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Middle East African Journal of... 2017To study the patterns of intermediate uveitis in the pediatric age group in a referral eye care center in South India.
PURPOSE
To study the patterns of intermediate uveitis in the pediatric age group in a referral eye care center in South India.
METHODS
This is a study of twenty consecutive patients under 16 years of age with intermediate uveitis, conducted at a tertiary referral center. Numerous variables were assessed, including age and gender distribution, laboratory data, the presence of systemic diseases, onset and course of ocular inflammation, clinical features, their complications, therapeutic strategies with their outcomes, remission, final visual acuity (VA), and characteristics associated with poor visual outcome.
RESULTS
Bilateral involvement was observed in 80% of the patients. Remission was observed in five out of 7 patients (78%) with completed follow-up of 5 years. Final VA improved by at least two lines in 11 patients, remained stable in 6 patients, and worsened in 3 patients. The etiological diagnosis showed one patient with Bechet's disease, one with juvenile idiopathic arthritis, 1 with human leukocyte antigen B27 associated uveitis, 9 with laboratory proven tuberculosis, and 3 with sarcoidosis and 5 where it was idiopathic. The mean follow-up was 4.8 years (range 3-8 years). Cataract was the most frequent complication observed (40%). Glaucoma, choroidal neovascularization, and amblyopia accounted for worsening of vision in three patients.
CONCLUSION
Median time of development of complications is about 3 years based on our study. Intermediate uveitis of childhood might exhibit a self-limiting course after several years. Visual recovery is good in the majority, and visual loss is limited despite the high rate of ocular complications.
Topics: Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Incidence; India; Male; Prognosis; Referral and Consultation; Retrospective Studies; Tertiary Care Centers; Time Factors; Uveitis, Intermediate; Visual Acuity
PubMed: 28936054
DOI: 10.4103/meajo.MEAJO_264_15 -
Medical Science Monitor : International... Dec 2019BACKGROUND Pars plana vitrectomy (PPV) is used to treat retinal conditions, including retinal detachment, and involves removal of the vitreous gel from the eye....
Comparison of Methods of Endotamponade Used During 23-Gauge Pars Plana Vitrectomy and the Risk of Raised Intraocular Pressure During 24-Month Follow-Up: A Retrospective Study of 196 Patients.
BACKGROUND Pars plana vitrectomy (PPV) is used to treat retinal conditions, including retinal detachment, and involves removal of the vitreous gel from the eye. Complications following PPV include raised intraocular pressure (IOP). This retrospective study aimed to compare methods of endotamponade used during 23-gauge PPV and the risk of raised IOP during 24-month follow-up at a single center. MATERIAL AND METHODS The study included 196 patients (age, 15-86 years; mean, 63.5 years) (196 eyeballs). There were 93 patients (47.45%) with a preoperative history of type 2 diabetes mellitus and 14 patients (7.14%) with a history of myopia. IOP was measured with Goldmann applanation tonometry at one-, three-, six-, 12-, and 24-month follow-up. The outcome was compared following endotamponade with silicone oil, sulfur hexafluoride (SF6), and balanced salt solution (BSS). RESULTS Mean IOP at one-month follow-up was 17.2 mmHg (±3.61 mmHg; range, 9-45 mmHg), and at 24-month follow-up was 17.3 mmHg (±3.23 mmHg; range, 7-30 mmHg). IOP following PPV was significantly associated with the indication for PPV (P=0.023), and the type of endotamponade used (P=0.049). In patients with silicone oil endotamponade, the risk of IOP at 24 months was increased by 2.3 times compared with SF6 or BSS endotamponade. Patients with SF6 endotamponade had a risk of IOP that was 3.3 times lower than for silicone oil tamponade or BSS tamponade. CONCLUSIONS Silicone oil endotamponade in PPV was associated with an increased risk of IOP at 24-month follow-up.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Endotamponade; Female; Follow-Up Studies; Glaucoma; Humans; Intraocular Pressure; Male; Middle Aged; Pars Planitis; Poland; Prospective Studies; Retinal Detachment; Retinal Diseases; Retrospective Studies; Risk Factors; Silicone Oils; Tonometry, Ocular; Vitrectomy; Vitreous Body
PubMed: 31811816
DOI: 10.12659/MSM.918114 -
Retina (Philadelphia, Pa.) Aug 2023To describe a novel technique of lens disassembly in posteriorly dislocated crystalline lens removal.
A New Technique of Pars Plana Vitrectomy With Microinterventional Nucleus Disassembly to Reduce the Energy of Fragmatome Lensectomy for Posteriorly Dislocated Crystalline Lens Removal.
PURPOSE
To describe a novel technique of lens disassembly in posteriorly dislocated crystalline lens removal.
METHODS
A microinterventional microfilament loop device was introduced through the sclerotomy created for the fragmatome to cleave the lens into smaller, manageable pieces.
RESULTS
Five cases were performed with this technique with improved visual acuity and no complications.
CONCLUSION
The use of microinterventional nucleus disassembly during pars plana vitrectomy for retained lens material is a novel approach with potential advantages including decreased operating time and reduced complications secondary to excessive production of ultrasound energy.
Topics: Humans; Pars Planitis; Vitrectomy; Lens, Crystalline; Postoperative Complications; Cataract Extraction
PubMed: 33315829
DOI: 10.1097/IAE.0000000000003048 -
BMC Ophthalmology May 2016The aim of this work is to refine understanding of anatomical and functional alterations in eyes with Intermediate Uveitis (IU), their natural history in mild cases not...
