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Annals of Medicine and Surgery (2012) Sep 2022In 2019, the discovery of a new strain of Coronavirus, later referred to as SARS-CoV2 took the world by storm, leading to a pandemic and shutting down all global... (Review)
Review
In 2019, the discovery of a new strain of Coronavirus, later referred to as SARS-CoV2 took the world by storm, leading to a pandemic and shutting down all global activities. Several measures were taken adequately to combat the viral havoc, including developing numerous vaccines. All the vaccines currently available for the general population went through rigorous screenings and trials to ensure maximum safety and were only approved after that. However, once they were rolled out in the markets and administered to the population, some adverse reactions were reported, one of which included uveitis. It is an ocular inflammatory condition of the uveal tract, choroid, or iris. If untreated, it can lead to severe consequences, including blindness. It is further divided into four categories based on its anatomical location. Despite the rare incidence of uveitis following COVID-19 vaccination, it may contribute to vaccine hesitancy; hence addressing and digging into the pathophysiological cause is crucial. This study evaluates all the pathophysiological and demographical links between COVID-19 vaccination and uveitis, suggesting appropriate management plans.
PubMed: 36060437
DOI: 10.1016/j.amsu.2022.104472 -
Romanian Journal of Ophthalmology 2019We present a case of a 47-year-old female patient, with papillitis in the right eye and anterior uveitis in both eyes, as a manifestation of untreated neurosyphilis.
We present a case of a 47-year-old female patient, with papillitis in the right eye and anterior uveitis in both eyes, as a manifestation of untreated neurosyphilis.
Topics: Diagnosis, Differential; Eye Infections, Bacterial; Female; Humans; Middle Aged; Neurosyphilis; Optic Disk; Papilledema; Slit Lamp Microscopy; Uveitis, Anterior; Visual Acuity; Visual Field Tests; Visual Fields
PubMed: 31915744
DOI: No ID Found -
Nature Reviews. Rheumatology Dec 2018Acute anterior uveitis (AAU) and the spondyloarthritis (SpA) subtypes ankylosing spondylitis, reactive arthritis and psoriatic arthritis are among the inflammatory... (Review)
Review
Acute anterior uveitis (AAU) and the spondyloarthritis (SpA) subtypes ankylosing spondylitis, reactive arthritis and psoriatic arthritis are among the inflammatory diseases affected by the biology of the intestinal microbiome. In this Review, the relationship between AAU, SpA and the microbiome is discussed, with a focus on the major SpA risk gene HLA-B*27 and how it is associated with both intestinal tolerance and the loss of ocular immune privilege that can accompany AAU. We provide four potential mechanisms to account for how dysbiosis, barrier function and immune response contribute to the development of ocular inflammation and the pathogenesis of AAU. Finally, potential therapeutic avenues to target the microbiota for the clinical management of AAU and SpA are outlined.
Topics: Animals; Gastrointestinal Microbiome; HLA-B27 Antigen; Humans; Immunity, Innate; Spondylarthropathies; Uveitis, Anterior
PubMed: 30301938
DOI: 10.1038/s41584-018-0097-2 -
Journal of the Formosan Medical... Aug 2023Cytomegalovirus (CMV) uveitis, a type of herpetic uveitis, is a major cause of infectious uveitis. Anterior and posterior CMV uveitis have diverse clinical presentations...
Cytomegalovirus (CMV) uveitis, a type of herpetic uveitis, is a major cause of infectious uveitis. Anterior and posterior CMV uveitis have diverse clinical presentations and treatment modalities. Based on expert consensus in Taiwan, this article provides suggestions regarding clinical manifestations, diagnosis, and treatment strategies for CMV uveitis based on clinical practice experience in Taiwan. CMV uveitis may have a distinct clinical presentation. Polymerase chain reaction (PCR) is an essential diagnostic tool to confirm a diagnosis. Antiviral therapy is the mainstay of treatment. Different agents, routes, and other supplemental treatments have been summarized and discussed in this article. Early diagnosis and appropriate treatment of CMV uveitis are crucial to avoid irreversible complications and vision loss. This consensus provides practical guidelines for ophthalmologists in Taiwan.
Topics: Humans; Cytomegalovirus; Cytomegalovirus Infections; Taiwan; Consensus; Uveitis, Anterior; Eye Infections, Viral; DNA, Viral; Uveitis
PubMed: 37003913
DOI: 10.1016/j.jfma.2023.03.014 -
American Journal of Ophthalmology Aug 2021To determine classification criteria for cytomegalovirus (CMV) anterior uveitis.
PURPOSE
To determine classification criteria for cytomegalovirus (CMV) anterior uveitis.
DESIGN
Machine learning of cases with CMV anterior uveitis and 8 other anterior uveitides.
METHODS
Cases of anterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the anterior uveitides. The resulting criteria were evaluated on the validation set.
RESULTS
One thousand eighty-three cases of anterior uveitides, including 89 cases of CMV anterior uveitis, were evaluated by machine learning. The overall accuracy for anterior uveitides was 97.5% in the training set and 96.7% in the validation set (95% confidence interval 92.4, 98.6). Key criteria for CMV anterior uveitis included unilateral anterior uveitis with a positive aqueous humor polymerase chain reaction assay for CMV. No clinical features reliably diagnosed CMV anterior uveitis. The misclassification rates for CMV anterior uveitis were 1.3% in the training set and 0% in the validation set.
