks of posterior or total chronic uveitis. The treatment undertaken in 10 patients consisted of 8 plasma exchanges in a 2 weeks period, associated with a corticosteroid and immunosuppressive therapy. Immediately after the plasma exchanges, there was a significant improvement in visual acuity and a decrease in inflammatory activity in most patients (70%). Plasma exchange seems to be an interesting adjuvant in the difficult treatment of some uveitis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Chronic Disease; Immunosuppressive Agents/therapeutic use; Visual Acuity; Acute Disease; Adrenal Cortex Hormones/therapeutic use; Plasma Exchange/*standards; Uveitis, Posterior/drug therapy/physiopathology/*therapy

[Results of treating the residual manifestations of uveitis of rheumatic and rheumatoid etiology at a health resort (the town of Yevpatoriya)]. - Mal'te, N. S.; Gudiev, A. T. (Oftalmologicheskii zhurnal, 1989)
The effect of a complex health resort treatment including eye applications of medical mud from the Sax lake has been studied in 100 patients (172 eyes) with residual effects after uveitis of rheumatic and rheumatoid etiology. Besides improvement of the general patient's state, the treatment provided a rise of visual functions, reduction of recurrences in remote terms. This effect can be, to a great extent, explained by antiinflammatory, resolving and desensitizing action of medical mud. The positive results obtained allow to recommend this method of treatment in conditions of a health resort and outside it (imported medical mud).
Keywords: Female; Humans; Male; Middle Aged; Adult; Combined Modality Therapy; Recurrence; Visual Acuity; Ukraine; *Health Resorts; Arthritis, Rheumatoid/*complications; Mud Therapy; Optic Disk; Rheumatic Diseases/*complications; Spondylitis, Ankylosing/complications; Uveitis/etiology/*therapy

Plasma exchange and immunoglobulins in the treatment of intermediate uveitis. - Brunner, R.; Borberg, H.; Kadar, J.; Hoffmann, A.; Konen, W.; Heidel, M.; Heidner, K. (Developments in ophthalmology, 1992)
Keywords: Humans; Treatment Outcome; Visual Acuity; *Plasma Exchange; *Immunization, Passive; Blood Component Removal; Uveitis, Intermediate/*therapy

[Long-term immunosuppressive treatment of sympathetic ophthalmia]. - Andrzejewska, W.; Puchalska-Niedbałowa, L. (Klinika oczna, 1989)
The authoresses present the results of treatment of 5 patients with sympathetic ophthalmia caused by injury of the eye. In 3 patients the removal of the excited eye and several years lasting conservative treatment--between others by immunosuppressive compounds--led to the arrest of the inflammatory process and enabled to preserve a good visual acuity in the saved eye. In 2 persons the function of either eye however could not be saved.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Time Factors; Adolescent; Immunosuppressive Agents; Dexamethasone/*administration & dosage; Visual Acuity/drug effects/physiology; Prednisone/*administration & dosage; Autoimmune Diseases/*drug therapy/etiology/physiopathology; Ophthalmia, Sympathetic/*drug therapy/etiology/physiopathology

[Heliotherapy in iridocyclitis and intermediate uveitis]. - Danielmeyer, F.; Manthey, K. F. (Fortschritte der Ophthalmologie : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 1989)
In a pilot in 1985 we treated 45 patients suffering from recurrent anterior uveitis with heliotherapy (Dead Sea, Israel), improvements were noticed in 40% of the probants during the following year. In a further clinical trial 14 patients (25 affected eyes) received treatment with heliotherapy twice for 3 weeks with a 12 months interval. The clinical findings showed a significant correlation between administration of the therapy and intermittent inflammation of the eyes.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Adolescent; Child; Uveitis, Intermediate/*therapy; Heliotherapy/*methods; Iridocyclitis/*therapy; Phototherapy/*methods; Visual Acuity/radiation effects

[The administration of preparations into the vorticose vein in the combined therapy of severe forms of uveitis]. - Pen'kov, M. A.; Zubarev, S. F.; Avrushchenko, N. M.; Saitov, M. A. (Oftalmologicheskii zhurnal, 1989)
The paper describes positive results after treatment of 15 patients with severe forms of uveitis by means of administering preparations into the portal vein of the eye. The method was substantiated by a series of experimental investigations. The treatment of patients with uveitis was prescribed when common therapy within a week and in some cases--a month after beginning of treatment proved to be ineffective. In 8 eyes with endogenous uveitis visual acuity rose from 0.06 +/- 0.4 at admission to 0.28 +/- 0.7 at discharge. In 4 patients with supposed enucleation of the eye the proposed method allowed to stop the inflammatory process. This method permitted to shorten the term of the patients stay at the hospital by 6.8 days. No complications during the treatment of recurrences in remote period were recorded.
Keywords: Female; Humans; Male; Uveitis/*drug therapy; Visual Acuity/drug effects; Animals; Cadaver; Injections, Intravenous/methods; Pharmaceutical Preparations/*administration & dosage; Rabbits; Sclera/*blood supply; Veins/anatomy & histology

The facility of aqueous outflow calculated from the rate of fall in applanation pressure after intravenous acetazolamide in man. - Nissen, O. I.; Hoppe, R. F. (Acta ophthalmologica, 1974)
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Adolescent; Injections, Intravenous; Visual Fields; Tonometry, Ocular; Cataract/physiopathology; *Intraocular Pressure/drug effects; Epinephrine/therapeutic use; Acetazolamide/administration & dosage/*pharmacology; Aqueous Humor/*metabolism; Diabetes Mellitus; Eye/*physiopathology; Glaucoma/drug therapy/*physiopathology; Hypertension; Models, Biological; Rheology; Sarcoidosis; Uveitis/physiopathology

[Phakectomy and vitrectomy in chronic uveitis]. - Gronemeyer, U. (Fortschritte der Ophthalmologie : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 1985)
Keywords: Humans; Adult; Adolescent; Recurrence; Chronic Disease; Child; Child, Preschool; Visual Acuity; Postoperative Care; *Vitrectomy; Uveitis/*surgery; Lens, Crystalline/*surgery

[EXPERIENCES WITH VERINA IN OPHTHALMOLOGY]. - SHIMIZU, K.; SANADA, T.; KUBO, T.; ENDO, N.; NISHIMURA, H.; ASAYA, H. (Rinsho ganka. Japanese journal of clinical ophthalmology, 1964)
Keywords: Humans; *Visual Fields; *Biomedical Research; *Chorioretinitis; *CHORIORETINITIS; *CLINICAL RESEARCH; *Drug Therapy; *DRUG THERAPY; *Hypertension; *HYPERTENSION; *Ophthalmology; *OPHTHALMOLOGY; *Retinal Hemorrhage; *RETINAL HEMORRHAGE; *Retinitis Pigmentosa; *RETINITIS PIGMENTOSA; *Vasodilator Agents; *VASODILATOR AGENTS; *VISUAL FIELDS

[The role of laser therapy in central serous choroidopathy]. - Pałenga-Pydyn, D.; Dziegielewski, K. (Klinika oczna, 1991)
The authors present early results of treatment of central serous choroidopathy by means of argon laser. Additionally they compare the fate of the patients with this condition treated conservatively in the last years. The results obtained confirm the world reports that application of laser in therapy of central serous choroidopathy shortens the course of the disease.
Keywords: Female; Humans; Male; Middle Aged; Adult; Visual Acuity/physiology; Postoperative Period; Macular Edema/*complications; Argon; Choroiditis/etiology/physiopathology/*surgery; Light Coagulation/*methods

[Intravenous corticosteroid therapy in optical nerve neuritis and uveitis]. - Draeger, J.; Andresen, P.; Tamm, J. (Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde, 1967)
Keywords: Female; Humans; Middle Aged; Adult; Injections, Intravenous; Visual Fields; Uveitis/*drug therapy; Adrenal Cortex Hormones/*administration & dosage; Optic Neuritis/*drug therapy

High-dose intravenous gammaglobulin therapy for uveitis. - Sunakawa, M. (Metabolic, pediatric, and systemic ophthalmology (New York, N.Y. : 1985), 1989)
One of my patients had severe uveitis with retinal phlebitis, retinal exudation and vitreous bleeding against high-dose steroid therapy. After high-dose intravenous gammaglobulin therapy was applied, retinal exudation and phlebitis subsided and visual acuity increased dramatically.
Keywords: Female; Humans; Middle Aged; Infusions, Intravenous; Fundus Oculi; Visual Acuity; gamma-Globulins/*administration & dosage; Immunization, Passive; Prednisone/adverse effects; Retinal Diseases/etiology/physiopathology; Uveitis, Posterior/complications/*therapy; Vitreous Body/physiopathology

[Climatotherapy in chronic inflammations of the uvea]. - Manthey, K. F.; Heidemann, H.; Hengst, W. (Klinische Monatsblatter fur Augenheilkunde, 1984)
Treatment of uveitis depends on the inhibition of the inflammatory reaction by corticosteroids or immunosuppressive agents. "Climatotherapy" remains a controversial subject and is generally not accepted. To test its efficacy a pilot study was undertaken. Children with chronic iridocyclitis or intermediate uveitis were sent to Israel for 3 weeks. During the follow-up period of 26 months there was an initial regression of the inflammatory reaction in most cases, followed by varied courses depending on the severity of the disease. Although no definite conclusions can be drawn owing to the small number of patients (5) there might been a beneficial effect. It seems very difficult to prove the efficacy of such "treatment", since not only the climate but also many other environmental factors were changed.
Keywords: Female; Humans; Male; Pilot Projects; Adolescent; Combined Modality Therapy; Recurrence; Chronic Disease; Prednisone/therapeutic use; Visual Acuity; Dexamethasone/therapeutic use; Uveitis/*therapy; *Climate; Macular Edema/therapy; Uveitis, Anterior/therapy

Intraocular lens implantation versus no intraocular lens implantation in patients with chronic iridocyclitis and pars planitis. A randomized prospective study. - Tessler, H. H.; Farber, M. D. (Ophthalmology, 1993)
PURPOSE: The authors studied the safety of intraocular lens (IOL) implantation in patients with uveitis. METHODS: The authors prospectively randomized 26 patients with chronic iridocyclitis (22 patients) or pars planitis (4 patients) to undergo IOL implantation or no IOL implantation at the time of cataract surgery. RESULTS: There was no statistical difference in visual acuity results at 1 year between the two groups. There was a trend toward better visual acuity in patients with chronic iridocyclitis without IOLs. Cocoon-like dense fibrous membranes enveloped the IOL in two patients. CONCLUSION: The authors conclude that IOLs are relatively safe in patients with chronic iridocyclitis but that only a much larger study could determine if the trend toward better visual acuity without an IOL was real.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Prospective Studies; Treatment Outcome; Chronic Disease; Contraindications; Visual Acuity; Sarcoidosis/complications; Macular Edema/etiology; Postoperative Complications; *Lenses, Intraocular/adverse effects; Iridocyclitis/complications/etiology/*surgery; Pars Planitis/complications/*surgery

Clinical background comparison of patients with and without ocular inflammatory attacks after initiation of infliximab therapy. - Yoshida, Atsushi; Kaburaki, Toshikatsu; Okinaga, Kimiko; Takamoto, Mitsuko; Kawashima, Hidetoshi; Fujino, Yujiro (Japanese journal of ophthalmology, 2012)
PURPOSE: To examine the factors affecting the efficacy of infliximab (IFX) as a treatment for uveitis in Behçet's disease. METHODS: Clinical records of 29 patients with refractory uveoretinitis were examined retrospectively for the period between 6 months before the initiation of IFX therapy to 12 months thereafter. The patients were divided into two groups based on the absence (Group 1) or occurrence (Group 2) of ocular inflammatory attacks during the observation period after IFX therapy, and the clinical records of the groups were compared RESULTS: The mean age at onset of ocular inflammation in Group 1 patients (n = 17) was lower than that in Group 2 patients (n = 12) (p = 0.023). Compared to Group 2 patients, the period from onset to IFX therapy in Group 1 was longer (p = 0.037), and the frequency of ocular inflammatory attacks before IFX therapy was lower (p = 0.013). The rates of ocular fundus attacks before IFX therapy were 0.82 ± 0.28 in Group 1 and 0.96 ± 0.10 in Group 2 (p = 0.040). Three of 33 (9.1 %) eyes in Group 1 and nine of 24 eyes (37.5 %) in Group 2 had an improved best-corrected visual acuity of >0.2 logarithm of the minimal angle resolution (p < 0.01). CONCLUSIONS: Patients in Group 1 tended to have fewer intraocular attacks (fewer fundus attacks in particular) prior to IFX therapy and have a longer period from onset of intraocular inflammation to IFX therapy. The improvement of the BCVA in Group 2 tended to be better.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Young Adult; Adolescent; Administration, Oral; Infusions, Intravenous; Infliximab; Cyclosporine/therapeutic use; Glucocorticoids/therapeutic use; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage; Visual Acuity/physiology; Antibodies, Monoclonal/*administration & dosage; Behcet Syndrome/complications/*drug therapy; Colchicine/therapeutic use; Retinitis/diagnosis/etiology/*prevention & control; Uveitis/diagnosis/etiology/*prevention & control

[Pathogenesis and therapy of central serous retinopathy]. - Buhl, M.; Liesenhoff, O.; Kampik, A. (Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 1994)
There is no consensus in the literature on the etiology and therapy of central serous retinopathy. We conducted a retrospective study to find out whether patients treated with argon laser coagulation (ALK) experienced long-term visual acuity improvement. We were also concerned to find whether choroidal perfusion was involved in the etiology. PATIENTS: In all, 28 patients (4 women/24 men) with RCS confirmed by angiography were analyzed. All patients were followed up from 1988 to 1992. Patients with chronic recurrent RCS were not considered. Angiography was performed to examine the type and localization of the leakage and also the choroidal perfusion. Patients who were treated with ALK were compared with patients who were not. RESULTS: Only 9 patients were treated with carefully directed ALK. Their mean visual acuity was 0.5 (STD 0.09) before therapy. After treatment the mean visual acuity was improved to an average of 0.8 (0.23). The follow-up time was up to 56 weeks. The patients without ALK had an initial visual acuity of 0.6 (0.21) which improved to 0.8 (0.22) during an observation period of 60 weeks. By the end of the study the visual acuity was the same in both groups. In 46% of all patients delayed choroidal perfusion was seen on angiography. CONCLUSION: There was no difference in visual acuity between patients treated with and without ALK. The angiographic examinations suggest general changes in choroidal perfusion in patients with RCS.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Fluorescein Angiography; Visual Acuity/physiology; *Laser Coagulation; Chorioretinitis/*etiology/surgery; Choroid/blood supply; Regional Blood Flow/physiology

Uveitis associated with an epidemic outbreak of leptospirosis. - Rathinam, S. R.; Rathnam, S.; Selvaraj, S.; Dean, D.; Nozik, R. A.; Namperumalsamy, P. (American journal of ophthalmology, 1997)
PURPOSE: To define uveitis associated with leptospirosis in a clinical setting. METHODS: We present the clinical features of 73 consecutive cases of uveitis linked clinically to an outbreak of systemic leptospirosis in patients with antibodies to Leptospira species who were examined from January to September 1994. RESULTS: In 73 patients, the pattern of ocular involvement was unilateral in 35 and bilateral in 38. Panuveitis was seen in 106 eyes (95.5%), retinal periphlebitis in 57 eyes (51.4%), and hypopyon in 14 eyes (12.6%). Anterior uveitis alone without hypopyon was observed in three eyes (2.7%), whereas vitreous inflammatory reaction alone was seen in two eyes (1.8%). Sixty of 73 patients (82.2%) or 91 of 111 eyes (82.0%) were followed up for 8 months. Final visual acuity was 6/6 (20/20) in 47 eyes (52%) and improved during treatment, although not up to 6/6, in 15 eyes (16%). Twenty-eight eyes (31%) maintained same vision, and one eye showed deterioration of vision. CONCLUSION: Uveitis associated with leptospirosis may manifest as unilateral or bilateral uveitis, anterior uveitis, or panuveitis. The prognosis is generally good in this entity, even when the inflammation is severe. Awareness of this disease in endemic areas is important in order to differentiate it from other uveitic entities, especially in young male patients in whom other immunologic uveitides are also common.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Retrospective Studies; India/epidemiology; Doxycycline/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity; Drug Administration Routes; Anti-Bacterial Agents/therapeutic use; Antibodies, Bacterial/analysis; *Disease Outbreaks; Eye Infections, Bacterial/drug therapy/*etiology/pathology; Leptospira/immunology/isolation & purification; Leptospirosis/diagnosis/drug therapy/*epidemiology; Uveitis/drug therapy/*microbiology/pathology

TINU-associated retinal pigment epithelium detachments: a possible novel posterior segment feature. - Sheth, Hiten G.; Laverde-Konig, Tania; Raina, Jyoti (International ophthalmology, 2009)
PURPOSE: To report a case of tubulointerstitial nephritis and uveitis syndrome (TINU) with novel posterior segment features of bilateral vitritis and retinal pigment epithelial detachments. METHODS: This is an interventional case report with fundus photographs and fluorescein angiograms of a 9-year-old girl presenting with bilateral acute anterior uveitis 4 months after a diagnosis of acute tubulointerstitial nephritis. RESULTS: Visual acuities remained normal throughout the 6-month period of follow-up. The anterior and posterior uveitis settled, although retinal pigment epithelial detachments persisted and may be related to the underlying disease process in TINU or exogenous steroid treatment, or both. CONCLUSIONS: The idiopathic inflammatory response seen in TINU is traditionally associated with an anterior uveitis. This case demonstrates that there may be more extensive ocular involvement and that posterior uveitis and retinal pigment epithelial detachments may represent emerging features of atypical cases of TINU.
Keywords: Female; Humans; Disease Progression; Administration, Oral; Child; Fluorescein Angiography; Anti-Inflammatory Agents/administration & dosage; Prednisolone/administration & dosage; Visual Acuity; Uveitis/*complications/diagnosis/drug therapy; Dexamethasone/administration & dosage; Administration, Topical; Syndrome; Nephritis, Interstitial/*complications/diagnosis/drug therapy; Retinal Detachment/diagnosis/drug therapy/*etiology

[Idiopathic central serous chorioretinopathy: two case reports observed in Togo]. - Balo, K. P.; Mihluedo, H. (Medecine tropicale : revue du Corps de sante colonial, 1996)
Central serous chorioretinopathy is due to accumulation of serous fluid between the sensory retina and pigmented epithelium. Our perusal of the literature did not turn up any reports on this topic in Black Africa. The disorder was observed in 2 patients from Togo who presented with unilateral reduction in visual acuity. Initially suspected by the presence of a macular lesion on the fundus and by ophthalmoscopic examination, diagnosis was confirmed by angiofluorography. Angiofluorography is the method of choice and the low incidence of this eye disorder in Black Africa is probably due to the poor availability of this method. Although the two patients in this study responded to corticosteroid therapy, treatment usually requires laser photocoagulation to eliminate the site of abnormal transudation and create a choroidal adhesion. In this regard recent studies indicate that the primary mechanism underlying this disorder is multifocal or diffuse hyperpermeability of the choroidal vessels.
Keywords: Female; Humans; Male; Adult; Visual Acuity; Adrenal Cortex Hormones/therapeutic use; Laser Coagulation; Chorioretinitis/*diagnosis/etiology/therapy; Fluorophotometry; Togo

Clinical Outcomes of Patients with Vogt-Koyanagi-Harada Disease Over 12 Years at a Tertiary Center. - Arevalo, J. Fernando; Lasave, Andres F.; Gupta, Vishali; Kozak, Igor; Al Harbi, Mosa Barakat; Al Rushood, Abdulaziz Adel; Al Dhibi, Hassan A. (Ocular immunology and inflammation, 2016)
PURPOSE: To describe the clinical characteristics and treatment outcomes of Vogt-Koyanagi-Harada (VKH) disease over a 12-year period. METHODS: A retrospective chart review was used to identify VKH patients, from January 1999 to December 2011. RESULTS: In total, 154 patients (308 eyes) were diagnosed with VKH. The mean age at diagnosis was 33.8 ± 13 years. Mean baseline best-corrected visual acuity (BCVA) was 20/125; (0.8 ± 0.6 logMAR). Recurrent episodes occurred in 107 (54%) patients. Oral prednisone was administered in all patients. At the last visit, the mean BCVA was 20/50 (0.4 ± 0.7 logMAR). The most common complications post-treatment were: glaucoma [104 (33.8%) eyes] and cataract [84 (27.2%) eyes]. CONCLUSIONS: In Saudi Arabia, VKH-related uveitis is predominant in young females. Bilateral panuveitis is the most common ocular manifestation and near 50% of eyes present with exudative retinal detachment. Oral prednisone was the primary treatment and the majority of eyes maintained 20/50 or better vision.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Adolescent; Prednisolone/therapeutic use; Administration, Oral; Recurrence; Chronic Disease; Child; Fluorescein Angiography; Tomography, Optical Coherence; Glucocorticoids/therapeutic use; uveitis; Visual Acuity/physiology; Acute Disease; Tertiary Care Centers; Vogt–Koyanagi–Harada disease; Panuveitis; Mycophenolic Acid/therapeutic use; prednisone; Antibiotics, Antitubercular; Saudi Arabia; Uveomeningoencephalitic Syndrome/*diagnosis/drug therapy

Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients. - van Boxtel, Lonneke A. A.; van der Lelij, Allegonda; van der Meer, Johannes; Los, Leonoor I. (Ophthalmology, 2007)
PURPOSE: To describe 7 cases of unilateral, chronic and/or recurrent anterior uveitis caused by cytomegalovirus (CMV) in immunocompetent patients; to identify specific ophthalmologic characteristics; and to evaluate the clinical effect of valganciclovir treatment. DESIGN: Retrospective observational case series. PARTICIPANTS: Immunocompetent patients (n = 7) with a history of chronic and/or recurrent unilateral anterior uveitis and a positive analysis for either CMV-DNA and/or antibodies against CMV in their aqueous humor (Goldmann-Witmer coefficient > 3). METHODS: Full ophthalmologic examination, anterior chamber fluid analysis, serologic examination, and systemic evaluation. Treatment modalities included topical steroids, topical and/or systemic antiglaucoma medications, glaucoma surgery, and systemic valganciclovir. MAIN OUTCOME MEASURES: Visual acuity, inflammation, and intraocular pressure (IOP). RESULTS: Chronic unilateral anterior uveitis was seen in 6 patients, whereas recurrent uveitis was observed in 1. Additional findings consisted of slight iris atrophy and secondary glaucoma (n = 3), secondary glaucoma without iris abnormalities (n = 3), and a slightly elevated IOP without iris abnormalities (n = 1). Examinations of the aqueous humor by polymerase chain reaction demonstrated CMV-DNA in 6 patients and were negative for other herpes viruses in all. Goldmann-Witmer coefficients were strongly positive in 4 out of 5 patients. Other laboratory investigations were within normal limits. No other causes for uveitis were identified. Because of the insufficient effect of topical steroids and antiglaucoma medications, 5 patients were treated with additional oral valganciclovir with good clinical response in terms of uveitis activity and IOP. Discontinuation of valganciclovir in 1 patient resulted in a prompt recurrence of uveitis activity. CONCLUSIONS: Cytomegalovirus may cause a chronic and/or recurrent anterior uveitis in otherwise healthy patients. Iris atrophy and glaucoma may accompany it, but an inflammatory reaction in the anterior chamber may be the only sign. Aqueous humor analysis is of the utmost importance in differentiating between CMV and other herpes viruses and in making a definite diagnosis in chronic anterior uveitis. Valganciclovir may be very effective in treating CMV anterior uveitis, but its exact role can only be determined in larger studies with a longer follow-up.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Antiviral Agents/therapeutic use; Recurrence; Child; Valganciclovir; Visual Acuity; Intraocular Pressure; Anterior Chamber/pathology; Glaucoma/etiology; Cytomegalovirus/genetics; DNA, Viral/analysis; *Immunocompetence; *Cytomegalovirus Infections/drug therapy/virology; Aqueous Humor/chemistry; Atrophy; Ganciclovir/analogs & derivatives/therapeutic use; Iris/pathology; Uveitis, Anterior/complications/pathology/physiopathology/*virology

Intravitreal Dexamethasone Implant as an Adjunct Weapon for Severe and Refractory Uveitis in Behçet's Disease. - Fabiani, Claudia; Emmi, Giacomo; Lopalco, Giuseppe; Vannozzi, Lorenzo; Bacherini, Daniela; Guerriero, Silvana; Franceschini, Rossella; Frediani, Bruno; Iannone, Florenzo; Marco Tosi, Gian; Rigante, Donato; Cantarini, Luca (The Israel Medical Association journal : IMAJ, 2017)
BACKGROUND: The evidence on the use of dexamethasone implants in the treatment of Behçet's disease (BD)-related uveitis is limited to a few cases. OBJECTIVES: To evaluate the efficacy of dexamethasone implants on ocular functional, morphological, and clinical parameters in BD patients with severe refractory uveitis. METHODS: Five eyes from five BD patients were enrolled. A single intravitreal dexamethasone injection was applied to each eye. Best corrected visual acuity (BCVA), central macular thickness (CMT) assessed with optical coherence tomography, retinal vasculitis assessed by fluorescein angiography, vitreous haze score (Nussenblatt scale), intraocular pressure (IOP), and lens status (LOCS III, Lens Opacities Classification System III) were recorded at baseline and at 1, 3, and 6 month follow-up visits. RESULTS: At baseline, all eyes showed marked macular edema and 4/5 had concomitant active retinal vasculitis. Mean BCVA was increased from baseline at each control visit with a mean improvement of 0.26 ± 0.18 lines at 6 months follow-up. Mean CMT decreased from baseline at each control visit with a mean improvement at 6 months follow-up of 198.80 ± 80.08 µm. At the end of the study, none of the eyes showed macular edema and the mean CMT was 276.80 ± 24.94 µm. Retinal vasculitis resolved in all eyes. One eye experienced an IOP spike during treatment that resolved spontaneously, and one eye developed a clinically significant lens opacity at 6 months follow-up. CONCLUSIONS: Treatment with a dexamethasone implant in BD-uveitis and inflammatory macular edema was safe and effective as an additional treatment combined with systemic immunomodulatory drugs.
Keywords: Humans; Treatment Outcome; Tomography, Optical Coherence; Visual Acuity; Intravitreal Injections; Dexamethasone/*administration & dosage; Glucocorticoids/*administration & dosage; Macular Edema/*drug therapy/etiology; Uveitis/*drug therapy/etiology; Drug Implants/*administration & dosage; Behcet Syndrome/*complications

Interferon versus methotrexate in intermediate uveitis with macular edema: results of a randomized controlled clinical trial. - Mackensen, Friederike; Jakob, Eva; Springer, Christina; Dobner, Bianca C.; Wiehler, Ute; Weimer, Petra; Rohrschneider, Klaus; Fiehn, Christoph; Max, Regina; Storch-Hagenlocher, Brigitte; Becker, Matthias D. (American journal of ophthalmology, 2013)
PURPOSE: To compare interferon (IFN) beta with methotrexate (MTX) in the treatment of intermediate uveitis with macular edema. DESIGN: Monocentric, prospective, randomized, controlled clinical trial. SETTING: Specialized uveitis center at the University of Heidelberg. PATIENT OR STUDY POPULATION: Patients with either primary intermediate uveitis or uveitis associated with multiple sclerosis. MAIN INCLUSION CRITERIA: Visual acuity of 20/30 or worse (0.2 logarithm of the minimal angle of resolution) and macular edema of more than 250 μm (central 1-mm in optical coherence tomography; Stratus). Randomization into either IFN beta 44 μg subcutaneously 3 times weekly or 20 mg MTX subcutaneously once weekly. MAIN OUTCOME MEASURES: At 3 months, the primary outcome parameter of mean change in visual acuity was evaluated and efficacy was determined. Secondary parameters were macular edema by optical coherence tomography, inflammatory activity, and retinal sensitivity by microperimetry (MP-1; Nidek). In case of treatment failure, switching to the other treatment arm was possible. RESULTS: Nineteen patients were included. Ten were randomized to MTX, and 9 were randomized to IFN beta. At 3 months, visual acuity improved a mean 0.31 logarithm of the minimal angle of resolution (range, -0.02 to -0.96, 15.6 letters on the Early Treatment Diabetic Retinopathy Study chart) in the IFN beta group versus a mean 0.09 logarithm of the minimal angle of resolution (range, 0.12 to -0.38, 4.7 letters) in the MTX arm (P = .0435, Mann-Whitney U test). Macular thickness decreased by a mean of 206 μm (range, -41 to -416 μm) in the IFN arm, but increased by 47 μm (range, 108 to -28 μm) in the MTX group (P < .0001). CONCLUSIONS: Although the sample size is small, results of the trial support superiority of IFN beta over MTX in the treatment of macular edema in the setting of intermediate uveitis.
Keywords: Female; Humans; Male; Adult; Prospective Studies; Treatment Outcome; Methotrexate/adverse effects/*therapeutic use; Tomography, Optical Coherence; Visual Field Tests; Visual Acuity/physiology; Injections, Subcutaneous; Uveitis, Intermediate/diagnosis/*drug therapy/physiopathology; Immunosuppressive Agents/adverse effects/*therapeutic use; Macular Edema/diagnosis/*drug therapy/physiopathology; Interferon-beta/adverse effects/*therapeutic use

Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. - Al-Mezaine, Hani S.; Al-Muammar, Abdulrahman; Kangave, Dustan; Abu El-Asrar, Ahmed M. (International ophthalmology, 2008)
PURPOSE: To define the clinical characteristics and optical coherence tomographic (OCT) features, and to assess the outcome of treatment, in patients with presumed tuberculous uveitis (PTU). METHODS: All patients diagnosed with PTU at King Abdulaziz University Hospital between January 1998 and May 2006 were reviewed. The diagnosis was made when findings were consistent with possible intraocular tuberculosis with no other cause of uveitis suggested by history, symptoms, or ancillary testing, strongly positive tuberculin skin-test results, and response to antituberculous therapy. RESULTS: Fifty-one patients (73 eyes) were identified. There were 34 males (66.7%) and 17 females (33.3%) with a mean age of 40.1+/-11.0 years (range 16-68 years). Fifty-eight eyes (79.5%) had panuveitis and 15 eyes (20.5%) had posterior uveitis at presentation. Clinical manifestations included vitritis (71.2%), macular edema (63%), retinal periphlebitis (35.6%), multifocal choroiditis (20.5%), and granulomatous anterior uveitis (17.9%). All patients received antituberculous therapy and systemic corticosteroids. After a mean follow-up of 18.9+/-21.9 months (range 6-96 months), all eyes showed resolution of inflammation, with no recurrences, associated with significant improvement in visual acuity (VA) (P=0.007). There was a significant positive correlation between initial and final VAs (r=0.7856, P<0.001). Thirty-one eyes with macular edema were examined at baseline and at follow-up with OCT. There were three patterns of macular edema: diffuse (DME) (28.5%), cystoid (29%), and serous retinal detachment (45.2%). Initial VA of 20/40 or better was significantly associated with central macular thickness (CMT) of 300 microm or less (P=0.0065) and DME (0.0484). At final follow-up, there was a significant reduction in CMT (P<0.001) associated with a significant improvement in VA (P=0.0091). CONCLUSIONS: Antituberculous therapy combined with systemic corticosteroids leads to resolution of inflammation and elimination of recurrences of PTU. OCT is useful in monitoring the efficacy of treatment in patients with macular edema.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Follow-Up Studies; Treatment Outcome; Adolescent; Fluorescein Angiography; Glucocorticoids/therapeutic use; Visual Acuity; Uveitis/*diagnosis/drug therapy; Antitubercular Agents/therapeutic use; Tuberculin Test; *Tomography, Optical Coherence; Macular Edema/diagnosis/drug therapy; Tuberculosis, Ocular/*diagnosis/drug therapy

Ranibizumab for refractory uveitis-related macular edema. - Acharya, Nisha R.; Hong, Kevin C.; Lee, Salena M. (American journal of ophthalmology, 2009)
PURPOSE: To evaluate the effect of intravitreal ranibizumab injections (Lucentis; Genentech Inc, South San Francisco, California, USA) on refractory cystoid macular edema (CME) in patients with controlled uveitis who have failed oral and regional corticosteroid treatment, the mainstays of current medical therapy. DESIGN: Prospective, noncomparative, interventional case series. METHODS: Seven consecutive patients with controlled uveitis and refractory CME who had failed corticosteroid treatment were studied. One eligible patient chose not to participate and another did not complete follow-up for nonmedical reasons. Intravitreal ranibizumab injections (0.5 mg) were given monthly for 3 months, followed by reinjection as needed. The primary outcome was the mean change in best spectacle-corrected visual acuity (VA) from baseline to 3 months, and the secondary objective was the mean change in central retinal thickness (CRT) on ocular coherence tomography. Six-month outcomes were also assessed. RESULTS: At 3 months, the mean increase in acuity for the 6 patients who completed follow-up was 13 letters (2.5 lines), and the mean decrease in CRT was 357 mum. Both VA and CRT improved significantly between baseline and 3 months (P = .03 for each). Although most patients required reinjection, this benefit was maintained at 6 months. There were no significant ocular or systemic adverse effects. CONCLUSIONS: Intravitreal ranibizumab led to an increase in VA and regression of uveitis-associated CME in patients refractory to or intolerant of standard corticosteroid therapy. Further studies of this promising treatment are warranted.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Treatment Failure; Prospective Studies; Treatment Outcome; Young Adult; Fluorescein Angiography; Tomography, Optical Coherence; Injections; Glucocorticoids/therapeutic use; Uveitis/diagnosis/*drug therapy/physiopathology; Visual Acuity/physiology; Vitreous Body; Retina/pathology; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal/adverse effects/*therapeutic use; Macular Edema/diagnosis/*drug therapy/physiopathology; Ranibizumab; Angiogenesis Inhibitors/adverse effects/*therapeutic use

