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Biomolecules Apr 2024Fundus autofluorescence (FAF) is a prompt and non-invasive imaging modality helpful in detecting pathological abnormalities within the retina and the choroid. This... (Review)
Review
Fundus autofluorescence (FAF) is a prompt and non-invasive imaging modality helpful in detecting pathological abnormalities within the retina and the choroid. This narrative review and case series provides an overview on the current application of FAF in posterior and panuveitis. The literature was reviewed for articles on lesion characteristics on FAF of specific posterior and panuveitis entities as well as benefits and limitations of FAF for diagnosing and monitoring disease. FAF characteristics are described for non-infectious and infectious uveitis forms as well as masquerade syndromes. Dependent on the uveitis entity, FAF is of diagnostic value in detecting disease and following the clinical course. Currently available FAF modalities which differ in excitation wavelengths can provide different pathological insights depending on disease entity and activity. Further studies on the comparison of FAF modalities and their individual value for uveitis diagnosis and monitoring are warranted.
Topics: Humans; Panuveitis; Fundus Oculi; Optical Imaging; Fluorescein Angiography
PubMed: 38785922
DOI: 10.3390/biom14050515 -
Ocular Immunology and Inflammation Dec 2023To provide an overview of pediatric pars planitis. (Review)
Review
PURPOSE
To provide an overview of pediatric pars planitis.
METHODS
Narrative literature review.
RESULTS
Pars planitis refers to the idiopathic subset of intermediate uveitis in which there is vitritis along with snowball or snowbank formation occurring in the absence of an associated infection or systemic disease. It is thought to be a T-cell mediated disease with a genetic predisposition. Pars planitis accounts for 5-26.7% of pediatric uveitis cases. Presentation is commonly bilateral but asymmetric, often with insidious onset of floaters and blurred vision. Although pars planitis is known to be a benign form of uveitis in most cases, severe complications secondary to chronic inflammation may arise, with cystoid macular edema being the most common cause of visual morbidity. Mild vitritis in the absence of symptoms, vision loss, or macular edema may be observed. Patients with severe vitritis and/or associated vision-threatening complications require prompt aggressive treatment. A stepladder approach including corticosteroids, immunosuppressive agents, anti‑tumor necrosis factor‑alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis.
CONCLUSION
Timely diagnosis and adequate treatment of pediatric pars planitis and associated complications are crucial in order to improve visual outcomes.
Topics: Humans; Child; Pars Planitis; Uveitis, Intermediate; Uveitis; Vitrectomy; Adrenal Cortex Hormones; Macular Edema; Endophthalmitis; Retrospective Studies
PubMed: 37976519
DOI: 10.1080/09273948.2023.2279683 -
Journal Francais D'ophtalmologie Feb 2020Placoid pigment epitheliopathy and serpiginous choroiditis are among the white dot retinal syndromes and possess similarities that can cause confusion between these two... (Review)
Review
Placoid pigment epitheliopathy and serpiginous choroiditis are among the white dot retinal syndromes and possess similarities that can cause confusion between these two diseases. However, they are very different in terms of their progression and prognosis, which requires a diagnosis of certainty in order to better manage the patients with the diseases and identify potentially serious progressive complications. The clinical presentation, results of testing, differential diagnoses and treatment of these two pathologies are discussed in this article.
Topics: Diagnosis, Differential; Disease Progression; Humans; Prognosis; Retinal Diseases; Retinal Pigment Epithelium; Treatment Outcome; White Dot Syndromes
PubMed: 31932062
DOI: 10.1016/j.jfo.2019.12.001 -
JAMA Ophthalmology Dec 2021
Topics: Chorioretinitis; Humans; Wounds, Gunshot
PubMed: 34910113
DOI: 10.1001/jamaophthalmol.2021.3316 -
Clinical and Experimental Rheumatology 2021This review aims to provide a critical digest of the recent studies that enhance our understanding of Behçet's syndrome by evaluating time trends, differences in... (Review)
Review
This review aims to provide a critical digest of the recent studies that enhance our understanding of Behçet's syndrome by evaluating time trends, differences in disease course between men and women, and between patients with an early and late disease onset, progress in disease assessment, novel findings on immunopathogenesis and genetics, clinical features and differential diagnosis of eye, vascular, nervous system and gastrointestinal system involvement, and new data on treatment modalities including TNF-alpha, IL-17 and IL-6 inhibitors, tofacitinib, and apremilast, as well as surgical interventions.
