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Harefuah Oct 2022A 68-year-old healthy female, with no past systemic or ocular history, presented with decreased vision in both eyes. On initial examination, there were extensive vitreal...
A 68-year-old healthy female, with no past systemic or ocular history, presented with decreased vision in both eyes. On initial examination, there were extensive vitreal opacities in both eyes. On the following visit, bilateral panuveitis was newly observed, without otherwise systemic clinical manifestations. The patient responded well to treatment with systemic and topical steroids. Initial workup excluded tuberculosis and syphilis. Angiotensin-converting enzyme (ACE) was within normal range. In order to make a definitive diagnosis and to exclude lymphoma, we decided to perform a vitreous biopsy after 2-weeks of steroids withdrawal. After cessation of steroids, new lesions appeared beneath the right eye and over the nasal bridge. Moreover, iris nodules over the stroma, pupil's margin and anterior chamber angle were noticed in both eyes. Biopsy from a skin lesion demonstrated non-caseating granulomas, supporting diagnosis of sarcoidosis. A chest computed tomography (CT) scan demonstrated compatible radiologic findings of bilateral hilar and mediastinal lymphadenopathy. Sarcoidosis is a chronic multisystem, autoimmune, granulomatous disease. Ocular involvement is common among patients with sarcoidosis, with the most common ocular manifestation being uveitis. We report a case that presented with bilateral panuveitis due to sarcoidosis with no systemic manifestations or elevated serum biomarkers. Definitive diagnosis was verified in histopathological findings from a skin biopsy and radiological findings in chest CT.
Topics: Humans; Female; Aged; Sarcoidosis; Uveitis; Biopsy; Tomography, X-Ray Computed; Panuveitis
PubMed: 36315210
DOI: No ID Found -
Canadian Journal of Ophthalmology.... Dec 2020
Topics: Angiogenesis Inhibitors; Bevacizumab; Endophthalmitis; Eye Infections, Bacterial; Humans; Intravitreal Injections; Panuveitis; Ranibizumab; Retrospective Studies
PubMed: 32827449
DOI: 10.1016/j.jcjo.2020.05.013 -
Ocular Immunology and Inflammation Aug 2020To describe the ocular manifestations in a case of novel coronavirus disease 2019 (COVID-19).
OBJECTIVE
To describe the ocular manifestations in a case of novel coronavirus disease 2019 (COVID-19).
MATERIAL AND METHODS
A case of unilateral panuveitis and optic neuritis as initial presentation of COVID-19.
RESULTS
As it is published, angiotensin-converting-enzyme-2 receptors can be found in many organs, such as the eyes, nerves, and vessels, so extrapulmonary involvement would be expected. According to current evidence and clinical characteristics of the patient, uveitis and optic neuritis could be produced by the virus.
CONCLUSIONS
It is fundamental to consider panuveitis and optic neuritis as an unusual presentation of ocular involvement in COVID-19 so proper care can be given to the patients.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Eye Infections, Viral; Female; Humans; Middle Aged; Optic Nerve; Optic Neuritis; Pandemics; Panuveitis; Pneumonia, Viral; SARS-CoV-2; Tomography, Optical Coherence
PubMed: 32870739
DOI: 10.1080/09273948.2020.1792512 -
Journal Francais D'ophtalmologie Jun 2017Vogt-Koyanagi-Harada (VKH) disease is defined as a severe bilateral, chronic granulomatous panuveitis associated with serous retinal detachments, disk edema, and... (Review)
Review
Vogt-Koyanagi-Harada (VKH) disease is defined as a severe bilateral, chronic granulomatous panuveitis associated with serous retinal detachments, disk edema, and vitritis, with central nervous system, auditory, and integumentary manifestations. It is an autoimmune inflammatory condition mediated by T cells that target melanocytes in individuals genetically susceptible to the disease. Vogt-Koyanagi-Harada disease presents clinically in 4 different phases: prodromal, acute inflammatory, chronic, and recurrent, with extraocular manifestations including headache, meningitis, hearing loss, poliosis, and vitiligo. Optical coherence tomography (OCT) allows earlier diagnosis of VKH disease by revealing heterogeneous exudative detachments of the retina in the acute stage and choroidal thickening, and by demonstrating choroidal thinning in the chronic stage. Treatment of this disease is initially with intravenous corticosteroids, with, if needed, a transition to immunosuppressant drugs for long-term control. Patients with VKH disease can have good final visual outcomes if treated promptly and aggressively.
