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Acta Medica Indonesiana Jan 2022There is an increasing number of HIV/AIDS patients in Indonesia, starting from <0.1% in 2010 to 0.4% in 2012, which warrants awareness of ocular manifestation in HIV....
There is an increasing number of HIV/AIDS patients in Indonesia, starting from <0.1% in 2010 to 0.4% in 2012, which warrants awareness of ocular manifestation in HIV. This might appear in 70-100% of patients with HIV. A 47 years old man came to the infection and immunology clinic with blurry vision on both eyes. He had been treated before but there was no clinical improvement. Examination showed both eyes had vitreous haziness. Visual acuity was 1/60 in both eyes with appearance of flare and cells within +3. Uveitis workup showed positive results for HIV, HSV and syphilis. Patient was given 100 mg of doxyciclin two times daily and fixed dose tablet which contains the combination of antiretroviral. Three months later, final acuity was 6/10 on the right eye and 6/18 on the left eye. Prompt diagnosis and treatment warrant good prognosis including multidisciplinary approach by ophthalmologist, clinical allergist and immunologist, and dermato-venerologist.
Topics: Acquired Immunodeficiency Syndrome; Eye Infections, Bacterial; Humans; Male; Middle Aged; Panuveitis; Syphilis; Uveitis
PubMed: 35398833
DOI: No ID Found -
Veterinary Ophthalmology 2006A case of panuveitis as a result of leptospiral infection in an 8-year-old Jack Russell Terrier is reported. Mild hyphema, aqueous flare, and partial serous retinal...
A case of panuveitis as a result of leptospiral infection in an 8-year-old Jack Russell Terrier is reported. Mild hyphema, aqueous flare, and partial serous retinal detachments were noted in both eyes on initial ophthalmic examination. The serum microscopic agglutination testing for Leptospira serovarieties revealed titers of 1 : 12 800 for Leptospira canicola and 1 : 200 for Leptospira icterohemorrhagiae. With medical therapy, the panuveitis resolved and functional vision was regained. Four weeks after the initial presentation, convalescent titers were 1 : 200 for L. canicola and 1 : 100 for L. icterohemorrhagiae. The incidence of leptospirosis, along with difficulties diagnosing, and current medical therapies for this disease are also discussed.
Topics: Agglutination Tests; Animals; Anti-Bacterial Agents; Dog Diseases; Dogs; Leptospirosis; Male; Panuveitis; Retinal Detachment; Treatment Outcome
PubMed: 16634930
DOI: 10.1111/j.1463-5224.2006.00464.x -
Ocular Immunology and Inflammation May 2023Sympathetic ophthalmia (SO) is rare, bilateral granulomatous panuveitis that typically occurs following penetrating or perforating ocular trauma or surgery. This review... (Review)
Review
INTRODUCTION
Sympathetic ophthalmia (SO) is rare, bilateral granulomatous panuveitis that typically occurs following penetrating or perforating ocular trauma or surgery. This review aims to provide an update on the etiopathogenesis, clinical presentations, diagnosis and treatment of SO.
METHODS
Reports cited in MEDLINE database, that analyzed SO in at least 5 patients, published prior to December 1st, 2021 were included.
RESULTS
Initially, SO was associated with penetrating ocular trauma, however, various studies reported an increased incidence of SO after surgical procedures including vitreoretinal surgeries. Multimodal imaging including fluorescein and indocyanine green angiography, optical coherence tomography (OCT) and OCT angiography have added further insights into the understanding of SO. While pulse dose corticosteroids & immunosuppressive drugs are still the treatment of choice, TNF-α blockers & other biologic drugs represent new promising agents.
CONCLUSION
There is a growing pool of evidence in understanding the pathogenesis of SO. Novel treatment options have provided better prognosis for this potentially blinding condition.
