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Ocular Immunology and Inflammation Dec 2023To describe the most important cause of infectious posterior uveitis in pediatric patients. (Review)
Review
PURPOSE
To describe the most important cause of infectious posterior uveitis in pediatric patients.
METHODS
Review of the literature.
RESULTS
The most important causes of infectious uveitis in pediatric patients are: cat-scratch disease, toxocariasis, tuberculosis, viral diseases and toxoplasmosis. Ocular manifestations include retinitis, neuroretinitis, choroidal granulomas, peripheral granulomas and posterior pole granulomas.
CONCLUSION
Infectious posterior uveitis is a challenging subject and should be considered in the differential diagnosis of any posterior uveitis in children. Infectious uveitis must be excluded before initiating immunosuppressive therapy.
Topics: Animals; Humans; Child; Uveitis, Posterior; Uveitis; Retinitis; Eye Infections; Eye Infections, Bacterial; Choroid; Granuloma
PubMed: 38096404
DOI: 10.1080/09273948.2023.2284990 -
Ocular Immunology and Inflammation Sep 2023To report and illustrate the main clinical presentations of posterior herpetic uveitis. (Review)
Review
PURPOSE
To report and illustrate the main clinical presentations of posterior herpetic uveitis.
METHODS
Narrative review.
RESULTS
The ocular manifestations of posterior herpetic uveitis include different clinical presentations. Herpes simplex and varicella zoster can cause acute retinal necrosis, progressive outer retinal necrosis, and non-necrotizing herpetic retinopathies. Cytomegalovirus has been associated with fulminant retinitis with confluent areas of retinal necrosis and retinal hemorrhages, indolent/granular retinitis, and frosted branch angiitis. These diverse clinical presentations are often associated with specific risk factors and different immunological profiles of the host.
CONCLUSIONS
Herpetic viruses can cause posterior uveitis, presenting various clinical findings. Specific ocular manifestations and the immunological status of the host can help to differentiate the various herpetic entities before laboratory tests confirm the diagnosis.
Topics: Humans; Herpesviridae Infections; Retinal Necrosis Syndrome, Acute; Retinitis; Retinal Diseases; Uveitis, Posterior; Necrosis
PubMed: 37364039
DOI: 10.1080/09273948.2023.2221338 -
Ocular Immunology and Inflammation Nov 2020To provide an overview of the current knowledge on the Human Immunodeficiency Virus (HIV)-associated retinopathies. (Review)
Review
PURPOSE
To provide an overview of the current knowledge on the Human Immunodeficiency Virus (HIV)-associated retinopathies.
METHODS
A PubMed search was performed, using the key terms "HIV Retinopathy OR Retinitis" and "HIV AND Retinitis" to find manuscripts published within the last ten years.
RESULTS
If left untreated, HIV infection causes a progressive immunodeficiency caused by depletion of CD4-positive T lymphocytes. Noninfectious HIV retinopathy, clinically manifested by cotton wool spots. Once the CD4 count drops below 200 c/μl, immunodeficiency creates a vulnerability for systemic opportunistic infections. Within the posterior segment of the eye, cytomegalovirus (CMV) retinitis has to be distinguished from infections with other members of the herpes virus family, as well as from toxoplasmosis, tuberculosis, and syphilis. Upon restoration of the immune system, immune recovery uveitis may manifest in one third of CMV affected eyes.
CONCLUSION
Targeted antiviral treatment and secondary recurrence prophylaxis prevent vision loss of the retina prior to immune recovery.
Topics: Antiviral Agents; Chorioretinitis; Cytomegalovirus Retinitis; Diagnostic Techniques, Ophthalmological; Eye Infections, Viral; HIV Infections; Humans; Retinal Necrosis Syndrome, Acute; Varicella Zoster Virus Infection
PubMed: 32966142
DOI: 10.1080/09273948.2020.1808225 -
Journal Francais D'ophtalmologie Mar 2019Sarcoidosis is a systemic granulomatosis characterized by the formation of epithelioid and giant cell granulomas without caseous necrosis. To make the diagnosis, it is... (Review)
Review
Sarcoidosis is a systemic granulomatosis characterized by the formation of epithelioid and giant cell granulomas without caseous necrosis. To make the diagnosis, it is necessary to prove systemic granulomatosis involving at least two organs; but in practice, a combination of clinical, paraclinical and histologic findings is used. It affects predominantly women with a bimodal age distribution: 25-29years and 65-69years. The most commonly affected organs are the mediastinal lymphatic system, lungs, skin and eyes. Ophthalmological involvement is present in 20 to 50% of cases. The typical ocular presentation is that of granulomatous uveitis associated with venous retinal vasculitis and lesions of peripheral multifocal choroiditis. This ophthalmological presentation, although very evocative, is not always associated with systemic disease. The diagnosis of ocular sarcoidosis is then presumed in the absence of histological evidence. Algorithms combining ophthalmological and systemic signs have been proposed in cases of isolated uveitis. They make it possible to establish the diagnosis of ocular sarcoidosis with various levels of probability. The absence of significant granulomas on a systemic level during primary ocular involvement remains the main hypothesis to explain these diagnostic difficulties. Treatment is well described, as the uveitis of sarcoidosis is most often steroid responsive. In the case of corticosteroid-dependent uveitis, the first-line immunosuppressant remains methotrexate. The use of anti-tumor necrosis factor-alpha is an interesting alternative in patients whose ocular sarcoidosis is refractory to conventional immunosuppressants.