Intravitreal triamcinolone for the treatment of refractory macular edema in idiopathic intermediate or posterior uveitis. - Hogewind, B. F. T.; Zijlstra, C.; Klevering, B. J.; Hoyng, C. B. (European journal of ophthalmology, 2008)
PURPOSE: Cystoid macular edema (CME) is the most significant cause of visual loss associated with idiopathic uveitis. The authors report on the use of intravitreal triamcinolone acetonide (IVTA) in a group of patients with macular edema due to idiopathic intermediate and posterior uveitis. METHODS: Retrospective, noncomparative, interventional case series. Thirty-three eyes were included with uveitic CME that was refractory to topical steroids, oral prednisone, or a combination thereof. Previous steroid treatment did not result in elevated intraocular pressure (IOP). The eyes received an intravitreal injection with 10 mg triamcinolone acetonide, after best-corrected visual acuity (BCVA) and fluorescein angiography (FA) were assessed. Ophthalmologic examination including FA was regularly performed during a 1-year follow-up period. RESULTS: Within 12 weeks after injection of IVTA, 50% of the eyes responded with an improvement in vision of more than two lines and 30% of the eyes reached an IOP of > or = 21 mmHg (p<0.01). All eyes with an elevated IOP responded well on topical antiglaucoma medication. After 12 months follow-up 40% of the eyes responded with an improvement in vision of more than two lines and 28% of the affected eyes underwent phacoemulsification during the follow-up. No other complications occurred within a year after the treatment. CONCLUSIONS: In macular edema due to idiopathic intermediate or posterior uveitis IVTA improves the visual acuity within the first 3 months. However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects.
Keywords: Female; Humans; Male; Middle Aged; Follow-Up Studies; Retrospective Studies; Glucocorticoids/administration & dosage/adverse effects/*therapeutic use; Recurrence; Fluorescein Angiography; Injections; Visual Acuity/physiology; Macular Edema/diagnosis/*drug therapy/etiology; Vitreous Body; Uveitis, Intermediate/complications/*drug therapy; Uveitis, Posterior/complications/*drug therapy; Triamcinolone Acetonide/administration & dosage/adverse effects/*therapeutic use

Response to comment on: Rebound inflammation after an intravitreal injection in Vogt-Koyanagi-Harada syndrome. - Ranjan, Richa; Agarwal, Manisha (Indian journal of ophthalmology, 2018)
Keywords: Humans; Inflammation; Visual Acuity; *Intravitreal Injections; *Uveomeningoencephalitic Syndrome

Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations. - Gutfleisch, Matthias; Spital, Georg; Mingels, Anne; Pauleikhoff, Daniel; Lommatzsch, Albrecht; Heiligenhaus, Arnd (The British journal of ophthalmology, 2007)
OBJECTIVE: To investigate the effect of pars plana vitrectomy (PPV) in combination with intraoperative intravitreal triamcinolone acetonide injection on the course of cystoid macular oedema (CME) in patients with uveitis. METHODS: Patients with uveitis with CME (n = 19) not responding to systemic corticosteroids and/or immunosuppression combined with acetazolamide were retrospectively studied after PPV with additional intravitreal injection of 4 mg triamcinolone acetonide. Patients had chronic anterior uveitis (n = 4), intermediate uveitis (n = 9), posterior uveitis (n = 3) or panuveitis (n = 3). Visual acuity tests, tonometry, fluorescein angiographic appearance and postoperative complications were analysed. Mean follow-up was 14 months (SD 4.6). RESULTS: CME improved in 58% of the patients within the first 6 weeks postoperatively. After 12 months, CME was further improved in 44% and worsened in another 12%. Improvement of visual acuity was noted in 42% after 3 months and in 28% after 12 months. Cataract progressed in 85% of the phacic patients postoperatively. Increased intraocular pressure was detected in 27% at 2 weeks and in 11% at 12 months after surgery. CONCLUSION: Uveitic CME that is unresponsive to systemic immunosuppression and acetazolamide may improve after PPV with additional intravitreal triamcinolone application. The effect seems to be transient in many of the patients. Frequent complications were cataract formation and ocular hypertension.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Adolescent; Glucocorticoids/*therapeutic use; Combined Modality Therapy; Injections; Visual Acuity; Vitreous Body; Triamcinolone Acetonide/*therapeutic use; *Vitrectomy; Postoperative Complications; Cataract/etiology; Uveitis/complications; Macular Edema/*drug therapy/etiology/*surgery

Comparisons of Clinical Features in Japanese Patients with Behçet's Uveitis Treated in the 1990s and the 2000s. - Nakahara, Hisae; Kaburaki, Toshikatsu; Tanaka, Rie; Yoshida, Atsushi; Takamoto, Mitsuko; Kawata, Mikiko; Fujino, Yujiro; Kawashima, Hidetoshi; Aihara, Makoto (Ocular immunology and inflammation, 2020)
Purpose: We investigated clinical characteristics of ocular Behçet's disease (BD) patients treated in the 1990s and the 2000s.Methods: We retrospectively examined records of 68 newly arrived patients with ocular BD followed for more than 4 months during the 2000s and compared to those of 107 patients during the 1990s. Patient profiles, ocular and systemic symptoms, frequency of ocular attacks, BD ocular attack score 24-6 months (BOS24-6M), best-corrected visual acuity (BCVA), and immunomodulatory treatment were noted.Results: Clinical characteristics in the 2000s showed increases in iridocyclitis type, intestinal-, vasculo-, and neuro-BD cases, oral corticosteroid, methotrexate, and infliximab therapy usage, cataract and glaucoma surgery, and pseudophakia, and decreases in BOS24-6M and cyclophosphamide usage. BCVA of 20/30 or better at the final visit was slightly increased in the 2000s.Conclusions: Milder ocular BD tendency was seen in cases in the 2000s, whereas the incidence of special type of BD might be increasing.
Keywords: Female; Humans; Male; Adult; Follow-Up Studies; Retrospective Studies; Severity of Illness Index; Immunosuppressive Agents/*therapeutic use; uveitis; *Visual Acuity; Immunosuppression Therapy/*methods; *Disease Management; Japan/epidemiology; *Forecasting; Behcet Syndrome/*diagnosis/drug therapy/epidemiology; Behçet’s disease; BOS24; iridocyclitis type; milder disease; Morbidity/trends; Uveitis/*diagnosis/drug therapy/epidemiology

Tattoo Granulomas With Uveitis. - Carvajal Bedoya, Guiset; Caplan, Liron; Christopher, Karen L.; Reddy, Amit K.; Ifantides, Cristos (Journal of investigative medicine high impact case reports, 2020)
Bilateral intraocular inflammation and simultaneous development of tattoo granulomas has been described in several case reports. The pathophysiology of this process is poorly understood, and it has been hypothesized that it could be a similar mechanism to systemic sarcoidosis versus a delayed hypersensitivity response. Granulomatous tattoo reaction with associated uveitis can manifest with or without evidence of systemic sarcoidosis, and it is usually responsive to immunosuppression and/or tattoo removal. We present a patient with no prior diagnosis of sarcoidosis who developed bilateral panuveitis and tattoo changes suggestive of tattoo granulomas with uveitis (TAGU). The patient was initially managed with intraocular steroids and systemic steroids with minimal improvement of symptoms. The patient later required steroid sparing therapy with a tumor factor inhibitor to achieve remission. There is a growing prevalence of tattooing among the general population and a low reported rate of tattooing complications. Granulomatous tattoo reaction with associated uveitis should be a consideration in patients with tattoos presenting with "idiopathic" uveitis.
Keywords: Humans; Male; Adult; Adalimumab/administration & dosage; Visual Acuity; Tattooing/*adverse effects; *uveitis; *granuloma; *panuveitis; *tattooing; *tumor necrosis factor-α; Biopsy/methods; Foreign-Body Reaction/etiology; Granuloma, Foreign-Body/drug therapy/*etiology/pathology; Macular Edema/*etiology; Steroids/administration & dosage; Uveitis/*chemically induced/drug therapy/pathology

[Improvement of visual acuity after light coagulation for central serous retinopathy (author's transl)]. - Ueno, S.; Yoshida, M.; Yoshida, H.; Amemiya, T. (Nippon Ganka Gakkai zasshi, 1976)
Keywords: Female; Humans; Male; Middle Aged; Adult; *Visual Acuity; *Light Coagulation; Chorioretinitis/*surgery

High-dose intravenous pulse methylprednisolone hemisuccinate in acute Behçet retinitis. - Reed, J. B.; Morse, L. S.; Schwab, I. R. (American journal of ophthalmology, 1998)
PURPOSE: To report the response of acute Behçet retinitis to high-dose corticosteroids. METHOD: Case report. A 58-year-old man with Behçet disease and severe bilateral glaucoma experienced a sudden decrease of visual acuity to counting fingers in his (better-seeing) left eye. Examination disclosed hypopyon uveitis and an infiltrative retinitis threatening the fovea. He received intravenous methylprednisolone hemisuccinate, 1 gram per hour on each of 3 successive days, followed by oral prednisone and cyclosporine. RESULTS: The retinal infiltrate disappeared within 24 hours. Visual acuity improved to LE, 20/400 by day 5 and returned to LE, 20/30 after 3 months. A visual field demonstrated a scotoma corresponding to the location of the previous retinitis. CONCLUSION: High-dose intravenous methylprednisolone can reverse severe vision loss in acute Behçet retinitis.
Keywords: Humans; Male; Middle Aged; Infusions, Intravenous; Prednisone/administration & dosage; Visual Fields; Immunosuppressive Agents/administration & dosage; Visual Acuity; Acute Disease; Glucocorticoids/*administration & dosage; Cyclosporine/administration & dosage; Behcet Syndrome/*drug therapy/pathology/physiopathology; Methylprednisolone Hemisuccinate/*administration & dosage; Retinitis/*drug therapy/pathology/physiopathology

Therapeutic interventions for macular diseases show characteristic effects on near and distance visual function. - Munk, Marion; Kiss, Christopher; Huf, Wolfgang; Sulzbacher, Florian; Bolz, Matthias; Sayegh, Ramzi; Eisenkölbl, Stefan; Simader, Christian; Schmidt-Erfurth, Ursula (Retina (Philadelphia, Pa.), 2013)
PURPOSE: To compare therapy-induced reading and distance visual acuity (dVA) increases in neovascular age-related macular degeneration (nAMD) and uveitis-associated cystoid macular edema. METHODS: This longitudinal study included 68 treatment-naive eyes: 39 subfoveal nAMD eyes with disrupted photoreceptor layers treated with monthly ranibizumab and 29 uveitis-associated cystoid macular edema eyes with intact photoreceptor layer treated with 1 triamcinolone injection. Patients were examined with high-definition optical coherence tomography, Early Treatment Diabetic Retinopathy Study dVA (logarithm of the minimum angle of resolution), reading acuity (logRADscore), and maximum reading speed (words per minute) over 3 months of therapy. RESULTS: In uveitis-associated cystoid macular edema, logarithm of the minimum angle of resolution and logRADscore improved 1 day post treatment, from 0.49 ± 0.28 to 0.39 ± 0.3 (P = 0.018) and 0.71 ± 0.53 to 0.56 ± 0.49 (P = 0.012), respectively. In nAMD, logarithm of the minimum angle of resolution improved 1 week after anti-vascular endothelial growth factor therapy from 0.59 ± 0.29 to 0.49 ± 0.24 (P = 0.002), with no change in logRADscore. One month after treatment, logRADscore improved from 1.09 ± 0.65 to 0.90 ± 0.60 (P = 0.002). In uveitis-associated cystoid macular edema, the recovery course of reading and dVA was comparable, and in nAMD, reading acuity recovery was delayed. Irrespective of disease, a small reduction in dVA resulted in a larger reading acuity decrease. CONCLUSION: Cystoid macular edema resolution was associated with rapid synchronous reading and dVA improvement, whereas nAMD was followed by faster recovery of distance than reading acuity. In both conditions, reading acuity expressed by critical angular resolution was more suppressed by active disease and recovered relatively more than distance acuity. These discrepancies indicate that reading acuity might be a more sensitive measure for vision decrease in macular diseases than dVA. Reading acuity seems to be an important adjunct assessing intravitreal therapy efficacy.
Keywords: Female; Humans; Male; Middle Aged; Aged; Follow-Up Studies; Antibodies, Monoclonal, Humanized/therapeutic use; Glucocorticoids/*therapeutic use; Recovery of Function; Tomography, Optical Coherence; Intravitreal Injections; Visual Acuity/*physiology; Macular Edema/*drug therapy/physiopathology; Uveitis/*drug therapy/physiopathology; Angiogenesis Inhibitors/*therapeutic use; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Triamcinolone Acetonide/therapeutic use; Ranibizumab; *Reading; Wet Macular Degeneration/*drug therapy/physiopathology

A Case Report of Sweet's Syndrome with Panuveitis and Rhegmatogenous Retinal Detachment. - Wang, Wenjuan; Wang, Xin; Zhao, Hongran; Cui, Yan (Ocular immunology and inflammation, 2021)
Purpose: To report a case of a patient who suffered from Sweet's syndrome with panuveitis in both eyes.Materials & Methods: Retrospective interventional case report.Results: A 54-year-old Chinese male patient complained of fever, painful skin lesions and blurry vision in both eyes lasting for 4 days. His visual acuity was hand motion in both eyes. Slit-lamp examination showed the hypopyon and severe vitreous opacification in both eyes. A skin pathology from head skin lesion demonstrated diffuse neutrophilic infiltration in the dermis with karyorrhexis. Based on the inspection above, the patient was diagnosed with Sweet's syndrome and given systemic corticosteroids therapy. However, he developed secondary rhegmatogenous retinal detachment in the right eye during his treatment.Conclusion: The association of bilateral uveitis with Sweet's syndrome has been described in this report.
Keywords: Humans; Male; Middle Aged; Retrospective Studies; Fluorescein Angiography; Glucocorticoids/therapeutic use; Visual Acuity/physiology; Intraocular Pressure/physiology; Slit Lamp Microscopy; Vitreous Body/pathology; Vitrectomy; Triamcinolone Acetonide/therapeutic use; Endotamponade; Behcet’s disease; Diabetes Mellitus/diagnosis; panuveitis; Panuveitis/*diagnosis/drug therapy; Retinal Detachment/*diagnosis/surgery; rhegmatogenous retinal detachment; Sweet Syndrome/*diagnosis/drug therapy; Sweet’s syndrome

Surgical Intervention in Inciting Eyes of Patients with Sympathetic Ophthalmia: A Case Series and Review of Literature. - Dogra, Mohit; Samanta, Ramanuj; Singh, Pallavi; Singh, Simar Rajan; Bajgai, Priya; Sharma, Aman; Bansal, Reema; Gupta, Vishali; Dogra, Mangat R.; Singh, Ramandeep (Ocular immunology and inflammation, 2019)
Purpose: To analyze the outcomes of surgical procedures on inciting eye of patients with Sympathetic ophthalmia (SO). Methods: Retrospective study of patients with SO who underwent surgical procedures on inciting eyes between January 2000 and December 2015. Outcome measures included flare up of inflammation in either eye and change in visual acuity in the inciting eye. Results: Four SO patients underwent surgeries in their inciting eyes after adequate control of inflammation. Surgical procedures included penetrating keratoplasty, glaucoma drainage device implantation, pars plana vitrectomy, and silicon oil removal. Keratoplasty, glaucoma surgery, and silicon oil removal were well tolerated, with no flare up of disease. The patient who underwent pars plana vitrectomy, however, had a poor outcome. Conclusions: Surgical intervention in inciting eyes of patients with SO, after being adequately treated with oral steroids and immunosuppression, is a viable option for improving anatomic and functional outcomes in these eyes.
Keywords: Female; Humans; Retrospective Studies; Adolescent; *Visual Acuity; Intraocular Pressure/*physiology; Vitrectomy/*methods; Inciting eye; Keratoplasty, Penetrating/*methods; Ophthalmia, Sympathetic/diagnosis/physiopathology/*surgery; surgical intervention; Sympathetic ophthalmia

Acute myelogenous leukaemia in an adult presenting with uveitis. - Daneshvar, H.; Hodge, W.; Gilberg, S. (The British journal of ophthalmology, 1999)
Keywords: Humans; Male; Adult; Visual Acuity; Fatal Outcome; Uveitis, Anterior/*complications; Bone Marrow Transplantation; Leukemia, Myeloid, Acute/*complications

Analysis of clinical features and visual outcomes of pars planitis. - Berker, Nilufer; Sen, Emine; Elgin, Ufuk; Atilgan, Cemile Ucgul; Dursun, Erdem; Yilmazbas, Pelin (International ophthalmology, 2018)
PURPOSE: To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey. METHODS: Medical records of patients with pars planitis were retrospectively reviewed. The data including demographic and ocular features and treatment outcomes were recorded. The distribution of clinical findings and complications were evaluated according to age and gender groups. The changes in final BCVA compared to the initial BCVA were noted. Statistical analysis was performed using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). RESULTS: Twenty-seven patients (54 eyes) were included in this study. 16 patients were male (59.3%), and 11 were female (40.7%). Mean age at diagnosis was 12.84 ± 8.26 (range 4-36) years. Mean follow-up period was 61.3 ± 52.15 (range 9-172) months. Mean BCVA was 0.58 ± 0.36 (range 0.03-1.00) (0.40 ± 0.45 logMAR) at presentation, and 0.81 ± 0.28 (range 0.10-1.00) (0.14 ± 0.27 logMAR) at final visit (P = 0.001). Vitreous inflammation (100%), vitreous haze (92.6%), snowballs (74.1%), snowbanks (66.7%), anterior chamber cells (66.7%) and peripheral retinal vascular sheathing (48.1%) were the most common presentations. Ocular complications included vitreous condensation (51.9%), cystoid macular edema (22.2%), cataract (18.5%), inferior peripheral retinal detachment (11.1%), glaucoma (5.6%) and vitreous hemorrhage (3.7%). Treatments included topical, periocular, intravitreal and systemic corticosteroids, immunosuppressives, peripheral laser photocoagulation and pars plana vitrectomy when needed. CONCLUSIONS: Pars planitis is an idiopathic chronic intermediate uveitis mostly affecting children and adolescents. In spite of its chronic nature with high potential of causing ocular complications, adequate treatment and close follow-up lead to favorable visual outcomes.
Keywords: Female; Humans; Male; Adult; Retrospective Studies; Young Adult; Adolescent; Treatment; Child; Child, Preschool; Sex Factors; Immunosuppressive Agents/therapeutic use; Visual Acuity/physiology; Vitreous Body/pathology; Adrenal Cortex Hormones/therapeutic use; Pediatric uveitis; Turkey; Age Factors; *Pars Planitis/complications/pathology/physiopathology/therapy; Intermediate uveitis; Laser Coagulation/methods; Pars planitis; Vitrectomy/methods

Uveitis and glaucoma. - Caprioli, J.; Samson, C. M.; Foster, C. S.; Araie, M.; Rockwood, E. J. (Journal of glaucoma, 2000)
Keywords: Female; Humans; Middle Aged; Drug Therapy, Combination; Antihypertensive Agents/therapeutic use; Visual Acuity; Intraocular Pressure; Glaucoma Drainage Implants; Cataract Extraction; Cataract/complications; Prednisolone/*analogs & derivatives/therapeutic use; Cyclopentolate/therapeutic use; Glaucoma/*complications/therapy; Sarcoidosis, Pulmonary/complications/diagnosis; Uveitis/*complications/therapy

Posterior sub-Tenon's triamcinolone injections in the treatment of uveitis. - Tanner, V.; Kanski, J. J.; Frith, P. A. (Eye (London, England), 1998)
PURPOSE: This is the first study reported in the United Kingdom to investigate the efficacy and safety of posterior, sub-Tenon's triamcinolone acetonide injections in the treatment of posterior and intermediate uveitis. METHODS: Twenty-eight posterior sub-Tenon's triamcinolone injections (40 mg) were given and the results analysed with a 6 month prospective follow-up in 13 cases. RESULTS: At 6 weeks follow-up, objective improvement in visual acuity occurred in 25 eyes (p < 0.05). Vitreous cellular activity was diminished in 21 eyes (p < 0.05). In most cases improvement was observed within 2 weeks of injection. No patient required repeat triamcinolone injection within 3 months and all patients previously treated with systemic immunosuppression were able to decrease or discontinue this treatment. Complications included transient elevation of intraocular pressure in 4 patients and persistent mild ptosis in 2 patients. CONCLUSIONS: We have demonstrated that posterior sub-Tenon's triamcinolone injection significantly decreases cystoid macular oedema, with a corresponding increase in visual acuity, in patients with posterior uveitis. Systemic immunosuppression may be reduced or discontinued with the avoidance of associated systemic side effects, and the technique has a high level of patient acceptability.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Prospective Studies; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Visual Acuity; Administration, Topical; Uveitis, Posterior/*drug therapy; Anti-Inflammatory Agents/*administration & dosage; Uveitis, Intermediate/*drug therapy; Glucocorticoids; Injections, Intralesional/methods; Triamcinolone/*administration & dosage

32 cases of sympathetic ophthalmia. A retrospective study at the National Eye Institute, Bethesda, Md., from 1982 to 1992. - Chan, C. C.; Roberge, R. G.; Whitcup, S. M.; Nussenblatt, R. B. (Archives of ophthalmology (Chicago, Ill. : 1960), 1995)
OBJECTIVE: To examine the relationship between visual outcome and the clinical management of patients with sympathetic ophthalmia. METHODS: Thirty-two patients with sympathetic ophthalmia who were seen at the National Eye Institute, Bethesda, Md, between 1982 and 1992, were retrospectively reviewed. RESULTS: There were equal numbers of males and females. Sympathetic ophthalmia occurred after trauma in 23 patients and surgery in nine patients. Sixteen of the 32 patients had a final visual acuity of 20/40 or better; 10 patients had a visual acuity worse than 20/200. Good visual outcome was associated with early and aggressive treatment with corticosteroids, sometimes in combination with other immunosuppressive agents. Poor visual acuity was associated with glaucoma, chorioretinal scars in the macula, and persistent uncontrolled inflammation. CONCLUSION: Prompt and aggressive use of antiinflammatory therapy can improve the visual outcome of patients with sympathetic ophthalmia.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Drug Therapy, Combination; United States; Retrospective Studies; Adolescent; Child; Cyclosporine/therapeutic use; Glucocorticoids/therapeutic use; Ophthalmic Solutions; Visual Acuity/*physiology; Postoperative Complications; Eye Injuries, Penetrating/complications; National Institutes of Health (U.S.); Ophthalmia, Sympathetic/*drug therapy/etiology/*physiopathology

CRYOPYRIN-ASSOCIATED PERIODIC SYNDROME-ASSOCIATED UVEITIS AND PAPILLITIS. - Ma, Lina; Lee, Stacey; Montieth, Alyssa; Stephenson, Andrew; Foster, C. Stephen; Anesi, Stephen D. (Retinal cases & brief reports, 2021)
PURPOSE: To report a case of uveitis and papillitis in a patient with cryopyrin-associated periodic syndrome. METHODS: Case report. A 44-year-old white woman with a long history of inflammatory arthritis, diffuse erythematous rashes and hives, and hearing loss was referred to the Massachusetts Eye Research and Surgery Institution for an evaluation of chronic ocular inflammation. She was diagnosed with bilateral papillitis and uveitis after a comprehensive eye examination, which included dilated fundoscopy, optic nerve ocular coherence tomography, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography. She was later diagnosed with cryopyrin-associated periodic syndrome, an interleukin-1-driven autoimmune disease, as confirmed by genetic testing. Soon after starting treatment with anakinra, a human interleukin-1 receptor antagonist, she experienced rapid improvement of her ocular and systemic symptoms, including rash, uveitis, and arthritis. RESULTS: Cryopyrin-associated periodic syndrome-associated ocular inflammation in remission with anakinra 100-mg daily subcutaneous injection. CONCLUSION: Anakinra is a very effective treatment for both cryopyrin-associated periodic syndrome and cryopyrin-associated periodic syndrome-associated ocular inflammation.
Keywords: Female; Humans; Adult; Antirheumatic Agents/therapeutic use; Ultrasonography; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity; Injections, Subcutaneous; Slit Lamp Microscopy; Interleukin 1 Receptor Antagonist Protein/therapeutic use; Coloring Agents/administration & dosage; Indocyanine Green/administration & dosage; Uveitis/diagnosis/drug therapy/*etiology; Cryopyrin-Associated Periodic Syndromes/*complications/diagnosis/drug therapy; Optic Neuritis/diagnosis/drug therapy/*etiology

Management of uncontrolled glaucoma with the Molteno system. - Goldberg, I. (Australian and New Zealand journal of ophthalmology, 1987)
In glaucomatous eyes refractory to medication, laser techniques and conventional drainage surgery, intraocular pressure is often high, and visual loss rapid. In this situation a reliable, robust artificial outflow system is required. Molteno has evolved a plastic tube and plate device combined with a fibrosis suppression medication regimen. Thirty-eight eyes of 32 patients with uncontrolled glaucoma were treated with the Molteno system. Six months after operation mean intraocular pressure had been reduced from 41.0 +/- 13.6 to 16.2 +/- 5.6 mmHg. Eighteen eyes had pressures of 20 mmHg or less on no hypotensive therapy, 17 on reduced treatment. Three eyes had a pressure of 21 to 35 mmHg on treatment at six months. The 13 aphakic eyes responded as well as 25 phakic eyes. Five eyes with rubeotic glaucoma demonstrated pressures of less than 20 mmHg without therapy, four eyes with traumatic glaucoma required continuing medication with three having pressures below 22 mmHg. Of the seven eyes with uveitic glaucoma, one was lost, two required maintenance therapy; five of six surviving eyes had pressures below 20 mmHg. Fifteen eyes with congenital or juvenile glaucoma achieved pressures below 20 mmHg, three of these with timolol drops, three with timolol and acetazolamide, and nine with no treatment. While seven of seven eyes with refractory primary open-angle glaucoma attained pressures below 20 mmHg, all seven needed continuing mild hypotensive therapy. Eleven eyes underwent a one-stage procedure, while 27 eyes required a two-stage operation. Twenty-eight eyes received fibrosis suppression medication after the second stage, and 24 maintained or improved their preoperative visual acuity. Results have been encouraging: in general the Molteno system is recommended as the second drainage operation in all glaucomatous eyes in which conventional therapy has failed, and as the primary surgical procedure (after laser techniques) in eyes with rubeotic and uveitic glaucoma. Ciliary body destructive procedures should be restricted to control of symptoms in blind eyes.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Prospective Studies; Adolescent; Child; Infant; Intraocular Pressure; Postoperative Complications; *Prostheses and Implants; Methods; Anterior Chamber/surgery; Drainage/*instrumentation/methods; Glaucoma/pathology/physiopathology/*surgery

Bevacizumab in inflammatory eye disease. - Lott, McGregor N.; Schiffman, Joyce C.; Davis, Janet L. (American journal of ophthalmology, 2009)
PURPOSE: To report the effect of intravitreal bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) on visual acuity and macular thickness in patients with inflammatory choroidal neovascularization (CNV) or cystoid macular edema (CME). DESIGN: Retrospective, noncomparative, interventional case series. METHODS: Each eye received 1.25 mg of intravitreal bevacizumab at baseline. Follow-up examinations were scheduled at 1- to 2-month intervals, with additional injections at the discretion of the physician. Comprehensive evaluations, including Snellen best-corrected visual acuity (BVCA) and optical coherence tomography measurements, were performed at each visit. Main outcome measures were BCVA and central subfield thickness (CST), as measured by optical coherence tomography. RESULTS: Thirty-four eyes of 30 patients with inflammatory CNV (n = 21 eyes of 19 patients; 9 male, 10 female) or CME (n = 13 eyes of 11 patients; 4 male, 7 female) were identified. Median ages were 52 years (range, 7 to 83) and 67 years (range, 17 to 83) for the CNV and CME groups, respectively. The median length of follow-up for CNV eyes was 7 months (range, 1 to 28) while the median follow-up for CME eyes was 13 months (range, 1 to 20). Both groups received a median of two injections (range, 1 to 9 for CNV and 1 to 4 for CME). For eyes with CNV, BCVA improved significantly at follow-up month 1, but was not different from baseline thereafter; CST remained unchanged throughout follow-up. For eyes with CME, neither BCVA nor CST changed significantly over the course of follow-up. CONCLUSIONS: Bevacizumab appears to stabilize BCVA and CST for eyes with inflammatory CNV or CME.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Retrospective Studies; Young Adult; Adolescent; Child; Antibodies, Monoclonal/*therapeutic use; Fluorescein Angiography; Tomography, Optical Coherence; Injections; Ophthalmoscopy; Vitreous Body; Macular Edema/*drug therapy/physiopathology; Uveitis/*drug therapy/physiopathology; Angiogenesis Inhibitors/*therapeutic use; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Antibodies, Monoclonal, Humanized; Bevacizumab; Visual Acuity/drug effects/physiology; Retina/drug effects/pathology; Choroidal Neovascularization/*drug therapy/physiopathology

[Retrospective study of patients treated with the laser for central serous choroidopathies]. - Saraux, H.; Pelosse, B.; Bouzas, E. (Bulletin de la Societe belge d'ophtalmologie, 1986)
Keywords: Female; Humans; Male; Adult; Recurrence; Visual Acuity; Laser Therapy; Light Coagulation/*methods; Choroiditis/physiopathology/*surgery

Immune recovery vitritis and uveitis in AIDS: clinical predictors, sequelae, and treatment outcomes. - Karavellas, M. P.; Azen, S. P.; MacDonald, J. C.; Shufelt, C. L.; Lowder, C. Y.; Plummer, D. J.; Glasgow, B.; Torriani, F. J.; Freeman, W. R. (Retina (Philadelphia, Pa.), 2001)
PURPOSE: To determine 1) clinical predictors of an inflammatory syndrome associated with cytomegalovirus (CMV) retinitis (immune recovery vitritis or uveitis [IRV or IRU]); 2) clinical sequelae of IRV; and 3) the effect of corticosteroid treatment on visual acuity. METHODS: A cohort study from the AIDS Ocular Research Unit of the University of California, San Diego, and a case series from the Cleveland Clinic consisted of patients who had acquired immunodeficiency syndrome and inactive CMV retinitis who responded to highly active antiretroviral therapy (HAART) with CD4 T-lymphocyte levels >60 cells/mm3. The cohort was followed for a median of 13.5 months following increase in CD4 count. The authors studied the occurrence of IRV, defined as symptomatic (vision decrease and/or floaters) vitritis of 1+ or greater severity associated with inactive CMV retinitis. Macular edema or epiretinal membrane formation was determined by clinical examination and fluorescein angiography. Five eyes were treated with sub-Tenon corticosteroid injections. RESULTS: In the cohort study, 19 (63%) of 30 HAART responders developed IRV (26 eyes). The clinical spectrum of inflammation included vitritis, papillitis, macular edema, and epiretinal membranes. Eyes with CMV surface area >30% of the retina were at the highest risk (relative risk = 4.5) of developing IRV (P = 0.03). During follow-up, inflammation persisted without treatment for a median of 20 weeks and 14 patients (16 eyes) developed macular changes. Treatment resulted in vision improvement without reactivation of retinitis. Histology and immunohistochemistry of associated epiretinal membranes showed evidence of chronic inflammation with a predominant T-lymphocyte cell population. In the case series, 3 (38%) of 8 HAART responders developed IRV (4 eyes). All four eyes were treated and resulted in visual acuity improvement of one line. CONCLUSIONS: Symptomatic IRV or IRU develops in a significant number of patients with CMV retinitis following successful HAART. Eyes with CMV surface area >30% of the retina are at the greatest risk. Eyes with IRV respond favorably to antiinflammatory therapy without reactivation of retinitis. Immune recovery vitritis may be the result of an immunologic reaction to latent CMV antigens in the eye in which T-lymphocytes play a role.
Keywords: Female; Humans; Male; Adult; Prospective Studies; Treatment Outcome; CD4 Lymphocyte Count; Cohort Studies; Fluorescein Angiography; Glucocorticoids/therapeutic use; Visual Acuity/drug effects; Uveitis/diagnosis/drug therapy/*etiology; Vitreous Body/*pathology; Antiretroviral Therapy, Highly Active; AIDS-Related Opportunistic Infections/*complications/drug therapy; CD4-Positive T-Lymphocytes/immunology; Cytomegalovirus Retinitis/*complications/drug therapy; Eye Diseases/diagnosis/drug therapy/*etiology; Regression Analysis