Topics: Humans; Ophthalmia, Sympathetic; Immunosuppressive Agents; Immunologic Factors; Prognosis; Tomography, Optical Coherence; Eye Injuries; Fluorescein Angiography
PubMed: 35579612
DOI: 10.1080/09273948.2022.2058554 -
Seminars in Ophthalmology 2011Sympathetic ophthalmia is a rare, bilateral granulomatous panuveitis following accidental or surgical trauma to one eye. The pathophysiology is not clearly understood,... (Review)
Review
Sympathetic ophthalmia is a rare, bilateral granulomatous panuveitis following accidental or surgical trauma to one eye. The pathophysiology is not clearly understood, but is believed to be a T-cell mediated autoimmune response. Clinical presentation most often occurs within the first year after trauma; anteriorly it manifests as a chronic or acute uveitis with mutton-fat keratic precipitates, while posteriorly it is often accompanied by yellowish-white choroidal lesions or Dalen-Fuchs nodules. The mainstay of treatment consists of systemic anti-inflammatory agents such as oral corticosteroids, or other immunosuppressive agents. Newer treatments include intravitreal injections of steroids in combination with systemic therapy, periocular injections of steroids without systemic therapy, and injections of infliximab, an anti-vascular endothelial growth factor.
Topics: Anti-Inflammatory Agents; Autoimmune Diseases; Humans; Ophthalmia, Sympathetic
PubMed: 21958181
DOI: 10.3109/08820538.2011.588658 -
BMJ Case Reports Nov 2017We report two patients with chronic myelogenous leukaemia (CML) in remission phase who developed panuveitis simulating Behçet's disease. A 26-year-old man presented...
We report two patients with chronic myelogenous leukaemia (CML) in remission phase who developed panuveitis simulating Behçet's disease. A 26-year-old man presented with bilateral panuveitis (hypopyon in the right eye, bilateral anterior segment inflammation, vitritis and retinitis). He was on imatinib for CML which was in remission. He gave a history of recurrent oral ulcers. The panuveitis responded to oral and topical steroids but recurred after the steroids were stopped. His ocular condition again stabilised on restarting oral steroids and azathioprine. The second patient, a 28-year-old man, presented with bilateral anterior segment inflammation, vitritis, exudative retinal detachment and hypopyon in the right eye. He was also on imatinib with the CML being in remission. The uveitis and exudative retinal detachment improved on systemic and topical steroids. The vision of this patient did not improve as optic atrophy ensued. The panuveitis seen in our patients with CML responded favourably to oral steroids/immunosuppressant therapy.
Topics: Adult; Antineoplastic Agents; Behcet Syndrome; Diagnosis, Differential; Humans; Imatinib Mesylate; Immunosuppressive Agents; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Maintenance Chemotherapy; Male; Oral Ulcer; Panuveitis; Retinal Detachment; Steroids
PubMed: 29170182
DOI: 10.1136/bcr-2017-222238 -
JAMA Ophthalmology Feb 2021
Topics: Administration, Ophthalmic; Administration, Oral; COVID-19; COVID-19 Nucleic Acid Testing; Eye Infections, Viral; Female; Fluorescein Angiography; Glucocorticoids; Humans; Middle Aged; Optic Neuritis; Panuveitis; Retinal Vasculitis; SARS-CoV-2; Slit Lamp Microscopy; Visual Acuity; COVID-19 Drug Treatment
PubMed: 33331870
DOI: 10.1001/jamaophthalmol.2020.5695 -
JAMA Ophthalmology Apr 2015
Topics: Administration, Oral; Dermatitis; Female; Glucocorticoids; Humans; Panuveitis; Tattooing; Young Adult
PubMed: 25856648
DOI: 10.1001/jamaophthalmol.2014.4543 -
BMC Ophthalmology Mar 2019To report 2 cases of bilateral granulomatous panuveitis accompanied by chronic active Epstein-Barr virus infection (CAEBV).
BACKGROUND
To report 2 cases of bilateral granulomatous panuveitis accompanied by chronic active Epstein-Barr virus infection (CAEBV).