Topics: Adult; Age Distribution; Aged; Choroiditis; Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; Endophthalmitis; Granuloma; Humans; Multifocal Choroiditis; Retinal Vasculitis; Sarcoidosis; Uveitis
PubMed: 30850198
DOI: 10.1016/j.jfo.2018.06.015 -
Indian Journal of Ophthalmology Sep 2017We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting...
We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting meteor-like leak emanating from the tumour and rising towards the superior retina in the later frames of the angiogram. Pictorially, we call it the "Retinal Meteor" and also describe the possible mechanism for this pattern of leakage.
Topics: Aged; Diagnosis, Differential; Fluorescein Angiography; Fundus Oculi; Humans; Male; Retinal Neoplasms; Retinal Vessels; Tomography, Optical Coherence; Uveitis, Posterior
PubMed: 28905838
DOI: 10.4103/ijo.IJO_68_17 -
Orvosi Hetilap Nov 2020Összefoglaló. Bevezetés és célkitűzés: A syphiliseredetű uveitis szemészeti és általános tüneteinek ismertetése, a prognózis elemzése olyan esetek...
UNLABELLED
Összefoglaló. Bevezetés és célkitűzés: A syphiliseredetű uveitis szemészeti és általános tüneteinek ismertetése, a prognózis elemzése olyan esetek kapcsán, amelyekben az uveitis kivizsgálása során derült fény a syphilisre. Módszer: 2011 és 2019 között 14 uveitises beteg vizsgálata során derült fény syphilisre (13 férfi, 1 nő), a tünetek 25 szemen jelentkeztek. A betegek adatait retrospektíven elemeztük. Eredmények: A betegek átlagéletkora 46 év volt (23-72 év). A szemészeti diagnózis felállítását követően 2 beteg nem jelent meg a további bőrgyógyászati és szemészeti vizsgálaton, 1 beteget más intézetben kezeltek. A gondozott 11 betegnél a gyulladásban érintett szemeken az első alkalommal észlelt átlagolt látóélesség a jobb szemen 0,71 (0,001-1,0), a bal szemen 0,53 (0,04-1,0) volt. A követési idő átlagosan 22 hónap (1-72) volt. A követési idő végén az átlagolt látóélesség a jobb szemen 0,9 (0,15-1,0), a bal szemen 0,82 (0,08-1,0) volt. A leggyakoribb szemészeti manifesztáció a hátsó uveitis volt, amely papillitis, chorioretinitis vagy kombinált formákban volt megfigyelhető, összesen 20 szemen. A neurosyphilis-protokoll alapján alkalmazott penicillinkezelés után a gyulladásos tünetek minden betegnél megszűntek, a követési idő végén a betegek többségénél a látóélesség teljes volt. A gyengébb látóélesség hátterében látóideg-atrophia, illetve a macula károsodása állt. Következtetés: Eseteinkben a betegek főként középkorú férfiak voltak. Bár jellemző volt a hátsószegmentum-érintettség, megfelelő kezelés mellett a prognózis jónak volt mondható. Orv Hetil. 2020; 161(45): 1927-1935.
INTRODUCTION AND OBJECTIVE
To describe the ocular and general characteristics and to assess prognosis of patients with uveitis, whose syphilis infection was revealed during uveitis workup.
METHOD
Between 2011 and 2019, 14 uveitis patients were diagnosed with syphilis (13 males, 1 female) with symptoms in 25 eyes. Patients' clinical records were analyzed retrospectively.
RESULTS
The mean age of patients was 46 years (range 23-72 years). 2 patients did not show up for further dermatological and ophthalmic examinations, and 1 patient was treated at another institute. In the 11 patients we treated, the mean visual acuity observed for the first time in the eyes affected by inflammation was 0.71 (0.001-1.0) in the right eye and 0.53 (0.04-1.0) in the left eye. The mean follow-up was 22 months (1-72). At the end of the follow-up period, the mean visual acuity was 0.9 (0.15-1.0) in the right eye and 0.82 (0.08-1.0) in the left eye. The most common ocular manifestation was posterior uveitis (papillitis, chorioretinitis, or in combined forms) in a total of 20 eyes. After receiving penicillin therapy according the neurosyphilis protocol, inflammatory symptoms resolved in all patients, and at the end of the follow-up, the majority of patients had complete visual recovery. Lower visual acuity was due to optic nerve atrophy and macular damage.