Topics: Diagnosis, Differential; Humans; Panuveitis; Prognosis; Retinal Detachment; Tomography, Optical Coherence; Uveomeningoencephalitic Syndrome
PubMed: 28579215
DOI: 10.1016/j.jfo.2017.02.006 -
Ocular Immunology and Inflammation Sep 2023Post-streptococcal uveitis syndrome is a rare inflammatory sequela following streptococcus infection most commonly occurring in young patients. Patients most typically...
BACKGROUND
Post-streptococcal uveitis syndrome is a rare inflammatory sequela following streptococcus infection most commonly occurring in young patients. Patients most typically present with bilateral anterior nongranulomatous uveitis, but posterior involvement occurs frequently.
CASE PRESENTATION
We report an immunosuppressed patient presenting with asymmetrically bilateral acute onset, panuveitis with diffuse multifocal retinitis resulting from post-streptococcal uveitis syndrome.
CONCLUSION
Post-streptococcal uveitis syndrome can present as a panuveitis with multifocal retinitis. A high clinical suspicion is needed for this diagnosis especially in patients under the age of 30 years old with bilateral non-granulomatous uveitis.
Topics: Humans; Adult; Uveitis; Panuveitis; Streptococcus; Retinitis; Syndrome; Multimodal Imaging
PubMed: 36074639
DOI: 10.1080/09273948.2022.2113803 -
The Pediatric Infectious Disease Journal Jan 2015A 13-year-old boy who presented with a red left eye, painful eye movement, blurred vision, photophobia and increased lacrimation, was diagnosed with 1-sided panuveitis...
A 13-year-old boy who presented with a red left eye, painful eye movement, blurred vision, photophobia and increased lacrimation, was diagnosed with 1-sided panuveitis with optic disk edema. Diagnostic work-up revealed borrelial antibodies in serum. Diagnosis of Lyme borreliosis was substantiated by demonstration of lymphocytic pleocytosis, intrathecal borrelial antibody synthesis, improvement after treatment with ceftriaxone and exclusion of other causes.
Topics: Adolescent; Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi Group; Ceftriaxone; Humans; Lyme Disease; Lymphocytosis; Male; Panuveitis; Treatment Outcome
PubMed: 25741803
DOI: 10.1097/INF.0000000000000473 -
Ocular Immunology and Inflammation Apr 2020To report a case of uveitis worsening in a patient with sarcoidosis while receiving guselkumab (anti-IL-23) for dermatologic disease.
PURPOSE:
To report a case of uveitis worsening in a patient with sarcoidosis while receiving guselkumab (anti-IL-23) for dermatologic disease.
METHODS:
Case report.
RESULTS:
A 61-year-old gentleman had been diagnosed with plaque psoriasis in his 30s. He had been unsuccessfully treated with multiple conventional immunosuppressive agents as well as biologics. He was subsequently diagnosed with pulmonary sarcoidosis with confirmatory oropharyngeal biopsy. His presumed psoriatic skin lesions were subsequently biopsied and were consistent with cutaneous sarcoidosis. His ocular involvement from sarcoidosis had been minimal, requiring only occasional topical corticosteroids. He was started on the interleukin (IL)-23 inhibitor, guselkumab, for his cutaneous disease. Despite mild improvement in his cutaneous disease, he had a bilateral flare of uveitis requiring oral and topical corticosteroids.
CONCLUSIONS:
IL-23 has been implicated in the pathogenesis of uveitis, but there are limited data supporting efficacy of inhibitors of IL-23 in the management of uveitis.
Topics: Disease Management; Humans; Interleukin-23; Male; Middle Aged; Panuveitis; Sarcoidosis
PubMed: 30811269
DOI: 10.1080/09273948.2019.1569245 -
Ocular Immunology and Inflammation Jul 2022To present a patient with Rosai-Dorfman Disease (RDD), a histiocytic proliferative disorder typified by lymphadenopathy with rare ocular manifestations, who developed...