[The choice of the treatment method for anterior rheumatoid uveitis in children at a health resort]. - Kaladze, N. N.; Karpov, P. M. (Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury, 1993)
Keywords: Female; Humans; Male; Adolescent; Combined Modality Therapy; Child; Child, Preschool; Visual Acuity; Ukraine; *Health Resorts; Arthritis, Juvenile/complications/diagnosis/*rehabilitation; Uveitis, Anterior/diagnosis/etiology/*rehabilitation

Outpatient cataract-implant surgery compared with outpatient cataract-standard surgery. - Williamson, D. E. (Annals of ophthalmology, 1978)
Keywords: Humans; *Ambulatory Care; Visual Acuity; *Cataract Extraction; Postoperative Care; Uveitis/etiology; Postoperative Complications; *Prostheses and Implants; Lens, Crystalline/*surgery; *Lenses; Edema/etiology; Patient Acceptance of Health Care; Pilocarpine/therapeutic use

Combined cyclosporine and corticosteroid therapy for sight-threatening uveitis in Behçet's disease. - Whitcup, S. M.; Salvo, E. C. Jr; Nussenblatt, R. B. (American journal of ophthalmology, 1994)
Behçet's disease is a multisystem disorder that may cause profound ocular inflammation and blindness. We reviewed 19 patients with severe ocular Behçet's disease treated with combined cyclosporine and corticosteroid therapy. Previous treatment with corticosteroids alone failed to control the uveitis in all patients. Ten patients were given cyclosporine therapy alone (mean dosage, 8.6 mg/kg of body weight per day), and nine patients were given lower dosages of cyclosporine (mean dosage, 6.2 mg/kg of body weight per day) in combination with prednisone (mean dosage, 29.4 mg per day). The mean follow-up on therapy was 51 months. After three months of therapy, a trend toward greater improvement in visual acuity was noted in patients treated with combined cyclosporine and prednisone compared to those receiving cyclosporine alone (17.8 letters vs 10.2 letters, P = .2379), but after one year little difference was observed in the improvement between the two groups (5.8 letters vs 3.3 letters, P = .7984). However, a trend toward greater renal toxicity was seen in patients treated with cyclosporine alone after both three months and one year of therapy. Because of either a suboptimal therapeutic response or adverse effects, all patients treated with cyclosporine alone at baseline had prednisone added to their regimen after a mean time of 23.5 months. Overall, visual acuity remained stable or improved in 28 of 37 eyes (75.7%) over the course of therapy. These data suggest that combined cyclosporine and prednisone therapy is an effective treatment for Behçet's uveitis and may be less toxic than therapy with cyclosporine alone. A prospective, randomized trial with a larger sample size is needed to provide definitive data.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Follow-Up Studies; Adolescent; Prednisone/*therapeutic use; Visual Acuity; Uveitis/*drug therapy; Behcet Syndrome/*drug therapy; Cyclosporine/adverse effects/*therapeutic use; Kidney/drug effects; Glomerular Filtration Rate; Hemodynamics

Periocular corticosteroid injection in the management of uveitis in children. - Habot-Wilner, Zohar; Sallam, Ahmed; Roufas, Athena; Kabasele, Paul Mb; Grigg, John R.; McCluskey, Peter; Lightman, Sue (Acta ophthalmologica, 2010)
PURPOSE: To report the outcome of orbital floor corticosteroid injection (OFCI) in the management of uveitis in children. METHODS:   A retrospective noncomparative interventional case series. The medical records of 15 consecutive children (19 eyes) with various forms of uveitis treated with OFCI of 40 mg/ml methylprednisolone acetate or a combination of 20 mg/0.5 ml Triamcinolone and 2 mg/0.5 ml dexamethasone were reviewed. Data were collected 6 months postinjection and included details of uveitis, best corrected visual acuity (BCVA), ocular inflammation, systemic therapy required and potential complications of OFCI. RESULTS: The mean BCVA improvement was 0.18 logarithm of the minimum angle of resolution (p < 0.001), at a mean of 6 weeks (range, 4-20). Fourteen eyes (74%) had significant improvement in inflammation, 4-7 weeks post-OFCI, with a median of 4 weeks. Anterior uveitis was treated effectively in all eyes, vitritis resolved in all but one case and resolution of cystoid macular oedema was achieved in six eyes (55%). Uveitis relapsed in seven eyes (50%) after a median time of 4 months (range, 2-5 months). Four eyes (21%) underwent more than one injection. The dosage of immunosuppressive systemic therapy was reduced or able to be stopped in three patients (50%). Steroid-induced cataract was observed in four eyes (21%), 5 months post-OFCI. One patient developed cushingoid features 6 weeks post his second OFCI. CONCLUSION: Corticosteroid orbital floor injections resulted in control of active uveitis and visual acuity improvement in most children. However, the effect might be transient and induce cataract formation.
Keywords: Female; Humans; Male; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Adolescent; Child; Child, Preschool; Visual Acuity/physiology; Injections, Intraocular; Cataract/chemically induced; Glucocorticoids/*administration & dosage/adverse effects; Uveitis/*drug therapy/physiopathology; Cataract Extraction; Orbit; Methylprednisolone Acetate; Dexamethasone/administration & dosage/adverse effects; Methylprednisolone/administration & dosage/adverse effects/analogs & derivatives; Triamcinolone Acetonide/administration & dosage/adverse effects

An unusual optic disc neovascularization in a case of intermediate uveitis associated with multiple sclerosis. - Karagiannis, D. A.; Ladas, I. D. (European journal of ophthalmology, 2008)
PURPOSE: To report a case of intermediate uveitis associated with multiple sclerosis (MS) presenting with a complex of an unusual optic disc neovascularization which was treated successfully. METHODS: Interventional case report. Best-corrected visual acuity measurements (BCVA), slitlamp examination, fundus biomicroscopy, and fluorescein angiography (FFA) were performed at baseline examination and during the follow-up period. The patient underwent one injection of intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation. RESULTS: A 28-year-old man presented with decreased vision in the right eye (RE) (BCVA 20/40). Compete examination showed a large new vessels complex on the optic disc of the RE protruding into the vitreous, ischemic vasculitis, and snowbanking inferiorly. Similar findings but less severe were found in the left eye (LE) with mild vitritis. The RE had also mild, diffuse vitreous hemorrhage. All tests were normal including blood tests, Mantoux, and chest X-ray except brain magnetic resonance imaging which showed three demyelinating lesions. Neurologic evaluation was unremarkable for the first year. The clinical appearance was consistent with intermediate uveitis associated with MS. The patient underwent one injection of intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation. After 6 months BCVA increased to 20/20 and the neovascular complex became fibrous in RE. The patient, 2 years after treatment, remains stable. CONCLUSIONS: Intermediate uveitis may precede the diagnosis of MS. Intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation proved successful in the management of this case.
Keywords: Humans; Male; Adult; Drug Therapy, Combination; Combined Modality Therapy; Fluorescein Angiography; Antibodies, Monoclonal/therapeutic use; Injections; Glucocorticoids/therapeutic use; Visual Acuity/physiology; Vitreous Body; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Antibodies, Monoclonal, Humanized; Bevacizumab; Laser Coagulation; Uveitis, Intermediate/*complications/diagnosis/drug therapy; Angiogenesis Inhibitors/therapeutic use; Multiple Sclerosis/*complications/diagnosis/drug therapy; Optic Disk/*blood supply; Retinal Neovascularization/diagnosis/drug therapy/*etiology

Vogt-Koyanagi-Harada disease presenting as acute angle closure glaucoma at onset. - Yang, Peizeng; Liu, Xiaoli; Zhou, Hongyan; Guo, Wenjuan; Zhou, Chunjiang; Kijlstra, Aize (Clinical & experimental ophthalmology, 2011)
BACKGROUND: To investigate the clinical features of Vogt-Koyanagi-Harada (VKH) disease presenting as acute angle closure glaucoma at onset. DESIGN: Retrospective non-comparative case series. PARTICIPANTS: Four hundred and eighty-six VKH patients seen from February 2001 to March 2010. METHODS: The history and clinical findings of all patients were reviewed. Auxiliary examinations, including ultrasound biomicroscopy, fundus fluorescein angiography and optical coherence tomography, were performed in certain cases. Corticosteroids with or without cyclosporine A were used to treat these patients. MAIN OUTCOME MEASURE: Patients' demographics, clinical presentation and auxiliary examination findings. RESULTS: Eight out of 486 VKH patients were misdiagnosed as acute angle closure glaucoma. The mean age of these eight patients was 55.6 years. Six patients were female. The mean intraocular pressure (IOP) at disease onset was 32.9 mmHg. All of these patients had a shallow anterior chamber and a narrow or closed angle at their first visit. The complaints of these patients were mostly headache and sudden decreased vision in both eyes. Alterations shown on ultrasound biomicroscopy included detachment of the ciliary body and peripheral choroid. The increased IOP did not respond to anti-glaucoma therapy, but resolved following treatment with corticosteroids. The eye of one patient was enucleated after failed trabeculectomies prior to referral to our uveitis centre. CONCLUSION: VKH disease presenting with a bilateral increased IOP mostly occurs in older women. The strikingly decreased visual acuity associated with mild to moderate increased IOP is a clue to the diagnosis. The increased IOP responded well to corticosteroids but not to anti-glaucoma treatment.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Follow-Up Studies; Retrospective Studies; Young Adult; Adolescent; Fluorescein Angiography; Tomography, Optical Coherence; Cyclosporine/therapeutic use; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity; Acute Disease; Age of Onset; Intraocular Pressure; Diagnosis, Differential; Microscopy, Acoustic; Uveomeningoencephalitic Syndrome/*diagnosis/drug therapy; Anterior Eye Segment/diagnostic imaging; Glaucoma, Angle-Closure/*diagnosis/drug therapy

Cochrane corner: why we still don't know whether anti-TNF biologic therapies impact uveitic macular oedema. - Braithwaite, Tasanee; Davis, Nicki; Galloway, James (Eye (London, England), 2019)
Keywords: Humans; Visual Acuity; *Uveitis; Immunotherapy; *Macular Edema; Tumor Necrosis Factor-alpha

Neodymium: YAG laser posterior capsulotomy: the first 100 cases at UCLA. - Gardner, K. M.; Straatsma, B. R.; Pettit, T. H. (Ophthalmic surgery, 1985)
Initial anatomic success was reported in 97 of the first 100 neodymium: YAG laser posterior capsulotomies performed at the Jules Stein Eye Institute. Visual acuity improved in 90 patients, was unchanged in five, and decreased in five. In the five patients with decreased visual acuity after posterior capsulotomy, the decrease was unrelated to capsulotomy and caused by progression of preexisting retinal disease. Our experience suggests that attention to patient evaluation and surgical technique can help minimize complications and assure best results.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Adolescent; Child; Child, Preschool; Infant; Visual Acuity; Intraocular Pressure; Uveitis/etiology; *Laser Therapy; Evaluation Studies as Topic; Lasers/adverse effects; Lens Capsule, Crystalline/*surgery; Lens, Crystalline/*surgery

A novel use of reticulated hyaluronic acid (Healaflow) for hypotony eyes in patients with uveitis. - Stead, R. E.; Juma, Z.; Turner, S.; Jones, L. D.; Sung, V. C. T. (The British journal of ophthalmology, 2016)
Persistent ocular hypotony is a complex and ongoing challenge faced in ophthalmology. It can result in early ocular phthisis and associated visual decline, pain and deformity. We present the first case series, in which repeated intracameral injections of highly reticulated hyaluronic acid (Healaflow) have successfully prevented the complications of ocular hypotony in the long term. We believe it is a viable management option that can bring about a significant improvement to the quality of life in this subgroup of patients while avoiding frequent intervention.
Keywords: Female; Humans; Male; Middle Aged; Adult; Time Factors; Follow-Up Studies; Young Adult; Injections; *Visual Acuity; Uveitis/*complications/drug therapy; Intraocular Pressure/*drug effects; Viscosupplements/administration & dosage; *Glaucoma; *Intraocular pressure; *Treatment other; Anterior Chamber; Cross-Linking Reagents/administration & dosage; Hyaluronic Acid/*administration & dosage; Ocular Hypotension/*drug therapy/etiology/physiopathology

Unilateral uveitis with vitreous haze following zoledronic Acid therapy for osteoporosis. - Freitas-Neto, Clovis Arcoverde; de Oliveira Fagundes, Willian Breno; Ribeiro, Manoel Jr; Pacheco, Katia Delalíbera; Freitas, Luiz Guilherme; Ávila, Marcos Pereira (Seminars in ophthalmology, 2015)
Zoledronic acid is widely used in the treatment of osteoporosis and other bone diseases. However, patients may experience adverse effects involving the anterior segment of the eye following intravenous infusion. This paper reports a rare case of uveitis involving the vitreous cavity following the intravenous administration of zoledronic acid.
Keywords: Female; Humans; Aged; Infusions, Intravenous; Ultrasonography; Fluorescein Angiography; Tomography, Optical Coherence; uveitis; Visual Acuity; Intraocular Pressure; Anterior chamber; Bone Density Conservation Agents/*adverse effects; Diphosphonates/*adverse effects; drug toxicity; Eye Diseases/*chemically induced/diagnostic imaging; Imidazoles/*adverse effects; osteoporosis; Osteoporosis, Postmenopausal/*drug therapy; Uveitis/*chemically induced/diagnosis; vitreous body; Vitreous Body/diagnostic imaging/*drug effects/pathology; Zoledronic Acid

[Role of photocoagulation in the treatment of recurrent chorioretinitides]. - Bonnet, M. (L'Annee therapeutique et clinique en ophtalmologie, 1972)
Keywords: Humans; Middle Aged; Adult; Follow-Up Studies; Adolescent; Recurrence; Child; Visual Fields; *Light Coagulation; Methods; Chorioretinitis/*surgery; Choroiditis/etiology; Retinitis/etiology

Tubulointerstitial nephritis and uveitis syndrome. - Guerriero, Silvana; Vischi, Antonio; Giancipoli, Giovanni; Leozappa, Marco; Ferrari, Tommaso Micelli (Journal of pediatric ophthalmology and strabismus, 2006)
Tubulointerstitial nephritis and uveitis syndrome is likely underdiagnosed. A 13-year-old girl with no significant medical history had photophobia, ocular pain, and decreased visual acuity. Bilateral papilledema was present. Renal biopsy revealed interstitial nephritis. Immunosuppressive therapy was added (3 mg/kg/d of cyclosporine). One year later, visual acuity was 20/20 and findings were normal on ocular examination and laboratory tests.
Keywords: Female; Humans; Drug Therapy, Combination; Adolescent; Fluorescein Angiography; Cyclosporine/therapeutic use; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity; Syndrome; Methylprednisolone/therapeutic use; Uveitis, Anterior/*complications/diagnosis/drug therapy; Nephritis, Interstitial/diagnosis/drug therapy/*etiology; Papilledema/diagnosis/drug therapy/etiology

A case of bilateral uveitis and papillitis in a patient treated with pembrolizumab. - Abu Samra, Khawla; Valdes-Navarro, Manuel; Lee, Stacey; Swan, Robert; Foster, C. Stephen; Anesi, Stephen D. (European journal of ophthalmology, 2016)
PURPOSE: Drug-induced uveitis is a well-known effect of ocular inflammation that has been reported with many medications. Pembrolizumab is a newer generation of the anti-programmed cell death-1 monoclonal antibodies that was recently approved by the Food and Drug Administration for the treatment of advanced melanoma. Immune-mediated adverse events involving different organs have been reported in recent literature in association with this drug. We present the first reported case of uveitis in association with pembrolizumab therapy. CASE REPORT: An 82-year-old man with stage IV melanoma was started on pembrolizumab infusion treatment every 3 weeks. Two months after initiating therapy, he presented with bilateral severe anterior uveitis and papillitis with fast and complete recovery after withholding further pembrolizumab infusions and treatment with topical steroid. Uveitis recurred after restarting pembrolizumab therapy. CONCLUSIONS: In current clinical practice, many new drugs are being approved, requiring better characterization of the prevalence, onset, and nature of adverse events in order to aid development of effective management strategies. Ophthalmologists should keep in mind that drugs are always a possible cause of ocular inflammation in patients presenting with uveitis.
Keywords: Humans; Male; Aged, 80 and over; Infusions, Intravenous; Neoplasm Staging; Visual Fields; Glucocorticoids/therapeutic use; Visual Acuity; Uveitis, Anterior/*chemically induced/diagnosis/drug therapy; Antibodies, Monoclonal, Humanized/*adverse effects; Antineoplastic Agents/*adverse effects; Fluprednisolone/analogs & derivatives/therapeutic use; Melanoma/drug therapy/pathology; Neoplasm Recurrence, Local/chemically induced/drug therapy; Papilledema/*chemically induced/diagnosis/drug therapy; Skin Neoplasms/drug therapy/pathology

Methotrexate in ocular manifestations of Behcet's disease: a longitudinal study up to 15 years. - Davatchi, Fereydoun; Shams, Hormoz; Shahram, Farhad; Nadji, Abdolhadi; Chams-Davatchi, Cheyda; Sadeghi Abdollahi, Bahar; Faezi, Tahereh; Akhlaghi, Massoomeh; Ashofteh, Farimah (International journal of rheumatic diseases, 2013)
BACKGROUND: Ocular manifestations of Behcet's disease (BD) need aggressive treatment to prevent severe loss of vision or blindness. Cytotoxic drugs are the main therapeutic agents and the first line treatment. Methotrexate is the least toxic, used mainly for posterior uveitis. We present here the outcome of eye lesions with methotrexate and prednisolone, in a longitudinal study of up to 15 years, on 682 patients (5447 eye-years of follow-up). PATIENTS AND METHODS: Methotrexate was started at 7.5-15 mg/week. Prednisolone was added at 0.5 mg/kg/daily, then adjusted as needed. INCLUSION CRITERIA: (i) fulfilling the International Criteria for Behcet's Disease; and (ii) having active posterior uveitis (PU). Visual acuity (VA) was calculated on a scale of 10. Activity indexes were calculated for PU and retinal vasculitis (RV) for each eye. Total Inflammatory Activity Index (TIAI) demonstrating the inflammatory index of both eyes of the patient, and Total Adjusted Disease Activity Index (TADAI) showing both TIAI + VA were also calculated. RESULTS: Overall results: the mean VA improvement was 0.4 (P < 001), PU 1.2 (P < 0.001) and RV 0.6 (P < 0.001). VA improved in 46.5%, PU in 75.4%, and RV in 53.7% of eyes. TIAI improved in 74% of patients and TADAI in 69.4%. VA was aggravated in 37.2%, PU in 11.1%, and RV in 30.3% of eyes. TIAI was aggravated in 17.4% and TADAI in 21.6% of the patients. The remaining kept their baseline values. CONCLUSION: All parameters improved, PU better than RV. Improvement of VA was the least, mainly due to secondary cataracts.
Keywords: Humans; Drug Therapy, Combination; Time Factors; Treatment Outcome; Severity of Illness Index; Methotrexate/adverse effects/*therapeutic use; Prednisolone/therapeutic use; Recovery of Function; Longitudinal Studies; Anti-Inflammatory Agents/adverse effects/*therapeutic use; Glucocorticoids/therapeutic use; ocular manifestations; Visual Acuity/*drug effects; Behcet Syndrome/complications/diagnosis/*drug therapy; Capsule Opacification/etiology; Behcet's disease; cytotoxic therapy; methotrexate; Registries; Retinal Vasculitis/diagnosis/*drug therapy/etiology/physiopathology; steroid therapy; Uveitis, Anterior/diagnosis/*drug therapy/etiology/physiopathology; Uveitis, Posterior/diagnosis/*drug therapy/etiology/physiopathology

Endogenous Listeria monocytogenes endophthalmitis presenting as keratouveitis. - Heidemann, D. G.; Trese, M.; Murphy, S. F.; Bradford, D.; Lewis, M.; Dunn, S. P. (Cornea, 1990)
We report a case of Listeria monocytogenes endophthalmitis that presented as a recalcitrant keratouveitis in a nonimmunocompromized patient. L. monocytogenes was recovered from the patient's aqueous, vitreous, and two of three blood cultures. He was treated with topical, subconjunctival, and systemic antibiotics, but the visual outcome was poor, possibly because of late diagnosis. A review of previous cases of L. monocytogenes endophthalmitis demonstrates unique features of this infection: (a) presentation as an anterior uveitis or keratouveitis with elevated intraocular pressure, (b) endogenous origin, and (c) frequent occurrence in nonimmunocompromized patients.
Keywords: Humans; Male; Aged; Drug Therapy, Combination; Visual Acuity; Ampicillin/therapeutic use; Uveitis/complications/*diagnosis/drug therapy; Cefazolin/therapeutic use; Endophthalmitis/*diagnosis/drug therapy; Eye Infections, Bacterial/*diagnosis/drug therapy; Keratitis/complications/*diagnosis/drug therapy; Listeriosis/*diagnosis/drug therapy

Work-up, diagnosis and management of acute Vogt-Koyanagi-Harada disease: a case of acute myopization with granulomatous uveitis. - Mantovani, Alessandro; Resta, Anna; Herbort, Carl P.; Abu El Asrar, Ahmed; Kawaguchi, Tatsushi; Mochizuki, Manabu; Okada, Annabelle A.; Rao, Narsing A. (International ophthalmology, 2007)
PURPOSE: In its typical form and when seen at onset, Vogt-Koyanagi-Harada (VKH) is characterized by easily recognizable signs that allow diagnosis without difficulty. In cases that do not have acute onset, that are seen at a later stage or that do not show the complete set of signs, appraisal is more difficult and diagnosis may cause difficulties. We present here a case of bilateral granulomatous uveitis compatible with VKH disease in order to allow several experts to give their opinion on the most appropriate manner to confirm or reject the diagnosis and their approach to the management of the case. CASE PRESENTATION: A 17-year-old female patient consulted her ophthalmologist for blurred vision OU following an episode of a flu-like disease with malaise, fever and headaches. A bilateral anterior granulomatous uveitis with a right papillitis was diagnosed and the patient presented with a bilateral acute myopization. Fluorescein angiography showed right disc hyperfluorescence with late leakage and slight left disc hyperfluorescence. The patient was given a course of one week of peroral corticosteroid therapy followed by an intramuscular injection of Bentelan twice weekly. In the absence of significant improvement the patient was sent six weeks later to a specialized center where a complete work-up was performed. EXPERT OPINION: The diagnostic work-up, investigational tests, and differential diagnosis to confirm or reject the diagnosis of VKH as well as the management of the case will be described by the experts.
Keywords: Female; Humans; Drug Therapy, Combination; Adolescent; Fluorescein Angiography; Tomography, Optical Coherence; Visual Fields; Azathioprine/therapeutic use; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Acute Disease; Methylprednisolone/therapeutic use; Indocyanine Green; Microscopy, Acoustic; Granuloma/*diagnosis; Myopia/*diagnosis; Uveitis, Anterior/*diagnosis; Uveomeningoencephalitic Syndrome/*diagnosis/*drug therapy

Intraocular xanthomatous tumor presenting as fulminant uveitis. - Cheng, C.-Y.; Chen, P.-Y.; Lin, C.-J. (Eye (London, England), 2015)
Keywords: Humans; Male; Middle Aged; Magnetic Resonance Imaging; Combined Modality Therapy; Glucocorticoids/therapeutic use; Visual Acuity; Uveitis/*diagnosis; Phacoemulsification; Methylprednisolone/therapeutic use; Uveal Diseases/*diagnosis/drug therapy/surgery; Xanthomatosis/*diagnosis/drug therapy/surgery

Clinical Outcomes of Intravitreal Preservative-Free Triamcinolone Preparation (Triesence®) for Cystoid Macular Oedema and Inflammation in Patients with Uveitis. - Steeples, Laura R.; Anand, Nitin; Moraji, Jiten; Jones, Nicholas P. (Ocular immunology and inflammation, 2018)
PURPOSE: To assess the outcomes of intravitreal benzyl alcohol-free triamcinolone acetonide suspension in uveitis-related macular oedema. METHODS: Single-center retrospective cohort study of 66 injections to 44 eyes of 40 patients. Uveitis diagnosis, systemic and local therapy, intraocular pressure (IOP), central retinal thickness (CRT), number of injections, time to re-injection and side-effects were noted during 6-months minimum follow-up. RESULTS: Sixty eight percent of eyes received a single injection. 18% required 2 injections, and 13% received ≥3 injections with mean time to second and third injections of 25.5 and 52.7 weeks, respectively. 90% of injections were unilateral. Mean CRT reduced, and by 12-weeks visual acuity improvement >0.3logMar was achieved in 46%. Cataract progression (47%) and IOP>21 mmHg (45%) were the commonest adverse events. CONCLUSION: Preservative-free triamcinolone is an additional option for uveitis-related macular oedema, particularly in unilateral cases, with favorable CRT and visual outcomes. Repeat injections may be necessary, and the period of efficacy varies between eyes.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Retrospective Studies; Treatment Outcome; Adolescent; Tomography, Optical Coherence; uveitis; Visual Acuity; Intravitreal Injections; Intraocular Pressure; Retina/pathology; Retreatment; Glucocorticoids/adverse effects/*therapeutic use; Triamcinolone Acetonide/adverse effects/*therapeutic use; Macular Edema/diagnosis/*drug therapy/physiopathology; macular oedema; triamcinolone; Inflammation/diagnosis/drug therapy/physiopathology; Intravitreal steroid; Preservatives, Pharmaceutical; Uveitis/*diagnosis/physiopathology

[Treatment of uveitis-associated refractory ocular hypotony with topical ibopamine]. - Windisch, B. K.; Iliev, M. E. (Klinische Monatsblatter fur Augenheilkunde, 2006)
BACKGROUND: Ibopamine is a non-selective dopamine- and adrenalin-receptor agonist that has been shown to cause pupillary dilation and an increase in aqueous humour secretion. This novel drug can be used as a mydriatic agent, as a provocative test in open-angle glaucoma, and for the treatment of persisting ocular hypotony. HISTORY AND SIGNS: This 47-year-old man had a history of uveitis associated with Crohn's disease. Six years after deep sclerectomy for uveitic secondary glaucoma, he developed severe hypotony in his left eye with drop of visual acuity (VA). The hypotony did not respond to topical steroid treatment. 2 % Ibopamine solution was ordered t. i. d. concomitant to 1 % prednisolone acetate. THERAPY AND OUTCOME: Intraocular pressure (IOP) began to rise after 3 weeks of Ibopamine treatment and returned to normal (12 mmHg) with continuous recovery of VA after 8 weeks. Ibopamine was discontinued at an IOP of 16 mmHg after a course of 12 weeks. IOP and VA remained stable during the 12-month follow-up period. CONCLUSIONS: Ibopamine 2 % eye drops in combination with topical steroids are a therapeutic option in uveitis-associated ocular hypotony.
Keywords: Humans; Male; Treatment Outcome; Chronic Disease; Administration, Topical; Uveitis/*complications/*drug therapy; Mydriatics/administration & dosage; Deoxyepinephrine/administration & dosage/*analogs & derivatives; Ocular Hypotension/*etiology/*prevention & control

Safety and efficacy of dexamethasone implant along with phacoemulsification and intraocular lens implantation in children with juvenile idiopathic arthritis associated uveitis. - Jinagal, Jitender; Gupta, Gaurav; Agarwal, Aniruddha; Aggarwal, Kanika; Akella, Madhuri; Gupta, Vishali; Suri, Deepti; Gupta, Anju; Singh, Surjit; Ram, Jagat (Indian journal of ophthalmology, 2019)
PURPOSE: To assess the safety and efficacy of intraoperative intravitreal dexamethasone implant in patients of juvenile idiopathic arthritis (JIA)-associated uveitis undergoing phacoemulsification with posterior chamber intraocular lens (PCIOL) implantation. METHODS: Retrospectively, data of patients with JIA-associated uveitis undergoing phacoemulsification with PCIOL implantation with intraoperative dexamethasone implant injection were analyzed. Patients with a minimum follow-up of 6 months were included. Primary outcome measures were ocular inflammation, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and worsening of uveitis. RESULTS: 8 eyes of 6 patients were included. BCVA was significantly improved at 1, 3, and 6 months postoperatively 0.20 ± 0.09, P = 0.008; 0.18 ± 0.11, P = 0.008; and 0.24 ± 0.11, P = 0.01, respectively. No statistical difference noted in mean IOP at various follow-up visits. None developed worsening of uveitis or Cystoid macular edema. CONCLUSION: Intraoperative intravitreal dexamethasone implant is a safe and effective in preventing and managing the postoperative inflammation in children with JIA-associated uveitic cataract.
Keywords: Female; Humans; Male; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Child; Tomography, Optical Coherence; Glucocorticoids/administration & dosage; Intraoperative Period; uveitis; *Visual Acuity; Drug Implants; Intravitreal Injections; Dexamethasone/*administration & dosage; Intraocular Pressure; Cataract/*complications; JIA; dexamethasone implant; Phacoemulsification/*methods; Uveitis/diagnosis/*etiology; juvenile idiopathic arthritis; cataract surgery; Lens Implantation, Intraocular/*methods; Arthritis, Juvenile/*complications/diagnosis; Children; phacoemulsification

[Bilateral central serous chorio-retinopathy, migratory on 1 side. Discussion of a case]. - Flament, J.; Risse, J. F.; Bronner, A. (Bulletin des societes d'ophtalmologie de France, 1975)
Keywords: Humans; Male; Adult; Visual Fields; Laser Therapy; *Chorioretinitis/diagnosis; Retinal Detachment/*etiology/surgery

Cataract extraction in the sympathizing eye. - Reynard, M.; Minckler, D. S. (Archives of ophthalmology (Chicago, Ill. : 1960), 1983)
Cataract extraction was performed on the sympathizing eyes of six patients with sympathetic ophthalmia. In five patients the clinical diagnosis of sympathetic ophthalmia was supported by the results of histologic examination of the exciting eye. The postoperative period averaged 12 years, and visual acuities ranged from 20/25 to light perception. The presence of posterior synechiae posed the major complicating operative factor. Cystoid macular edema, vitreous opacity, pupillary membrane formation, and corneal opacification were associated with postoperative visual impairment in four cases. We conclude that the underlying status of the sympathizing eye at the time of cataract extraction and postoperative management are critical factors that influence ultimate visual outcome.
Keywords: Humans; Follow-Up Studies; Visual Acuity; *Cataract Extraction; Postoperative Care; Postoperative Complications; *Ophthalmia, Sympathetic/complications/diagnosis

A combined anterior and posterior approach to cataract surgery in patients with chronic uveitis. - Walker, J.; Rao, N. A.; Ober, R. R.; Liggett, P. E.; Smith, R. E. (International ophthalmology, 1993)
Although several recent papers have focused on the results of cataract surgery in patients with uveitis, little has been published on specific surgical techniques that are most appropriate to such cases. We have found that a combined anterior and posterior approach using extracapsular techniques (usually phacoemulsification) and pars plana vitrectomy, with or without intraocular lens placement, is best suited for selected uveitis patients who have cataract, vitreous opacities, and cystoid macula edema. This paper discusses the surgical techniques that we have found to be best for the management of these cases.
Keywords: Female; Humans; Adult; Chronic Disease; Visual Acuity; Postoperative Care; Preoperative Care; Vitrectomy; Cataract Extraction/*methods; Anterior Eye Segment/*surgery; Lenses, Intraocular; Pars Planitis/*surgery

Randomized clinical trial of cryotherapy versus laser photocoagulation for retinopexy in conventional retinal detachment surgery. - Veckeneer, M.; Van Overdam, K.; Bouwens, D.; Feron, E.; Mertens, D.; Peperkamp, E.; Ringens, P.; Mulder, P.; Van Meurs, J. (American journal of ophthalmology, 2001)
PURPOSE: To investigate whether the method of retinopexy influences the visual recovery rate and the breakdown of the blood-ocular barrier after conventional retinal detachment surgery. METHODS: Forty-eight patients (48 eyes) with primary rhegmatogenous retinal detachment entered into the study. All eyes were phakic, had an attached macula, and were scheduled for conventional scleral buckling surgery. Patients were randomly assigned to have either laser or cryotherapy for retinopexy. All visual acuity and flare measurements were performed by a masked observer. The interventional procedure was cryopexy at the time of scleral buckling surgery or postoperative (4 weeks) laser photocoagulation. Visual acuity testing with ETDRS chart and aqueous flare measurement with laser flare photometry were performed by a masked observer at standard intervals: preoperatively and 1 day, 7 days, 4 weeks, and 10 weeks postoperatively. Analysis of covariance by multiple linear regression was used for statistical evaluation. RESULTS: Postoperative flare values from patients receiving cryotherapy were significantly higher at each measurement point in time (P < or =.001). The visual recovery was slower in the patients receiving cryotherapy (1 week, P =.003; 4 weeks, P =.03; 10 weeks, P =.081). CONCLUSION: Laser flare photometry proved sufficiently sensitive to quantify an increase in aqueous flare after limited external retinal cryotherapy. Postoperative flare, as a measure of blood-ocular barrier breakdown, was significantly higher and visual recovery slower in the cryotherapy group. Visual acuity after 10 weeks was not significantly different between both groups.
Keywords: Female; Humans; Male; Middle Aged; Prospective Studies; Treatment Outcome; Visual Acuity; *Laser Coagulation; *Cryotherapy; Blood-Retinal Barrier/physiology; Postoperative Complications/physiopathology; Retinal Detachment/physiopathology/*surgery; Uveitis, Anterior/etiology/physiopathology

