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Current Opinion in Ophthalmology May 2021Given the heterogeneity of uveitis, markers of inflammation vary from patient to patient. Multimodal imaging has proven itself to be critical for accurate evaluation for... (Review)
Review
PURPOSE OF REVIEW
Given the heterogeneity of uveitis, markers of inflammation vary from patient to patient. Multimodal imaging has proven itself to be critical for accurate evaluation for disease activity and treatment response in uveitis.
RECENT FINDINGS
Ultra-widefield (UWF) fluorescein angiography and autofluorescence (AF) as well as optical coherence tomography angiography (OCTA) have provided insights into disease pathogenesis and monitoring not previously appreciated. In addition to structural retinal imaging, OCT can be used to assess the choroid, the posterior cortical vitreous and the retinal vasculature in eyes with uveitis.
SUMMARY
Multimodal ocular imaging in eyes with uveitis is critical for disease diagnosis and assessing response to treatment. UWF fluorescein angiography can detect retinal vasculitis even in the absence of overt vascular sheathing. UWF AF can help detect more chorioretinal lesions than clinically visible. OCT can be used to assess the posterior cortical vitreous, retina, large retinal vessels and choroid in uveitis. The use of multimodal imaging will likely be needed to determine clinical trial endpoints in studies evaluating therapeutics for uveitis.
Topics: Choroid; Fluorescein Angiography; Humans; Multimodal Imaging; Optical Imaging; Panuveitis; Retina; Retinal Vessels; Tomography, Optical Coherence; Uveitis, Intermediate; Uveitis, Posterior; Vitreous Body
PubMed: 33710009
DOI: 10.1097/ICU.0000000000000762 -
International Ophthalmology Jan 2019To report a childhood case of tumor necrosis factor receptor-associated periodic syndrome (TRAPS) carrying the R92Q variant with a vision-threatening bilateral... (Review)
Review
PURPOSE
To report a childhood case of tumor necrosis factor receptor-associated periodic syndrome (TRAPS) carrying the R92Q variant with a vision-threatening bilateral panuveitis.
METHODS
Case report and review of the literature.
RESULTS
A 7-year-old boy presented with an active bilateral panuveitis and a macular rash associated with fever. Fundus examination showed two choroidal lesions on the posterior pole of the right eye, and fluorescein angiography revealed early hypofluorescence and late hyperfluorescence of the lesions, which were hyper-autofluorescent. Extensive clinical laboratory analyses ruled out autoimmune diseases and systemic infection. The only remarkable finding was a positive IgG for herpes simplex 1. He underwent two successive diagnostic pars plana vitrectomies as well as cataract and glaucoma surgeries. Genetic analysis revealed a mutation in the TNFRSF1A gene, and the patient was diagnosed with TRAPS-associated bilateral panuveitis. He was treated with adalimumab and has been free of active inflammation since then.
CONCLUSIONS
We present here the first case reported of panuveitis in a patient with TRAPS. This finding stresses the increasing importance of genetic analysis in search of autoinflammatory diseases to establish an adequate diagnosis and treatment in cases of uveitis of unknown etiology.
Topics: Child; Fever; Fluorescein Angiography; Fundus Oculi; Genetic Testing; Hereditary Autoinflammatory Diseases; Humans; Male; Ophthalmoscopy; Panuveitis; Visual Acuity; Vitrectomy
PubMed: 29256170
DOI: 10.1007/s10792-017-0785-y -
Der Ophthalmologe : Zeitschrift Der... Jul 2018Zoledronate-induced (Aclasta®) uveitis is a rare iatrogen-induced inflammation of ocular structures, which can result in substantial morphological and functional...
Zoledronate-induced (Aclasta®) uveitis is a rare iatrogen-induced inflammation of ocular structures, which can result in substantial morphological and functional limitations. This case report describes the clinical course of a female patient with zoledronate-induced panuveitis. Additionally, the diagnostic procedure, therapy and follow-up are presented.
