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Journal of Clinical Medicine Dec 2021Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other...
Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18-83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet's disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1-30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.
PubMed: 34945256
DOI: 10.3390/jcm10245960 -
Graefe's Archive For Clinical and... Jun 2022
Topics: Adalimumab; Humans; Multiple Sclerosis; Pars Planitis; Uveitis, Intermediate
PubMed: 35015113
DOI: 10.1007/s00417-021-05527-z -
Ophthalmology. Retina Nov 2022To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current...
PURPOSE
To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow.
DESIGN
Retrospective, observational case series.
PARTICIPANTS
Eyes presenting with fernlike patterns of dye leakage on UWFA were included in this study.
METHODS
Analysis of the clinical characteristics and multimodal imaging findings using UWFA and wide-angle swept-source OCT-angiography (SS-OCTA).
MAIN OUTCOME MEASURES
The disease spectrum, anatomic origin, and clinical implications of this fernlike leakage.
RESULTS
Multimodal retinal images from 40 eyes of 29 patients with fernlike leakage on UWFA were studied. The underlying etiologies included a wide range of inflammatory disorders, including pars planitis (18 eyes) and central retinal vein occlusion (2 eyes). On UWFA, the fernlike leakage originated from the retinal capillaries and venules directly adjacent to the veins and spared the periarterial zone. This perivenular fernlike leakage involved the far periphery in all cases and progressed more diffusely and centripetally in cases with more severe intraocular inflammation. On wide-angle SS-OCTA, the impairment of deep capillary plexus (DCP) flow signals precisely colocalized with the perivenular fernlike leakages identified on UWFA.
CONCLUSIONS
The fernlike leakage on UWFA refers to the distinctive perivenular dye leakage that originates from the retinal capillaries and venules. Multimodal imaging correlation suggests that the predominant impairment is at the level of the DCP. The axial symmetry of the fernlike leakage with the veins and sparing of the periarterial zone may support the dominant venous role of the DCP.
Topics: Humans; Fluorescein Angiography; Retrospective Studies; Tomography, Optical Coherence; Retinal Vein Occlusion; Retinal Vein
PubMed: 35545196
DOI: 10.1016/j.oret.2022.05.001 -
Pediatric Emergency Care Oct 2017Point-of-care ocular ultrasound can provide the clinician with more information about potential intraorbital and extraocular pathology, especially in cases when direct... (Review)
Review
Point-of-care ocular ultrasound can provide the clinician with more information about potential intraorbital and extraocular pathology, especially in cases when direct visualization of the eye is limited. This case report describes the findings in a pediatric patient who presented with a 1-month history of eye injection and worsening blurry vision. After point-of-care ultrasound demonstrated abnormal debris in the posterior vitreous cavity, subsequent evaluation revealed a diagnosis of pars planitis.
Topics: Child; Glucocorticoids; Humans; Male; Pars Planitis; Point-of-Care Systems; Ultrasonography; Vision Disorders
PubMed: 28968308
DOI: 10.1097/PEC.0000000000001272 -
Journal Francais D'ophtalmologie Feb 2023The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
PURPOSE
The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
METHODS
We performed a retrospective study of all cases of all pediatric uveitis seen at our institution over a 7-year period.
RESULTS
A total of 141 eyes of 86 children were included. The mean age was 10.7 years, and 61.6% were girls. The uveitis was bilateral in 64.0% of cases. Anterior uveitis (41.0%) and intermediate uveitis (32.0%) were the most frequent forms. The most frequent etiologies were idiopathic (27.9%), juvenile idiopathic arthritis (25.6%) and pars planitis (18.6%). During the follow-up period, systemic corticosteroids were received by 43.0% of children, immunosuppressive drugs by 31.4% and biological agents by 18.6%. At the final examination, complications were present in 67.0% of patients: 18.0% had cataracts, and 11.3% had intraocular hypertension. Posterior synechiae were present in 27.6% of eyes, optic disc edema in 10.5% and macular edema in 16.2%. At the last visit, visual acuity was better than 20/200 in 97.0% of cases. The presence of band keratopathy, cataract or glaucoma was an independent predictor of impaired visual outcomes at follow-up.
CONCLUSION
Juvenile idiopathic arthritis is one of the most frequent and severe pediatric uveitides. Close monitoring and early treatment could prevent complications.
Topics: Female; Child; Humans; Male; Prognosis; Arthritis, Juvenile; Retrospective Studies; Uveitis; Uveitis, Anterior; Cataract
PubMed: 36642594
DOI: 10.1016/j.jfo.2022.08.005 -
Ophthalmology. Retina Sep 2023To comprehensively examine the cost effectiveness, reattachment rate, and complications of pneumatic retinopexy (PnR) compared with pars plana vitrectomy (PPV) for...
