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Ocular Immunology and Inflammation Dec 2023To report demographic and clinical profiles of children with uveitis in theTurkishpopulation.
PURPOSE
To report demographic and clinical profiles of children with uveitis in theTurkishpopulation.
METHODS
The data of the pediatric uveitis cases in the nation wide uveitis database were analyzed.
RESULTS
The study included 697 eyes of 442 patients with a meanage of 10.8 ± 3.8 years. There were 333 patients (75.3%) with non-infectious uveitis and 69 patients (15.6%) with infectious uveitis. Pars planitis (20.1%) was leading clinical form followed by idiopathic cases with uveitis other than pars planitis (18.8%), juvenile idiopathic arthritis(JIA) related uveitis (12.4%), Behçet uveitis (9.3%) and toxoplasma retinochoroiditis (7.9%). Ocular involvement was unilateral in 187 patients (42.3%) and bilateral in 255 patients (57.7%). The most common anatomiclocation of uveitis was anterior uveitis (39.1%), followed by intermediate uveitis (29.4%), panuveitis (16.1%) and posterior uveitis (15.4%).
CONCLUSION
The most common systemic association was JIA in the younger children and Behçet disease in the older children.
Topics: Child; Humans; Adolescent; Pars Planitis; Turkey; Retrospective Studies; Uveitis; Behcet Syndrome; Arthritis, Juvenile; Registries
PubMed: 36083691
DOI: 10.1080/09273948.2022.2110900 -
Graefe's Archive For Clinical and... Jun 2022
Topics: Adalimumab; Humans; Multiple Sclerosis; Pars Planitis; Uveitis, Intermediate
PubMed: 35015113
DOI: 10.1007/s00417-021-05527-z -
Ocular Immunology and Inflammation May 2024To evaluate outcomes of intravenous (IV) tocilizumab (TCZ) in patients with pars planitis refractory to conventional immunomodulatory therapy and anti-tumor necrosis...
PURPOSE
To evaluate outcomes of intravenous (IV) tocilizumab (TCZ) in patients with pars planitis refractory to conventional immunomodulatory therapy and anti-tumor necrosis factor (TNF) alpha agents.
METHODS
Medical records of eight patients diagnosed with pars planitis and treated with monthly 4 or 8 mg/kg IV TCZ were reviewed. The primary objective was to initiate and sustain remission continuously for three consecutive months. Secondary outcome measures were changes in best corrected visual acuity (BCVA), degree of anterior chamber (AC) inflammation, vitreous cell, vitreous haze, presence of vitreous or pars plana exudates, peripheral vasculitis, fluorescein angiography (FA) score and central subfieldthickness (CST) on macular optical coherence tomography (OCT).
RESULTS
Fourteen eyes of eight patients were treated with IV TCZ. Seven patients were women. The average age was 31.35 ± 16.42 years. In 6 (75%) out of 8 patients, IV TCZ, either as monotherapy or in combination with another conventional immunomodulatory agent, induced and sustained remission. The average FA score reduced from 11.15 ± 3.52 at the baseline visit to 6.50 ± 2.12 at the one-year follow-up visit (p-value < 0.05). None of the patients experienced any side effects of IV TCZ.
CONCLUSION
IV Tocilizumab (TCZ) may represent an effective and safe treatment option for patients diagnosed with pars planitis resistant to conventional immunomodulatory therapy and anti-TNF alpha agents.
PubMed: 38781578
DOI: 10.1080/09273948.2024.2354751 -
Journal of Clinical Medicine Dec 2021Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other...
Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18-83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet's disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1-30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.
PubMed: 34945256
DOI: 10.3390/jcm10245960 -
Journal of Ophthalmic Inflammation and... Feb 2023We describe a case report of pediatric pars planitis complicated with massive exudative retinal detachment (ERD). A 7-year-old presented with visual acuity (VA) in the...
We describe a case report of pediatric pars planitis complicated with massive exudative retinal detachment (ERD). A 7-year-old presented with visual acuity (VA) in the right eye (RE) of 6/9 and in the left eye (LE) 6/15. Fundoscopy revealed BE inferior retinoschisis, vitritis and snowballs. He was treated with systemic immunosuppressants. RE retinoschisis resolved within 2 months. Three years later presented with LE VA 6/60 and total ERD. Systemic and intravitreal steroids were administered. Due to refractoriness, he underwent 360° scleral buckle and drainage of subretinal fluid. No retinal breaks or traction were detected. Five months postoperatively LE VA was 6/7.5. Long-term stable outcome was maintained. We report a challenging total ERD as a complication of pars planitis. Although extensive and non-responsive to medical therapy, complete resolution and improvement in vision was achieved with surgical intervention and systemic immunosuppression. We speculate that uncontrolled chronic vasculitic process culminated in diffuse ERD.
PubMed: 36849851
DOI: 10.1186/s12348-023-00328-3 -
Graefe's Archive For Clinical and... Jun 2022
Topics: Adalimumab; Humans; Multiple Sclerosis; Pars Planitis; Uveitis, Intermediate
PubMed: 35088114
DOI: 10.1007/s00417-021-05528-y -
Mediators of Inflammation 2020In patients, an increase in the population of Th17-secreting cells negatively correlated with the abundance of both IFN--producing and T regulatory as well as suppressor...
Imbalance in PB IL-17-Secreting and Regulatory Cells in Pars Planitis Is Associated with Dysregulation of IFN--Secreting Cells, Especially in Patients with Clinical Complications.
RESULTS
In patients, an increase in the population of Th17-secreting cells negatively correlated with the abundance of both IFN--producing and T regulatory as well as suppressor cells, regarding all the phenotypes studied. Although a strong dependence of the PB Th1 cell compartment on the duration of the disease was observed, it was limited to the subgroup of patients with macular edema only. The frequency of B regulatory cells was unchanged compared to controls.