Topics: Female; Glucocorticoids; Humans; Panuveitis; Zoledronic Acid
PubMed: 28748264
DOI: 10.1007/s00347-017-0538-3 -
Canadian Journal of Ophthalmology.... Dec 2023
Topics: Humans; Retinoblastoma; Retinal Neoplasms; Panuveitis
PubMed: 37488053
DOI: 10.1016/j.jcjo.2023.07.007 -
Journal Francais D'ophtalmologie Apr 2020Controlling long-term inflammation during non-infectious intermediate, posterior or panuveitis while limiting side effects remains challenging. There is no standardized... (Review)
Review
Controlling long-term inflammation during non-infectious intermediate, posterior or panuveitis while limiting side effects remains challenging. There is no standardized pre-therapeutic evaluation providing diagnostic certainty, but some simple tests allow us to identifiy the main etiologies. The ophthalmologist identifies the type of uveitis, and the internist completes the investigations according to the ophthalmologist's findings. Fundus photographs, optical coherence tomography, and fluorescein and indocyanine green angiography should be considered during diagnosis and follow-up. Ocular complications of uveitis are numerous. They require close monitoring and specific medical and sometimes surgical management. The growing number of available drugs makes it possible to optimize the management of these conditions with varied etiologies and presentations. Currently, systemic corticosteroids remain the mainstay of therapy, and other alternatives are considered in the case of poor tolerance, steroid resistance or dependence. The choice of a systemic, periocular or intravitreal treatment depends on several factors: chronicity or recurrence of uveitis, duration, bilaterality, association with a systemic inflammatory disease, the presence of contraindications to certain treatments, and also socioeconomic constraints. It is of the utmost importance to find the best compromise allowing tight control of ocular inflammation by means of adapted systemic and/or local treatment while avoiding the main complications.
Topics: Glucocorticoids; Humans; Immunosuppressive Agents; Panuveitis; Tomography, Optical Coherence; Uveitis, Intermediate; Uveitis, Posterior; Vision Disorders
PubMed: 31818505
DOI: 10.1016/j.jfo.2019.03.033 -
Medicina Clinica May 2022
Topics: Humans; Melanoma; Panuveitis
PubMed: 34656338
DOI: 10.1016/j.medcli.2021.07.014 -
Eastern Mediterranean Health Journal =... 2007
Review
Topics: Adolescent; Anti-Inflammatory Agents; Biopsy; Drug Eruptions; Drug Monitoring; Female; Fever; Fluorescein Angiography; Humans; Iran; Measles-Mumps-Rubella Vaccine; Methylprednisolone; Ophthalmoscopy; Panuveitis; Precipitating Factors; Vasculitis; Visual Acuity
PubMed: 17684869
DOI: No ID Found -
Retinal Cases & Brief Reports 2016To report a case of panuveitis, retinal vasculitis, and optic disk granuloma due to sarcoidosis. (Review)
Review
PURPOSE
To report a case of panuveitis, retinal vasculitis, and optic disk granuloma due to sarcoidosis.
METHODS
Case report and literature review.
RESULTS
A 26-year-old previously healthy African American male presented with four months of gradual progressive visual decline in the right eye. Clinical examination revealed severe panuveitis, retinal vasculitis, and large optic nerve mass lesion. Diffuse supraclavicular lymphadenopathy was also present. Histopathologic examination of the lymph node biopsy revealed granulomatous inflammation with some areas of caseous necrosis consistent with sarcoidosis.
CONCLUSION
Sarcoidosis is a common cause of uveitis and retinal vasculitis. In rare cases, an optic disk granuloma may occur and can be treated with immunosuppressive therapy.
Topics: Adult; Granuloma; Humans; Male; Optic Nerve Diseases; Panuveitis; Retinal Vasculitis; Sarcoidosis
PubMed: 26650564
DOI: 10.1097/ICB.0000000000000254 -
JAMA Ophthalmology Feb 2022
Topics: Child; Female; Humans; Panuveitis
PubMed: 34940793
DOI: 10.1001/jamaophthalmol.2021.3076 -
European Journal of Ophthalmology Jul 2019There has been an increasing number of tattoo-related uveitis without evidence of systemic sarcoidosis. This finding may indicate a possible association of tattoos with...
INTRODUCTION
There has been an increasing number of tattoo-related uveitis without evidence of systemic sarcoidosis. This finding may indicate a possible association of tattoos with uveitis.
CASE DESCRIPTION
This report is a 10-year follow-up of a single case of tattoo-related uveitis with no proven systemic sarcoidosis.
CONCLUSION
Literature review suggests possible pathogenesis and the patient's management is discussed. This case highlights the importance of a good systemic history and physical examination, especially with regard to tattoos.
Topics: Azathioprine; Biopsy; Cataract Extraction; Epiretinal Membrane; Follow-Up Studies; Glucocorticoids; Granuloma, Foreign-Body; Humans; Immunosuppressive Agents; Ink; Male; Middle Aged; Panuveitis; Prednisolone; Skin; Tattooing; Tomography, Optical Coherence
PubMed: 31072124
DOI: 10.1177/1120672119846341