BACKGROUND
The aim of this work is to refine understanding of anatomical and functional alterations in eyes with Intermediate Uveitis (IU), their natural history in mild cases not necessitating treatment and their response to treatment in severely affected eyes with macular edema.
METHODS
61 consecutive patients with IU presenting over a 6-year period were prospectively recruited into the study. Two subgroups of patients with IU were identified on the basis of the need or not for systemic cortico-steroid treatment. A group of healthy volunteers was identified for determining normal average central foveal thickness (CFT) values. Statistical comparisons were sought between patient sub-groups and with the group of normal volunteers for CFT and Best Corrected Visual Acuity (BCVA) at baseline and after 6 months. In a post hoc analysis, a cut-off value of CFT for systemic treatment initiation in IU was statistically identified and its sensitivity and specificity determined.
RESULTS
A statistically significant difference in mean CFT at baseline was observed between patients under systemic treatment and untreated patients (p = 0.0005) as well as between untreated patients and healthy volunteers. (p < 0.001) After six months difference in CFT between the two patients subgroups was no longer significant (p = 0.699). BCVA was worse for patients under systemic treatment. No statistically significant difference could be identified between the subgroup of untreated patients and the group of healthy volunteers either at baseline or after 6 months. Correlation between LogMAR visual acuity and central retinal thickness at baseline was strong (r = 0.7436, p < 0.0001, Pearson's correlation coefficient). The cut-off value of CFT for initiating systemic treatment was determined at 215.5 μm in a post hoc analysis (sensitivity 62.5 %, specificity 96.4 %).
CONCLUSIONS
Subclinical retinal thickening of mildly inflamed eyes with IU can occur though bearing no functional clinical significance and spontaneously resolving within 6 months. A cut-off CFT value for treatment of macular edema in IU, in the presence of other relevant morphological features on Optical Coherence Tomography, seems to emerge from post hoc analysis of collected data demonstrating strong specificity and moderate sensitivity.
Topics: Adrenal Cortex Hormones; Adult; Case-Control Studies; Cross-Sectional Studies; Female; Fluorescein Angiography; Fovea Centralis; Humans; Macular Edema; Male; Middle Aged; Prospective Studies; Tomography, Optical Coherence; Uveitis, Intermediate; Visual Acuity; Young Adult
PubMed: 27188332
DOI: 10.1186/s12886-016-0230-4 -
Saudi Journal of Ophthalmology :... 2015The term intermediate uveitis (IU) refers to a subgroup of uveitis in which the vitreous is the site of greatest inflammation. Patients with multiple sclerosis (MS) have...
The term intermediate uveitis (IU) refers to a subgroup of uveitis in which the vitreous is the site of greatest inflammation. Patients with multiple sclerosis (MS) have a greater frequency of IU compared with the general population. The IU associated with MS is characterized by the presence of pars planitis (occasionally accompanied by anterior uveitis) and the presence of peripheral retinal vasculitis in the form of periphlebitis (venous sheathing) in 6-26% of patients. We present a patient with an unusual initial presentation of MS involving central retinal artery occlusion (CRAO) in the right eye (RE). Although retinal vascular changes are asymptomatic in the majority of MS patients, the spectrum of impairment ranges from simple peripheral retina periphlebitis to the presence of peripheral occlusive retinal vasculitis in 6.5% of patients. This atypical case may represent an extreme of the spectrum of retinal vasculitis associated with demyelinating disease.
PubMed: 25892937
DOI: 10.1016/j.sjopt.2014.12.001 -
Arquivos Brasileiros de Oftalmologia 2015To evaluate the use of a slow-release dexamethasone 0.7-mg intravitreal implant for cystoid macular edema (CME) secondary to intermediate uveitis and refractory to...
PURPOSE
To evaluate the use of a slow-release dexamethasone 0.7-mg intravitreal implant for cystoid macular edema (CME) secondary to intermediate uveitis and refractory to systemic steroids.
METHODS
A retrospective study of the best-corrected visual acuity (BCVA), intraocular inflammation, intraocular pressure (IOP), fundus photography, optical coherence tomography (OCT), inflammation, and adverse reactions of five patients (women, mean age of 35 years) with cystoid macular edema treated with a dexamethasone implant. Patients were evaluated in seven visits until the 150th day after the implant.
RESULTS
Four patients had bilateral pars planitis and one had bilateral intermediate uveitis associated with juvenile idiopathic arthritis. Six dexamethasone devices were implanted, under topical anesthesia (one each in six eyes, five patients). The mean follow-up time was 5 months. The best-corrected visual acuity improved in all eyes that received an implant, with five having improvements of two or more lines. Optical coherence tomography showed thinning of the macula in all eyes treated, and we saw a correlation between the best-corrected visual acuity and retinal thinning. No serious adverse events occurred and no significant increase in intraocular pressure was observed.
CONCLUSIONS
Slow-release dexamethasone intravitreal implants can effectively treat CME secondary to intermediate uveitis and refractory to systemic steroids.
Topics: Adult; Aged; Anti-Inflammatory Agents; Delayed-Action Preparations; Dexamethasone; Drug Implants; Female; Humans; Macular Edema; Middle Aged; Retrospective Studies; Uveitis, Intermediate; Visual Acuity; Young Adult
PubMed: 26222112
DOI: 10.5935/0004-2749.20150049 -
BMJ Case Reports Sep 2018
Topics: Child; Coloboma; Humans; Iris; Male; Pars Planitis; Retinal Detachment; Retinal Perforations; Tomography, Optical Coherence; Treatment Outcome; Vision Disorders; Visual Acuity; Vitrectomy
PubMed: 30173139
DOI: 10.1136/bcr-2018-226919