Topics: Behcet Syndrome; Disease Progression; Female; Humans; Male; Tumor Necrosis Factor Inhibitors
PubMed: 34524077
DOI: 10.55563/clinexprheumatol/lnvc9k -
Clinical Reviews in Allergy & Immunology Dec 2021Behcet's syndrome (BS) is a chronic systemic inflammatory vasculitis with a wide range of clinical manifestations including recurrent oral and genital ulcers; cutaneous... (Review)
Review
Behcet's syndrome (BS) is a chronic systemic inflammatory vasculitis with a wide range of clinical manifestations including recurrent oral and genital ulcers; cutaneous lesions; and ophthalmic, neurologic, and gastrointestinal involvement. BS has a global distribution but is particularly prevalent in so-called Silk Road populations. Disease onset is usually around the third or fourth decade of life, and the sex ratio is roughly 1:1. Both environmental and genetic factors contribute to the etiology of BS, although the detailed mechanisms remain unclear. At present, there is no laboratory examination with diagnostic value for BS; therefore, a diagnosis is made based on clinical manifestations. The International Study Group diagnostic criteria published in 1990 is the most widely used and recognized, but in order to improve sensitivity, the International Criteria for Behcet's Disease is developed in 2014. Evaluating disease activity in BS is an important basis for treatment selection and monitoring, the simplified Behcet's Disease Current Activity Form (2006 version) is a well-established scoring method. Given that multiple organs are affected in BS, it must be differentiated from other diseases with similar manifestations or that may be induced by drug treatment. The goal of BS treatment is to eradicate triggers and/or aggravating factors, alleviate and control clinical symptoms, prevent and treat any damage to organs, slow disease progression, and improve the patient's quality of life. The clinical management of BS depends on the affected organs and disease severity. In this review, we summarize the current state of knowledge of BS pathogenesis and therapeutic options.
Topics: Behcet Syndrome; Humans
PubMed: 34076835
DOI: 10.1007/s12016-021-08864-3 -
Deutsche Medizinische Wochenschrift... Sep 2023Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself...
Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself in both arterial and venous vessels. Its extensive and at the same time interindividually very different clinical picture is not uncommon a challenge, both with regard to the diagnosis of this rheumatic systemic disease, which is rather rare in our latitudes, and its therapeutic options. In addition to the four cardinal symptoms of recurrent oral aphthae, genital aphthae, skin and eye lesions, the clinical picture offers numerous other manifestations which often require interdisciplinary cooperation. In addition to the above mentioned ocular involvement, which can still lead to blindness if inadequately treated, this is especially true for intestinal and cerebral manifestations as well as for large vessel vasculitis.A final revision of the European League Against Rheumatism recommendations for the management of Behcet's syndrome (EULAR) was made in 2018, and the recommendations are now established internationally as an important treatment guide. Therapy is based on the leading organ involvement. After adalimumab received approval for the treatment of posterior ocular involvement in 2016, another agent, apremilast, became available in 2020. The drug is recommended for the treatment of recurrent oral aphthae in adult Behçet's patients requiring systemic therapy. Nevertheless, there is a further need for new drugs.This article aims to highlight recent findings in the areas of epidemiology, immunopathogenesis & genetics, clinical findings, and therapy, with an emphasis on clinical relevance.
Topics: Adult; Humans; Behcet Syndrome; Stomatitis, Aphthous; Vasculitis; Arteries; Blindness; Rheumatic Diseases
PubMed: 37611579
DOI: 10.1055/a-1958-2338 -
La Tunisie MedicaleBehçet's disease is a chronic vasulitis. The aphtous stomatitis is present in nearly the totality of patients having this disease.
INTRODUCTION
Behçet's disease is a chronic vasulitis. The aphtous stomatitis is present in nearly the totality of patients having this disease.