Ocular Inflammation: Can It Be a Sign of Activity of Weber-Christian Disease? A Case Report and Review of Literature. - Verrilli, Sara; Ciarnella, Angela; Laganà, Bruno; Calafiore, Silvia; Guglielmelli, Fabio; Basile, Luisanna; Mutolo, Maria Giulia; Recupero, Santi Maria (Ocular immunology and inflammation, 2016)
PURPOSE: To present a case of Weber-Christian disease with symptomatic ocular involvment. Weber-Christian disease is a relapsing febrile nodular nonsuppurative panniculitis. It is characterized by malaise and fever accompanied by subcutaneous inflammatory nodules on the trunk and extremities. It can affect several organs, but ocular signs have been infrequently described in literature. METHODS: A 20-year-old woman with Weber-Christian disease presented with severe bilateral ocular inflammation. A complete ophthalmologic examination was performed. RESULTS: Visual acuity was 20/100 in both eyes and slit-lamp examination showed bilateral iridocyclitis. Bilateral cortico-nuclear cataract did not allow funduscopy and she underwent cataract extraction. Retinal vasculitis was detected. CONCLUSIONS: Patients with Weber-Christian disease can develop severe ocular inflammation. A complete ophthalmolgic examination should be done in these patients, especially when ocular involvement is the main sign of the disease. A further understanding of the severity of ocular inflammation proved fundamental in the management of the disease.
Keywords: Female; Humans; Drug Therapy, Combination; Young Adult; Methotrexate/therapeutic use; Cyclosporine/therapeutic use; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; uveitis; Visual Acuity; Dexamethasone/therapeutic use; Corticosteroids; Uveitis/*diagnosis/drug therapy; ocular inflammation; retinal vasculitis; Cataract Extraction; Immunoglobulins, Intravenous/therapeutic use; Panniculitis, Nodular Nonsuppurative/*diagnosis/drug therapy; Retinal Vasculitis/*diagnosis/drug therapy; weber-christian disease

Recurrent anterior uveitis and glaucoma associated with inadvertent entry of ointment into the anterior chamber after radial keratotomy. - Garzozi, H. J.; Muallem, M. S.; Harris, A. (Journal of cataract and refractive surgery, 1999)
Anterior uveitis and elevated intraocular pressure (IOP) occurred after radial keratotomy that was complicated by microperforation and penetration of antibiotic ophthalmic ointment into the anterior chamber. Anterior uveitis and IOP elevation were observed during the early postoperative follow-up and 41 and 61 months after surgery. All 3 attacks responded well to topical anti-inflammatory and antiglaucoma treatment. The probable causes of the uveitis and glaucoma in this case are discussed.
Keywords: Humans; Male; Adult; Recurrence; Visual Acuity; Intraocular Pressure/drug effects; Administration, Topical; Anti-Bacterial Agents/*adverse effects; Uveitis, Anterior/*chemically induced; *Corneal Injuries; *Intraoperative Complications; Anterior Chamber/*drug effects; Glaucoma/*chemically induced; Keratotomy, Radial/*adverse effects; Ointments/adverse effects; Rupture; Tobramycin/*adverse effects

[Immuno-correcting therapy of sympathetic ophthalmia]. - Chentsova, O. B.; Grechanyĭ, M. P.; Riabtseva, A. A.; Kil'diushevskiĭ, A. V. (Vestnik oftalmologii, 1991)
Exchange plasmapheresis was used in correction of the immune homeostasis in 5 patients with sympathetic ophthalmia. The inflammatory process ceased in all the cases. Exchange plasmapheresis resulted in improvement of the blood supply to ocular vessels, of intraocular vessel function, and of metabolic processes in the external layers of the retina. Cellular and humoral immunity parameters normalized. The hemo- and hydrodynamic parameters of the eye improved; all these results evidence that exchange plasmapheresis is an effective method in the treatment of sympathetic ophthalmia.
Keywords: Humans; Male; Adult; Visual Acuity; *Plasmapheresis; Electrooculography; Ophthalmia, Sympathetic/immunology/*therapy

Intravitreal infliximab for choroidal neovascularization in patients refractory to conventional treatments. - Semeraro, F.; Romano, M. R.; Danzi, P.; Angi, M.; Costagliola, C. (International journal of immunopathology and pharmacology, 2013)
The aim of the study is to evaluate the effectiveness and safety of intravitreal infliximab in the course of compassionate use in patients affected by choroidal neovascularization. This prospective interventional case series includes four eligible patients, affected by exudative age-related macular degeneration (2/4), retinal angiomatous proliferation (1/4) and central retinal vein occlusion (1/4), who were refractory to conventional treatments. The patients received a single intravitreal injection of 0.05 ml of reconstituted infliximab solution (20mg/ml). The main outcomes measure were changes in best-corrected visual acuity and central retinal thickness. Patients were evaluated at baseline, every week for the first month, then every two weeks, and on demand. Morphologic parameters improved after a single infliximab intravitreal injection. However, all patients developed acute uveitis in a period ranging from 4 to 7 weeks after treatment. Control of the intraocular inflammation was achieved with topical and systemic steroids in 3 patients, whereas in one case pars plana vitrectomy was needed. A single intravitreal injection of infliximab does not seem to improve the natural history of CNV from different aetiologies. However, all patients in our series developed a serious inflammatory response that required surgical management in one case. The intravitreal administration of infliximab is hence not safe and not recommended in clinical practice.
Keywords: Female; Humans; Male; Aged; Aged, 80 and over; Prospective Studies; Time Factors; Treatment Outcome; Infliximab; Intravitreal Injections; Visual Acuity/drug effects; Anti-Inflammatory Agents/*administration & dosage/adverse effects; Vitrectomy; Retina/drug effects/pathology; Antibodies, Monoclonal/*administration & dosage/adverse effects; Choroidal Neovascularization/diagnosis/*drug therapy/physiopathology; Steroids/administration & dosage; Compassionate Use Trials; Macular Degeneration/complications; Retinal Vein Occlusion/complications; Uveitis/chemically induced/diagnosis/therapy; von Hippel-Lindau Disease/complications

[Birdshot chorioretinopathy: systemic therapy with corticosteroids and nonsteroidal anti-inflammatory drugs]. - Hofmann, H. M.; Feicht, B. (Klinische Monatsblatter fur Augenheilkunde, 1990)
The symptoms and clinical course of a case of birdshot chorioretinopathy are described. The patient was a 40-year-old woman. The condition can be treated with two types of medication, i.e., steroids and nonsteroidal anti-inflammatory drugs. Both appear to have a beneficial effect. Overall, however, the prognosis for this rare disease of unknown etiology remains uncertain. Given the slow progressive course, with spontaneous remissions and exacerbations, it is extremely difficult to evaluate the success of different forms of therapy.
Keywords: Humans; Drug Administration Schedule; Administration, Oral; Recurrence; Fluorescein Angiography; Visual Acuity/drug effects; Chorioretinitis/diagnosis/*drug therapy; Diclofenac/administration & dosage; Fluocortolone/*administration & dosage

Reduction of macular oedema by acetazolamide in patients with chronic iridocyclitis: a randomised prospective crossover study. - Farber, M. D.; Lam, S.; Tessler, H. H.; Jennings, T. J.; Cross, A.; Rusin, M. M. (The British journal of ophthalmology, 1994)
Thirty patients with cystoid macular oedema secondary to chronic iridocyclitis were enrolled in a two period, prospective, randomised, double masked, crossover study that compared sustained release acetazolamide (500 mg twice a day) with a placebo to measure the effects on the reduction of cystoid macular oedema and improvement of visual acuity. All patients were treated for 1 month with either acetazolamide or placebo, received no treatment for 1 month, and were then treated for 1 month with the other medication. Statistically significant improvement in visual acuity was seen at 14 and 28 days in the treated patients. No improvement was seen when patients received placebo. Improved visual acuity was not associated with race or sex. However, younger patients (under age 55 years) were more likely to benefit from treatment. Results of vitreous fluorophotometry, obtained at baseline and 4 weeks, demonstrated an improvement in posterior vitreous penetration ratios and mid vitreous penetration ratios after treatment with acetazolamide but not with placebo.
Keywords: Double-Blind Method; Female; Humans; Male; Middle Aged; Adult; Aged; Prospective Studies; Chronic Disease; Visual Acuity; Delayed-Action Preparations; Acetazolamide/*administration & dosage; Age Factors; *Macula Lutea; Iridocyclitis/*complications; Retinal Diseases/*drug therapy/etiology

Uveitis associated with varicella virus vaccine. - Esmaeli-Gutstein, B.; Winkelman, J. Z. (American journal of ophthalmology, 1999)
PURPOSE: To report a case of uveitis associated with the live attenuated varicella virus vaccine (Varivax; Merck & Co, Inc, West Point, Pennsylvania) in a young, otherwise healthy girl. METHODS: The time of onset of uveitis in relation to vaccination and the number and the pattern of distribution of vesicles were noted. The patient received oral acyclovir and topical steroids and cycloplegic drops. RESULTS: The uveitis and vesicular rash improved significantly after 7 days of treatment. A literature review and communications with the drug's manufacturer disclosed no identifiable previous cases of uveitis associated with Varivax. CONCLUSIONS: Uveitis should be recognized as a possible adverse side effect of the varicella vaccine.
Keywords: Female; Humans; Drug Therapy, Combination; Adolescent; Visual Acuity; Intraocular Pressure; Acyclovir/therapeutic use; Prednisolone/analogs & derivatives/therapeutic use; Anterior Eye Segment/pathology; Chickenpox Vaccine/*adverse effects; Uveitis, Anterior/drug therapy/*etiology

Transitory outward pupillary curling in a case of HSV associated acute anterior uveitis: a hitherto unreported sign. - Karkhur, Samendra; Soni, Deepak; Sharma, Bhavana (BMJ case reports, 2020)
We report a case of herpes simplex virus (HSV) associated acute anterior uveitis in otherwise healthy 38-year-old man with an unusual finding of outward pupillary margin curling. At presentation visual acuity was 20/60 in right eye (OD) and 20/20 in left eye (OS). Intraocular pressure was 44 and 18 mm Hg in OD and OS respectively. OD revealed diffuse conjunctival congestion, stromal oedema, pigmented keratic precipitates, cells grade 3+ and flare 2+ on slit-lamp examination and diminished corneal sensations. OS was unremarkable. There was a history of three similar episodes in last 1 year. Aetiology of this recurrent acute anterior uveitis was confirmed to be HSV via DNA-PCR assay of aqueous fluid. This hitherto unreported sign associated with viral hypertensive uveitis was transitory in nature and reversible with control of anterior chamber inflammation, without leaving any permanent damage. Topical steroids and antiglaucoma were stopped, while antiviral therapy was continued for 3 months.
Keywords: Humans; Male; Adult; Antiviral Agents/*therapeutic use; *Visual Acuity; Acute Disease; glaucoma; DNA, Viral/analysis; anterior chamber; Aqueous Humor/virology; Eye Infections, Viral/*diagnosis/drug therapy/virology; Herpes Zoster Ophthalmicus/*diagnosis/drug therapy/virology; iris; pupil; Simplexvirus/genetics; Uveitis, Anterior/*diagnosis/drug therapy/virology

Clinical Manifestations and Outcome of Syphilitic Uveitis. - Bollemeijer, Jan G.; Wieringa, Wietse G.; Missotten, Tom O. A. R.; Meenken, Ina; ten Dam-van Loon, Ninette H.; Rothova, Aniki; Los, Leonoor I. (Investigative ophthalmology & visual science, 2016)
PURPOSE: To analyze visual outcome, effectiveness of various modes of antibiotic treatment, and prognostic factors in patients with serologically proven syphilitic uveitis. METHODS: The clinical records of 85 patients (139 eyes) diagnosed with syphilitic uveitis between 1984 and 2013 at tertiary centers in The Netherlands were retrospectively analyzed. RESULTS: Mean age was 47 years (range, 27-73 years), 82.4% were male. HIV positivity was found in 28 (35.9%) patients; 13 were newly diagnosed. Most patients had pan (45.9%) or posterior (31.8%) uveitis. On average, logMAR visual acuity (VA) improved significantly from 0.55 at the start of syphilis treatment to 0.34 at 1 month and to 0.27 at 6 months follow-up. Most patients (86.7%) reached disease remission. No differences in efficacy between the various treatment regimens were found. A high logMAR VA at the start of syphilis treatment and a treatment delay of more than 12 weeks were prognostic for a high logMAR VA at 6 months follow-up. Chronicity was not related to any form of treatment, HIV status, or Venereal Disease Research Laboratory test outcome. CONCLUSIONS: In this large cohort of 85 patients with syphilitic uveitis, visual outcomes were favorable in the majority of cases. Visual outcome was dependent on VA at the start of syphilis treatment and treatment delay.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Administration, Oral; Infusions, Intravenous; Ceftriaxone/therapeutic use; Doxycycline/therapeutic use; Injections, Intramuscular; Visual Acuity; Syphilis Serodiagnosis; Anti-Bacterial Agents/therapeutic use; Eye Infections, Bacterial/*diagnosis/drug therapy/microbiology; Penicillin G/therapeutic use; Syphilis/*diagnosis/drug therapy/microbiology; HIV Seropositivity/diagnosis; Penicillin G Procaine/therapeutic use; Uveitis/*diagnosis/drug therapy/microbiology

Valganciclovir therapy for immune recovery uveitis complicated by macular edema. - Kosobucki, Brian R.; Goldberg, Daniel E.; Bessho, Kenichiro; Koh, Hyoung J.; Rodanant, Nuttawut; Labree, Laurie; Cheng, Lingyun; Schrier, Rachel D.; Azen, Stanley P.; Freeman, William R. (American journal of ophthalmology, 2004)
PURPOSE: To determine whether treatment with valganciclovir will improve visual acuity in eyes with immune recovery uveitis complicated by macular edema. DESIGN: Prospective open label controlled Phase II drug study. METHODS: Five patients with chronic macular edema as a result of immune recovery uveitis were studied. Baseline fluorescein angiograms, best-corrected ETDRS visions, and cytomegalovirus (CMV) lymphoproliferative T-cell function assays were obtained and repeated after three months of valganciclovir therapy (900 mg daily) and again three months after withdrawal of therapy. RESULTS: Vision improved by a mean of 11 letters in the treatment phase (P =.05). Graded angiograms showed three patients had treatment reduction of macular edema. One patient had rebound increase in macular edema after the withdrawal phase. The CMV lymphoproliferative response was not affected by the valganciclovir. CONCLUSION: Results suggest valganciclovir treatment may benefit visual acuity in patients with macular edema from immune recovery uveitis.
Keywords: Female; Humans; Male; Adult; Prospective Studies; Antiviral Agents/*therapeutic use; CD4 Lymphocyte Count; Fluorescein Angiography; Valganciclovir; Visual Acuity/drug effects; Uveitis/*drug therapy/etiology; Antiretroviral Therapy, Highly Active; Macular Edema/complications/*drug therapy; CD4-Positive T-Lymphocytes/immunology; AIDS-Related Opportunistic Infections/drug therapy/immunology; Cytomegalovirus Retinitis/drug therapy/immunology; Ganciclovir/*analogs & derivatives/*therapeutic use; Immune System/physiology

Bilateral panuveitis following intravesical BCG immunotherapy for bladder carcinoma. - Uppal, Gurmit S.; Shah, Anish N.; Tossounis, Charalambos M.; Tappin, Michael J. (Ocular immunology and inflammation, 2010)
PURPOSE: To report a case of bilateral panuveitis following local treatment with Bacille Calmette-Guérin (BCG) immunotherapy for superficial bladder carcinoma. DESIGN: Case report and literature review. METHODS: A 70-year-old female presented with severe bilateral anterior chamber inflammation 5 days after intravesical BCG instillation. Despite topical steroids and mydriatics, inflammation worsened and bilateral optic nerve swelling developed. RESULTS: Oral corticosteroids settled the ocular inflammation, and optic nerve function recovered. A trial of steroid cessation caused rebound uveitis, so she remains on maintenance doses of oral corticosteroid. CONCLUSIONS: Ocular inflammations following BCG therapy for bladder cancer are rare, and little is known about the management of such cases. This is the first report of bilateral panuveitis with optic nerve edema following such treatment.
Keywords: Female; Humans; Aged; Prednisolone/therapeutic use; Anti-Inflammatory Agents/therapeutic use; Visual Acuity/drug effects; Dexamethasone/therapeutic use; Mydriatics/therapeutic use; Immunotherapy/*adverse effects; Administration, Intravesical; BCG Vaccine/*adverse effects/therapeutic use; Carcinoma, Transitional Cell/*drug therapy; Panuveitis/*diagnosis/drug therapy/*immunology; Urinary Bladder Neoplasms/*drug therapy

Octreotide long-acting repeatable for the treatment of chronic macular edema in uveitis. - Missotten, Tom; van Laar, Jan A. M.; van der Loos, Theo L.; van Daele, Paul L. A.; Kuijpers, Robert W. A. M.; Baarsma, G. Seerp; van Hagen, P. Martin (American journal of ophthalmology, 2007)
PURPOSE: To report on the efficacy of the somatostatin analog octreotide long-acting repeatable (LAR), in the treatment of uveitic chronic macular edema (CME). DESIGN: Case series, retrospective analysis. METHODS: In 20 patients, 20 episodes of recurrent CME during otherwise quiescent uveitis were treated with intramuscular octreotide LAR injections. Patients were included if CME control with acetazolamide or systemic and periocular steroids had failed during previous CME episodes or if contraindications existed for persistent use of these therapies. Mean outcome points were CME and visual acuity changes. Correlation of prognostic factors with these outcomes was analyzed. RESULTS: The included CME episodes occurred 7.6 +/- 1.4 years after onset of uveitis. Octreotide LAR treatment started 7.0 +/- 7.3 months after diagnosis of CME. CME decreased in 70% of episodes, after 2.7 +/- 1.3 months of treatment. After arrest of successful treatment, CME recurred instantly (27.2%) or within six months (36.4%). In 36.4% of successfully treated episodes, CME was absent for more than one year. A probable prognostic factor for success was the duration of CME before treatment. CONCLUSIONS: Octreotide LAR had an edema-reducing effect in 70% of treated CME episodes. Successful response was related to duration of CME before start of treatment. The early recurrence of CME (63.6%) after arrest of octreotide LAR advocates a long-term treatment in recent episodes of macular edema in otherwise quiescent uveitis.
Keywords: Female; Humans; Male; Middle Aged; Time Factors; Retrospective Studies; Recurrence; Chronic Disease; Fluorescein Angiography; Tomography, Optical Coherence; Injections, Intramuscular; Visual Acuity; Macular Edema/diagnosis/*drug therapy/etiology; Uveitis/*complications; Octreotide/administration & dosage/*therapeutic use

Panuveitis With Exudative Retinal Detachments After Vaccination Against Human Papilloma Virus. - Dansingani, Kunal K.; Suzuki, Mihoko; Naysan, Jonathan; Samson, C. Michael; Spaide, Richard F.; Fisher, Yale L. (Ophthalmic surgery, lasers & imaging retina, 2015)
A 20-year-old white woman presented with bilateral acute visual loss (visual acuity: 20/60), panuveitis, and exudative retinal detachments 3 weeks after a second dose of quadrivalent human papillomavirus (HPV4) vaccine. She was treated with oral prednisolone for 6 weeks and responded rapidly. By week 4, vision had normalized and clinical signs resolved. Uveitis after HPV4 vaccination has been reported in two cases. Although the differential diagnosis includes Harada disease, temporal correlation with HPV4 and definitive response to a short course of treatment implicate the vaccine in this case. Vaccine-induced uveitis is rare and difficult to distinguish from coincidental autoimmune disease.
Keywords: Female; Humans; Young Adult; Prednisolone/therapeutic use; Administration, Oral; Ultrasonography; Fluorescein Angiography; Tomography, Optical Coherence; Glucocorticoids/therapeutic use; Vaccination/adverse effects; Visual Acuity/drug effects; Choroid/diagnostic imaging; Exudates and Transudates; Retinal Detachment/diagnosis/drug therapy/*etiology; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/*adverse effects; Panuveitis/diagnosis/drug therapy/*etiology; Papillomavirus Infections/prevention & control; Vision Disorders/diagnosis/drug therapy/*etiology

Evaluation of cataract surgery in intermediate uveitis. - Fogla, R.; Biswas, J.; Ganesh, S. K.; Ravishankar, K. (Ophthalmic surgery and lasers, 1999)
BACKGROUND AND OBJECTIVE: The authors analyzed the results of cataract surgery performed on patients with intermediate uveitis from January 1990 through January 1997. MATERIALS AND METHODS: Fifty-two eyes of 44 patients with intermediate uveitis underwent cataract surgery during this period. These patients were evaluated with respect to duration of intermediate uveitis, treatment regimen, intraoperative complications and final visual results. RESULTS: Visual acuity improved following surgery in 94.2% eyes and 71.2% eyes achieved a final visual acuity better than or equal to 20/60. Intraocular lens implantation accompanied the surgery in 24 eyes. Regional and systemic steroids were required for control of inflammation. The factors that limited visual recovery were severe cystoid macular edema, epiretinal membrane formation, and secondary retinal detachment. Recurrence of uveitis was noted in 6 cases. CONCLUSION: Absolute control of inflammation, atraumatic surgery, and regular postoperative follow-up can improve the results of cataract extraction. Intraocular lens implantation in selected cases is well tolerated with good visual results.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Adolescent; Child; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity; Cataract/*complications; Vitrectomy; Lens Implantation, Intraocular; Cataract Extraction/*methods; Postoperative Complications/prevention & control; Cryotherapy; Uveitis, Intermediate/*complications/therapy

Combined fluocinolone acetonide intraocular delivery system insertion, phacoemulsification, and intraocular lens implantation for severe uveitis. - Chieh, Janet J.; Carlson, Alan N.; Jaffe, Glenn J. (American journal of ophthalmology, 2008)
PURPOSE: To determine whether a three-year fluocinolone acetonide sustained drug delivery system can be implanted safely at the same time that phacoemulsification and intraocular lens (IOL) implantation are performed for a visually significant cataract in eyes with uveitis. DESIGN: Retrospective, single-center case series. METHODS: All consecutive patients treated from April 1998 through September 2006 at an academic clinical practice with intermediate uveitis, posterior uveitis, or panuveitis requiring immunosuppressive therapy, periocular corticosteroid injections, or both. Phacoemulsification, IOL implantation, and fluocinolone acetonide implant insertion were performed during a single surgical session. The main outcome measures were preoperative and postoperative ocular inflammation, visual acuity (VA), intraoperative complications, anti-inflammatory medication use, IOP, and postoperative adverse events. RESULTS: Twenty-four eyes of 21 patients were studied. Mean follow-up duration was 27 months (range, six to 60 months). No patients had intraoperative complications. The mean Snellen VA at baseline was 20/316, which improved significantly to 20/75 at 12 months. The average number of recurrences in the 12 months before implantation was 2.2 episodes per eye. Only one eye experienced a recurrence at seven months after implantation. Topical corticosteroids, posterior sub-Tenon capsule injections, and systemic anti-inflammatory medications were reduced significantly at 12 months. Average IOP was unchanged after surgery compared with preoperative IOP; 15% underwent glaucoma filtering surgery. CONCLUSIONS: A fluocinolone acetonide implant insertion can be combined safely with phacoemulsification plus IOL implantation during the same surgical session in eyes with uveitis. VA generally was improved, uveitis recurrences decreased, and the need for immunosuppression decreased. The most common side effect was increased IOP.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Adolescent; Tomography, Optical Coherence; Visual Acuity; Drug Implants; Uveitis/complications/*drug therapy; Intraocular Pressure; Glucocorticoids/*administration & dosage/adverse effects; Delayed-Action Preparations; *Phacoemulsification; Intraoperative Complications; Postoperative Complications; Fluocinolone Acetonide/*administration & dosage/adverse effects; *Lens Implantation, Intraocular; Cataract/complications

Intravitreal triamcinolone acetonide in Vogt-Koyanagi-Harada syndrome. - Karacorlu, M.; Arf Karacorlu, S.; Ozdemir, H. (European journal of ophthalmology, 2006)
PURPOSE: To report the results of intravitreal triamcinolone acetonide in two eyes of a patient with Vogt-Koyanagi-Harada syndrome. METHODS: A 24-year-old woman with Vogt-Koyanagi-Harada syndrome was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide in both eyes. RESULTS: On the seventh day after injection, visual acuity improved from 20/50 to 20/20 in the right eye and from 20/100 to 20/32 in the left. One month after injection, visual acuity was 20/20 in the right eye and 20/32 in the left, and fluorescein angiography showed that serous detachment had almost completely resorbed. The ocular examination remained stable during the 8-month follow-up period. CONCLUSIONS: In this study, a prompt improvement in the clinical picture of a patient with Vogt-Koyanagi-Harada syndrome after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of Vogt-Koyanagi-Harada syndrome.
Keywords: Female; Humans; Adult; Glucocorticoids/*therapeutic use; Fluorescein Angiography; Tomography, Optical Coherence; Injections; Visual Acuity; Vitreous Body; Uveomeningoencephalitic Syndrome/diagnosis/*drug therapy; Triamcinolone Acetonide/*therapeutic use

Safety and Efficacy of Gevokizumab in Patients with Behçet's Disease Uveitis: Results of an Exploratory Phase 2 Study. - Tugal-Tutkun, Ilknur Md; Kadayifcilar, Sibel Md; Khairallah, Moncef Md; Lee, Sung Chul Md PhD; Ozdal, Pinar; Özyazgan, Yilmaz; Song, Ji Hun Md; Yu, Hyeong Gon Md PhD; Lehner, Valerie PhD; de Cordoue, Agnès Md; Bernard, Oana Md; Gül, Ahmet Md (Ocular immunology and inflammation, 2017)
PURPOSE: To evaluate the safety and efficacy of gevokizumab for the treatment of Behçet's disease uveitis in a prospective, open-label, randomized phase 2 trial. METHODS: Behçet's disease patients with new acute ocular exacerbation or at risk of exacerbation received 30 or 60 mg gevokizumab every 4 weeks intravenously or subcutaneously, on top of a stable regimen of immunosuppressives and corticosteroids (≤20 mg/day equivalent prednisolone). Patients withdrew in cases of ocular exacerbation. RESULTS: A total of 21 patients were included (17 acute and 4 at-risk; mean duration of uveitis 45.6 ± 37.4 months). There were no serious adverse events related to gevokizumab. Recorded adverse events were mostly associated with exacerbation of uveitis or its complications. Response was evaluated for 14 acute patients and all showed rapid control of acute ocular exacerbation, mostly within 1 week, without any increase in corticosteroid dosage. CONCLUSIONS: Gevokizumab was well tolerated and rapidly controlled acute ocular exacerbations of Behçet's disease uveitis without the need for high-dose corticosteroid.
Keywords: Female; Humans; Male; Middle Aged; Adult; Prospective Studies; Treatment Outcome; Injections, Intravenous; Glucocorticoids/administration & dosage; Visual Acuity; Injections, Subcutaneous; *retinal vasculitis; Antibodies, Monoclonal, Humanized/adverse effects/*therapeutic use; Uveitis/*drug therapy/physiopathology; *uveitis; Immunosuppressive Agents/adverse effects/*therapeutic use; Behcet Syndrome/*drug therapy/physiopathology; *Behçet’s disease; *gevokizumab; *interleukin-1 beta

[Value and complications of immunosuppressive therapy in uveitis of Behcet's disease or of other etiology. Apropos of 40 cases]. - Niessen, F.; Campinchi, R.; Bloch-Michel, E. (Journal francais d'ophtalmologie, 1982)
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Follow-Up Studies; Child; Azathioprine/therapeutic use; Visual Acuity; Uveitis/*drug therapy; Immunosuppressive Agents/adverse effects/*therapeutic use; Behcet Syndrome/*drug therapy; Chlorambucil/therapeutic use

Bromfenac alone or with single intravitreal injection of bevacizumab or triamcinolone acetonide for treatment of uveitic macular edema. - Radwan, Alaa E.; Arcinue, Cheryl A.; Yang, Paul; Artornsombudh, Pichaporn; Abu Al-Fadl, Esam M.; Foster, C. Stephen (Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2013)
PURPOSE: To evaluate the efficacy of bromfenac drops alone or with a single intravitreal injection of bevacizumab (IVB) or triamcinolone acetonide (IVTA) in the treatment of uveitic macular edema (UME). DESIGN: Comparative case series. STUDY PARTICIPANT: Sixty-seven eyes (of 55 patients) with UME that received either bromfenac drops alone (n = 34), IVB plus bromfenac (n = 21) or IVTA plus bromfenac (n = 12). METHODS: Chart review of patients at the Massachusetts Eye Research and Surgery Institution (MERSI) was done. Eyes that received either bromfenac drops alone (Br), IVB plus bromfenac (IVB/Br) or IVTA plus bromfenac (IVTA/Br), with follow-up of up to 3 months, were included. MAIN OUTCOME MEASURE: Visual acuity. RESULTS: There was no statistically significant effect seen in VA or CMT in the Br group, with 17 of 34 eyes (50 %) needing re-injection before 3 months of follow-up. Mean change in CMT at 4 weeks for the Br group was 5.06 µm. Compared to baseline, both the IVTA/Br and IVB/Br groups showed significant decrease in CMT and improvement in VA at 1 and 3 months follow-up. There was also a continuous decrease in CMT up to 3 months of follow-up with the IVTA/Br group, which was found to be significant in comparison with the IVB/Br group; this trend was not seen in the IVB/Br group at 3 months. The greatest mean change in CMT at 1 month was seen in the IVTA/Br group (154.33 ±178.22 µm), and this was statistically significant in comparison with the other groups (p = <0.0001). However, in terms of mean change in VA, there was no change in the Br group (0.01 ± 0.11 VA logMAR), and only 0.12 ± 0.19 and 0.15 ± 0.20 in the IVB/Br and IVTA/Br groups, respectively. CONCLUSION: IVB and IVTA are both effective in improving VA and decreasing CMT up to 3 months. Bromfenac is ineffective alone for UME treatment, but may have a synergistic effect with IVTA in reducing CMT up to 3 months of follow-up.
Keywords: Female; Humans; Male; Middle Aged; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Antibodies, Monoclonal, Humanized/*therapeutic use; Glucocorticoids/therapeutic use; Ophthalmic Solutions; Visual Acuity/physiology; Intravitreal Injections; Macular Edema/*drug therapy/physiopathology; Uveitis/*drug therapy/physiopathology; Triamcinolone Acetonide/*therapeutic use; Retreatment; Bevacizumab; Angiogenesis Inhibitors/therapeutic use; Benzophenones/*therapeutic use; Bromobenzenes/*therapeutic use

Cataract surgery in sympathetic ophthalmia. - Ganesh, Sudha K.; Sundaram, Padmaja M.; Biswas, Jyotirmay; Babu, Kalpana (Journal of cataract and refractive surgery, 2004)
PURPOSE: To analyze the results of cataract surgery in patients with sympathetic ophthalmia. SETTING: Sankara Nethralaya, Medical Research Foundation, Chennai, India. METHODS: This study comprised 66 patients (132 eyes) with sympathetic ophthalmia seen at the uveitis referral clinic between January 1990 and July 2001; 42 eyes (31.8%) had cataract. Cataract surgery was performed in 17 sympathizing eyes and 1 exciting eye (17 patients). The records of these 18 eyes were retrospectively analyzed. Three eyes had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, 6 eyes had ECCE without IOL implantation, and 9 eyes had phacoemulsification with IOL implantation. The mean follow-up was 28.7 months (range 3 to 60 months). RESULTS: The causes of sympathetic ophthalmia were penetrating trauma (n = 8 eyes), ocular surgery (n = 6), perforated corneal ulcer (n = 2), and cyclocryotherapy (n = 1). The most common cataract type, present in 7 eyes (38.8%), was mixed (posterior subcapsular and posterior polar). Visual acuity improved after surgery in 13 eyes (72.2%). The main factors impairing visual recovery were submacular scar and optic atrophy, which were sequelae of the sympathetic ophthalmia. Posterior capsule opacification was noted in 14 eyes (77.7%); it was visually significant in 6 eyes. There was no significant difference in postoperative inflammation or disease reactivation between the 3 types of surgery. CONCLUSIONS: Cataract extraction in cases of sympathetic ophthalmia can be safely and successfully performed with vigilant preoperative and postoperative control of inflammation, careful surgical planning, and meticulous surgical technique. The final visual outcome, however, depends on the posterior segment complications of the disease.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Retrospective Studies; Risk Factors; Safety; Adolescent; Child; Visual Acuity; *Cataract Extraction; Postoperative Care; Preoperative Care; Lens Implantation, Intraocular; Postoperative Complications; Ophthalmia, Sympathetic/complications/*surgery