CASE PRESENTATION
Case 1 was a 38-year-old man who had a history of bilateral mild panuveitis who was diagnosed with CAEBV. Fifteen months later, a severe bilateral granulomatous panuveitis developed. White infiltrates covered the optic disc and all the retinal vessels of the right eye, and white nodules were seen along the retinal veins and arteries of the left eye. Case 2 was a 34-year-old man with bilateral panuveitis showing mutton-fat keratic precipitates and diffuse vitreous opacity in both eyes. A snow ball-like vitreous opacity was present in the right eye. Systemic investigations revealed the presence of CAEBV. In both cases, a comprehensive polymerase chain reaction (PCR) analyses of the aqueous humor detected significant copy numbers of EBV-DNA. The intraocular inflammation did not respond to steroid, methotrexate, and other immunosuppressive therapies, but was ameliorated after hematopoietic stem cell transplantation with preceding chemotherapy and low-dose total body irradiation in both cases.
CONCLUSION
Granulomatous panuveitis can develop in eyes with CAEBV as a primary symptom. Ophthalmologists should rule out CAEBV when EBV-DNA is positive in the intraocular fluids of steroid-resistant panuveitis.
Topics: Adult; Chronic Disease; Epstein-Barr Virus Infections; Granuloma; Humans; Male; Panuveitis
PubMed: 30922271
DOI: 10.1186/s12886-019-1090-5 -
The Journal of International Medical... Apr 2024Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by massive lymphadenopathy and systemic extranodal lesions. We present the case of... (Review)
Review
Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by massive lymphadenopathy and systemic extranodal lesions. We present the case of a 28-year-old woman who presented with recurrent blurred vision in her right eye for 3 months. She developed blindness and atrophy in her left eye a decade prior to presentation. She subsequently developed headache, fever, and impaired mental status. Cranial magnetic resonance imaging indicated hypertrophic pachymeningitis (HP), and F-fluoro-2-deoxy-2-d-glucose (FDG) positron emission tomography/computed tomography revealed significant FDG uptake in the left dura mater. Autoimmune testing revealed elevated anti-nuclear, anti-SS-A, and anti-SS-B antibody levels. Incisional biopsy of the atrophic eyeball revealed RDD with marked polyclonal plasmacytosis. The patient was diagnosed with RDD accompanied by multisystem involvement, including Sjögren's syndrome (SS), panuveitis, and HP. Treatment with methylprednisolone for several weeks resulted in significant improvement. This is the first reported case of RDD presenting with SS in combination with panuveitis and HP. Although RDD is rarely diagnosed in young patients, interdisciplinary collaboration is essential to prevent a delayed diagnosis.
Topics: Humans; Female; Adult; Histiocytosis, Sinus; Sjogren's Syndrome; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Hypertrophy; Panuveitis
PubMed: 38629479
DOI: 10.1177/03000605241233141 -
Ocular Immunology and Inflammation Jul 2022We present the case of a 50 year old male patient being treated for chronic myeloid leukemia by the tyrosine kinase inhibitor, Ponatinib. After 3 months of treatment,...
CASE SUMMARY
We present the case of a 50 year old male patient being treated for chronic myeloid leukemia by the tyrosine kinase inhibitor, Ponatinib. After 3 months of treatment, he developed a sight-threatening granulomatous panuveitis in both eyes, with choroidal effusions and neurosensory retinal detachments. Except for a positive interferon-gamma release assay suggesting previous Tuberculosis exposure, all uveitis investigations were normal. Discontinuation of the suspected causative drug led to resolution of signs and a consequent improvement in visual acuity.
CONCLUSION
Ponatinib use may be associated with with a uveitic phenotype that is reminiscent of Harada's disease. We compare and contrast this rare ocular phenomenon with Vogt-Koyanagi-Harada syndrome and discuss a possible immunological basis.
Topics: Choroidal Effusions; Humans; Imidazoles; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Panuveitis; Protein Kinase Inhibitors; Pyridazines; Retinal Detachment; Uveitis; Uveomeningoencephalitic Syndrome
PubMed: 33661078
DOI: 10.1080/09273948.2020.1866618