CONCLUSIONS
In pars planitis, the alterations in lymphocyte cell distribution affect primarily the T cell repertoire. The imbalance in PB Th1/Th17/Treg cells creates proinflammatory conditions, strengthening the suggestion that the immune background may play a role in pars planitis pathogenesis. Also, circulating Th1 level may be of potential clinical relevance in terms of prediction of a more severe course of the disease.
Topics: Adolescent; Adult; Aged; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Female; Flow Cytometry; Humans; Interferon-gamma; Interleukin-17; Male; Middle Aged; Pars Planitis; T-Lymphocytes, Regulatory; Th1 Cells; Th17 Cells; Young Adult
PubMed: 32801998
DOI: 10.1155/2020/9175083 -
Journal Francais D'ophtalmologie Feb 2023The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
PURPOSE
The purpose of this study is to describe the characteristics and prognostic factors of pediatric uveitis in a French university referral hospital.
METHODS
We performed a retrospective study of all cases of all pediatric uveitis seen at our institution over a 7-year period.
RESULTS
A total of 141 eyes of 86 children were included. The mean age was 10.7 years, and 61.6% were girls. The uveitis was bilateral in 64.0% of cases. Anterior uveitis (41.0%) and intermediate uveitis (32.0%) were the most frequent forms. The most frequent etiologies were idiopathic (27.9%), juvenile idiopathic arthritis (25.6%) and pars planitis (18.6%). During the follow-up period, systemic corticosteroids were received by 43.0% of children, immunosuppressive drugs by 31.4% and biological agents by 18.6%. At the final examination, complications were present in 67.0% of patients: 18.0% had cataracts, and 11.3% had intraocular hypertension. Posterior synechiae were present in 27.6% of eyes, optic disc edema in 10.5% and macular edema in 16.2%. At the last visit, visual acuity was better than 20/200 in 97.0% of cases. The presence of band keratopathy, cataract or glaucoma was an independent predictor of impaired visual outcomes at follow-up.
CONCLUSION
Juvenile idiopathic arthritis is one of the most frequent and severe pediatric uveitides. Close monitoring and early treatment could prevent complications.
Topics: Female; Child; Humans; Male; Prognosis; Arthritis, Juvenile; Retrospective Studies; Uveitis; Uveitis, Anterior; Cataract
PubMed: 36642594
DOI: 10.1016/j.jfo.2022.08.005 -
Ophthalmology. Retina Sep 2023To comprehensively examine the cost effectiveness, reattachment rate, and complications of pneumatic retinopexy (PnR) compared with pars plana vitrectomy (PPV) for...
PURPOSE
To comprehensively examine the cost effectiveness, reattachment rate, and complications of pneumatic retinopexy (PnR) compared with pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) within a universal health care system.
DESIGN
Population-based, multicenter, consecutive, retrospective longitudinal cohort analysis.
SUBJECTS
We identified consecutive adults aged ≥ 50 years requiring surgery for primary RRD over a 20-year interval between April 1, 2002, and March 31, 2022. Initial surgery was considered the index date for analyses.
INTERVENTION
Pneumatic retinopexy was compared with PPV in all analyses.
MAIN OUTCOME MEASURES
The primary analysis investigated the mean annualized health care costs comparing PnR to PPV over the 2 years after initial surgery. Secondary analyses examined the primary reattachment rate and complications.
RESULTS
In total, 25 665 eligible patients were identified, with 8794 undergoing PnR and 16 871 undergoing PPV. The mean patient age was 65 years and 39% were women. The mean annualized cost after PnR was $8924 and $11 937 after PPV (mean difference, $3013; 95% confidence interval, $2533-$3493; P < 0.001). The primary reattachment rate at 90 days after PnR was 83% and after PPV was 93% (P < 0.001). The risk of cataract or glaucoma surgery was lower after PnR, and the frequency of ophthalmology clinic visits, intravitreal injections, and anxiety was higher after PnR. Hospitalizations and long-term disability were less frequent after PnR.
CONCLUSIONS
Pneumatic retinopexy, when compared with PPV, was associated with lower long-term health care costs. Pneumatic retinopexy appeared to be effective, safe, and inexpensive, thus offering a viable option for improving access to RRD repair in appropriately selected cases.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Humans; Retrospective Studies; Longitudinal Studies; Pars Planitis; Vitrectomy; Retinal Detachment; Male; Female; Aged; Aged, 80 and over; Cryotherapy; Light Coagulation
PubMed: 37286134
DOI: 10.1016/j.oret.2023.05.021 -
International Ophthalmology Jan 2023To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs)...
AIM
To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs) in the treatment of pars planitis (PP).
METHODS
The patients with PP who were treated with anti-TNF-alpha agents for at least six months were qualified for the chart review. The outcome parameters were the steroid-free remission state, the best-corrected visual acuity (BCVA) and the central macular thickness (CMT) of the patients at the last visit.
RESULTS
After a mean total follow-up time of 15.5 ± 5.8 months (8-24 months), all the cases were in steroid-free remission at the last visit. The mean BCVA increased, and the mean CMT decreased significantly at the last visit (p < 0.001, p < 0.001, respectively).
CONCLUSION
ADA combined with IMAs offers effective and safe treatment modalities in the control of chronic intraocular inflammation in PP cases.
Topics: Child; Humans; Adalimumab; Inflammation; Necrosis; Pars Planitis; Retrospective Studies; Treatment Outcome; Tumor Necrosis Factor Inhibitors; Turkey
PubMed: 35780435
DOI: 10.1007/s10792-022-02398-z