PURPOSE
To present a patient with Rosai-Dorfman Disease (RDD), a histiocytic proliferative disorder typified by lymphadenopathy with rare ocular manifestations, who developed panuveitis that responded to pegylated interferon.
METHODS
Descriptive case report of a patient with RDD with multi-organ involvement including ocular manifestations including bilateral panuveitis with choroidal masses.
RESULTS
A 54-year-old African American woman with known systemic RDD of the breast, lung, and gastrointestinal tract presented with panuveitis with choroidal masses in both eyes. Her systemic and ocular disease initially responded well to oral and topical steroid therapy. Later, however, her systemic disease progressed with multiple muscular and bony lesions. Systemic therapy was switched to pegylated interferon, a cytokine with antiviral, antitumor and immunomodulatory activity. After 14 months of therapy with pegylated interferon, the patient's systemic and ocular disease stabilized.
CONCLUSION
Rosai-Dorfman disease may be complicated by panuveitis and choroidal masses that may respond to pegylated interferon with stabilization of systemic and ocular manifestations. A multi-disciplinary approach is essential given the unique diagnostic and management challenges of RDD.
Topics: Antiviral Agents; Female; Histiocytosis, Sinus; Humans; Interferons; Middle Aged; Panuveitis; Polyethylene Glycols; Steroids
PubMed: 33683183
DOI: 10.1080/09273948.2020.1867190 -
Ocular Immunology and Inflammation 2019: To report a rare case of relapsing polychondritis with bilateral panuveitis as the first presentation of systemic disease : A 26-year-old female presented with...
: To report a rare case of relapsing polychondritis with bilateral panuveitis as the first presentation of systemic disease : A 26-year-old female presented with bilateral decreased vision, red eye and ocular pain underwent complete ocular examination, retinal imaging and systemic investigation. : Investigations revealed bilateral panuveitis associated with keratitis, retinal hemorrhages and retinal vasculitis. Following systemic work-ups and the pinna cartilage biopsy, diagnosis of relapsing polychondritis was made. : Owing to debilitating and even life-threatening consequences of enigmatic relapsing polychondritis, high suspicion of the disease is of paramount importance in cases of retinal vasculitis and uveitis.
Topics: Adult; Biopsy; Diagnosis, Differential; Disease Progression; Female; Fluorescein Angiography; Fundus Oculi; Humans; Keratitis; Panuveitis; Polychondritis, Relapsing; Retinal Vessels; Tomography, Optical Coherence
PubMed: 30193073
DOI: 10.1080/09273948.2018.1517893 -
Frontiers in Immunology 2022Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a serious pandemic. COVID-19 vaccination is urgent...
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a serious pandemic. COVID-19 vaccination is urgent needed for limiting SARS-CoV-2 outbreaks by herd immunity. Simultaneously, post-marketing surveillance to assess vaccine safety is important, and collection of vaccine-related adverse events has been in progress. Vision-threatening ophthalmic adverse events of COVID-19 vaccines are rare but are a matter of concern. We report a 45-year-old Japanese male with positive for HLA-DR4/HLA-DRB1*0405, who developed bilateral panuveitis resembling Vogt-Koyanagi-Harada (VKH) disease after the second dose of Pfizer-BioNTech COVID-19 mRNA (BNT162b2) vaccine. Glucocorticosteroid (GC) therapy combined with cyclosporine A (CsA) readily improved the panuveitis. The immune profile at the time of onset was analyzed using CyTOF technology, which revealed activations of innate immunity mainly consisting of natural killer cells, and acquired immunity predominantly composed of B cells and CD8 T cells. On the other hand, the immune profile in the remission phase was altered by GC therapy with CsA to a profile composed primarily of CD4 cells, which was considerably similar to that of the healthy control before the vaccination. Our results indicate that BNT162b2 vaccine may trigger an accidental immune cross-reactivity to melanocyte epitopes in the choroid, resulting in the onset of panuveitis resembling VKH disease.
Topics: BNT162 Vaccine; CD8-Positive T-Lymphocytes; COVID-19; COVID-19 Vaccines; Cyclosporine; Epitopes; HLA-DR4 Antigen; Humans; Male; Middle Aged; Panuveitis; RNA, Messenger; SARS-CoV-2; Uveomeningoencephalitic Syndrome
PubMed: 36248859
DOI: 10.3389/fimmu.2022.967972