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Turkish Journal of Ophthalmology Apr 2024We report the visual and clinical outcomes of a middle-aged woman who presented with exudative retinal detachment (ERD) secondary to a vasoproliferative tumor (VPT) in...
We report the visual and clinical outcomes of a middle-aged woman who presented with exudative retinal detachment (ERD) secondary to a vasoproliferative tumor (VPT) in an eye with sarcoidosis-associated intermediate uveitis. A 55-year-old woman previously diagnosed with sarcoidosis presented with decreased vision in the left eye (LE). Visual acuity in the LE was counting fingers. She had active vitritis, and a peripheral retinal vascular mass was noted in the superotemporal periphery. The mass was associated with ERD involving the posterior pole. The patient was managed with systemic and intravitreal steroids, and cyclosporine was subsequently added as a steroid-sparing agent. Because of recurrence of ERD, the patient underwent pars plana vitrectomy, and cryotherapy and laser photocoagulation were applied to the VPT. Two months postoperatively, visual acuity in the LE improved to 6/10. There was marked regression of the VPT and total resolution of the ERD. In conclusion, we report a favorable visual and clinical outcome in a patient with VPT-associated ERD who responded to a combination of medical therapy and surgical intervention. VPT may lead to different remote complications, so timely diagnosis of these tumors and proper management of their complications is warranted.
Topics: Humans; Female; Middle Aged; Sarcoidosis; Visual Acuity; Fluorescein Angiography; Retinal Neoplasms; Uveitis, Intermediate; Tomography, Optical Coherence; Fundus Oculi; Vitrectomy; Glucocorticoids; Retinal Detachment
PubMed: 38645965
DOI: 10.4274/tjo.galenos.2024.36926 -
Ocular Immunology and Inflammation Dec 2023To report the causes of childhood-onset uveitis in a tertiary pediatric ophthalmology hospital in Egypt.
PURPOSE
To report the causes of childhood-onset uveitis in a tertiary pediatric ophthalmology hospital in Egypt.
METHODS
Retrospective study of the medical records of all uveitis patients following up at a tertiary pediatric ophthalmology hospital in Egypt from January 2017 to December 2020.
RESULTS
The present study included 388 patients. The most common anatomical category was intermediate uveitis (30.4%), and around half of these children had pars planitis. This was followed by panuveitis (25.5%), posterior uveitis (23.5%), and anterior uveitis (20.6%), in decreasing frequency. Juvenile idiopathic arthritis, toxoplasmosis, and Vogt-Koyanagi-Harada syndrome were the most common causes of anterior uveitis, posterior uveitis, and panuveitis respectively. Cataract (40.5%), glaucoma (33.8%), and cystoid macular edema (31.6%) were the most frequent ocular complications.
CONCLUSION
The present report provides the relative prevalence of the different anatomical types of uveitis, as well as their main causes in a cohort of Egyptian patients with childhood-onset uveitis.
Topics: Humans; Child; Egypt; Retrospective Studies; Uveitis; Panuveitis; Uveitis, Posterior; Tertiary Care Centers; Uveitis, Anterior; Acute Disease
PubMed: 36094930
DOI: 10.1080/09273948.2022.2117201 -
Bioengineered Dec 2024Exosomes are membranous structures measuring between 40-120 nm that are secreted by various cells of the human body into the body fluid system. Exosomes contain...