Deep intramuscular methylprednisolone for the treatment of cystoid macular oedema in uveitis. - Tehrani, N. N.; Saeed, T.; Murray, P. I. (Eye (London, England), 2000)
PURPOSE: To study the use of intramuscular methylprednisolone in the treatment of cystoid macular oedema in patients with uveitis. METHODS: A total of 32 patients with various types of uveitis with unilateral cystoid macular oedema were recruited. Patients received 160 mg of intramuscular methylprednisolone into the thigh and were reassessed 6-8 weeks later. In 17 patients in whom there had been no significant improvement, a further injection of methylprednisolone was given; a total of 49 injections. RESULTS: After a first injection a significant improvement in vision (an increase of > or = 2 Snellen lines) was seen in 15 of 32 eyes (47%), and 17 of 32 eyes (53%) showed no significant change. After the second injection 7 of 17 eyes (41%) showed a significant improvement but there was no change in 9 of 17 eyes (53%). Only one eye deteriorated more than 2 lines of Snellen acuity. There were minimal ocular or systemic side effects associated with this form of treatment. CONCLUSIONS: Despite limited success, deep intramuscular methylprednisolone may have a role as an alternative mode of treatment in uveitis patients with unilateral cystoid macular oedema, thus avoiding the potential hazards of periocular injections. In comparison with orally administered systemic corticosteroids, an injection ensures patient compliance and is associated with fewer side effects.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Prospective Studies; Adolescent; Glucocorticoids/*administration & dosage; Uveitis/*complications; Visual Acuity/drug effects; Anti-Inflammatory Agents/*administration & dosage; Macular Edema/*drug therapy/etiology/physiopathology; Methylprednisolone/*administration & dosage; Injections, Intramuscular/methods

Transscleral diode laser cyclophotocoagulation for refractory glaucoma secondary to juvenile idiopathic arthritis: a short term follow-up. - Dastiridou, Anna I.; Androudi, Sofia; Praidou, Anna; Brazitikos, Periklis; Brozou, Catherine G.; Tsironi, Evangelia E. (International ophthalmology, 2013)
To evaluate the success rates of transscleral diode cyclophotocoagulation (TD-CPC) for refractory secondary glaucoma in a paediatric patient with juvenile idiopathic arthritis. Report of a case of a 6-year-old boy suffering from severe uveitis, and secondary open angle glaucoma. The patient had undergone bilateral cataract surgery, two prior trabeculectomies in the left and one in the right eye. He was under systemic immunomodulation with methotrexate and cyclosporine. He presented with medically uncontrolled glaucoma, with an intraocular pressure (IOP) of 36 and 34 mmHg in the right and left eye, respectively, under maximal medical antiglaucoma therapy. TD-CPC was performed under general anesthesia, including a total of 20 spots in the right and 34 in the left eye (2,000 mW, 2 s/spot) applied in one session. Visual acuity remained stable in the right eye and deteriorated in the left eye from 0.1 to no light perception. Postoperative hypotony was present 1 month post op and IOP was 14 mmHg in the left and 17 mmHg in the right eye, respectively, in the 6-month follow-up with a topical beta-blocker. The anterior chamber was quiet in both eyes. TD-CPC was effective in the short term as IOP lowering therapy in a pediatric patient with refractory uveitic glaucoma.
Keywords: Humans; Male; Treatment Outcome; Child, Preschool; Glaucoma/etiology/*surgery; Arthritis, Juvenile/*complications; Light Coagulation/*methods; Lasers, Semiconductor/*therapeutic use; Sclera/surgery

Trans-Tenon's retrobulbar triamcinolone infusion for the treatment of uveitis. - Okada, A. A.; Wakabayashi, T.; Morimura, Y.; Kawahara, S.; Kojima, E.; Asano, Y.; Hida, T. (The British journal of ophthalmology, 2003)
AIM: To assess efficacy and complications of trans-Tenon's retrobulbar infusion of triamcinolone acetonide for posterior uveitic inflammation. METHODS: Non-randomised, uncontrolled, retrospective study of 51 eyes of 37 patients who underwent triamcinolone infusion for vitritis, cystoid macular oedema (CMO), or posterior retinal vasculitis using a long blunt cannula via an incision made through conjunctiva and Tenon's capsule. RESULTS: Overall clinical efficacy was 86%; 96% for vitritis, 82% for CMO, and 33% for posterior retinal vasculitis. Mean visual acuity improved within 1 month after triamcinolone infusion (p <0.05). Cataract progression and intraocular pressure elevation were observed in 31% and 27% of eyes, respectively. CONCLUSION: Trans-Tenon's retrobulbar triamcinolone infusion may be a safe and effective treatment for posterior uveitic inflammation.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Retrospective Studies; Treatment Outcome; Disease Progression; Triamcinolone Acetonide/*administration & dosage; Glucocorticoids/*administration & dosage; Visual Acuity/drug effects; Uveitis, Posterior/*drug therapy/physiopathology; Intraocular Pressure/drug effects; Anti-Inflammatory Agents/*administration & dosage; Cataract/pathology; Infusions, Intralesional

Transscleral red laser cyclophotocoagulation for the treatment of therapy-resistant inflammatory glaucoma. - Puska, P. M.; Tarkkanen, A. H. A. (European journal of ophthalmology, 2007)
PURPOSE: To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma. METHODS: The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6-81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8+/- 40.0 (range 2-145) months. RESULTS: The mean preoperative intraocular pressure (IOP) of 35.6+/-8.1 mmHg fell to 6-21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred. CONCLUSIONS: Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken.
Keywords: Humans; Middle Aged; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Retrospective Studies; Adolescent; Chronic Disease; Child; Drug Resistance; Visual Acuity; Intraocular Pressure; Ciliary Body/*surgery; Sclera; Uveitis/complications/drug therapy/*surgery; *Laser Coagulation; Glaucoma/drug therapy/etiology/*surgery; Scleritis/complications/drug therapy/*surgery

Diagnostic and therapeutic challenges. - Milenkovic, Svetislav M.; Jaksic, Vesna Z.; Jakovic, Natalija; Stefanovic, Ivan B.; Risimic, Dijana S.; Paovic, Jelena D.; Folk, James C. (Retina (Philadelphia, Pa.), 2010)
Keywords: Humans; Male; Middle Aged; Drug Therapy, Combination; Fluorescein Angiography; Cyclosporine/therapeutic use; Immunosuppressive Agents/therapeutic use; Visual Acuity/physiology; Triamcinolone Acetonide/therapeutic use; Choroiditis/*diagnosis/drug therapy/physiopathology; Methylprednisolone/therapeutic use; Vision Disorders/*diagnosis

Intravitreal Triamcinolone Injection for Uveitic Macular Edema: A Randomized Clinical Study. - Shin, Joo Young; Yu, Hyeong Gon (Ocular immunology and inflammation, 2015)
PURPOSE: To evaluate the additive effect of intravitrial triamcinolone (TA) injection in uveitic macular edema compared to systemic anti-inflammatory treatment only. METHODS: Patients were randomized into the intravitreal TA injection group and the sham group. All patients received systemic anti-inflammatory treatment with follow-up monthly to 6 months, with additional treatment as needed. RESULTS: Fifty eyes of 50 patients were enrolled. Central foveal thickness decreased significantly from month 1 in the TA group, and from month 3 in the sham group. Parafoveal area thickness significantly decreased in both groups from month 1, with greater decrease in the TA group at months 2 and 3. Leakage area on fluorescein angiography was significantly smaller in the TA group at months 1 to 3. Intraocular pressure increased in the TA group at months 1 and 2. CONCLUSIONS: Intravitreal TA injection showed earlier reduction of leakage and retinal edema compared to systemic anti-inflammatory treatment alone.
Keywords: Double-Blind Method; Female; Humans; Male; Middle Aged; Prospective Studies; Follow-Up Studies; Treatment Outcome; Fluorescein Angiography; Tomography, Optical Coherence; Glucocorticoids/administration & dosage; uveitis; Fundus Oculi; Visual Acuity; Macular Edema/diagnosis/*drug therapy/etiology; Triamcinolone Acetonide/*administration & dosage; Uveitis/*complications/diagnosis/drug therapy; Intravitreal Injections; macular edema; Intravitreal injection; triamcinolone; steroid

Efficacy of Intravitreal Dexamethasone Implant in Patients of Uveitis Undergoing Cataract Surgery. - Gupta, Gaurav; Ram, Jagat; Gupta, Vishali; Singh, Ramandeep; Bansal, Reema; Gupta, Parul Chawla; Gupta, Amod (Ocular immunology and inflammation, 2019)
Purpose: To assess postoperative inflammation using laser flare photometer, following phacoemulsification with or without single intraoperative intravitreal dexamethasone implant in addition to standard of care, in patients of uveitis with cataract.Methods: Prospectively, 30 eyes with uveitic cataract were randomized into 2 groups (i) standard of care (SOC group) (ii) Dexamethasone implant (DEXA group). Both the groups underwent phacoemulsification with intraocular lens implantation and standard of care treatment for uveitis, but DEXA group additionally received intraoperative intravitreal dexamethasone implant. Patients were followed at least till 6 months.Results: DEXA group had significantly less postoperative flare (LFP values) (P<0.05) as compared to SOC group and also recovery of flare to preoperative value occurred much early in DEXA group. 37.5% cases developed CME in SOC group but none in DEXA group. Mean CMT (267.81±34.26μm) and final logMar BCVA (0.036±0.063) was significantly better in DEXA group (p<0.04).Conclusions: Intraoperative intravitreal dexamethasone implant is a safe and effective option for preventing and managing the postoperative inflammation in uveitic cataract.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Prospective Studies; Follow-Up Studies; Treatment Outcome; Tomography, Optical Coherence; Glucocorticoids/administration & dosage; Intraoperative Period; *Visual Acuity; Drug Implants; Intravitreal Injections; Dexamethasone/*administration & dosage; Uveitis/diagnosis/*drug therapy; Cataract/*complications; Phacoemulsification/*methods; Postoperative Complications/prevention & control; phacoemulsification; Intravitreal dexamethasone implant; laser flare photometer; uveitic cataract

MONTHLY INTRAVITREAL INFLIXIMAB IN BEHÇET'S DISEASE ACTIVE POSTERIOR UVEITIS: A Long-Term Safety Study. - Refaat, Mohammad; Abdullatif, Abdussalam M.; Hamza, Mostafa M.; Macky, Tamer A.; El-Agha, Mohamed-Sameh H.; Ragab, Gaafar; Soliman, Mahmoud M. (Retina (Philadelphia, Pa.), 2021)
PURPOSE: To study the safety of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease. METHODS: This is a prospective, interventional, noncomparative, open-label, pilot study of 9 monthly intravitreal infliximab injections (1 mg/0.05 mL) for 22 eyes of 16 patients with active posterior uveitis in Behcet's disease. Control of inflammation and visual outcomes were assessed, and ocular complications were monitored during the study period. RESULTS: Successful treatment was achieved in 7 eyes (35%), and failure was encountered in 13 eyes (65%). Only seven eyes of six patients (35%) had completed the study and achieved complete resolution of inflammation with improved best-corrected visual acuity and no complications. Failure was either because of inability to control the inflammation in nine eyes (45%) or development of exacerbation of inflammation in four eyes (20%). Four eyes developed severe immunological reaction from the drug after first (n = 1), second (n = 2), and third (n = 1) injections and had to discontinue the injections. Kaplan-Meier survival analysis showed that the mean estimated time to failure was 3.3 ± 0.2 months, and all failed eyes required revision of their systemic immunotherapy to control the ocular inflammation. CONCLUSION: Intravitreal infliximab for active posterior uveitis in Behcet's disease was associated with a high complication rate and failure to control inflammation in most eyes. It should not be considered a substitute to systemic therapy.
Keywords: Female; Humans; Male; Pilot Projects; Adult; Prospective Studies; Time Factors; Follow-Up Studies; Treatment Outcome; Young Adult; Dose-Response Relationship, Drug; Infliximab/*administration & dosage; *Visual Acuity; Intravitreal Injections; Behcet Syndrome/complications/diagnosis/*drug therapy; Tumor Necrosis Factor Inhibitors/administration & dosage; Uveitis, Posterior/diagnosis/drug therapy/*etiology

Adverse events after intravitreal triamcinolone in patients with and without uveitis. - Galor, Anat; Margolis, Ron; Brasil, Oswaldo M. F.; Perez, Victor L.; Kaiser, Peter K.; Sears, Jonathan E.; Lowder, Careen Y.; Smith, Scott D. (Ophthalmology, 2007)
PURPOSE: To evaluate the rates of adverse ocular events after intravitreal triamcinolone acetonide (IVTA) injection in patients with and without uveitis. DESIGN: Retrospective observational case series. PARTICIPANTS: Two hundred twenty-two eyes of 173 patients were included in the study: 45 eyes of 31 patients with macular edema (ME) due to uveitis and 177 eyes of 142 patients with ME secondary to other etiologies. METHODS: Retrospective review of patients who received IVTA at the Cole Eye Institute for ME attributable to various causes between the years 2001 and 2005. Data review of clinical records included patient demographics, etiology of ME, and adverse outcomes after injection. Rates of adverse outcomes in patients with and without uveitis were compared. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) elevation and posterior subcapsular cataract (PSC) progression. RESULTS: Uveitis patients were significantly younger, more likely to be female, and more likely to have had prior posterior sub-Tenon's capsule steroid injection and/or glaucoma therapy than their nonuveitis counterparts. In a multivariate analysis adjusting for the differences in these factors, the presence of uveitis was the strongest risk factor for an adverse IOP event (odds ratio, 2.5; 95% confidence interval [CI], 1.0-6.1; P = 0.05). The odds of having a documented increase in PSC after IVTA injection were 5.6 times greater in uveitis eyes (P = 0.007; 95% CI, 1.6-19.6). CONCLUSIONS: Intraocular pressure elevation and PSC progression occurred with greater frequency in uveitis patients receiving IVTA. Patients with uveitis treated with IVTA should be counseled about these risks and monitored closely.
Keywords: Female; Humans; Male; Middle Aged; Aged; Retrospective Studies; Risk Factors; Disease Progression; Injections; Uveitis/*complications; Vitreous Body; Visual Acuity/drug effects; Intraocular Pressure/drug effects; Glucocorticoids/*adverse effects; Macular Edema/drug therapy/etiology; Cataract/chemically induced/diagnosis; Lens Capsule, Crystalline/drug effects; Triamcinolone Acetonide/*adverse effects

Analysis of the Clinical Profile and Management of Inflammatory Choriodal Neovascular Membranes in Uveitic Eyes: A Study from a Tertiary Referral Center. - Ganesh, Sudha; Ahmed, Arshee; Biswas, Jyotirmay (Ocular immunology and inflammation, 2019)
Purpose: To analyze clinical profile and management of inflammatory choroidal neovascularization (CNV) seen at a referral uveitis clinic.Methods: Records of patients with uveitis and inflammatory CNV from January 1989 to April 2012 were retrieved and the data was analyzed.Results: Forty-nine eyes of 43 patients were included. Mean age at presentation was 35.81 years. Eighteen eyes (36.7%) had infective etiology and 31 eyes (63.2%) had non-infective etiology. The most common location of the CNV was subfoveal, in 18 eyes (36.7%). Management included corticosteroids in all patients, additional immunosuppressive in 17 eyes (34.6%) and local management, with anti-VEGF injections in 29 eyes (63%). Visual outcome was favorable in 37 eyes (75%).Conclusion: Inflammatory CNV can be successfully managed and vision can be improved or stabilized, with prompt and adequate therapy of the underlying uveitic disease coupled with additional local therapy to selectively target the CNV.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Adolescent; Glucocorticoids/*therapeutic use; Child; Child, Preschool; Immunosuppressive Agents/*therapeutic use; Fluorescein Angiography; Tomography, Optical Coherence; *Visual Acuity; Fundus Oculi; Uveitis/*complications/diagnosis/drug therapy; tuberculosis; *Tertiary Care Centers; corticosteroids; Photochemotherapy/*methods; Anti-VEGF; Choroid/blood supply/diagnostic imaging; Choroidal Neovascularization/*diagnosis/drug therapy/etiology; CNV; immunosuppressive

Posttransplantation lymphoproliferative disorder initially seen as iris mass and uveitis. - Cook, T.; Grostern, R. J.; Barney, N. P.; Mills, M. D.; Judd, R.; Albert, D. M. (Archives of ophthalmology (Chicago, Ill. : 1960), 2001)
Primary ocular posttransplantation lymphoproliferative disorder is rare. Epstein-Barr virus is implicated as the cause as a result of systemic immunosuppression after transplant surgery. We studied a patient who developed ocular posttransplantation lymphoproliferative disorder after orthotopic liver transplantation. Slitlamp and light microscopic photographs confirmed the diagnosis.
Keywords: Female; Humans; Infant; Visual Acuity; Uveitis, Anterior/diagnosis/*etiology; Iris Neoplasms/diagnosis/*etiology; Liver Transplantation/*adverse effects; Lymphoproliferative Disorders/diagnosis/*etiology

Results of peripheral laser photocoagulation in pars planitis. - Pulido, J. S.; Mieler, W. F.; Walton, D.; Kuhn, E.; Postel, E.; Hartz, A.; Jampol, L. M.; Weinberg, D. V.; Logani, S. (Transactions of the American Ophthalmological Society, 1998)
PURPOSE: To determine the effect of peripheral retinal laser photocoagulation (PLP) on visual acuity, intraocular inflammation, and other ocular findings, including retinal neovascularization in eyes with pars planitis. METHODS: A retrospective chart review of eyes with pars planitis that had undergone PLP. RESULTS: Twenty-two eyes in 17 patients with pars planitis had undergone treatment with PLP at 2 centers. The mean age at the time of treatment was 19.3 years. Following treatment, mean follow-up was 16.3 months (range, 6 to 37 months). Mean visual acuity was 20/60 preoperatively and 20/50 postoperatively. This level of improvement was not statistically significant (P > .10), but there was a statistically significant decrease in the use of corticosteroids between the preoperative examination and the last postoperative examination (86% versus 27%, P < .05). There was also a statistically significant decrease in vitritis at the last follow-up (P = .0008) and a decrease in neovascularization of the vitreous base (P = .03) and in clinically apparent cystoid macular edema (P = .02). Epiretinal membranes were noted in 23% of eyes preoperatively and in 45% of eyes postoperatively. Only one of these epiretinal membranes was considered to be visually significant. One eye developed a tonic dilated pupil, which slowly improved. CONCLUSIONS: Although the long-term natural history of clinical findings in pars planitis is not well documented, PLP appears to decrease the need for corticosteroids while stabilizing visual acuity. It also appears to decrease vitreous inflammation. PLP has few complications and should be considered in patients with pars planitis who are unresponsive or have adverse reactions to corticosteroids.
Keywords: Female; Humans; Male; Adult; Retrospective Studies; Adolescent; Child; Visual Acuity/physiology; Postoperative Period; Adrenal Cortex Hormones/administration & dosage/therapeutic use; *Laser Coagulation; Endophthalmitis/surgery; Macular Edema/surgery; Neovascularization, Pathologic/surgery; Pars Planitis/drug therapy/physiopathology/*surgery; Vitreous Body/blood supply

The spectrum of ocular inflammation caused by euphorbia plant sap. - Eke, T.; Al-Husainy, S.; Raynor, M. K. (Archives of ophthalmology (Chicago, Ill. : 1960), 2000)
OBJECTIVE: To report the spectrum of clinical findings in patients with ocular inflammation caused by plant sap from Euphorbia species. DESIGN: Clinical case series. SETTING: Ophthalmology emergency referrals in the United Kingdom. PATIENTS: We examined 7 patients, all of whom gave a history of recent ocular exposure to the sap of Euphorbia species. INTERVENTIONS: All patients were treated with antibiotic drops or ointment (chloramphenicol). Cycloplegic and steroid drops were also used for some patients. Patients were observed until all signs and symptoms had resolved. MAIN OUTCOME MEASURES: Symptoms, visual acuity, and clinical signs of inflammation. All patients provided a specimen of the plant for formal identification. RESULTS: Initial symptoms were generally burning or stinging pain with blurred vision. In most cases, visual acuity was reduced between 1 and 2 Snellen lines. In 1 patient with age-related maculopathy, acuity dropped from 20/80 to hand motions before recovering. Clinical findings varied from a mild epithelial keratoconjunctivitis to a severe keratitis with stromal edema, epithelial sloughing, and anterior uveitis. All signs and symptoms had resolved by 1 to 2 weeks. CONCLUSIONS: These cases illustrate the range of severity of Euphorbia sap keratouveitis. The condition seems to be self-limiting when managed supportively. People who work with Euphorbia plant species should wear eye protection. Clinicians managing keratopathy caused by Euphorbia species should be aware of the danger of sight-threatening infection and uveitis, particularly during the first few days.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Glucocorticoids/therapeutic use; Ophthalmic Solutions; Visual Acuity/drug effects; Therapeutic Irrigation; Cyclopentolate/therapeutic use; Chloramphenicol/therapeutic use; Euphorbiaceae/*poisoning; Keratitis/diagnosis/*etiology/therapy; Keratoconjunctivitis/diagnosis/*etiology/therapy; Ointments; Plant Extracts/*poisoning; Plant Poisoning/diagnosis/*etiology/therapy; Uveitis, Anterior/diagnosis/*etiology/therapy

Vogt-Koyanagi-Harada syndrome in an 11-year-old Boy. - Ikeda, N.; Hayasaka, S.; Kadoi, C.; Nagaki, Y. (Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde, 1999)
An 11-year-old boy complained of headache, slight fever and decreased visual acuity. Intracameral cells and serous retinal detachment were found in both eyes. Pleocytosis was seen in the cerebrospinal fluid. Bilateral uveitis diminished rapidly in response to corticosteroid treatment. Depigmentation of the fundi developed several months later. We believe that Vogt-Koyanagi-Harada syndrome in a child, as demonstrated in our patient, may be uncommon.
Keywords: Humans; Male; Drug Therapy, Combination; Follow-Up Studies; Prednisolone/therapeutic use; Child; Fluorescein Angiography; Glucocorticoids/therapeutic use; Fundus Oculi; Visual Acuity; Retina/pathology; Mydriatics/therapeutic use; *Uveomeningoencephalitic Syndrome/complications/diagnosis/drug therapy; Atropine/therapeutic use; Retinal Detachment/diagnosis/drug therapy/etiology

Outcomes of adalimumab therapy in refractory punctate inner choroidopathy and multifocal choroiditis. - Shmueli, Or; Amer, Radgonde (Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2022)
PURPOSE: This study aims to evaluate the outcomes of adalimumab (ADA) therapy in patients with refractory punctate inner choroidopathy (PIC) and multifocal choroiditis (MFC). METHODS: Demographic and clinical data, including LogMAR best-corrected visual acuity (BCVA), were retrospectively collected. Doses of prednisone, immunomodulatory therapies (IMT), and anti-vascular endothelial growth factor (VEGF) injections before and after baseline (ADA initiation) were recorded, as well as the time to clinical remission, time to first flare, and drug-associated adverse events. RESULTS: Seven patients (4 females, ten eyes) were included. The mean follow-up after baseline was 17.8 ± 11.1 months (range 6-33). The mean LogMAR BCVA was 0.35 ± 0.77 at 6 months before baseline and remained stable throughout 12 months after baseline (0.31 ± 0.46 at 12 months; p = 0.47). The mean dose of prednisone decreased from 17.3 ± 19.6 mg/day 6 months before baseline (range 0-60) to 2.6 ± 2.4 mg/day at the last follow-up (range 0-6, p = 0.03). The mean number of flares decreased significantly from 1.43 ± 0.79 over a 6-month period before baseline to 0.2 ± 0.45 (p = 0.02) at 6-12 months after baseline. The mean number of anti-VEGF injections was 4.17 ± 3.92 over the 12-month period before baseline, and it was 2.17 ± 3.06 (p = 0.31) during the first 12 months after baseline. No adalimumab-related adverse events were noted. CONCLUSION: Adalimumab therapy for refractory PIC/MFC enabled a significant steroid-sparing effect, decreased disease flares, and preserved vision over a mean follow-up of 17.8 months.
Keywords: Female; Humans; Male; Follow-Up Studies; Retrospective Studies; Adalimumab; Fluorescein Angiography; Tomography, Optical Coherence; Prednisone/therapeutic use; Visual Acuity; Intravitreal Injections; Multifocal choroiditis; Angiogenesis Inhibitors; Adalimumab/therapeutic use; Multifocal Choroiditis; *Choroiditis/diagnosis/drug therapy; *White Dot Syndromes; Choroidal neovascular membrane; Punctate inner choroidopathy; Steroid-sparing

[Safety and efficacy of subconjunctival triamcinolone injections in the management of uveitic macular edema: retrospective study of thirty-one cases]. - Bleriot, A.; Couret, C.; Le Meur, G.; Lebranchu, P.; Weber, M. (Journal francais d'ophtalmologie, 2014)
Triamcinolone acetonide (Kenacort) is a corticosteroid that can be administrated by subconjunctival injection, with an extended release for up to three months. Our retrospective study aims to analyze safety and efficacy of subconjunctival triamcinolone injections in the treatment of uveitic macular edema. We included 31 eyes of 30 patients, who had one or several injections. We studied the progression of visual acuity, central macular thickness by optical coherence tomography (OCT), intraocular pressure, and presence or absence of cataract, on the day of injection (T0), and at 1, 3, 6 and 12 months after injection. Twenty-one patients had only one injection; 10 patients had 2. The 12-month follow-up showed an improvement in visual acuity with an initial mean of 0.36 ± 0.27 logMAR to 0.23 ± 0.33 logMAR at 3 months of follow-up (P<0.0004), and to 0.24 ± 0.21 logMAR at 12 months (P=0.0371), for a two-line improvement. A decrease in mean central macular thickness was measured by OCT, from a mean of 444 ± 112 μm (0.24 ± 0.11 logSD-OCT) at T0 to 355 ± 103 μm (0.14 $ ± 0.10 logSD-OCT) at 3 months (P=0.0002). We did not find a significant increase in intraocular pressure, and we diagnosed one cataract during follow-up but this occurred in the uninjected eye as well. Subconjunctival injection of triamcinolone acetonide is a safe and effective treatment of macular edema related to uveitis. Initial clinical monitoring is necessary to detect iatrogenic events.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Treatment Outcome; Tomography, Optical Coherence; Drug Evaluation; Uveitis; Injections, Intraocular; Visual Acuity/drug effects; Macular Edema/*drug therapy/etiology; Uveitis/*complications/drug therapy; Intraocular Pressure/drug effects; Cataract/complications; Anti-Inflammatory Agents/administration & dosage/adverse effects/pharmacology/*therapeutic use; Conjunctiva; Corticothérapie péri-oculaire; Epiretinal Membrane/complications; Injection sous-conjonctivale; Macula Lutea/ultrastructure; Œdème maculaire inflammatoire; Periocular corticosteroid therapy; Subconjunctival injection; Triamcinolone Acetonide/administration & dosage/adverse effects/pharmacology/*therapeutic use; Uvéite; Uveitic macular edema

TWENTY-FOUR MONTH FOLLOW-UP OF TOCILIZUMAB THERAPY FOR REFRACTORY UVEITIS-RELATED MACULAR EDEMA. - Mesquida, Marina; Molins, Blanca; Llorenç, Victor; Hernández, María V.; Espinosa, Gerard; Sainz de la Maza, Maite; Adán, Alfredo (Retina (Philadelphia, Pa.), 2018)
BACKGROUND: To report the 24-month efficacy and safety of the interleukin-6 receptor antagonist tocilizumab (TCZ) for refractory uveitis-related macular edema (ME). METHODS: Data were obtained by standardized chart review. Patients with quiescent uveitis seen at a single tertiary referral center, for whom ME was the principal cause of reduced visual acuity. OUTCOME MEASURES: Central foveal thickness measured by optical coherence tomography; degree of anterior and posterior chamber; inflammation (Standardization of Uveitis Nomenclature Working Group criteria); and visual acuity (Snellen and logarithm of the minimum angle of resolution) were recorded in all patients during TCZ therapy at months 1, 3, 6, 12, 18, and 24. RESULTS: Sixteen eyes from 12 patients (10 women) were included. Mean age was 34.6 years. Mean duration of ME was 13.2 years. All patients achieved 24 months of follow-up and that is the census date for data collection. Before TCZ was commenced, ME was present, and all patients had been previously treated with immunosuppressive therapy and biologic agents. Uveitis diagnoses were juvenile idiopathic arthritis associated, uveitis (n = 6), birdshot chorioretinopathy (n = 2), idiopathic panuveitis (n = 2), sympathetic ophthalmia (n = 1), and ankylosing spondylitis (n = 1). Mean central foveal thickness (95%; confidence interval) was 516 ± 55 μm at baseline, improving to 274 ± 13 at Month 12 (P = 0.0004), and sustained at 274 ± 14 at Month 24 of follow-up (P = 0.00039). Mean logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.78 ± 0.18 (Snellen 20/120 ± 20/30) at baseline to 0.42 ± 0.17 (20/52 ± 20/30) at Month 12 (P = 0.0001) and 0.40 ± 0.17 (20/50 ± 20/30) at Month 24 of follow-up (P = 0.0002). Tocilizumab therapy was withdrawn in 5 patients with sustained remission at Month 12 but in all, ME relapsed between 1 and 3 months after TCZ discontinuation. Rechallenge of TCZ infusions led to recovery of uveitis control and ME resolution. Two adverse events were reported during two 4-month follow-ups: one Grade 1 neutropenia and one community-acquired pneumonia. CONCLUSION: In this long-term study, TCZ was effective and had a comparable safety profile to published data for TCZ use in other indications, when used for the treatment of refractory uveitis-related ME.
Keywords: Female; Humans; Male; Middle Aged; Adult; Time Factors; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Dose-Response Relationship, Drug; Adolescent; Injections, Intravenous; *Visual Acuity; Fluorescein Angiography/*methods; Fundus Oculi; Macular Edema/diagnosis/*drug therapy/etiology; Uveitis/*complications/diagnosis; Tomography, Optical Coherence/*methods; Antibodies, Monoclonal, Humanized/*administration & dosage; Fovea Centralis/drug effects/*pathology; Interleukin-6/antagonists & inhibitors

[Visual field examinations using the Octopus computerized perimeter following laser therapy of central serous chorioretinitis (Wessing type I)]. - Faschinger, C.; Brunner, H. (Klinische Monatsblatter fur Augenheilkunde, 1982)
The authors examined 19 patients who were suffering from central serous chorioretinopathy were treated with argon laser beams with a special user-defined program of the Octopus computerized perimeter. Relative scotomata were found at a depth of between 4 and 10 decibels in 66 percent of the patients; they were seldom subjectively considered to be a disturbance.
Keywords: Humans; Male; Middle Aged; Adult; *Laser Therapy; *Visual Fields; *Lasers; Chorioretinitis/*surgery; *Computers; *Visual Field Tests

Interferon alpha-2a treatment for refractory Behcet uveitis in Korean patients. - Lee, Ji Hwan; Lee, Christopher Seungkyu; Lee, Sung Chul (BMC ophthalmology, 2018)
BACKGROUND: To evaluate therapeutic outcomes of interferon alpha-2a (IFNα2a) treatment in patients with Behcet's disease who were refractory to immunosuppressive agents. METHODS: This retrospective case series reviewed the medical records of 5 patients with refractory Behcet uveitis from January 2011 to February 2017. IFNα2a was administered at a dose of 3 million IU 3 times per week. Clinical response, relapse rate, and change of visual acuity were evaluated. RESULTS: The mean age of patients was 39.60 ± 9.21 years, and the median treatment duration was 6 months. Four of the 5 patients (80%) presented with responses to IFNα2a without any uveitis attack during the treatment period. The mean number of uveitis attacks/year per patient during the treatment was 0.40 ± 0.89. The mean log of the Minimum Angle of Resolution visual acuity improved from 1.44 ± 0.38 at baseline to 1.02 ± 0.58 at the final follow up. CONCLUSIONS: IFNα2a is an effective therapy for Behcet uveitis refractory to conventional immunosuppressants in Korean patients.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Young Adult; Recurrence; Visual Acuity; Uveitis; Uveitis/*drug therapy; Immunosuppressive Agents/adverse effects/*therapeutic use; Interferon alpha-2; Therapeutics; Behcet Syndrome/*drug therapy; Behcet syndrome; Interferon-alpha; Interferon-alpha/adverse effects/*therapeutic use; Recombinant Proteins/adverse effects/therapeutic use; Republic of Korea