AIM
The purpose of this study was to evaluate the oral health of Behcet's disease (BD) patients and then compare it with healthy controls.
METHODS
Twenty patients with BD and 20 healthy subjects were included in this cross-sectional study conducted at the military hospital of Bizerta from 01/10/2017 to 31/05/2019. The level of plaque were recorded using the plaque index (PI). The gingival index (GI) was used to evaluate the gingival inflammation. The depths of the sulci/pockets were probed with a periodontal probe. The clinical attachment loss (CAL) was measured from the cementoenamel junction to the sulcus base. The caries status was scored by using DMFT introduced by Klein and Palmer.The diagnosis of oral lesions was performed using the visual tactile examination.
RESULTS
The two groups were age, sexe, and socioeconomic level matched. The percentage of oral ulcers was observed to be higher in BD patients compared with healthy controls (40% Vs 5%, p0.01). Statistical significant differences in the two groups' PI (1,19±0,38 Vs 0,86±0,37 ; p=0,011) and GI (1,10±0,30 Vs 0,75±0,36 ; p=0,03) were observed. The probing depth, the CAL and the DMF/T showed no associations with the BD.
CONCLUSION
Our results showed that gingival health is worse in BD patients. Therfore, the dentist must play an important part in the management of BD and the motivation for the oral hygiene.
Topics: Behcet Syndrome; Cross-Sectional Studies; Humans; Oral Health; Periodontal Index
PubMed: 36155901
DOI: No ID Found -
Medicina Clinica Aug 2023Analyse and describe the anatomical and etiological classification, clinical and epidemiological characteristics and most frequent symptoms of uveitis cases in our... (Observational Study)
Observational Study
PURPOSE
Analyse and describe the anatomical and etiological classification, clinical and epidemiological characteristics and most frequent symptoms of uveitis cases in our population.
PATIENTS AND METHOD
Descriptive, retrospective observational study of uveitis cases treated in the Ophthalmology Department of Virgen del Rocío University Hospital in 2021. The demographic and clinical characteristics were studied.
RESULTS
A total of 109cases of uveitis were studied, 46 men and 63 women, with a mean age of 45.43±16.11 years. The most frequent symptoms were pain (74.31%), hyperemia (73.39%) and blurred vision (65.14%). The most frequent anatomical classification was anterior (55.96%), followed by panuveitis (18.35%), posterior (12.84%) and intermediate uveitis (7.34%). Regarding etiology, most uveitis were idiopathic (42.99%), followed by non-infectious (38.32%) and finally infectious (18.69%).
CONCLUSIONS
In southern España, the characteristics of uveitis are similar to other studies in Western countries.
Topics: Male; Humans; Female; Adult; Middle Aged; Uveitis; Panuveitis; Retrospective Studies; Vision Disorders; Hospitals, University
PubMed: 37248128
DOI: 10.1016/j.medcli.2023.04.009 -
Postgraduate Medicine Jan 2023Behçet Disease is a relapsing and remitting variable vessel vasculitis characterized by recurrent mucocutaneous ulcers that can involve almost every organ system in the... (Review)
Review
Behçet Disease is a relapsing and remitting variable vessel vasculitis characterized by recurrent mucocutaneous ulcers that can involve almost every organ system in the body. Indeed, the presence of recurrent oral or genital ulcers with other auto-inflammatory symptoms should raise suspicion for this elusive disease. It is unique among the vasculitides in that it can affect vessels of small, medium, and large size and tends to involve venous rather than arterial circulation, and its effects on the pulmonary venous circulation are particularly notable for their role in disease mortality. Classically seen in Mediterranean, Middle-Eastern, and eastern Asian countries, and relatively rare in the United States, prevalence has been increasing, prompting an increased need for internists to be aware of Behcet's clinical presentation and treatment. As early recognition and diagnosis of the disease is key to successful treatment and better prognosis, this review provides a brief summary of the current etiological theories, important clinical manifestations, and treatments including newer biologic alternatives.
Topics: Humans; Behcet Syndrome; Ulcer; Prognosis
PubMed: 36533384
DOI: 10.1080/00325481.2022.2159205