Exosomes are membranous structures measuring between 40-120 nm that are secreted by various cells of the human body into the body fluid system. Exosomes contain proteins, mRNA, miRNA, and signaling molecules, and physiologically they assist in the intercellular transport of proteins and RNA molecules. In this study, we used an immunoaffinity filter paper platform combined with scanning electron microscopy and microfluidic systems to detect the size of exosomes within the aqueous humor. Eight aqueous humor samples showed three distinct sizes of exosomes that were significantly different on scanning electron microscopy( < 0.01). We further used nanoparticle tracking analysis to assess the size distribution of exosomes within the aqueous humor. We found significantly different distributions of exosomes between patients with three different ocular diseases and patients with normal cataracts as controls. An obvious peak of exomeres(size around 35 nm)was found in the patients with central retinal vein occlusion and vitreous hemorrhage. Flare-ups of large exosomes(size 90-120 nm)were found in the patients with the inflammatory ocular disease pars planitis. No obvious peaks in exomeres or large exosomes were found in the control group. There was a high association between the distribution of exosomes and the pathogenesis of ocular diseases. After intravitreal anti-vascular endothelial growth factor treatment, the aqueous humor from the patients with neovascular diseases showed a significant reduction in exosomes in nanoparticle tracking analysis. These findings suggest that at least three distinct sizes of exosomes exist in the aqueous humor:(1)exomeres:<35 nm;(2)small exosomes:60-80 nm; and (3)large exosomes:90-120 nm. Different sizes of exosomes may have different implications in normal or diseased eyes.
Topics: Humans; Exosomes; Retinal Diseases; MicroRNAs; Aqueous Humor; Cataract
PubMed: 38155415
DOI: 10.1080/21655979.2023.2297320 -
Scientific Reports Apr 2024Fuchs Uveitis Syndrome (FUS), also known as Fuchs Heterochromic Iridocyclitis, is a chronic form of uveitis characterized by mild inflammation primarily affecting one...
Fuchs Uveitis Syndrome (FUS), also known as Fuchs Heterochromic Iridocyclitis, is a chronic form of uveitis characterized by mild inflammation primarily affecting one eye. This study aimed to investigate the clinical and epidemiological features of FUS in an Iranian population. A retrospective analysis was conducted on 466 patients diagnosed with FUS at an ophthalmology center affiliated with Isfahan University of Medical Sciences between 2003 and 2021. The Kimura et al. criteria were used for FUS diagnosis. Demographic data, clinical characteristics, misdiagnosed cases, concurrent diseases, and associated ocular findings were analyzed. The study included 507 eyes of 466 FUS patients, with a mean age of 34.01 ± 11.25 years. Iris atrophy, keratic precipitates, and vitritis were common clinical findings. Heterochromia was an infrequent feature. Initial misdiagnosis occurred in 13 patients, with pars planitis being the most common incorrect diagnosis. Toxoplasmosis and multiple sclerosis were common concurrent diseases. Pediatric FUS cases were noted, possibly attributed to early-onset manifestations. Differences in clinical characteristics were observed when compared to other populations. This study provides insights into the clinical and epidemiological aspects of FUS in an Iranian population. Variations in clinical features, misdiagnosis patterns, and concurrent diseases were noted. Attention to specific clinical parameters can aid in accurate FUS diagnosis. Understanding these differences contributes to a better understanding of FUS presentation and its relationship with other diseases.
Topics: Humans; Child; Young Adult; Adult; Middle Aged; Iridocyclitis; Iran; Retrospective Studies; Eye; Iris Diseases
PubMed: 38616214
DOI: 10.1038/s41598-024-59393-w -
Turkish Journal of Ophthalmology Apr 2024In recent years, adalimumab has been increasingly used in the chronic treatment of non-infectious uveitis. This case report aimed to describe a drug-induced adverse...
In recent years, adalimumab has been increasingly used in the chronic treatment of non-infectious uveitis. This case report aimed to describe a drug-induced adverse event in a 34-year-old man who presented with blurred vision and floaters in the right eye and was being treated for intermediate uveitis. The patient had started topical treatment with a diagnosis of uveitis at another center. Best corrected visual acuity at presentation was 0.8 (decimal) in the right eye and 1.0 in the left eye. On examination, the anterior chamber in the right eye was clear, with anterior vitreous cells and mild haze, and snow banking and vitreous opacities in the inferior periphery. Fluorescein angiography (FA) showed hyperfluorescence in the right disc and leakage in the inferior periphery. As the inflammation did not resolve with local treatment, systemic cyclosporine was administered, after which the patient exhibited vomiting and weakness. Cyclosporine was discontinued and adalimumab treatment was started. On examination 5 months later, bilateral vitreous cells and mild vitreous opacity were noted, and FA showed mild leakage in the inferior periphery bilaterally. In addition, a depigmented patchy vitiligo lesion was observed on the chin. Due to the persistence of intraocular inflammation and on the recommendation of the dermatology clinic, adalimumab treatment was continued and topical tacrolimus was started for the lesion. On examination 3 months later, the inflammatory findings had resolved and there was no progression of the vitiligo lesion. The patient's treatment was continued. Taken together with the previous literature findings, no pathology was found in the patient's systemic examination, suggesting that this lesion was a side effect of the treatment. Ophthalmologists should be alert for this side effect in patients receiving adalimumab.