PURPOSE
To comprehensively examine the cost effectiveness, reattachment rate, and complications of pneumatic retinopexy (PnR) compared with pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) within a universal health care system.
DESIGN
Population-based, multicenter, consecutive, retrospective longitudinal cohort analysis.
SUBJECTS
We identified consecutive adults aged ≥ 50 years requiring surgery for primary RRD over a 20-year interval between April 1, 2002, and March 31, 2022. Initial surgery was considered the index date for analyses.
INTERVENTION
Pneumatic retinopexy was compared with PPV in all analyses.
MAIN OUTCOME MEASURES
The primary analysis investigated the mean annualized health care costs comparing PnR to PPV over the 2 years after initial surgery. Secondary analyses examined the primary reattachment rate and complications.
RESULTS
In total, 25 665 eligible patients were identified, with 8794 undergoing PnR and 16 871 undergoing PPV. The mean patient age was 65 years and 39% were women. The mean annualized cost after PnR was $8924 and $11 937 after PPV (mean difference, $3013; 95% confidence interval, $2533-$3493; P < 0.001). The primary reattachment rate at 90 days after PnR was 83% and after PPV was 93% (P < 0.001). The risk of cataract or glaucoma surgery was lower after PnR, and the frequency of ophthalmology clinic visits, intravitreal injections, and anxiety was higher after PnR. Hospitalizations and long-term disability were less frequent after PnR.
CONCLUSIONS
Pneumatic retinopexy, when compared with PPV, was associated with lower long-term health care costs. Pneumatic retinopexy appeared to be effective, safe, and inexpensive, thus offering a viable option for improving access to RRD repair in appropriately selected cases.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Humans; Retrospective Studies; Longitudinal Studies; Pars Planitis; Vitrectomy; Retinal Detachment; Male; Female; Aged; Aged, 80 and over; Cryotherapy; Light Coagulation
PubMed: 37286134
DOI: 10.1016/j.oret.2023.05.021 -
International Ophthalmology Jan 2023To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs)...
AIM
To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs) in the treatment of pars planitis (PP).
METHODS
The patients with PP who were treated with anti-TNF-alpha agents for at least six months were qualified for the chart review. The outcome parameters were the steroid-free remission state, the best-corrected visual acuity (BCVA) and the central macular thickness (CMT) of the patients at the last visit.
RESULTS
After a mean total follow-up time of 15.5 ± 5.8 months (8-24 months), all the cases were in steroid-free remission at the last visit. The mean BCVA increased, and the mean CMT decreased significantly at the last visit (p < 0.001, p < 0.001, respectively).
CONCLUSION
ADA combined with IMAs offers effective and safe treatment modalities in the control of chronic intraocular inflammation in PP cases.
Topics: Child; Humans; Adalimumab; Inflammation; Necrosis; Pars Planitis; Retrospective Studies; Treatment Outcome; Tumor Necrosis Factor Inhibitors; Turkey
PubMed: 35780435
DOI: 10.1007/s10792-022-02398-z -
Journal of Glaucoma Mar 2017The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children.
PURPOSE OF THE STUDY
The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children.
MATERIALS AND METHODS
The medical records of consecutive aphakic and pseudophakic children (<16 y of age) who underwent BGI surgery with pars plana tube insertion between 1990 and 2013 were retrospectively reviewed. Main outcome measures were intraocular pressure and number of glaucoma medications. Postoperative complications were recorded. Failure was defined as an intraocular pressure <5 or ≥21 mm Hg (with or without glaucoma medications), loss of light perception, or need for additional glaucoma surgery.
RESULTS
Thirty-seven children were identified with a mean age of 6.0±4.7 years (range, 4 mo to 14.5 y). Mean follow-up after pars plana BGI surgery was 6.5±3.4 years (range, 9 mo to 12.8 y) for patients who met success criteria. Mean intraocular pressure and mean number of glaucoma medications at most recent follow-up for patients with successful intraocular pressure control were 13.8±4.1 and 2.3±1.9 mm Hg, respectively. The Kaplan-Meier survival analysis revealed 1-, 3-, 5-, and 7-year success rates of 94.5%, 74.6%, 65.0%, and 45.8%, respectively. Complications included tube exposure in 1 patient (2.7%), tube obstruction in 8 patients (21.6%), and retinal detachment in 9 patients (24.3%). Seventeen patients (45.9%) failed due to inadequate intraocular pressure control, of whom 9 (24.3%) required additional glaucoma surgery.
CONCLUSIONS
Although pars plana BGI surgery is a reasonable option for managing refractory glaucoma in aphakic and pseudophakic children, surgeons must be aware of the potential need for additional glaucoma surgery and/or posterior segment complications with extended follow-up.