Tocilizumab as an Effective Treatment Option in Children with Refractory Intermediate and Panuveitis. - Wennink, Roos A. W.; Ayuso, Viera Kalinina; de Vries, Lieuwe A.; Vastert, Sebastiaan J.; de Boer, Joke H. (Ocular immunology and inflammation, 2021)
Purpose: To describe the results of tocilizumab treatment in children with refractory non-anterior uveitis.Methods: A case series of seven children with refractory non-anterior uveitis (onset ≤16 years) with leakage on fluorescein angiogram (FA) were treated with tocilizumab intravenously every 4 weeks (eight mg/kg). Minimum follow-up was 6 months. Reported outcomes are changes in BCVA, central macular thickness (CMT) on OCT image, FA scores, dose of systemic steroids, complications and side effects.Results: In all patients, there was an improvement of macular edema and capillary leakage on FA. The median FA score decreased from 14 (10-18) at baseline to 8 (2-9) after 6 months of treatment (p = .018). The CMT decreased from 321 (314-384) to 295 (255-312) (p = .043). BCVA improved in five eyes and worsened in one eye due to cataract. No systemic or ocular complications were reported.Conclusion: Tocilizumab is an effective therapeutic option for reducing disease activity in children with refractory non-anterior uveitis.
Keywords: Female; Humans; Male; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Dose-Response Relationship, Drug; Infusions, Intravenous; Child; Child, Preschool; treatment; uveitis; *Visual Acuity; Fundus Oculi; Panuveitis/diagnosis/*drug therapy; Fluorescein Angiography/methods; inflammation; tocilizumab; Antibodies, Monoclonal, Humanized/*administration & dosage; Pediatric

Cataract extraction in patients with chronic posterior uveitis. - Brinkman, C. J.; Los, G. J.; Breebaart, A. C. (Acta ophthalmologica, 1990)
The surgical management of cataract in patients with chronic posterior uveitis is described. Of 41 eyes, 88% acquired improvement of the visual acuity 4 months postoperatively, which then remained stable in most of the cases during a follow-up of one year. The type of cataract extraction, extracapsular or intracapsular, did not influence these results, nor did the implantation of an intraocular lens. Recurrence of the uveitis occurred in about one third of the cases. Postoperative complications consisted of macular edema, retinal detachment and vitreous hemorrhage.
Keywords: Humans; Middle Aged; Prognosis; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Retrospective Studies; Chronic Disease; Visual Acuity; Cataract/*complications; Preoperative Care; Uveitis, Posterior/*complications; Lenses, Intraocular; *Cataract Extraction/adverse effects

Outcome of tocilizumab treatment in refractory ocular inflammatory diseases. - Silpa-Archa, Sukhum; Oray, Merih; Preble, Janine M.; Foster, Charles Stephen (Acta ophthalmologica, 2016)
PURPOSE: To report the outcomes of tocilizumab treatment for refractory ocular inflammatory diseases. METHODS: A retrospective case series of 17 patients (28 eyes) diagnosed with recalcitrant ocular inflammatory diseases including uveitis (10 cases), scleritis (six cases) and orbital pseudotumour (one case), who received tocilizumab between April 2010 and March 2015. All patients were initiated with treatment of 4 mg/kg or 8 mg/kg tocilizumab. The primary outcome was absence of inflammation and achievement of steroid sparing at 6 and 9 months. Secondary outcomes were change in visual acuity and major adverse effects of tocilizumab causing discontinuation of the treatment. RESULTS: Mean age at initiation of tocilizumab was 41 ± 16 years. Prior to tocilizumab treatment, all patients underwent unsuccessful conventional immunosuppressive therapy while 94% of patients (16/17) failed treatment with various biological agents. After tocilizumab administration, control of inflammation and steroid sparing were achieved in 63% and 71% of uveitis patients at 6 and 9 months, while 50% of scleritis patients achieved the primary outcome at 6 and 9 months. Mean duration of tocilizumab therapy was 12.6 ± 10.0 (range, 2-35) months. Three of four patients who had a follow-up of at least 18 (range, 18-35) months experienced quiescent inflammation for up to 32 months of tocilizumab use until last visit. Four patients (24%) discontinued tocilizumab due to serious side effects including neutropenia, unacceptable dizziness and nausea, severe angioedema and severe abdominal pain. CONCLUSION: Our series demonstrated moderate efficacy of tocilizumab in recalcitrant uveitis and scleritis. Serious adverse effects were not uncommon.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Adolescent; Infusions, Intravenous; Fluorescein Angiography; Tomography, Optical Coherence; uveitis; Visual Acuity; Ophthalmoscopy; Uveitis/diagnosis/*drug therapy; inflammation; tocilizumab; scleritis; Antibodies, Monoclonal, Humanized/administration & dosage/*therapeutic use; Interleukin-6/antagonists & inhibitors; Orbital Pseudotumor/diagnosis/*drug therapy; Scleritis/diagnosis/*drug therapy

POSTERIOR UVEITIS OR WET AGE-RELATED MACULAR DEGENERATION? CASE REPORT. - Filip, Mircea; Moisescu, Raluca (Romanian journal of ophthalmology, 2015)
We present the case of a 61-year-old patient without previous ophthalmic or general history, who developed unilateral posterior pole granuloma and was diagnosed with posterior uveitis most likely due to a systemic Toxocara canis infection. Clinical examination and ancillary investigations showed elements that were also consistent with wet ARMD, but laboratory tests and successful use of oral anti-helminthic and corticosteroid therapy in decreasing the macular lesion and improving visual acuity, confirmed the diagnosis of posterior uveitis.
Keywords: Female; Humans; Middle Aged; Drug Therapy, Combination; Treatment Outcome; Tomography, Optical Coherence; Anti-Bacterial Agents/*therapeutic use; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage; Visual Acuity; Administration, Ophthalmic; Diagnosis, Differential; Animals; Angiography; Anthelmintics/*therapeutic use; Ceftriaxone/*therapeutic use; Fluorescein/pharmacology; Fluorescent Dyes/pharmacology; Toxocara canis; Toxocariasis/*complications; Uveitis, Posterior/*diagnosis/*drug therapy/parasitology; Wet Macular Degeneration/*diagnosis

Cytomegalovirus anterior uveitis: outcome of treatment. - Chee, S.-P.; Jap, A. (The British journal of ophthalmology, 2010)
AIM: To determine the outcome of antiviral treatment of cytomegalovirus (CMV) anterior uveitis. METHODS: A retrospective review of patients from Singapore National Eye Centre with CMV anterior uveitis diagnosed by aqueous polymerase chain reaction. Ganciclovir treatment consisted of systemic, topical, intravitreal injections or intravitreal implant. The main outcome measure was resolution of anterior chamber inflammation. RESULTS: 72 eyes of 70 patients were positive for CMV DNA. 35 eyes were treated (23 eyes with acute recurrent anterior uveitis and 12 eyes with chronic anterior uveitis). Eyes that did not respond or recurred with one treatment may receive another course of treatment. There were 47 treatment episodes, 36 (76.6%) of which resulted in a response. However, there were 27 (75.0%) episodes of recurrences after stopping treatment. Systemic and intravitreal ganciclovir and ganciclovir implant had good response rates but also had very high recurrence rates. Ganciclovir gel had moderate response rates, but its recurrence rates were also lower than those of the other modalities. CONCLUSIONS: Ganciclovir gel had lower recurrence rates than the systemic ganciclovir and the implant and should be considered as an option for treatment of CMV anterior uveitis.
Keywords: Female; Humans; Male; Retrospective Studies; Antiviral Agents/*therapeutic use; Treatment Outcome; Visual Acuity/physiology; Intravitreal Injections; Uveitis, Anterior/*drug therapy; Cytomegalovirus Retinitis/*drug therapy; Ganciclovir/*therapeutic use; Immunocompetence; Singapore

Treatment strategies for scleritis and uveitis associated with inflammatory bowel disease. - Soukiasian, S. H.; Foster, C. S.; Raizman, M. B. (American journal of ophthalmology, 1994)
We treated 19 patients with anterior uveitis, episcleritis, or scleritis associated with inflammatory bowel disease. Adequate control of ocular inflammation was achieved in 16 patients (84%). Ocular inflammation was adequately controlled with corticosteroids alone, without systemic adverse effects, in only three patients, all of whom had anterior uveitis associated with ulcerative colitis. Systemic nonsteroidal anti-inflammatory drugs proved beneficial in six of seven patients, and one additional patient benefited from another anti-inflammatory drug (hydroxychloroquine sulfate). Systemic cytotoxic immunosuppressive therapy was used in the remaining seven patients, six of whom had bilateral disease. Ocular inflammation was controlled in six of these patients. Azathioprine was beneficial for scleritis but was less effective for anterior uveitis, especially in Crohn's disease, thus necessitating the use of another cytotoxic agent. HLA-B27-positive anterior uveitis was more refractory to corticosteroid therapy and was more likely to require systemic cytotoxic immunosuppressive therapy. With the medical and surgical strategies described, vision was improved or maintained in all patients in the study group.
Keywords: Female; Humans; Male; Middle Aged; Adult; Combined Modality Therapy; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Immunosuppressive Agents/therapeutic use; Visual Acuity; Administration, Topical; Adrenal Cortex Hormones/adverse effects/therapeutic use; Colitis, Ulcerative/*complications; Crohn Disease/*complications; Scleritis/complications/*drug therapy/surgery; Uveitis, Anterior/complications/*drug therapy/surgery

Macular hole closure after peribulbar steroid injection. - Halkiadakis, Ioannis; Pantelia, Eugenia; Giannakopoulos, Nikos; Koutsandrea, Chrisanthi; Markomichelakis, Nikos N. (American journal of ophthalmology, 2003)
PURPOSE: To report the closure of a macular hole after a peribulbar corticosteroid injection in a patient with anterior uveitis associated with human leukocyte antigen B*27. DESIGN: Interventional case report.The patient was evaluated by comprehensive ophthalmic check-up and optical coherence tomography. RESULTS: A healthy 50-year-old woman presented to our service with active human leukocyte antigen B*27-associated anterior uveitis, macular hole in the right eye and macular edema in the left eye. Visual acuity was 20/200 in both eyes. Peribulbar injections of triamcinolone acetonide were administered in both eyes. Three months later, visual acuity improved to 20/50 in both eyes, and the uveitis was in complete remission. Optical coherence tomography verified that the macular hole in the right eye was closed. CONCLUSIONS: Inflammation and macular edema might be contributing factors in macular hole formation in patients with uveitis. This case indicates that treatment of inflammation and macular edema might lead to macular hole closure in similar cases.
Keywords: Female; Humans; Middle Aged; Tomography, Optical Coherence; Injections; Visual Acuity; Triamcinolone Acetonide/*administration & dosage; Glucocorticoids/*administration & dosage; Orbit; Macular Edema/complications/diagnosis/drug therapy; HLA-B27 Antigen/immunology; Retinal Perforations/*drug therapy/etiology; Uveitis, Anterior/complications/diagnosis/drug therapy

Transillumination guided cyclocryotherapy in the treatment of secondary glaucoma. - Vest, E.; Rong-Guang, W.; Raitta, C. (European journal of ophthalmology, 1992)
A consecutive series of 38 eyes of 35 glaucoma patients treated with transillumination guided cyclocryotherapy (CCT) either to obtain pain relief or to achieve IOP control was studied at Helsinki University Eye Hospital. Transillumination was used to guide the applications to the correct site. The follow-up range was 1-43 months (mean 9 months). Pretreatment IOP was 39 +/- 13 mm Hg and postoperative 26 +/- 16 mm Hg (mean +/- SD). Twenty-three eyes underwent one and 15 eyes 2-5 procedures. IOP control (IOP 9-23 mm Hg) was achieved in 50%. The response was more favorable in eyes without iris neovascularisation (59% achieved IOP control) than in eyes with neovascular glaucoma (38% achieved IOP control). The best response was achieved in eyes with chronic uveitis (5/7 eyes achieved IOP control). Repeated procedures improved the IOP control rate. Hypotony (IOP < 9 mm Hg) without clinical signs of phthisis occurred in three eyes (8%). Thirteen eyes needed primarily pain relief and 92% achieved it. Postoperatively vision was better in 8%, unchanged in 37% and worse in 55%. Visual acuity was 0.05 or better in nine eyes pretreatment and in eight eyes after treatment.
Keywords: Humans; Middle Aged; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Retrospective Studies; Chronic Disease; Visual Acuity; Intraocular Pressure; Ciliary Body/*surgery; Glaucoma/*etiology/*surgery; Uveitis/surgery; *Cryosurgery/methods; Glaucoma, Neovascular/*surgery; Lighting; Palliative Care

Three-year visual and anatomic results of administrating intravitreal bevacizumab in inflammatory ocular neovascularization. - Mansour, Ahmad M.; Arevalo, J. Fernando; Fardeau, Christine; Hrisomalos, Emily N.; Chan, Wai-Man; Lai, Timothy Y. Y.; Ziemssen, Focke; Ness, Thomas; Sibai, Abla Mehio; Mackensen, Friederike; Wolf, Armin; Hrisomalos, Nicholas; et al. (Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2012)
OBJECTIVE: To assess the 3-year visual outcome of intravitreal bevacizumab in inflammatory ocular neovascularization. DESIGN: Experimental study. METHODS: Retrospective multicenter consecutive case series in 81 patients with inflammatory ocular neovascularization refractory to standard therapy and treated with intravitreal bevacizumab. The outcome measures included improvement of best corrected visual acuity expressed as logarithm of minimum angle of resolution (logMAR) and paired comparison decrease in central foveal thickness by optical coherence tomography. RESULTS: Mean best corrected visual acuity improved from baseline 0.699 (6/30 or 20/101) (SD 0.434) to 0.426 (6/16 or 20/53) (SD 0.428) (n = 81; p < 0.001), a gain of 2.7 lines (median 3 injections; 81 eyes; 81 patients). Paired comparisons revealed significant central foveal flattening at 3 years of 97.9 μm (n = 51; p < 0.001). In a subgroup analysis, visual improvement was significant for ocular histoplasmosis (p = 0.026); multifocal choroiditis (p = 0.05); serpiginous choroiditis (p = 0.028); ocular toxoplasmosis (p = 0.042); and punctate inner choroidopathy (p = 0.015). In a subgroup analysis, foveal flattening was significant for ocular histoplasmosis (p = 0.004); multifocal choroiditis (p = 0.007); serpiginous choroiditis (p = 0.011); and punctate inner choroidopathy (p = 0.001). Of the group, 5 eyes developed submacular fibrosis, 1 eye retinal pigment epithelial tear, and 1 eye macular ischemia in the context of vasculitis. CONCLUSION: At 3 years, intravitreal bevacizumab sustained significant visual improvement of 2.7 lines and significant foveal flattening of 98 μm in a wide variety of inflammatory ocular diseases without major complications after a median of 3 injections.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Time Factors; Retrospective Studies; Treatment Outcome; Adolescent; Child; Chemotherapy, Adjuvant; Tomography, Optical Coherence; Immunosuppressive Agents/therapeutic use; Intravitreal Injections; Visual Acuity/*physiology; Retina/*pathology; Uveitis/*drug therapy/physiopathology; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Bevacizumab; Antibodies, Monoclonal, Humanized/*administration & dosage; Angiogenesis Inhibitors/*administration & dosage; Choroidal Neovascularization/*drug therapy/physiopathology; Choroiditis/*drug therapy/physiopathology

Novel treatment regimen of Vogt-Koyanagi-Harada disease with a reduced dose of corticosteroids combined with immunosuppressive agents. - Yang, Peizeng; Ye, Zi; Du, Liping; Zhou, Qingyun; Qi, Jian; Liang, Liang; Wu, Lili; Wang, Chaokui; Kijlstra, Aize (Current eye research, 2018)
PURPOSE: To investigate the effectiveness, visual outcome, and prognostic factors of Vogt-Koyanagi-Harada (VKH) disease treatment with a reduced dose of corticosteroids combined with immunosuppressive agents. METHODS: The clinical characteristics, auxiliary examinations, treatment result, visual outcome, and prognostic factors in VKH patients were analyzed. RESULTS: A total of 998 VKH patients were divided into posterior uveitis group (Group1), anterior uveal involvement group (Group 2), and recurrent granulomatous anterior uveitis group (Group 3). Reduced doses of corticosteroids combined with immunosuppressive agents were used for 1-1.5 years. Uveitis was controlled in 100%, 100%, and 96.8% of these three groups, respectively. Visual improvement and stability was observed in 98.1%, 96.5%, and 88.3%, respectively. Treatment after disease onset, visual acuity at first visit, and 1 month after treatment was positively associated with BCVA at last visit (p < 0.05). CONCLUSION: A reduced dose of corticosteroids combined with immunosuppressive agents effectively controlled the intraocular inflammation and improved visual acuity in most Chinese VKH patients.
Keywords: Humans; Drug Therapy, Combination; Retrospective Studies; Treatment Outcome; Recurrence; Methotrexate/administration & dosage; Prednisone/administration & dosage; Fluorescein Angiography; Cyclophosphamide/administration & dosage; Visual Acuity/physiology; Acute Disease; Glucocorticoids/*administration & dosage; Immunosuppressive Agents/*administration & dosage; Off-Label Use; Cyclosporine/administration & dosage; Uveomeningoencephalitic Syndrome/diagnosis/*drug therapy/physiopathology; *Prognosis factor; *Treatment regimen; *VKH disease; Azathioprine/administration & dosage

[Diathermy and cryotherapy of the pars plana in the treatment of pars planitis. Long-term evaluation]. - Bonnet, M.; Moron Morel, F. (Journal francais d'ophtalmologie, 1985)
Seventeen eyes of 14 patients affected with severe pars planitis underwent surgical treatment with either cryotherapy - 3 eyes - or diathermy - 14 eyes. The indications for surgery were selected as follows: ten eyes of 9 patients showed recurrence(s) or increase of ocular inflammation following tapering of systemic corticoids; 5 patients had contra-indications to systemic corticoids. Ten eyes had cystoid macular edema. The follow-up after surgery varies from 2,5 years to 10 years with an average of 5 years. Complete and permanent recovery from ocular inflammation was achieved in 7 eyes (41,2%). Permanent although incomplete improvement was achieved in 4 eyes (23,5%). Recurrences of ocular inflammation after incomplete improvement occurred in 4 eyes (23,5%). Complications - cystoid macular degeneration and severe ocular hypotension - occurred in 2 eyes (11,8%). Cystoid macular edema cleared in 9 out of 10 eyes. The final visual acuity was the same or better as compared to the initial visual acuity in 10 eyes, and worse in 7 eyes. It is concluded that the long term evaluation of cryotherapy and diathermy in the treatment of pars planitis confirms the results achieved in other series with a shorter follow-up. The treatment is beneficial in selected cases of severe pars planitis. However complete and permanent recovery from ocular inflammation should be expected in less than 50% of the cases.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Adolescent; Recurrence; Child; Visual Acuity; Intraocular Pressure; Ciliary Body/*surgery; Adrenal Cortex Hormones/administration & dosage; Sclera/surgery; *Cryosurgery/adverse effects; *Electrocoagulation/adverse effects; Macular Edema/etiology/therapy; Microsurgery/methods; Uveitis/drug therapy/*surgery

Psoriatic uveitis-associated cystoid macular oedema treated with intravitreal triamcinolone acetonide. - Dhir, Luna; Prasad, Som D. (Acta ophthalmologica Scandinavica, 2006)
Keywords: Female; Humans; Adult; Glucocorticoids/*therapeutic use; Injections; Visual Acuity; Vitreous Body; Macular Edema/*drug therapy/etiology; Triamcinolone Acetonide/*therapeutic use; Uveitis, Intermediate/*drug therapy/etiology; Arthritis, Psoriatic/*complications

A clinical grading system based on ultra-wide field retinal imaging for sunset glow fundus in Vogt-Koyanagi-Harada disease. - Lee, Eun Kyoung; Lee, Sang-Yoon; Yu, Hyeong Gon (Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2015)
BACKGROUND: To develop a grading system for sunset glow fundus (SGF) based on the results of ultra-wide field retinal imaging and to investigate the factors related to the severity of SGF in patients with Vogt-Koyanagi-Harada (VKH) disease. METHODS: Records of 55 eyes with VKH disease were retrospectively reviewed. All patients had undergone serial fundus photography, ultra-wide field retinal imaging and spectral-domain optical coherence tomography. The morphologic characteristics of SGF and associated features related to the severity of the condition were evaluated. RESULTS: Sunset glow fundi were classified into 3 groups based on the extent and severity of depigmentary changes: early (n = 7), intermediate (n = 10) and advanced (n = 20). Grade 0 indicates the absence of sunset glow appearance. Eyes with a higher SGF grade were more likely to exhibit chronic recurrence (P < 0.001) and an anterior chamber reaction ≥ 2+ (P < 0.001), and were less likely to exhibit exudative retinal detachment (P < 0.001) at the initial presentation. Higher grades were more likely to exhibit cataracts (P < 0.001), glaucoma (P = 0.010), patchy chorioretinal atrophic lesions (P = 0.012), depigmented atrophic lesions (P < 0.001), an increased peripapillary atrophy/disc area ratio (P < 0.001), a decreased subfoveal choroidal thickness (P < 0.001), more frequent uveitis recurrences (P = 0.012) and a longer disease duration (P < 0.001). SGF progression was faster in eyes with a longer active inflammatory period. CONCLUSIONS: We present a simple and logical grading system for SGF as determined by using ultra-wide field retinal imaging. This grading system offers a means of assessing the degree of inflammation and facilitates speculation about the duration of VKH disease.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Retrospective Studies; Adolescent; Tomography, Optical Coherence; Glucocorticoids/administration & dosage; Immunosuppressive Agents/administration & dosage; Visual Acuity/physiology; Pulse Therapy, Drug; *Fundus Oculi; Photography; Retinal Diseases/*classification/*diagnosis/drug therapy; Uveomeningoencephalitic Syndrome/*classification/*diagnosis/drug therapy

[Diode laser cyclophotocoagulation of secondary glaucoma caused by anterior, necrotizing scleritis]. - Schlote, T.; Mielke, J.; Zierhut, M.; Jean, B.; Thiel, H. J. (Klinische Monatsblatter fur Augenheilkunde, 1998)
PATIENT: A 60-year-old female patient presented with recurrent anterior, necrotizing scleritis with inflammation and a newly developed secondary glaucoma in the right eye. Anterior uveitis occurred some years before. Severe scleral thinning was circumferentially present and focal scleral ectasia was found. Physical examination revealed no systemic association of scleritis. Immunosuppressive therapy with metotrexate was initiated and control of scleritis achieved. Intraocular pressure elevation persisted and was refractory to glaucoma medication. Diurnal pressure curve showed IOP-values of 40 mm Hg despite the use of systemic carbonic anhydrase inhibitors. Visual acuity was 20/50 in the right and 20/25 in the left eye. METHOD: Diode laser cyclophotocoagulation (Oculight SLx 810 nm, Iris Medical Instruments Inc. California, USA) was performed under general anaesthesia using reduced parameters for application (12 laser spots, 1 second, 1.25 W). No complications occurred during and after laser application. Postoperatively, intraocular pressure was within normal range between 14 and 18 mm Hg. No reactivation of scleritis or uveitis was seen. CONCLUSION: In our experience, diode laser cyclophotocoagulation is effective and safe in treating secondary glaucoma associated with anterior, necrotizing scleritis with inflammation and uveitis using reduced parameters for application.
Keywords: Female; Humans; Middle Aged; Laser Coagulation/*methods; Uveitis, Anterior/complications; Glaucoma/*etiology/*therapy; Scleritis/*complications

The efficacy of corticosteroid-sparing immunomodulatory therapy in treating patients with central multifocal choroiditis. - de Groot, Evianne L.; Ten Dam-van Loon, Ninette H.; de Boer, Joke H.; Ossewaarde-van Norel, Jeannette (Acta ophthalmologica, 2020)
PURPOSE: To evaluate the efficacy of corticosteroid-sparing immunomodulatory therapy (IMT) in patients with recurrent and/or sight-threatening central multifocal choroiditis (MFC). METHODS: This was a retrospective cohort study in a tertiary uveitis centre including all patients with MFC who have been treated with IMT for at least 12 months. Clinical data and imaging results were collected regarding the period prior to the start of IMT and at 3, 6, 12 and - where available - 24 months after the start of IMT. Main outcome measure was the number of annual recurrences of choroiditis with or without active choroidal neovascularization before and after the start of IMT. Secondary outcomes were the percentage of patients with (steroid-free) remission and the median time between the start of IMT and (steroid-free) remission. RESULTS: Thirty-two patients (39 eyes) were included. At the start of IMT, none of the patients were in (steroid-free) remission. At 24 months, the probability of achieving remission and steroid-free remission was 88,5% and 50%, respectively. The median time to achieve remission and steroid-free remission was 21 and 83 weeks, respectively. In 17 patients (20 eyes) with available clinical data and imaging results for ≥ 12 months prior to the start of IMT, the mean number of recurrences/year decreased significantly from 1.40 ± 0.81 at baseline to 0.49 ± 0.47 (p = 0.001) after the start of IMT. CONCLUSIONS: Preventive therapy with IMT should be considered in patients with recurrent and/or sight-threatening MFC to decrease the number of recurrences/year and to increase the prospects of achieving either remission or steroid-free remission.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Retrospective Studies; Young Adult; Adolescent; Glucocorticoids/*therapeutic use; Recurrence; Remission Induction/methods; *Visual Acuity; *Immunomodulation; Immunomodulatory therapy; corticosteroid-sparing therapy; DMARD; Immunosuppressive therapy; MFC; multifocal choroiditis; Multifocal choroiditis without panuveitis; Multifocal Choroiditis/diagnosis/*drug therapy; PIC

[Local choroiditis after influenza vaccination (a clinical case study)]. - Stoyukhina, A. S. (Vestnik oftalmologii, 2019)
The article describes a difficult case of differential diagnosis of local choroiditis developed after influenza (flu) vaccination in a patient with bronchial asthma who receives systemic steroid therapy.
Keywords: Humans; Fluorescein Angiography; Visual Acuity; *Choroiditis; *Influenza, Human; influenza vaccination; local choroiditis; metastatic choroidal lesions; optic coherence tomography; Vaccination

Randomized, double-blind, placebo-controlled clinical trial on the efficacy of 0.5% indomethacin eye drops in uveitic macular edema. - Allegri, Pia; Murialdo, Ugo; Peri, Simona; Carniglia, Rosanna; Crivelli, Maria Grazia; Compiano, Silvia; Autuori, Silvia; Mastromarino, Antonio; Zurria, Monia; Marrazzo, Giuseppina (Investigative ophthalmology & visual science, 2014)
PURPOSE: The aim of the present randomized, double-blind, placebo-controlled clinical trial was to assess the efficacy and tolerability of 0.5% indomethacin (INDOM) eye drops in adult patients suffering from macular edema (ME) related to different etiology uveitis. METHODS: Forty-six eyes of 31 adult patients (20 females and 11 males) mean age 39 years, affected by inflammatory ME, were randomized to receive a dose of commercial 0.5% INDOM eye-drops four times per day (16 subjects = 23 eyes) or placebo (the vehicle of INDOM, 15 subjects = 23 eyes) during a 6-month active therapy follow-up. Study assessment at each visit included visual acuity testing (VA), slit-lamp examination, IOP evaluation, and Heidelberg Spectralis optical coherence tomography (OCT) central foveal thickness (CFT) measurement. Any variation in subjective symptoms and tolerability was also detected. RESULTS: Statistical analysis showed, from baseline to the 6-month visit, a significant reduction in CFT (P < 0.0001) and a significant improvement in VA only in the 0.5% INDOM-treated group; a global reduction of discomfort symptoms was present in both groups (P < 0.001). CONCLUSIONS: The four times per day administration of 0.5% INDOM eye drops in eyes affected with uveitic ME from different etiologies, compared with placebo, is associated with a significant reduction in ME at the 6-month follow-up visit, as measured by spectral-domain optical coherence tomography (SD-OCT). However, not all eyes showed a complete resolution of ME because of vitreoretinal traction. (https://eudract.ema.europa.eu/index.html number, EUDRACT 2011-001522-20.).
Keywords: Double-Blind Method; Female; Humans; Male; Middle Aged; Aged; Prospective Studies; Follow-Up Studies; Treatment Outcome; Dose-Response Relationship, Drug; Drug Administration Schedule; Fluorescein Angiography; Tomography, Optical Coherence; Fundus Oculi; Ophthalmic Solutions; Visual Acuity; Macular Edema/diagnosis/*drug therapy/etiology; Uveitis/*complications/diagnosis/drug therapy; Cyclooxygenase Inhibitors/administration & dosage; 0.5% indomethacin eye drops; Indomethacin/*administration & dosage; Spectralis OCT; uveitic macular edema

INTRAVITREAL INFLIXIMAB IN REFRACTORY UVEITIS IN BEHCET'S DISEASE: A Safety and Efficacy Clinical Study. - Hamza, Mostafa M. E.; Macky, Tamer A.; Sidky, Mohamed Karim; Ragab, Gaafar; Soliman, Mahmoud M. (Retina (Philadelphia, Pa.), 2016)
PURPOSE: To assess the safety and efficacy of intravitreal infliximab (1 mg/0.05 mL) in patients with refractory posterior uveitis in Behcet's disease. METHODS: Twenty patients were included in this study. Best corrected visual acuity (BCVA), vitreous haze (graded 0-4), vasculitis, retinitis, and papillopathy (presence or absence) were assessed at baseline, Day 1 and Week 2, 4, 6, 8, 12, and 18. Optical coherence tomography (OCT) central foveal thickness, fluorescein angiography, and flash electroretinogram were done at baseline and 4, 12, and 18 weeks. RESULTS: Mean baseline logMAR BCVA was 0.94 (20/160), had improved significantly by Week 2 to 0.6 (20/80) (P < 0.0001), and reached 0.36 (20/40) by Weeks 18 with three injections (P < 0.0001). Mean central foveal thickness OCT decreased significantly from baseline 361 μm to 180 μm at the end of follow-up (P < 0.0001). Profound decrease in mean vitreous haze gradings from two to 0.2 by the end follow-up (P < 0.05). There was a significant reduction in the number of patients with vasculitis (15 at baseline to 1 weeks at 18 weeks), retinitis (nine at baseline to none at 4 weeks), and papillitis (two at baseline to none at 4 weeks) (P < 0.05). No significant electrophysiological changes or ocular adverse inflammatory reactions were observed during the study period. CONCLUSION: Intravitreal infliximab appeared to be safe and effective in treating uveitis in Behcet's disease and should be considered as an alternative to systemic therapies.
Keywords: Female; Humans; Male; Adult; Follow-Up Studies; Antibodies, Monoclonal/*therapeutic use; Tumor Necrosis Factor-alpha/antagonists & inhibitors; Infliximab/*therapeutic use; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity; Intravitreal Injections; Uveitis/*drug therapy; Behcet Syndrome/*complications

Combination of pulse cyclophosphamide and azathioprine in ocular manifestations of Behcet's disease: longitudinal study of up to 10 years. - Davatchi, Fereydoun; Sadeghi Abdollahi, Bahar; Shams, Hormoz; Shahram, Farhad; Nadji, Abdolhadi; Chams-Davatchi, Cheyda; Faezi, Tahereh; Akhlaghi, Massoomeh; Ghodsi, Zahra; Ashofteh, Farimah; Mohtasham, Negin (International journal of rheumatic diseases, 2014)
AIM: Ocular lesions of Behcet's disease (BD) need aggressive treatment to prevent severe loss of vision or blindness. Cytotoxic drugs are the main therapeutic agents and the first line treatment. Retinal vasculitis is the most aggressive lesion of ocular manifestations and predicts a worse systemic outcome. We present here the outcome with a combination of pulse cyclophosphamide, azathioprine and prednisolone, on long-term usage, up to 10 years, on 295 patients (18 493 eye-months of follow-up). METHODS: Cyclophosphamide was used as a 1-g monthly pulse for 6 months and then every 2-3 months as necessary. Azathioprine was used at 2-3 mg/kg daily. Prednisolone was initiated at 0.5 mg/kg daily. Upon the suppression of the inflammatory reaction, prednisolone was tapered gradually. Patients fulfilled the International Criteria Behcet's Disease (ICBD) and had active posterior uveitis (PU) and/or retinal vasculitis (RV). Visual acuity (VA), PU, RV and TADAI (Total Adjusted Disease Activity Index) were calculated. RESULTS: Overall results: mean VA improved from 3.5 to 4.3 (P < 0.0001), 44% of eyes improved (95% CI = 40-50). Mean PU improved from 2.1 to 0.8 (P < 0.0001), 73% of eyes improved (95% CI = 69-78). Mean RV improved from 3.0 to 1.4 P < 0.0001), 70% of eyes improved (95% CI = 65-74). Mean TADAI improved from 29 to 18 (P < 0.0001), 72% of patients improved (95% CI = 66-77). The details of the longitudinal studies are given in the main article. CONCLUSION: All parameters significantly improved. VA improvement was the least, mainly due to cataracts. This combination is the best treatment choice for retinal vasculitis before opting for biologic agents.
Keywords: Humans; Drug Therapy, Combination; Time Factors; Treatment Outcome; Drug Resistance; Recovery of Function; Longitudinal Studies; Prednisolone/administration & dosage; Visual Acuity/drug effects; Immunosuppressive Agents/*administration & dosage; Behcet Syndrome/complications/diagnosis/*drug therapy; Pulse Therapy, Drug; Cyclophosphamide/*administration & dosage; Behcet's disease; Registries; Retinal Vasculitis/diagnosis/*drug therapy/etiology/physiopathology; Uveitis, Anterior/diagnosis/*drug therapy/etiology/physiopathology; Uveitis, Posterior/diagnosis/*drug therapy/etiology/physiopathology; Azathioprine/*administration & dosage; cytotoxic drugs; longitudinal study; ocular lesions