Topics: Humans; Adalimumab; Male; Adult; Fluorescein Angiography; Vitiligo; Anti-Inflammatory Agents; Visual Acuity; Fundus Oculi
PubMed: 38646109
DOI: 10.4274/tjo.galenos.2024.04575 -
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 -
Journal Francais D'ophtalmologie Jun 2024Ocular toxocariasis is a rare disease, predominantly affecting children and young adolescents, and usually presenting as unilateral posterior uveitis. We report the case...
INTRODUCTION
Ocular toxocariasis is a rare disease, predominantly affecting children and young adolescents, and usually presenting as unilateral posterior uveitis. We report the case of a child with toxocariasis associated with serous retinal detachment.
OBSERVATION
A 8-year-old child with no previous history of toxocariasis was referred for a 1-year decline in visual acuity, unimproved by optical correction, with vitreous condensation on examination, without central or peripheral granulomas, and serous retinal detachment on OCT. The diagnosis was made after extensive questioning, with evidence of contact with dogs and positive serology. Medical treatment combining corticosteroid therapy and antiparasitic therapy was initiated, and the clinical picture improved.
DISCUSSION
Ocular toxocariasis is a rare infection, unilateral in 90% of cases. Its clinical manifestation in children is pars planitis, posterior uveitis with a posterior pole chorioretinal focus associated with vitreoretinal traction and/or peripheral granuloma. In our case, the patient presented with vitreous condensation only, with OCT serous retinal detachment and no peripheral or central granulomas. Positive plasma serology or ocular samples confirmed the diagnosis.
CONCLUSION
Ocular toxocariasis should not be ruled out in the absence of a typical clinical picture, and seropositivity enables confirmation of the diagnosis when clinical suspicion arises.
Topics: Humans; Toxocariasis; Child; Eye Infections, Parasitic; Retinal Detachment; Male; Dogs; Animals
PubMed: 38713931
DOI: 10.1016/j.jfo.2024.104191 -
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 -
European Journal of Ophthalmology Mar 2024To report a rare case of a 65 year old patient with a single caterpillar hair with localised lenticular opacity around it and no active inflammation.
PURPOSE
To report a rare case of a 65 year old patient with a single caterpillar hair with localised lenticular opacity around it and no active inflammation.
OBSERVATIONS
A single quiescent caterpillar hair embedded in the anterior lens capsule causing localised cataract around it. There was no other sign of ocular toxicosis and the patient was unaware of the presence of this intraocular foreign body.
CONCLUSIONS
Caterpillar hair (also known as setae) are a common cause of ophthalmia nodosa. These setae can penetrate intraocularly with ease to cause various forms of ocular toxicosis ranging from conjunctivitis, keratitis, pars planitis, chorioretinitis to even severe vitritis warranting enucleation. As per our knowledge and experience, no case of caterpillar hair without inflammation has been reported till date. We hereby report a rare case of a 65 year old patient with a single caterpillar hair embedded in the anterior lens capsule causing localised cataract around it without any active inflammation. In our opinion, if the eye is quiescent, the patient should be kept on close and long term follow-up and active intervention can be undertaken at the first instance of inflammation or if cataract progresses.
Topics: Animals; Humans; Aged; Lepidoptera; Eye Foreign Bodies; Cataract; Hair; Inflammation
PubMed: 37649334
DOI: 10.1177/11206721231199274