Topics: Adolescent; Antihypertensive Agents; Aphakia; Child; Child, Preschool; Ciliary Body; Female; Glaucoma; Glaucoma Drainage Implants; Humans; Intraocular Pressure; Kaplan-Meier Estimate; Male; Pars Planitis; Postoperative Complications; Prosthesis Implantation; Pseudophakia; Retinal Detachment; Retrospective Studies; Treatment Outcome; Visual Acuity
PubMed: 28002192
DOI: 10.1097/IJG.0000000000000611 -
American Journal of Ophthalmology Feb 2016To compare the long-term outcomes of peripheral retinal cryoablation to conventional treatment for active pars planitis. (Comparative Study)
Comparative Study
PURPOSE
To compare the long-term outcomes of peripheral retinal cryoablation to conventional treatment for active pars planitis.
DESIGN
Retrospective, interventional, comparative case series.
METHODS
Review at a single institution was conducted to compare the effect of cryotherapy to eyes with pars planitis to those receiving conventional therapy (topical, regionally injected, or oral corticosteroid therapy). Best-corrected visual acuity (VA), complications, resolution of cystoid macular edema (CME), and anterior chamber and vitreous inflammation were assessed.
RESULTS
One hundred thirty-six eyes were treated conventionally, 50 eyes were treated with cryotherapy. Median follow-up was 60.8 months (range 8.1-223.1 months) in the cryotherapy group and 45.0 months (range 3.1-339.0 months) in the controls. There were no significant differences in baseline VA, anterior chamber and vitreous inflammation, presence of CME, and prior use of regional corticosteroid injections. VA improved over time in the cryotherapy group (slope of -0.0018 logMAR units per month; P = .023) but declined in the controls (slope of +0.0011 logMAR units per month; P = .023). Kaplan-Meier survival estimates demonstrated faster times to resolution of anterior chamber cell, vitreous cell, and CME in the cryotherapy-treated eyes. Hazard ratios of remission (adjusted for confounding factors) for vitreous cell and CME for those treated with cryotherapy compared to controls were 4.73 (95% confidence interval 1.63, 13.63; P = .004) and 6.85 (95% confidence interval 1.06, 44.78; P = .044), respectively. No ocular complications were identified in the cryotherapy group.
CONCLUSIONS
These data suggest that peripheral retinal cryoablation therapy is an effective treatment for active pars planitis and may be better than conventional regional corticosteroid injections and oral corticosteroid therapy for induction of remission.
Topics: Adolescent; Adult; Aged; Anterior Chamber; Child; Cryotherapy; Eye Diseases; Female; Follow-Up Studies; Humans; Macular Edema; Male; Middle Aged; Pars Planitis; Retrospective Studies; Treatment Outcome; Visual Acuity; Vitreous Body
PubMed: 26576712
DOI: 10.1016/j.ajo.2015.11.009 -
Ocular Immunology and Inflammation May 2024To characterize and describe clinical experience with childhood-onset non-infectious uveitis.
OBJECTIVE
To characterize and describe clinical experience with childhood-onset non-infectious uveitis.
STUDY DESIGN
A multicenter retrospective multidisciplinary national web-based registry of 507 patients from 21 hospitals was analyzed. Cases were grouped as immune disease-associated (IMDu), idiopathic (IDIu) or ophthalmologically distinct. Characteristics of juvenile idiopathic arthritis-associated (non-HLA-B27-related) uveitis (JIAu), IDIu, and pars planitis (PP) were compared.
RESULTS
IMDu (62.3%) and JIAu (51.9%) predominated in young females; and IDIu (22.7%) and PP (13.6%) in older children, without sex imbalance. Ocular complications occurred in 45.3% of cases (posterior synechiae [28%], cataracts [16%], band keratopathy [14%], ocular hypertension [11%] and cystoid macular edema [10%]) and were associated with synthetic (86%) and biologic (65%) disease-modifying antirheumatic drug (DMARD) use. Subgroups were significantly associated ( < 0.05) with different characteristics. JIAu was typically anterior (98%), insidious (75%), in ANA-positive (69%), young females (82%) with fewer complications (31%), better visual outcomes, and later use of uveitis-effective biologics. In contrast, IDIu was characteristically anterior (87%) or panuveitic (12.1%), with acute onset (60%) and more complications at onset (59%: synechiae [31%] and cataracts [9.6%]) and less DMARD use, while PP is intermediate, and was mostly bilateral (72.5%), persistent (86.5%) and chronic (86.8%), with more complications (70%; mainly posterior segment and cataracts at last visit), impaired visual acuity at onset, and greater systemic (81.2%), subtenon (29.1%) and intravitreal (10.1%) steroid use.
CONCLUSION
Prognosis of childhood uveitis has improved in the "biologic era," particularly in JIAu. Early referral and DMARD therapy may reduce steroid use and improve outcomes, especially in PP and IDIu.
PubMed: 38728578
DOI: 10.1080/09273948.2024.2336609