Interferon Alpha-2a Treatment for Post-Uveitic Refractory Macular Edema. - De Simone, L.; Sangiovanni, A.; Aldigeri, R.; Mastrofilippo, V.; Bolletta, E.; Invernizzi, A.; Fares, L.; Pipitone, N.; Fontana, L.; Salvarani, C.; Cimino, L. (Ocular immunology and inflammation, 2020)
Purpose: To assess the efficacy of interferon (IFN) alpha-2a in the treatment of post-uveitic refractory macular edema (ME).Methods: Retrospective cohort of patients with post-uveitic refractory ME, who received subcutaneous IFN alpha-2a injections for at least 3 months. Baseline central macular thickness (CMT) and best-corrected visual acuity (BCVA) were compared with those at follow-up visits up to 12 months.Results: Thirty-seven patients were included. Treatment duration (median [interquartile range]) was 14[8-24] months with a follow-up of 17[10-38] months. CMT (mean [standard deviation]) decreased from 438[140] to 335[119] μm after 1 month (p < 0.0001) and remained significantly lower up to 12 months (286[98] μm, p = 0.001). BCVA (0.48[0.33] logMAR at baseline) improved by 0.26[0.33] logMAR (p = 0.001) at 12 months. There were 14 recurrences. Seven patients had treatment side effects, without serious adverse events.Conclusions: IFN alpha-2a was effective, safe, and well tolerated in treating post-uveitic refractory ME.
Keywords: Female; Humans; Male; Middle Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; uveitis; *Visual Acuity; Fundus Oculi; Macular Edema/diagnosis/*drug therapy/etiology; Tomography, Optical Coherence/methods; Intravitreal Injections; Uveitis/*complications/diagnosis; Interferon alpha-2/*administration & dosage; Fluorescein Angiography/methods; macular edema; Antineoplastic Agents/administration & dosage; IFN; Interferon alpha-2a; post-uveitic

A 10-year follow-up of infliximab monotherapy for refractory uveitis in Behçet's syndrome. - Horiguchi, Noe; Kamoi, Koju; Horie, Shintaro; Iwasaki, Yuko; Kurozumi-Karube, Hisako; Takase, Hiroshi; Ohno-Matsui, Kyoko (Scientific reports, 2020)
Infliximab (IFX) was the first biologic introduced for refractory uveitis treatment in Behçet's syndrome (BS). However, there have been few reports on the safety and efficacy of IFX monotherapy over follow-up periods of more than 10 years. This retrospective study evaluated the 10-year safety and efficacy of IFX monotherapy compared to IFX combination therapies with colchicine or corticosteroid for refractory uveitis in BS patients. Monotherapy was performed in 30 eyes of 16 patients while combination therapies were performed in 20 eyes of 11 patients. Continuation of IFX occurred in 70.3% of enrolled patients for 10 years without any significant difference noted in the retention rate between the monotherapy and combination therapies (p = 0.86). Reduction of ocular inflammatory attacks and improvement of best corrected visual acuity occurred in the monotherapy group after 10 years, which was equivalent to that for the combination therapies. Although adverse events (AEs) or therapy discontinuation occurred during the initial 5 years in both therapies, no AEs were observed for either therapy after 6 years. Our results suggested that IFX monotherapy proved to be effective and not inferior to combination therapies over a 10-year follow-up. Although loss of response and AEs may be noticed during the initial 5-year period, a safe and effective continuation can be expected thereafter.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Drug Therapy, Combination; Follow-Up Studies; Treatment Outcome; Antirheumatic Agents/administration & dosage/adverse effects/*therapeutic use; Recurrence; Drug Resistance; Visual Acuity; Uveitis/diagnosis/*drug therapy; Retreatment; Behcet Syndrome/diagnosis/*drug therapy; Immunosuppressive Agents/administration & dosage/adverse effects/therapeutic use; Infliximab/administration & dosage/adverse effects/*therapeutic use; Symptom Assessment

A Comparison of the Dexamethasone Implant (Ozurdex®) and Inferior Fornix-Based Sub-Tenon Triamcinolone Acetonide for Treatment of Inflammatory Ocular Diseases. - Errera, Marie-Hélène; Westcott, Mark; Benesty, Jonathan; Falah, Sabrina; Smadja, Jérôme; Orès, Raphaëlle; Pratas, Ana C.; Sedira, Neila; Bensemlali, Amine; Héron, Emmanuel; Goldschmidt, Pablo; Bodaghi, Bahram; et al. (Ocular immunology and inflammation, 2019)
PURPOSE: To evaluate the efficacy and safety of dexamethasone (DEX) implant compared with inferior fornix-based sub-Tenon triamcinolone injection (PSTA) for treatment of uveitis. METHODS: A total of 48 eyes received DEX and 49 eyes received PSTA as the first treatment. RESULTS: A total of 31 eyes were implanted with DEX relapsed (64.5%) after the first injection, while 32 eyes were injected with PSTA as the first treatment relapsed (65.3%). Kaplan-Meier estimated survival to overall relapse after the first injection was a mean 20 months± 3.6 months for DEX (median,7) and 14 months± 1.9 months (median,9) for the PSTA (P = 0.505). Of 49 eyes receiving the PSTA implant as the first treatment, inflammation persisted in 14.3% after the first injection but persisted in none after the DEX injection (P = 0.005). CONCLUSIONS: DEX implantation achieved a higher rate of disease control in the initial 12 weeks postinjection with a relative equivalence in the duration of effect and relapse rates when compared with PSTA.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Time Factors; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Tomography, Optical Coherence; Glucocorticoids/administration & dosage; uveitis; *Visual Acuity; Injections, Intraocular; Triamcinolone Acetonide/*administration & dosage; Drug Implants; Dexamethasone/*administration & dosage; Uveitis/diagnosis/*drug therapy; Ozurdex; Tenon Capsule; triamcinolone; sub-Tenon injection

Intravitreal Dexamethasone for the Treatment of CMO Associated with Refractory Sclerouveitis. - Pohlmann, Dominika; Winterhalter, Sibylle; Pleyer, Uwe (Ocular immunology and inflammation, 2018)
PURPOSE: To assess the efficacy and tolerability of intravitreal dexamethasone 0.7 mg sustained-release insert (Ozurdex(®)) in patients with sclerouveitis and recurrent cystoid macula edema (CMO) refractory to treatment. METHODS: Interventional retrospective case series of five patients receiving 13 intravitreal dexamethasone inserts. RESULTS: Three of five patients presented with an associated systemic disorder, whereas two patients had idiopathic sclerouveitis. All patients received immunosuppressive therapy. The CRT mean (SD) decreased in all eyes from 428 μm (137) (baseline) to 327 μm (149) (1 month), 342 μm (155) (3 months), 297 μm (99) (6 months) and reduced scleral inflammation. No morphologic adverse changes were noted, in particular, no scleral melting or necrosis occurred. CONCLUSIONS: Intravitreal dexamethasone may be an effective and safe therapeutic option in sclerouveitis with otherwise treatment-resistant CMO. It resolves not only CMO, but also provides a reduction of scleral inflammation and ocular pain. Nonetheless, adequate immunosuppressive treatment of an underlying disease must ensue.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Tomography, Optical Coherence; uveitis; Visual Acuity; Drug Implants; Intravitreal Injections; Uveitis/complications/*drug therapy; Dexamethasone/*administration & dosage; Glucocorticoids/*administration & dosage; Macular Edema/*drug therapy/etiology; scleritis; CMO; intravitreal dexamethasone; Scleritis/complications/*drug therapy; systemic disease

Rate of hypotony following 25-gauge pars plana vitrectomy. - Gupta, Naina; Punjabi, Omar S.; Steinle, Nathan C.; Singh, Rishi P. (Ophthalmic surgery, lasers & imaging retina, 2013)
BACKGROUND AND OBJECTIVE: To report the rates of hypotony after 25-gauge vitrectomy. PATIENTS AND METHODS: A retrospective review of 111 consecutive cases was performed in patients undergoing transconjunctival 25-gauge pars plans vitrectomy with either air or gas as a tamponade agent. The primary outcome measure was postoperative intraocular pressure less than 5 mm Hg. A Wilcoxon rank-sum test was conducted to determine the statistical significance of continuous variables in association with rates of hypotony. RESULTS: The overall incidence of hypotony on postoperative day 1 was found to be 8.1%. The rate of hypotony was 16.7% in uveitis cases and 0% in routine macular surgery. The rate of hypotony in cases in which sutures were used was 41.7%, compared to 4% in cases in which sutures were not used (P = .001). CONCLUSION: Hypotony rates were significantly higher after 25-gauge transconjunctival pars plana vitrectomy in uveitis and some other conditions.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Retrospective Studies; Risk Factors; Incidence; Visual Acuity/physiology; Tonometry, Ocular; *Vitrectomy; Endotamponade; *Postoperative Complications; *Intraocular Pressure; Uveitis/surgery; *Microsurgery; Fluorocarbons/administration & dosage; Hypotension/epidemiology/*etiology; Retinal Diseases/surgery; Sulfur Hexafluoride/administration & dosage

Uveitis associated with interleukin-3 and interleukin-6 therapy. - Wu, W. C.; Mannion, B.; Stone, R. M. (Archives of ophthalmology (Chicago, Ill. : 1960), 1995)
Keywords: Female; Humans; Aged; Drug Therapy, Combination; Visual Acuity/drug effects; Vitreous Body/pathology; Anterior Chamber/pathology; Hodgkin Disease/drug therapy; Interleukin-3/*adverse effects/therapeutic use; Interleukin-6/*adverse effects/therapeutic use; Uveitis/*chemically induced

Intravitreal ranibizumab for the treatment of inflammatory choroidal neovascularization. - Rouvas, Alexander; Petrou, Petros; Douvali, Maria; Ntouraki, Amalia; Vergados, Ioannis; Georgalas, Ilias; Markomichelakis, Nikolaos (Retina (Philadelphia, Pa.), 2011)
PURPOSE: To evaluate the effect of individualized repeated intravitreal injections of ranibizumab (Lucentis) on visual acuity and central foveal thickness in patients with choroidal neovascular membrane (CNV) associated with various ocular inflammatory clinical entities. METHODS: Our study was a retrospective, noncomparative, interventional, and observational case series. Sixteen eyes of 15 consecutive patients diagnosed with inflammatory CNV treated with repeated intravitreal injections of ranibizumab were evaluated. The underlying diagnoses were toxoplasmosis (n = 4), serpiginous choroidopathy (n = 2), punctate inner choroidopathy (n = 5), multifocal choroiditis (MFC, n = 3), and scleroderma (n = 2). All patients underwent monthly optical coherence tomography (OCT) scans and fluorescein angiography/indocyanine green angiography every 1 month after every injection and then every 3 months. Optical coherence tomography scans and fluorescein angiography were performed by the same experienced physician. Repeated intravitreal injections were performed when persistent/recurrent fluid on OCT and/or signs of active CNV on angiography were present. Changes in Early Treatment Diabetic Retinopathy Study visual acuity and central foveal thickness were statistically analyzed. RESULTS: The mean follow-up time was 70.4 ± 24 weeks (17.6 months; range, 44-116 weeks [11-29 months]). The mean number of injections performed was 2.3, and the mean best-corrected visual acuity improved from 55 Early Treatment Diabetic Retinopathy Study letters (logarithm of the minimum angle of resolution, 0.9 ± 0.4 [mean ± SD]) at baseline to 70.3 Early Treatment Diabetic Retinopathy Study letters (logarithm of the minimum angle of resolution, 0.6 ± 0.4) at the end of the follow-up, a statistically significant change compared with baseline (P < 0.0001). The mean letter gain was 15.3 letters, and best-corrected visual acuity improved in 14 of 16 patients (88%) and remained stable in 2 patients (12.5%) without any patient demonstrating deterioration. The mean central foveal thickness (although not excessively increased at baseline) improved from 285 ± 20 μm at baseline to 233 ± 21 μm (statistically significant compared with baseline, P < 0.0001) at the end of the follow-up. At the end of the follow-up, all patients demonstrated CNV regression, and retinal pigment epithelial atrophy surrounding the regressed CNV was developed in 11 of the 16 eyes (68.8%). During the same period, no CNV recurrence was observed and no injection-related complications such as cataract, retinal detachment, endophthalmitis, or exacerbation of uveitis were noted. CONCLUSION: Overall, our findings suggest that intravitreal injections of ranibizumab have shown promising results in visual acuity improvement and a decrease in macular thickness in patients with inflammatory CNV. Of course, further studies are needed to confirm the exact benefit and standardize the optimal treatment regimen.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity/physiology; Intravitreal Injections; Retreatment; Antibodies, Monoclonal, Humanized/*administration & dosage; Ranibizumab; Choroidal Neovascularization/diagnosis/*drug therapy/physiopathology; Choroiditis/diagnosis/*drug therapy/physiopathology; Angiogenesis Inhibitors/*administration & dosage

Oral vitamins C and E as additional treatment in patients with acute anterior uveitis: a randomised double masked study in 145 patients. - van Rooij, J.; Schwartzenberg, S. G.; Mulder, P. G.; Baarsma, S. G. (The British journal of ophthalmology, 1999)
AIM: To investigate the effect of additional oral vitamins C and E on acute anterior uveitis. METHODS: A placebo controlled double masked study on the effect of vitamin C 500 mg in combination with vitamin E 100 mg twice daily in 145 patients with acute anterior uveitis. As a primary end point variable, laser cell/flare measurements were performed. Best corrected and stenopeic visual acuity (VA) testing and clinical variable scores were measured. RESULTS: Laser flare measurements (ph/s) before treatment were 207.1 (SD 258) in the vitamin group and 143.6 (156) in the placebo group. After 3 days corresponding values were 80.2 (129) and 54.7 (82), after 7 days 89.2 (187) (12.5) and 85.8 (208), after 14 days 47.1 (109.5) and 40.5 (116) after 28 days 23.1 (53.6) and 23.1 (48), and after 56 days 15.6 (26) and 15.3 (17). There was no significant difference in time trend between the two treatment groups (RMANOVA; p = 0.53). Baseline VA (logMAR) was 0.106 (0.241) in the vitamin group and 0.128 (0.456) in the placebo group. VA after 3 days was 0. 236 (0.293) and 0.344 ( 0.489), after 7 days 0.204 (0.292) and 0.292 (0.479), after 14 days 0.162 (0.274) and 0.193 (0.454), after 28 days 0.096 (0.232) and 0.158 (0.436), and 0.026 (0.213) and 0.106 (0. 437) after 56 days. Although no significant difference in time trend was detected, evaluation of the VA data of the last time point (56 days) by means of the Mann-Whitney test showed a significantly better VA in the vitamin group (p = 0.01). CONCLUSIONS: There was no significant effect of vitamins C and E on laser flare measurements. The significant effect of the oral vitamins on visual acuity at 8 weeks after start of the oral vitamins C and E may indicate a protective effect in patients with acute anterior uveitis.
Keywords: Double-Blind Method; Female; Humans; Male; Middle Aged; Adult; Aged; Drug Administration Schedule; Administration, Oral; Analysis of Variance; Ascorbic Acid/*administration & dosage/therapeutic use; Acute Disease; Visual Acuity/drug effects; Uveitis, Anterior/*drug therapy; Vitamin E/*administration & dosage/therapeutic use

Euphorbia lactea sap keratouveitis: case report and review of the literature. - Merani, Rohan; Sa-Ngiampornpanit, Tarinee; Kerdraon, Yves; Billson, Frank; McClellan, Kathy A. (Cornea, 2007)
PURPOSE: To describe a case of Euphorbia lactea sap keratouveitis and to review all reported cases of ocular toxicity caused by Euphorbia species. METHODS: Case report and review of literature. RESULTS: A 79-year-old woman presented 34 hours after she felt some sap of an E. lactea plant spray into her right eye. Visual acuity was counting fingers at 1 m. Examination revealed ciliary injection, 90% corneal epithelial defect, marked stromal edema with Descemet folds, and anterior-chamber flare with a 1-mm hypopyon. There was no vitreitis, and funduscopy was unremarkable. No foreign body was seen on B scan ultrasound or computed tomography scan of the orbits. Corneal scraping excluded bacterial and herpetic keratitis. Intensive topical antibiotic therapy was started with cephalothin 5% and gentamicin 0.9%, and the pupil was dilated with atropine. Topical steroids were started once the epithelial defect had healed. Examination 11 weeks after the injury revealed minimal subepithelial corneal haze and marked improvement in visual acuity. CONCLUSIONS: To the best of our knowledge, this is only the third reported case of E. lactea sap keratouveitis. The clinical course of E. lactea sap keratouveitis is compared with that reported for other Euphorbia species.
Keywords: Female; Humans; Aged; Drug Therapy, Combination; Visual Acuity/drug effects; Anti-Infective Agents/administration & dosage; Cornea/*drug effects; Corneal Edema/chemically induced/drug therapy; Euphorbia/*chemistry; Keratitis/*chemically induced/drug therapy; Plant Extracts/*adverse effects; Uveitis, Anterior/*chemically induced/drug therapy

Long-term efficacy and safety of low-dose interferon alpha2a therapy in severe uveitis associated with Behçet disease. - Gueudry, Julie; Wechsler, Bertrand; Terrada, Céline; Gendron, Gaël; Cassoux, Nathalie; Fardeau, Christine; Lehoang, Phuc; Piette, Jean-Charles; Bodaghi, Bahram (American journal of ophthalmology, 2008)
PURPOSE: To investigate long-term responsiveness of patients with severe uveitis associated with Behçet disease to interferon alpha2a (IFN-alpha2a). DESIGN: Retrospective study. METHODS: Thirty-two patients with sight-threatening uveitis associated with Behçet disease who relapsed despite corticosteroids and immunosuppressive agents were included. IFN-alpha2a was administered subcutaneously (three million units thrice a week). Ophthalmologic examination and fluorescein angiography associated with laboratory tests were performed at regular intervals. Main outcome measures were visual acuity and recurrence of uveitis attacks before, during, and after initiation of IFN-alpha2a therapy. RESULTS: Control of inflammation was achieved in 28 of 32 patients (88%). Mean observation period of the 28 responder patients was 70.6 months (range, 30.3 to 129.2 months). Median visual acuity improved from 0.52 to 0.33 (logarithm of the minimum angle of resolution units; P = .005) two years after initiation of IFN-alpha2a therapy. The relapse rate decreased significantly during IFN-alpha2a treatment from 1.68 +/- 1.22 relapses/patient/year to 0.11 +/- 0.20 relapses/patient/year (P < .0001). IFN-alpha2a was discontinued in 19 of 28 patients (68%) after 32 months of treatment (range, 16 to 50 months). Mean follow-up after IFN-alpha2a discontinuation was 43 months (range, 11 to 84 months). After IFN-alpha2a discontinuation, the relapse rate increased from 0.08 +/- 0.21 relapse/person/year to 0.74 +/- 1.40 relapse/person/year (P = 0.04). CONCLUSIONS: IFN-alpha2a is efficient and safe for the long-term management of severe uveitis associated with Behçet disease. Meanwhile it seems to be a suspensive therapeutic strategy, even though long-term remission is possible in some patients.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Adolescent; Recurrence; Child; Recombinant Proteins; Fluorescein Angiography; Visual Acuity; Uveitis/diagnosis/*drug therapy/etiology; Immunosuppressive Agents/*administration & dosage/adverse effects; Interferon alpha-2; Prednisone/administration & dosage/adverse effects; Behcet Syndrome/complications/diagnosis/*drug therapy; Infusions, Subcutaneous; Interferon-alpha/*administration & dosage/adverse effects; Methylprednisolone/administration & dosage/adverse effects

Inflammatory Choroidal Neovascularization: Beyond the Intravitreal Approach. - Cerquaglia, Alessio; Fardeau, Christine; Cagini, Carlo; Fiore, Tito; LeHoang, Phuc (Ocular immunology and inflammation, 2018)
PURPOSE: To describe the importance of a customized combined systemic and local therapy in the management of inflammatory choroidal neovascularization (iCNV). METHODS: Observational retrospective case series. RESULTS: Four iCNV cases, complicating posterior uveitis or panuveitis affecting young patients, are reported. Combination of both intravitreal (IVT) and systemic drugs represented a successful treatment strategy. CONCLUSIONS: iCNV is a sight-threatening disease which affects mostly young people. Customized and both systemic and IVT therapies might represent the best therapeutic option in order to obtain disease control and good prognosis.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Retrospective Studies; Young Adult; Adolescent; Glucocorticoids/*therapeutic use; Fluorescein Angiography; Tomography, Optical Coherence; uveitis; Visual Acuity; Choroid; Intravitreal Injections; therapy; Angiogenesis Inhibitors/*therapeutic use; Vascular Endothelial Growth Factor A/antagonists & inhibitors; inflammation; Ranibizumab/*therapeutic use; Bevacizumab/*therapeutic use; Choroidal Neovascularization/diagnosis/*drug therapy/etiology/physiopathology; neovascularization; Panuveitis/complications/diagnosis/*drug therapy/physiopathology; Uveitis, Posterior/complications/diagnosis/*drug therapy/physiopathology

Efficacy of Infliximab for Early Remission Induction in Refractory Uveoretinitis Associated with Behçet Disease: A 2-year Follow-up Study. - Keino, Hiroshi; Okada, Annabelle A.; Watanabe, Takayo; Nakayama, Makiko; Nakamura, Tomoko (Ocular immunology and inflammation, 2017)
PURPOSE: To compare the efficacy of infliximab (IFX) on refractory uveoretinitis between Behçet disease (BD) patients with short duration (≤18 months, n = 6) versus long duration (>18 months, n = 7) of their ocular disease. METHODS: Records of 13 BD patients treated with IFX for 24 months were retrospectively reviewed. RESULTS: Frequency of ocular attacks decreased with IFX treatment in both groups, with no significant difference. Retinal and disc vascular leakage scores also decreased in both groups, however was significantly lower in the short-duration group. Percentage of eyes with a best-corrected visual acuity (BCVA) of 1.0 or better at year 2 was 100% in the short-duration and 21% in the long-duration group. CONCLUSIONS: Induction of early remission using IFX appeared to be more effective in reducing background vascular leakage and in maintaining good visual acuity in BD patients.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Adolescent; Antirheumatic Agents/*therapeutic use; Remission Induction; Infliximab/*therapeutic use; Fluorescein Angiography; Visual Acuity; Uveitis/*drug therapy/physiopathology; *infliximab; Behcet Syndrome/*drug therapy/physiopathology; *Behçet disease; *BOS24; *fluorescein angiography; *uveoretinitis; Retinitis/*drug therapy/physiopathology

Repeat intravitreal triamcinolone acetonide injections in uveitic macular oedema. - Sallam, Ahmed; Taylor, Simon R. J.; Habot-Wilner, Zohar; Elgohary, Mostafa; Do, Helen H.; McCluskey, Peter; Lightman, Sue (Acta ophthalmologica, 2012)
Keywords: Humans; Retrospective Studies; Recurrence; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity/physiology; Intravitreal Injections; Cataract/chemically induced; Glucocorticoids/*administration & dosage/adverse effects; Macular Edema/*drug therapy/physiopathology; Uveitis/*drug therapy/physiopathology; Retreatment; Triamcinolone Acetonide/*administration & dosage/adverse effects

Serpiginous Choroiditis. - Ahmed, Aseef H.; Kubaisi, Buraa; Foster, C. Stephen (JAMA ophthalmology, 2017)
Keywords: Female; Humans; Middle Aged; Drug Therapy, Combination; Fluorescein Angiography; Prednisone/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity/drug effects; Chlorambucil/therapeutic use; Antineoplastic Agents, Alkylating/therapeutic use; Choroiditis/*diagnosis/drug therapy

[Effect of complications on the results of surgical treatment of retinal detachment]. - Swietliczko, I.; Braciak, W. (Klinika oczna, 1983)
Keywords: Humans; Visual Acuity; Postoperative Complications/physiopathology; Electrocoagulation/*adverse effects; Retinal Detachment/*surgery; Retinal Hemorrhage/*physiopathology; Uveitis/*physiopathology

Ocular jellyfish stings. - Glasser, D. B.; Noell, M. J.; Burnett, J. W.; Kathuria, S. S.; Rodrigues, M. M. (Ophthalmology, 1992)
BACKGROUND: Corneal stings from the sea nettle (Chrysaora quinquecirrha) indigenous to the Chesapeake Bay are usually painful but self-limited injuries, with resolution in 24 to 48 hours. METHODS: Five patients who developed unusually severe and prolonged iritis and intraocular pressure elevation after receiving corneal sea nettle stings were followed for 2 to 4 years. RESULTS: Decreased visual acuity, iritis, and increased intraocular pressure (32 to 48 mmHg) were noted in all cases. Iritis responded to topical corticosteroids and resolved within 8 weeks. Elevated intraocular pressure responded to topical beta blockers and oral carbonic anhydrase inhibitors. Mydriasis (4 of 5 cases), decreased accommodation (2 of 5 cases), peripheral anterior synechiae (2 of 5 cases), and iris transillumination defects (3 of 5 cases) also were noted. Mydriasis and decreased accommodation persisted for 5 months in 1 case and for more than 2 years in another. One patient has chronic unilateral glaucoma. Visual acuity returned to normal in all cases. CONCLUSIONS: The precise relationship between sea nettle venom and the observed clinical responses is not known. Corneal jellyfish stings usually produce a brief and self-limited reaction, but they do have the potential for long-term sequelae.
Keywords: Female; Humans; Male; Middle Aged; Adult; Glucocorticoids/therapeutic use; Visual Acuity; Intraocular Pressure; Ocular Hypertension/drug therapy/etiology; Animals; Mydriatics/therapeutic use; *Scyphozoa; Bites and Stings/*complications/drug therapy; Cnidarian Venoms/adverse effects; Corneal Injuries; Eye Injuries/drug therapy/*etiology; Iritis/drug therapy/etiology; Mydriasis/drug therapy/etiology; Ocular Motility Disorders/drug therapy/etiology

Intravitreal infliximab for sight-threatening relapsing uveitis in Behçet disease: a pilot study in 15 patients. - Markomichelakis, Nikos; Delicha, Evie; Masselos, Stylianos; Sfikakis, Petros P. (American journal of ophthalmology, 2012)
PURPOSE: To assess the safety and to conduct a preliminary assessment of efficacy of intravitreal infliximab, an anti-tumor necrosis factor antibody, for sight-threatening relapsing uveitis in Behçet disease. DESIGN: Prospective, noncomparative, interventional pilot study. METHODS: A single intravitreal injection of infliximab (1 mg/0.05 mL) was given to 15 patients with relapsing posterior uveitis at the onset of a unilateral attack. Best-corrected visual acuity, anterior chamber cells, vitreous haze, and posterior eye segment inflammation were assessed at baseline and at 1, 7, 14, and 30 days after treatment. RESULTS: Ocular or extra-ocular side effects were not observed. Baseline best-corrected visual acuity (mean logarithm of minimal angle of resolution, 0.74; range, 0.15 to 1.7) improved significantly by day 7 and continued to improve through day 30 after infliximab (mean, 0.30; P < .0001). Profound decreases in anterior chamber cells and vitreous haze (both P < .0001), as well as beneficial effects in retinal vasculitis (P = .0001) and retinitis (P = .001) were evident through day 30. Cystoid macular edema persisted in 9 of 11 eyes affected, but central macular thickness decreased from a baseline mean of 434 to 309 mm at the end of follow-up (P < .0001). Lack of systemic treatment at baseline in 4 patients or background immunosuppressive medications, which remained unchanged during follow-up, did not influence significantly these responses; additional treatment was not required. CONCLUSIONS: These findings suggest that intraocularly produced or acting tumor necrosis factor, or both, is crucial in Behçet disease-associated relapsing uveitis and that intravitreal infliximab should be considered when systemic administration is not feasible or contraindicated. Further studies may identify patients for whom intravitreal infliximab is preferable to systemic treatment.
Keywords: Female; Humans; Male; Middle Aged; Pilot Projects; Adult; Prospective Studies; Follow-Up Studies; Treatment Outcome; Young Adult; Recurrence; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects; Infliximab; Tumor Necrosis Factor-alpha/antagonists & inhibitors; Visual Acuity/physiology; Intravitreal Injections; Antibodies, Monoclonal/*administration & dosage/adverse effects; Behcet Syndrome/complications/*drug therapy/physiopathology; Uveitis, Posterior/*drug therapy/etiology/physiopathology

Vogt-Koyanagi-Harada disease after stapedotomy. - Accorinti, Massimo; Gilardi, Marta; Nardella, Chiara; Amorelli, Giulia Maria; Pesci, Francesca Romana (European journal of ophthalmology, 2015)
PURPOSE: To report on Vogt-Koyanagi-Harada disease that occurred after stapedotomy. METHODS: Case report. RESULTS: A 46-year-old woman developed bilateral choroiditis, papillitis, and serous retinal detachment 10 days after an uneventful surgical stapedotomy. The diagnosis was confirmed on the basis of the clinical features, fundus fluorescein angiography and optical coherence tomography findings, and a clinical course with subsequent involvement of the anterior segment, uveitis relapses with serous retinal detachment, and negative laboratory work-up for uveitis. CONCLUSIONS: Vogt-Koyanagi-Harada disease may appear after an uneventful surgical intervention of stapedotomy, suggesting that surgical trauma in the inner ear, a melanocyte-containing organ, may induce an inflammatory response within the eye.
Keywords: Female; Humans; Middle Aged; Infusions, Intravenous; Fluorescein Angiography; Tomography, Optical Coherence; Glucocorticoids/therapeutic use; Visual Acuity; Dexamethasone/therapeutic use; Methylprednisolone/therapeutic use; Choroiditis/diagnosis/etiology; Hearing Loss, Bilateral/surgery; Papilledema/diagnosis/etiology; Retinal Detachment/diagnosis/etiology; Stapes Surgery/*adverse effects; Uveomeningoencephalitic Syndrome/diagnosis/drug therapy/*etiology

Ophthalmic outcomes after prenatal and postnatal treatment of congenital toxoplasmosis. - Brézin, Antoine P.; Thulliez, Philippe; Couvreur, Jacques; Nobré, Roberto; Mcleod, Rima; Mets, Marilyn B. (American journal of ophthalmology, 2003)
PURPOSE: To describe the ophthalmologic outcomes of cases of congenital toxoplasmosis treated prenatally and postnatally. DESIGN: Observational case series. METHOD: Follow-up ophthalmologic examinations of 18 children born to mothers who were infected before 25 weeks gestation were performed concurrently by two ophthalmologists. The infection in these children was first suspected when their mothers seroconverted during gestation. Toxoplasmic infection of the fetus was diagnosed by fetal blood or amniotic fluid analysis. Mothers were treated by a regimen of alternating pyrimethamine-sulfonamides and spiramycin during gestation. Pyrimethamine-sulfonamides treatment was continued from birth to 1 year of age. RESULTS: The median age of the children was 4.5 years (range 1-11), when the follow-up ophthalmologic examinations were performed. Visual acuity was decreased in only one child, who had extensive bilateral macular and peripheral lesions. A posterior pole scar was noted in four eyes (four children) for whom visual acuity remained normal. Peripheral lesions were observed in nine eyes (five children). Both eyes were normal in 11 of 18 (61%) of the children. CONCLUSIONS: In these children at a high risk for congenital toxoplasmic retinochoroiditis, a favorable visual outcome was observed in all but one case.
Keywords: Female; Humans; Male; Drug Therapy, Combination; Treatment Outcome; Pregnancy; Child; Child, Preschool; Infant; Visual Acuity; Antiprotozoal Agents/*therapeutic use; Chorioretinitis/*diagnosis; Gestational Age; Infectious Disease Transmission, Vertical/*prevention & control; Pregnancy Complications, Parasitic/*drug therapy/epidemiology; Prenatal Care; Pyrimethamine/therapeutic use; Spiramycin/therapeutic use; Toxoplasmosis, Congenital/*drug therapy/epidemiology; Toxoplasmosis, Ocular/*diagnosis

Photodynamic therapy for choroidal neovascularization in patients with multifocal choroiditis and panuveitis. - Gerth, C.; Spital, G.; Lommatzsch, A.; Heiligenhaus, A.; Pauleikhoff, D. (European journal of ophthalmology, 2006)
PURPOSE: To evaluate the visual benefit of photodynamic therapy (PDT) with verteporfin in patients with choroidal neovascularization (CNV) secondary to multifocal choroiditis and panuveitis over a longer follow-up period. METHODS: A total of 14 eyes of 12 patients (mean age 34 years) with a classic subfoveal CNV (13/14) or juxtafoveal CNV (1/14) were treated with PDT. Visual outcome was assessed by best-corrected visual acuity (VA). Morphologic characteristics of CNVs such as localization, size, and activity were monitored by fluorescein angiography. RESULTS: Patients were followed for 3 to 45 months (mean 23 months). During this period, one to six PDTs (mean 2.4) were performed. At the time of the first PDT no acute inflammation was seen in the affected eyes. Improved or stabilized visual function (VA loss < or = 2 lines in the Early Treatment Diabetic Retinopathy Study chart) was observed in 71.4% of the eyes. A total of 78% of the eyes showed an inactive scar in the area of CNV after PDT. Treatment failure after PDT occurred due to uninfluenced CNV growth. No further complications were observed. CONCLUSIONS: PDT in subfoveal or juxtafoveal classic CNV secondary to multifocal choroiditis and panuveitis stabilized or improved VA in the majority of patients over a longer follow-up period. No risk factor for failed VA rehabilitation could be defined.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Adolescent; Fluorescein Angiography; Visual Acuity; Retreatment; *Photochemotherapy; Choroidal Neovascularization/diagnosis/*drug therapy/etiology; Choroiditis/complications/diagnosis/*drug therapy; Panuveitis/complications/diagnosis/*drug therapy; Photosensitizing Agents/*therapeutic use; Porphyrins/*therapeutic use; Verteporfin