CONCLUSIONS
The criteria for CMV anterior uveitis had a low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.
Topics: Adolescent; Adult; Aged; Aqueous Humor; Consensus; Cytomegalovirus; Cytomegalovirus Infections; DNA, Viral; Eye Infections, Viral; Female; Humans; Machine Learning; Male; Middle Aged; Uveitis, Anterior; Young Adult
PubMed: 33845019
DOI: 10.1016/j.ajo.2021.03.060 -
Case Reports in Ophthalmology 2022This report describes a case of acute uveitis following COVID-19 vaccination. A 21-year-old patient was referred to our department for decreased visual acuity and...
This report describes a case of acute uveitis following COVID-19 vaccination. A 21-year-old patient was referred to our department for decreased visual acuity and injection of the left eye. Two days prior, the patient received her second dose of the severe acute respiratory syndrome coronavirus 2 vaccine (BNT162b2, Pfizer-BioNTech). On ocular examination, her left eye's best-corrected visual acuity was 20/250, and its intraocular pressure was 16 mm Hg on a noncontact tonometer. Hypopyon, 4+ cells, and flares were observed in the anterior chamber. The patient was diagnosed with acute uveitis. She received topical dexamethasone (0.1%) hourly and systemic prednisone (50 mg/day). After 7 days, her inflammatory symptoms were mostly resolved. COVID-19 vaccination can cause acute anterior uveitis, which is responsive to steroids.
PubMed: 35431883
DOI: 10.1159/000521785 -
American Journal of Ophthalmology Aug 2021The purpose of this study was to determine classification criteria for sarcoidosis-associated uveitis.
PURPOSE
The purpose of this study was to determine classification criteria for sarcoidosis-associated uveitis.
DESIGN
Machine learning of cases with sarcoid uveitis and 15 other uveitides.
METHODS
Cases of anterior, intermediate, and panuveitides were collected in an informatics-designed preliminary database, and a final database was constructed including cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were analyzed by anatomic class, and each class was split into a training set and a validation set. Machine learning using multinomial logistic regression was used in the training sets to determine a parsimonious set of criteria that minimized the misclassification rate among the uveitides. The resulting criteria were evaluated in the validation sets.
RESULTS
A total of 1,083 cases of anterior uveitides, 589 cases of intermediate uveitides, and 1,012 cases of panuveitides, including 278 cases of sarcoidosis-associated uveitis, were evaluated by machine learning. Key criteria for sarcoidosis-associated uveitis included a compatible uveitic syndrome of any anatomic class and evidence of sarcoidosis, either 1) tissue biopsy results demonstrating non-caseating granulomata or 2) bilateral hilar adenopathy on chest imaging. The overall accuracy of the diagnosis of sarcoidosis-associated uveitis in the validation set was 99.7% (95% confidence interval: 98.8-99.9). The misclassification rates for sarcoidosis-associated uveitis in the training sets were 3.2% in anterior uveitis, 2.6% in intermediate uveitis, and 1.2% in panuveitis; in the validation sets, the misclassification rates were 0% in anterior uveitis, 0% in intermediate uveitis, and 0% in panuveitis.
CONCLUSIONS
The criteria for sarcoidosis-associated uveitis had a low misclassification rate and appeared to perform sufficiently well for use in clinical and translational research.
Topics: Adult; Biopsy; Female; Humans; Male; Middle Aged; Sarcoidosis; Uvea; Uveitis
PubMed: 33845001
DOI: 10.1016/j.ajo.2021.03.047 -
Clinical Optometry 2016Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners... (Review)
Review
Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, non-infectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued.
PubMed: 30214346
DOI: 10.2147/OPTO.S72079 -
CMAJ : Canadian Medical Association... Mar 2024
Topics: Humans; Scleritis; Pamidronate; Uveitis, Anterior; Acute Disease
PubMed: 38527748
DOI: 10.1503/cmaj.230859-f -
Indian Journal of Ophthalmology Dec 2022A 35-year-old Asian Indian female previously diagnosed with bilateral anterior uveitis and on oral methotrexate developed bilateral anterior uveitis following...
A 35-year-old Asian Indian female previously diagnosed with bilateral anterior uveitis and on oral methotrexate developed bilateral anterior uveitis following first/second dose of coronavirus disease 2019 (COVID-19) vaccination. She had skipped her weekly dose of oral methotrexate following first dose of vaccination. Following the second dose, she reduced her oral methotrexate from 25 to 15 mg on her own, but did not stop like the previous occasion. She had extensive workup for her uveitis in the past with only positive severe acute respiratory syndrome coronavirus (SARS-CoV-2) antibodies. She developed unilateral anterior uveitis after she had COVID-19 in July 2022, which resolved with topical steroids and continuation of immunosuppression. This report illustrates that COVID-19 or its vaccination may presumably play a role in triggering the immune system and can cause recurrent ocular inflammation even in the absence of an extraocular inflammation.
Topics: Female; Humans; Adult; COVID-19; SARS-CoV-2; COVID-19 Vaccines; Methotrexate; Uveitis, Anterior; Vaccination; Acute Disease; Inflammation
PubMed: 36453363
DOI: 10.4103/ijo.IJO_1089_22