CONCLUSION
In our case series, the patients were predominantly middle-aged men. Although most patients showed posterior segment involvement, with appropriate treatment the visual outcome was good. Orv Hetil. 2020; 161(45): 1927-1935.
Topics: Adult; Aged; Chorioretinitis; Eye Infections, Bacterial; Female; Humans; Male; Middle Aged; Neurosyphilis; Retrospective Studies; Syphilis; Uveitis; Young Adult
PubMed: 33161392
DOI: 10.1556/650.2020.31892 -
Ocular Immunology and Inflammation Oct 2017
Topics: Adult; Aged; Birdshot Chorioretinopathy; Chorioretinitis; Choroid; Female; Fluorescein Angiography; Fundus Oculi; Humans; Immunosuppressive Agents; Male; Middle Aged; Retina; Tomography, Optical Coherence; Visual Acuity
PubMed: 29144845
DOI: 10.1080/09273948.2017.1400800 -
Current Opinion in Ophthalmology Nov 2020This article summarizes the systemic and ocular manifestations of Blau syndrome, its genetic basis, and reviews recently published literature. (Review)
Review
PURPOSE OF REVIEW
This article summarizes the systemic and ocular manifestations of Blau syndrome, its genetic basis, and reviews recently published literature.
RECENT FINDINGS
A large multicenter prospective case series is underway, with 3-year preliminary results indicating the prevalence of uveitis, clinical characteristics and early data on its visual prognosis. Case reports have demonstrated the successful use of newer biologic agents.
SUMMARY
Blau syndrome is an exceedingly rare autoinflammatory disorder with skin, joint and eye manifestations. It is caused by autosomal dominant mutations of the NOD2 protein. Eye involvement is typically a chronic bilateral granulomatous iridocyclitis, often with multifocal choroiditis in the posterior segment. Treatment starts with topical and systemic steroids and often requires antimetabolites or biologic agents.
Topics: Arthritis; Humans; Multifocal Choroiditis; Mutation; Nod2 Signaling Adaptor Protein; Sarcoidosis; Synovitis; Uveitis
PubMed: 33009086
DOI: 10.1097/ICU.0000000000000705 -
Revista de La Facultad de Ciencias... Mar 2022To provide a complete picture and to improve understanding of the serpiginous-like choroiditis caused by Mycobacterium Tuberculosis. (Review)
Review
OBJECTIVE
To provide a complete picture and to improve understanding of the serpiginous-like choroiditis caused by Mycobacterium Tuberculosis.
MATERIALS AND METHODS
Literature review of serpiginous-like choroiditis. A number of scientific search engines were searched including Medline (PubMed), Scielo, and Cochrane Library. Using MeSH and DeCS terms.
RESULTS
107 articles were obtained, of which 44 met inclusion criteria.
DISCUSSION
serpiginous-like choroiditis is described as its etiology, pathogenesis, ocular findings, diagnosis, differential diagnosis and treatment.
CONCLUSIONS
Modern studies are needed to understand the pathophysiology, new diagnostic strategies, and future treatments of serpiginous-like choroiditis
Topics: Choroiditis; Diagnosis, Differential; Humans
PubMed: 35312256
DOI: 10.31053/1853.0605.v79.n1.32223 -
International Ophthalmology Jun 2021Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a... (Review)
Review
INTRODUCTION
Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a significant personal and social impact. Although steroids and nonbiologic- Disease-Modifying Antirheumatic Drugs (nbDMARDs) are effective both in acute and long- lasting diseases, however they are increasingly being replaced by biologic (DMARDs). bDMARD. This article therefore aims to identify recent advances in the therapy of noninfectious posterior segment uveitis.
METHODS
A Medline-search was conducted using the terms: nbDMARD, bDMARD, posterior uveitis, intermediate uveitis, treatment, corticosteroid. In addition, clinical studies were included as registered at ClinicalTrials.gov.
RESULTS
Currently two major lines of treatments can be identified: (1) the intraocular application of anti-inflammatory agents and (2) the introduction of new agents, e.g., (bDMARDs) and small-molecule-inhibitors. Whereas intravitreal treatments have the advantage to avoid systemic side effects, new systemic agents are progressively earning credit on the basis of their therapeutic effects.
CONCLUSION
Even when current treatment strategies are still hampered by the limited number of randomized controlled trials, promising progress and continuous efforts are seen.
Topics: Adolescent; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Antirheumatic Agents; Humans; Uveitis; Uveitis, Intermediate; Uveitis, Posterior
PubMed: 33634341
DOI: 10.1007/s10792-021-01763-8