VASOPROLIFERATIVE TUMORS IN INTERMEDIATE UVEITIS. - Pichi, Francesco; Neri, Piergorgio; Agarwal, Aniruddha; Invernizzi, Alessandro; Choudhry, Netan; Amer, Radgonde; Lembo, Andrea; Nucci, Paolo; Thompson, Ian; Sen, H. Nida; Shields, Carol L. (Retina (Philadelphia, Pa.), 2020)
PURPOSE: To describe patients with intermediate uveitis complicated by vasoproliferative tumors (VPTs). METHODS: Data were collected at seven Uveitis/Ocular Oncology centers on demographic, ophthalmic findings at baseline and at follow-up, and on imaging. The therapeutic intervention, final visual acuity, and duration of follow-up were recorded. RESULTS: A total of 36 eyes from 34 patients (12 men, 22 women; mean age 35.3 ± 14.2 years) were included in this study. Visual acuity at presentation ranged from 20/40 to counting fingers. At the time of VPT diagnosis, intermediate uveitis was active in all eyes. The mean VPT thickness was 3.06 ± 0.86 mm. Local treatment to the VPT was provide in 22 eyes (61.1%) and no local treatment to the VPT in 14 eyes (38.9%). After the VPT was detected, systemic or local treatment for the inflammation was initiated and on follow-up FAs 94.4% of the eyes showed resolution of the vascular leakage. During follow-up of 35.8 months, the 22 VPTs treated locally had a reduction in the tumor thickness to 1.25 mm, whereas the 14 VPTs untreated remained stable (final mean tumor thickness 2.65 mm). CONCLUSION: The presence of active intermediate uveitis accompanied by VPTs suggests the need for an aggressive uveitis treatment.
Keywords: Female; Humans; Male; Middle Aged; Adult; Retrospective Studies; Young Adult; Adolescent; Child; Ultrasonography; Fluorescein Angiography; Tomography, Optical Coherence; Visual Acuity/physiology; Vitrectomy; Laser Therapy; Uveitis, Intermediate/*complications; Neoplasms, Vascular Tissue/diagnosis/*etiology/surgery; Retinal Neoplasms/diagnosis/*etiology/surgery; Retinal Vessels/*pathology

Orbital floor steroid injections in the treatment of uveitis. - Riordan-Eva, P.; Lightman, S. (Eye (London, England), 1994)
Orbital floor steroid injections, like other posterior periocular injections, are advocated as a means of avoiding systemic immunosuppression in the management of uveitis in which there is significant posterior segment inflammation, but there are no published studies on their efficacy. The results of 54 orbital floor steroid injections to 33 eyes with uveitis were analysed. A positive response with an average duration of effect of 9 weeks was obtained after 48% of injections. These results compare favourably with the results of systemic immunosuppression in patients with comparable patterns of uveitis, thus establishing the efficacy of orbital floor steroid injections and their potential value when systemic immunosuppression needs to be avoided.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Time Factors; Treatment Outcome; Adolescent; Injections; Visual Acuity; Uveitis/*drug therapy; Anti-Inflammatory Agents/*administration & dosage; Orbit; Methylprednisolone Acetate; Methylprednisolone/administration & dosage/analogs & derivatives; Pars Planitis/drug therapy; Triamcinolone/administration & dosage

Dissociations of the Fluocinolone Acetonide Implant: The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study. - Holbrook, Janet T.; Sugar, Elizabeth A.; Burke, Alyce E.; Vitale, Albert T.; Thorne, Jennifer E.; Davis, Janet L.; Jabs, Douglas A. (American journal of ophthalmology, 2016)
PURPOSE: To describe fluocinolone acetonide implant dissociations in the Multicenter Uveitis Steroid Treatment (MUST) Trial. DESIGN: Randomized clinical trial with extended follow-up. METHODS: Review of data collected on the first implant in the eye(s) of participants. Dissociation was defined as the drug pellet no longer being affixed to the strut and categorized as spontaneous or surgically related. RESULTS: A total of 250 eyes (146 patients) had at least 1 implant placed. Median follow-up time after implant placement was 6 years (range 0.5-9.2 years). Thirty-four dissociations were reported in 30 participants. There were 22 spontaneous events in 22 participants; 6-year cumulative risk of a spontaneous dissociation was 4.8% (95% confidence interval [CI]: 2.4%-9.1%). The earliest event occurred 4.8 years after placement. Nine of 22 eyes with data had a decline in visual acuity ≥5 letters temporally related to the dissociation. Thirty-nine implant removal surgeries were performed, 33 with replacement. Twelve dissociations were noted during implant removal surgeries in 10 participants (26%, 95% CI 15%-48%); 5 of these eyes had a decline in visual acuity ≥5 letters after surgery. The time from implant placement to removal surgery was longer for the surgeries at which dissociated implants were identified than for those without one (5.7 vs 3.7 years, P < .001). Overall, visual acuity declined 15 or more letters from pre-implant values in 22% of affected eyes; declines were frequently associated with complications of uveitis or its treatment. CONCLUSION: There is an increasing risk of dissociation of Retisert implants during follow-up; the risk is greater with removal/exchange surgeries, but the risk of both spontaneous and surgically related events increases with longevity of the implants. In 22% of affected eyes visual acuity declined by 15 letters. In the context of eyes with moderate to severe uveitis for years, this rate is not unexpected.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Aged, 80 and over; Time Factors; Follow-Up Studies; Risk Factors; Adolescent; Intravitreal Injections; Uveitis/*drug therapy; Visual Acuity/drug effects; Reoperation; Postoperative Complications; Glucocorticoids/administration & dosage/*adverse effects; Fluocinolone Acetonide/administration & dosage/*adverse effects; Drug Implants/*adverse effects; *Equipment Failure; Foreign-Body Migration/diagnosis/*etiology/surgery

INTRAVITREAL DEXAMETHASONE IMPLANTATION FOR BIRDSHOT CHORIORETINOPATHY. - Walsh, James; Reddy, Ashvini K. (Retinal cases & brief reports, 2017)
PURPOSE: Birdshot chorioretinopathy is a rare form of posterior uveitis. This article reports a case series of patients with HLA-A29+ birdshot chorioretinopathy managed with intravitreal dexamethasone implants. METHODS: Retrospective case report. RESULTS: Three patients with birdshot chorioretinopathy (6 eyes) were seen from 2013 to 2015 and managed with dexamethasone intravitreal implant; there was an average of 6 months between implants. All 3 experienced control of ocular inflammation and macular edema with intravitreal dexamethasone and achieved best-corrected visual acuity of at least 20/25 during the course of treatment. Two patients tolerated serial dexamethasone implants for over a year without glaucoma or cataract surgery. Dexamethasone implantation was not repeated in one patient with preexisting uveitic glaucoma because of persistently elevated intraocular pressure. In this series, all patients had improvement in visual acuity, macular edema, intraocular inflammation, and quality of life, and no patients developed visually significant cataracts. Only one eye with preexisting uveitic glaucoma exhibited an increased intraocular pressure requiring discontinuation of therapy. CONCLUSION: Intravitreal dexamethasone implant can be an effective alternative in the management of birdshot chorioretinopathy.
Keywords: Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Intravitreal Injections; Dexamethasone/*administration & dosage; Glucocorticoids/*administration & dosage; *Drug Implants; Birdshot Chorioretinopathy; Chorioretinitis/*drug therapy

Clinical features and visual outcomes of 111 patients with new-onset acute Vogt-Koyanagi-Harada disease treated with pulse intravenous corticosteroids. - Nakayama, Makiko; Keino, Hiroshi; Watanabe, Takayo; Okada, Annabelle A. (The British journal of ophthalmology, 2019)
PURPOSE: To describe the clinical features, treatment and visual outcomes of Japanese patients with new-onset acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: Clinical records of 111 patients who presented between 1999 and 2015 to the Ocular Inflammation Service of the Kyorin Eye Center, Tokyo, were reviewed. RESULTS: Of the 111 patients (68 women, 43 men), 16 had complete, 90 had incomplete and 5 had probable VKH disease. The median follow-up period was 36 months (4-175 months). The mean age at presentation was 41 years (19-74 years). Serous retinal detachment (202 eyes) and optic disc hyperaemia (89 eyes) were observed at presentation. Of the patients tested, 45/48 (93.8%) were human leucocyte antigen-DR4 positive and 63/77 (81.8%) had cerebrospinal fluid pleocytosis. Initial corticosteroid treatment consisted of pulse intravenous therapy in all patients. Sunset glow fundus was observed in 49.5% of eyes, and anterior and/or posterior segment recurrence of inflammation was observed in 25 patients (22.5%). Treatment was transitioned to cyclosporine in 17 patients (15.3%) for steroid sparing (6 patients) or recurrent inflammation (11 patients), with good subsequent control. Ocular complications were observed in 47 of 222 eyes (21.2%) (mostly cataract), and systemic complications were observed in 8.1% of patients (mostly hypertension and diabetes mellitus). Ninety-three percent of eyes (167 of 178 eyes) had a visual acuity of ≥1.0 at 1 year after presentation. CONCLUSIONS: An aggressive corticosteroid treatment strategy in a large number of patients with new-onset acute VKH disease, with transitioning to cyclosporine in selected cases, resulted in excellent visual outcomes and low rates of recurrence.
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Follow-Up Studies; Retrospective Studies; Young Adult; Recurrence; Fluorescein Angiography; Acute Disease; Glucocorticoids/*administration & dosage; Visual Acuity/*physiology; Methylprednisolone/*administration & dosage; Pulse Therapy, Drug; *corticosteroids; *cyclosporine; *treatment; *visual outcome; *Vogt-Koyanagi-Harada disease; Uveomeningoencephalitic Syndrome/*diagnosis/*drug therapy/physiopathology

Serpiginous-like choroiditis as a marker for tuberculosis in a non-endemic area. - Gan, Weh-Loong; Jones, Nicholas P. (The British journal of ophthalmology, 2013)
AIM: To describe the increasing incidence of multifocal outer retinal and inner choroidal inflammation as a marker for intraocular tuberculosis in the UK, a non-endemic area. PATIENTS AND METHODS: Retrospective case series. RESULTS: 14 patients presented with serpiginous-like choroiditis over 10 years (seven within the last 2 years). Seven of 14 patients showed evidence of exposure to tuberculosis and received antituberculous treatment. 17 of 23 eyes showed stable or improved visual acuity. All with decreased acuity had direct macular involvement at presentation. CONCLUSIONS: Multifocal outer retinal and inner choroidal inflammation is a marker for intraocular tuberculosis of increasing importance, even in a non-endemic area. Originally described as 'serpiginous-like choroiditis', the lesions are multifocal, irregular in shape, very numerous, widespread, often asymmetrical and often demonstrating both active and resolved lesions simultaneously. Active lesions show contiguous extension. We recommend that every patient with SLC should undergo testing for previous exposure to tuberculosis, and undergo antituberculous treatment if lesions are progressive and sight-threatening.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Retrospective Studies; Young Adult; Incidence; Adolescent; Child; Visual Acuity/physiology; Interferon-gamma Release Tests; United Kingdom/epidemiology; Antitubercular Agents/therapeutic use; Tuberculin Test; Choroiditis/*diagnosis/drug therapy/ethnology; Emigrants and Immigrants; Ethnicity; Mycobacterium tuberculosis/isolation & purification; Panuveitis/*diagnosis/drug therapy/ethnology; Tuberculosis, Ocular/*diagnosis/drug therapy/ethnology

[Immunocorrective therapy of sympathetic ophthalmia]. - Arkhipova, L. T. (Oftalmologicheskii zhurnal, 1987)
Keywords: Female; Humans; Male; Middle Aged; Adult; Aged; Adolescent; Combined Modality Therapy; Child; Child, Preschool; Immunotherapy/*methods; Visual Acuity; Ophthalmia, Sympathetic/immunology/*therapy; Antibody Formation; Immunity, Cellular

IgG4-positive sclerosing orbital inflammation involving the conjunctiva: a case report. - Paulus, Yannis M.; Cockerham, Kimberly P.; Cockerham, Glenn C.; Gratzinger, Dita (Ocular immunology and inflammation, 2012)
PURPOSE: To describe IgG4-positive sclerosing orbital inflammation with prominent conjunctival and scleral involvement. DESIGN: Case report. METHODS: Clinical, radiologic, and pathologic correlation. RESULTS: A 66-year-old man presented with right eye redness and irritation. Examination revealed unilateral scleritis and nongranulomatous anterior uveitis with elevated p-ANCA and CRP. Orbital CT scan showed inferotemporal scleral thickening. Biopsy revealed sclerosis and IgG4-positive plasma cells in the conjunctiva and inferior rectus. CONCLUSIONS: IgG4-mediated sclerosing inflammation is well-recognized in the orbit and adnexa, particularly the lacrimal gland. Scleritis with anterior uveitis should be recognized as a possible presentation for this entity, which has important systemic associations.
Keywords: Humans; Male; Aged; Drug Therapy, Combination; Treatment Outcome; Methotrexate/therapeutic use; Anti-Inflammatory Agents/therapeutic use; Radiography; C-Reactive Protein/analysis; Biopsy; Prednisone/therapeutic use; Visual Acuity/drug effects/physiology; Triamcinolone/therapeutic use; Antibodies, Antineutrophil Cytoplasmic/blood; Conjunctival Diseases/*diagnosis/diagnostic imaging/drug therapy/pathology; Immunoglobulin G/*blood; Plasma Cells/pathology; Scleritis/*diagnosis/diagnostic imaging/drug therapy/pathology; Sclerosis/diagnosis; Uveitis, Anterior/*diagnosis/diagnostic imaging/drug therapy/pathology

Long-term clinical outcomes in patients with refractory uveitis associated with Behçet disease treated with infliximab. - Al Rashidi, Sultan; Al Fawaz, Abdullah; Kangave, Dustan; Abu El-Asrar, Ahmed M. (Ocular immunology and inflammation, 2013)
PURPOSE: To assess long-term efficacy and safety of infliximab for refractory Behçet disease (BD) uveitis and to evaluate the effect of withdrawal of infliximab after achieving long-term remission. METHODS: Retrospective study of 19 patients. RESULTS: Mean follow-up was 44.1 ± 36.5 months and mean number of infliximab infusions was 21.6 ± 14.6. At end of follow-up, there was significant improvement of visual acuity and reduction of central macular thickness. All patients achieved remission, 14 of whom were able to discontinue corticosteroids. Ten patients developed autoantibodies and 1 patient developed infusion reactions. Eight eyes underwent intraocular surgery without exacerbation of quiescent uveitis. After achieving complete remission, 5 patients discontinued infliximab and maintained remission during a mean of 24.6 ± 5.5 months. CONCLUSIONS: Infliximab is effective and safe for long-term treatment for refractory BD uveitis. Repeated infusions are required to maintain long-term remission, which may be sustained despite withdrawal of infliximab. Induction of autoantibodies is common.
Keywords: Female; Humans; Male; Adult; Time Factors; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Adolescent; Infusions, Intravenous; Remission Induction; Child; Infliximab; Tumor Necrosis Factor-alpha/antagonists & inhibitors; Fluorescein Angiography; Tomography, Optical Coherence; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage; Fundus Oculi; Visual Acuity; Behcet Syndrome/*complications/diagnosis/drug therapy; Antibodies, Monoclonal/*administration & dosage; Uveitis, Posterior/diagnosis/*drug therapy/etiology

Mesenchymal stem cell therapy unable to rescue the vision from advanced Behcet's disease retinal vasculitis: report of three patients. - Davatchi, Fereydoun; Nikbin, Behrooz; Shams, Hormoz; Sadeghi Abdollahi, Bahar; Mohyeddin, Mandana; Shahram, Farhad (International journal of rheumatic diseases, 2013)
OBJECTIVE: Retinal vasculitis (RV) is the most aggressive lesion of ocular manifestations of Behcet's disease, seen in 32.1% of patients. Although visual acuity (VA) improves with early and aggressive treatment, in the long run it is seen in only 48% of patients. Mesenchymal stem cell (MSC) transplantation (MSCT) can theoretically reverse the RV process. PATIENTS AND METHODS: Three patients with advanced RV and very low VA were selected. Eyes selected for MSCT were legally blind (no useful vision) with severe retinal damage due to vasculitis, resistant to combinations of monthly pulse-cyclophosphamide (1000 mg) + azathioprine 2-3 mg/kg/day + prednisolone 0.5 mg/kg/day. After patient signed written consent, 30 mL of bone marrow were taken and cultured for MSC growth. After having enough MSCs in culture (4-5 weeks) and taking into consideration all safety measures, cells were injected in one eye of each patient (approximately 1.8 million MSCs). VA was measured. Disease Activity Index (DAI) was calculated for anterior uveitis (AU), posterior uveitis (PU) and RV. RESULTS: Visual acuity was light perception (LP) for two patients and finger count (FC) for the third. Follow-up at 1, 6 and 12 months were respectively LP/LP/FC at 0.5 m, no-light perception (NLP)/LP/LP, NLP/LP/NLP. DISCUSSION: Results showed a total failure of the procedure, essentially due to the late and advanced state of vasculitis. However, the autoimmune/inflammatory reaction was greatly controlled by the procedure. CONCLUSION: Earlier cases have to be selected for further trials.
Keywords: Female; Humans; Male; Middle Aged; Adult; Treatment Failure; Time Factors; Severity of Illness Index; Recovery of Function; *Visual Acuity; Injections, Intraocular; *Mesenchymal Stem Cell Transplantation; Behcet Syndrome/complications/diagnosis/physiopathology/*surgery; Cells, Cultured; Retinal Vasculitis/diagnosis/etiology/physiopathology/*surgery; Uveitis, Anterior/etiology/physiopathology/surgery; Uveitis, Posterior/etiology/physiopathology/surgery; Vision Disorders/diagnosis/etiology/physiopathology/*surgery

Earlier immunomodulatory treatment is associated with better visual outcomes in a subset of patients with Vogt-Koyanagi-Harada disease. - Urzua, Cristhian A.; Velasquez, Victor; Sabat, Pablo; Berger, Osvaldo; Ramirez, Sebastian; Goecke, Annelise; Vásquez, Darío H.; Gatica, Hector; Guerrero, Julia (Acta ophthalmologica, 2015)
PURPOSE: To evaluate clinical outcomes of first-line immunomodulatory therapy (IMT) and prednisone alone or late IMT in Vogt-Koyanagi-Harada disease. METHODS: Retrospective cohort study of 152 patients with Vogt-Koyanagi-Harada disease evaluated in a referral uveitis clinic in Chile from 1985 to 2011. Medical records of these patients were reviewed. Demographic data, clinical evaluation, type of treatment, functional outcomes, glucocorticoid (GC) dose and complications were recorded. Multivariate logistic regression was used to identify prognostic factors of poor response to GC. RESULTS: There were no significant differences between first-line IMT group and prednisone alone/late IMT group in terms of visual acuity (VA) improvement, complications and GC sparing effect. There was a trend for a higher frequency of systemic adverse effects leading to discontinuation of treatment in patients receiving IMT than in those receiving prednisone (14.6% and 6.5%, respectively). The subgroup of patients with poor response to GC who showed functional improvement had a significantly earlier time to IMT initiation than the patients who had no improvement. We identified following prognostic factors of poor response to GC: VA ≤ 20/200, fundus depigmentation, chronic disease and tinnitus at diagnosis. Patients with a prognostic factor (excluding tinnitus) and VA improvement had an earlier IMT initiation than those who had worse functional outcome. CONCLUSION: There were no differences in outcomes between first-line IMT and prednisone alone/late IMT in the entire VKH group. However, in a subset of patients, there was a significant better functional outcome with earlier IMT initiation.
Keywords: Female; Humans; Male; Middle Aged; Adult; Drug Therapy, Combination; Retrospective Studies; Young Adult; *Immunomodulation; complications; Visual Acuity/*physiology; Immunosuppressive Agents/adverse effects/*therapeutic use; Glucocorticoids/adverse effects/*therapeutic use; Uveomeningoencephalitic Syndrome/*drug therapy/physiopathology; glucocorticoids; Vogt-Koyanagi-Harada disease; first-line treatment; functional outcomes; immunomodulatory treatment; Prednisolone/adverse effects/*therapeutic use; prognostic factors

Clinical management algorithm of uveitis associated with juvenile idiopathic arthritis: interdisciplinary panel consensus. - Bou, Rosa; Adán, Alfredo; Borrás, Fátima; Bravo, Beatriz; Calvo, Inmaculada; De Inocencio, Jaime; Díaz, Jesús; Escudero, Julia; Fonollosa, Alex; de Vicuña, Carmen García; Hernández, Victoria; Merino, Rosa; et al. (Rheumatology international, 2015)
Uveitis associated with juvenile idiopathic arthritis (JIA) typically involves the anterior chamber segment, follows an indolent chronic course, and presents a high rate of uveitic complications and a worse outcome as compared to other aetiologies of uveitis. Disease assessment, treatment, and outcome measures have not been standardized. Collaboration between pediatric rheumatologists and ophthalmologists is critical for effective management and prevention of morbidity, impaired vision, and irreparable visual loss. Although the Standardization of Uveitis Nomenclature Working Group recommendations have been a great advance to help clinicians to improve consistency in grading and reporting data, difficulties arise at the time of deciding the best treatment approach in the individual patient in routine daily practice. For this reason, recommendations for a systematized control and treatment strategies according to clinical characteristics and disease severity in children with JIA-related uveitis were developed by a panel of experts with special interest in uveitis associated with JIA. A clinical management algorithm organized in a stepwise regimen is here presented.
Keywords: Humans; Severity of Illness Index; Methotrexate/therapeutic use; Abatacept/therapeutic use; Antibodies, Monoclonal, Humanized/therapeutic use; Antirheumatic Agents/*therapeutic use; Child; Child, Preschool; Infliximab/therapeutic use; Visual Acuity; Administration, Ophthalmic; Uveitis/complications/*drug therapy; Adrenal Cortex Hormones/*therapeutic use; Adalimumab/therapeutic use; Arthritis, Juvenile/*complications; Ophthalmology; Practice Guidelines as Topic; *Algorithms; Cooperative Behavior; Disease Management; Mydriatics/*therapeutic use; Rheumatology

Uveitis and iris photoablation secondary to intense pulsed light therapy. - Jewsbury, Hugh; Morgan, Francesca (Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2012)
Keywords: Female; Humans; Adult; Glucocorticoids/administration & dosage; Visual Acuity/physiology; Mydriatics/administration & dosage; Eyelids; Iris/*radiation effects; Photophobia/drug therapy/etiology/physiopathology; Phototherapy/*adverse effects; Plasma Skin Regeneration/*adverse effects; Radiation Injuries/drug therapy/*etiology/physiopathology; Rejuvenation; Uveitis, Anterior/drug therapy/*etiology/physiopathology

Adalimumab Treatment in Patients with Vogt-Koyanagi-Harada Disease. - Couto, Cristóbal; Schlaen, Ariel; Frick, Mercedes; Khoury, Marina; Lopez, Matilde; Hurtado, Erika; Goldstein, Debra (Ocular immunology and inflammation, 2018)
PURPOSE: To evaluate the clinical outcome and safety of adalimumab in patients with Vogt-Koyanagi-Harada (VKH) disease. METHODS: VKH patients treated with adalimumab seen at the University of Buenos Aires were reviewed. Main outcome measures were visual acuity, anterior segment inflammation, optic nerve inflammation (ONI), steroid sparing effect, number of immunosuppressives, and relapses. RESULTS: In total, 14 VKH patients, mean age 23.07 ± 8 years; median of adalimumab treatment 10 months, were analyzed. At start of adalimumab treatment (baseline), median of corticosteroid dose was 20 mg and at 6 months, 4 mg. At baseline, 11 patients were on immunosuppressive treatment and at 6 months only four continued with immunosuppressive therapy. In the 28 eyes, the median of active inflammation was 2 at baseline and 0 after 6 months on adalimumab. CONCLUSIONS: Treatment with adalimumab is an effective and safe option, reducing the need for oral corticosteroid and conventional immunosuppressive therapy.
Keywords: Female; Humans; Male; Adult; Young Adult; Adolescent; Prednisolone/therapeutic use; Recurrence; Child; Adalimumab; Anti-Inflammatory Agents/adverse effects/*therapeutic use; Glucocorticoids/therapeutic use; uveitis; Visual Acuity/physiology; Vogt–Koyanagi–Harada disease; Immunosuppression Therapy; Uveomeningoencephalitic Syndrome/*drug therapy/physiopathology; Adalimumab/adverse effects/therapeutic use; chronic stage; clinical outcome

Immunomodulatory therapy for chronic tubulointerstitial nephritis-associated uveitis. - Gion, N.; Stavrou, P.; Foster, C. S. (American journal of ophthalmology, 2000)
PURPOSE: To describe the clinical course and treatment with immunomodulatory agents in patients with tubulointerstitial nephritis and uveitis syndrome. METHODS: Retrospective analysis of the charts of six patients with tubulointerstitial nephritis and uveitis syndrome. RESULTS: The mean (+/-SD) age was 24.3 (+/-16.5) years, range 13 to 49 years. Four patients were children, and two were adults. Three were men, and three were women. Five of the six patients had anterior uveitis, and one had panuveitis. All patients had several relapses despite treatment with topical, regional, and oral steroids and methotrexate in one case. The introduction or modification of immunosuppressants (methotrexate, azathioprine, or cyclosporin A) achieved control of the uveitis and prevented relapses over a mean (+/-SD) follow-up period of 19.66 (+/-10.01) months, range 6 to 34 months. No treatment-related side effects were observed. CONCLUSIONS: Tubulointerstitial nephritis and uveitis syndrome is a distinct disease entity in which the nephritis typically resolves, but the uveitis often becomes chronic and is treatment resistant. Immunomodulatory agents can achieve control of the inflammation and prevent relapses.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Retrospective Studies; Methotrexate/therapeutic use; Adolescent; Chronic Disease; Immunosuppressive Agents/*therapeutic use; Cyclosporine/therapeutic use; Azathioprine/therapeutic use; Visual Acuity; Uveitis, Anterior/complications/*drug therapy; Secondary Prevention; Nephritis, Interstitial/complications/*drug therapy; Panuveitis/complications/*drug therapy

Presentation and outcome of patients with punctate inner choroidopathy at a tertiary referral center. - Patel, Kevin H.; Birnbaum, Andrea D.; Tessler, Howard H.; Goldstein, Debra A. (Retina (Philadelphia, Pa.), 2011)
PURPOSE: To describe the clinical course of patients with punctate inner choroidopathy seen at the University of Illinois, with emphasis on development of choroidal neovascularization (CNV). METHODS: Patients with a diagnosis of punctate inner choroidopathy were identified retrospectively. The diagnosis was made clinically based on findings of multiple, small "punched-out" lesions in the posterior pole without intraocular inflammation. Medical records were evaluated for evidence of CNV. RESULTS: Twelve patients with a diagnosis of punctate inner choroidopathy were identified. Average age at presentation was 32 years (range, 24-52 years). Eleven were women, and 11 were white. Eleven patients had available refractive data: 10 were myopic. Eight had CNV at initial presentation, and 1 later developed CNV. Eight had follow-up averaging 4 years (range, 1.4-9.6 years). Of these, five had CNV at initial presentation, and five developed new CNV. Four had multiple CNV membranes. All 6 patients with follow-up of ≥ 3 years had visual acuity at 3 years postpresentation of >20/40 in at least 1 eye. Four had visual acuity >20/40 bilaterally. CONCLUSION: Of punctate inner choroidopathy patients in this series, 75% had CNV, and more than 30% developed multiple neovascular membranes. With treatment, all patients with follow-up of ≥ 3 years had >20/40 vision in at least 1 eye.
Keywords: Female; Humans; Male; Middle Aged; Adult; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Recurrence; Fluorescein Angiography; Tomography, Optical Coherence; Immunosuppressive Agents/therapeutic use; Glucocorticoids/therapeutic use; Visual Acuity/physiology; Photochemotherapy; Choroidal Neovascularization/*diagnosis/drug therapy/physiopathology; Referral and Consultation; Refractive Errors/diagnosis; Uveitis, Posterior/*diagnosis/drug therapy/physiopathology

[Macular oedema and intravitreal triamcinolone injections]. - Gunnlaugsdóttir, Elín; Oehman, Dan O.; Gunnarsdóttir, Sigurlaug Guethrún; Stefánsson, Einar (Laeknabladid, 2006)
PURPOSE: To evaluate the efficacy of intravitreal triamcinolone injections for macular oedema in Iceland 2004-2006. METHODS: We reviewed hospital records of 28 patients who underwent intravitreal injection with triamcinolone acetonide 2004-2006. Most patients were treated with 8 mg of triamcinolone acetonide. Patients were categorized according to the cause of macular oedema (diabetes (n=10), phacoemulsification (n=7), branch retinal vein occlusion (BRVO) (n=7) and uveitis (n=4)). Best corrected visual acuity was determined before treatment and 1, 3 and 6 months postoperatively. Intraocular pressure and foveal thickness were measured before and after treatment. RESULTS: Visual acuity improved in 4 patients with diabetic macular oedema while 5 had unchanged vision. The effect lasted 6 months in 8 out of 9 cases. Seven were treated for macular oedema after phacoemulsification. Two had improved visual acuity after the injection and 5 had unchanged eye sight. The effect lasted for 6 months in every case except for one who lost vision. Out of 7 who were treated for macular oedema after BRVO, 3 had improved visual acuity and 4 remained unchanged for 6 months. Four patients with uveitis got triamcinolone injections and a month after treatment 2 had better vision and 2 had unchanged visual acuity. The effect lasted for 6 months in all cases but one. In the diabetes and BRVO groups OCT showed a significant reduction of foveal thickness. In 4 cases intraocular pressure increased, all of them were successfully treated with topical treatment. CONCLUSION: Intravitreal triamcinolone improves visual acuity in about 40% of patients with macular oedema, about 10% lose vision and about 50% remain unchanged. OCT reveal improved anatomic results with significant reduction of foveal thickness and macular oedema. No serious complications were noted.
Keywords: Humans; Middle Aged; Adult; Aged; Aged, 80 and over; Time Factors; Follow-Up Studies; Treatment Outcome; Tomography, Optical Coherence; Injections; Triamcinolone Acetonide/*administration & dosage; Vitreous Body; Visual Acuity/drug effects; Anti-Inflammatory Agents/*administration & dosage; Phacoemulsification/adverse effects; Uveitis/complications; Retinal Vein Occlusion/complications; Diabetic Retinopathy/complications; Iceland; Macular Edema/*drug therapy/*etiology/pathology/physiopathology

Pulse cyclophosphamide therapy in the management of patients with macular serpiginous choroidopathy. - Venkatesh, Pradeep; Gogia, Varun; Gupta, Shikha; Tayade, Akshay; Shilpy, Neha; Shah, Bhavin M.; Guleria, Randeep (Indian journal of ophthalmology, 2015)
PURPOSE: To evaluate safety and efficacy of intravenous pulse cyclophosphamide (CyP) in acute macular serpiginous choroiditis (SC). METHODS: Patients with acute macular SC with lesions threatening and/or involving fovea were enrolled. All patients received CyP (1 g/m2) for 3 days followed by high-dose oral steroids (1.5 mg/kg) tapered over 6 months and monitored for visual acuity, response to treatment and systemic side effects. RESULTS: Eight patients (seven unilateral and one bilateral) with median age of 27 years (range: 13-40 years) were recruited. Mean visual acuity at presentation was 0.71 ± 0.35 logarithm of the minimum angle of resolution while postpulse visual acuity was 0.40 ± 0.32. Final mean visual acuity at 1-year was 0.31 ± 0.23 (P ≤ 0.05). Three eyes had recurrence and 3 patients developed transient hair loss with no other adverse effect. CONCLUSION: Intravenous CyP provides rapid resolution of lesion activity and thereby helps in maintaining good functional acuity.
Keywords: Female; Humans; Male; Adult; Follow-Up Studies; Retrospective Studies; Treatment Outcome; Young Adult; Adolescent; Infusions, Intravenous; Fluorescein Angiography; Immunosuppressive Agents/administration & dosage; *Visual Acuity; Fundus Oculi; Macula Lutea/*pathology; Multifocal Choroiditis; Choroiditis/diagnosis/*drug therapy/physiopathology; Cyclophosphamide/*administration & dosage