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Indian Journal of Ophthalmology Jul 2023To study the clinical presentation and treatment outcome of epidemic retinitis (ER) during pregnancy. (Observational Study)
Observational Study
PURPOSE
To study the clinical presentation and treatment outcome of epidemic retinitis (ER) during pregnancy.
METHODS
This is a retrospective, observational chart review of pregnant patients diagnosed with ER from January 2014 to February 2023. Demographic details, month of pregnancy at the onset of ocular symptoms, history of present illness, clinical manifestations, and treatment outcomes were studied.
RESULTS
In 9 years, ER was seen in 86 females, of whom 12 (13.9%) were pregnant. Twenty-one eyes of those 12 patients were studied. Most of the patients presented in the sixth month of pregnancy (range: 5-9 months, mean: 6.3 months). Physicians diagnosed viral exanthematous fever in six, typhoid in three, and suspected rickettsia in one patient. Medical termination of pregnancy (MTP) was performed in two patients before presentation. Weil-Felix test was positive in five, Brucella in one, WIDAL in three, and coronavirus disease 2019 (COVID-19) IgG and dengue IgG in one patient each. Oral antibiotics were given in five patients (two post-medical termination of pregnancy [MTP]) for the retinitis. All except four received oral steroids. Mean presenting corrected distant visual acuity (n = 21) was 20/125 (range: 20/20-20/20,000), which improved to (n = 18) 20/30 (range: 20/20-20/240). Macular edema (n = 11) resolved in 33.18 days (range: 20-50 days), and retinitis (n = 13) resolved in 58 days (range: 30-110 days). Ocular and systemic examination of newborn was possible in two and the babies were normal.
CONCLUSION
ER is seen commonly at the beginning of the third trimester. Lack of antibiotics may delay the resolution of retinitis. Ocular health needs to be assessed in larger series to conclude absence of retinal involvement in newborns.
Topics: Infant, Newborn; Female; Humans; Pregnancy; COVID-19; Retinitis; Retina; Anti-Bacterial Agents; Immunoglobulin G; Retrospective Studies
PubMed: 37417121
DOI: 10.4103/IJO.IJO_3169_22 -
Canadian Journal of Ophthalmology.... Jun 2019
Topics: Eye Infections, Viral; Herpes Simplex; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Pregnancy Complications, Infectious; Retina; Retinitis; Ultrasonography
PubMed: 31109490
DOI: 10.1016/j.jcjo.2018.08.009 -
American Journal of Ophthalmology Jul 1979
Topics: Adult; Humans; Male; Retina; Retinitis; Sunlight
PubMed: 464005
DOI: 10.1016/0002-9394(79)90773-6 -
American Journal of Ophthalmology Aug 2021To determine classification criteria for acute retinal necrosis (ARN).
PURPOSE
To determine classification criteria for acute retinal necrosis (ARN).
DESIGN
Machine learning of cases with ARN and 4 other infectious posterior uveitides / panuveitides.
METHODS
Cases of infectious posterior uveitides / panuveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the infectious posterior uveitides / panuveitides. The resulting criteria were evaluated on the validation set.
RESULTS
Eight hundred three cases of infectious posterior uveitides / panuveitides, including 186 cases of ARN, were evaluated by machine learning. Key criteria for ARN included (1) peripheral necrotizing retinitis and either (2) polymerase chain reaction assay of an intraocular fluid specimen positive for either herpes simplex virus or varicella zoster virus or (3) a characteristic clinical appearance with circumferential or confluent retinitis, retinal vascular sheathing and/or occlusion, and more than minimal vitritis. Overall accuracy for infectious posterior uveitides / panuveitides was 92.1% in the training set and 93.3% (95% confidence interval 88.2, 96.3) in the validation set. The misclassification rates for ARN were 15% in the training set and 11.5% in the validation set.
CONCLUSIONS
The criteria for ARN had a reasonably low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.
Topics: Adult; Female; Fluorescein Angiography; Fundus Oculi; Humans; Machine Learning; Male; Middle Aged; Retina; Retinal Necrosis Syndrome, Acute; Tomography, Optical Coherence
PubMed: 33845012
DOI: 10.1016/j.ajo.2021.03.057 -
American Journal of Ophthalmology Jun 1989We studied two patients, one with histologically confirmed endogenous bacterial retinitis associated with the acquired immunodeficiency syndrome and a second with... (Review)
Review
We studied two patients, one with histologically confirmed endogenous bacterial retinitis associated with the acquired immunodeficiency syndrome and a second with ophthalmoscopically identical findings who also responded to antibiotic treatment. Both patients had focal, discrete patches of retinitis that enlarged slowly over weeks and ultimately accumulated large amounts of subretinal fluid and retinal exudate. One patient underwent retinal biopsy after systemic and vitreous cultures were negative. Histopathologic sections showed necrotic retina infiltrated with multiple histiocytes containing intracytoplasmic, iodine-positive, pleomorphic, encapsulated bacterial forms. The organism was not grown from the retinal biopsy specimen. Treatment with antibiotics resulted in improved vision in both patients. Our results indicate that endogenous bacterial infection should be considered in the differential diagnosis of retinitis associated with the acquired immunodeficiency syndrome.
Topics: Acquired Immunodeficiency Syndrome; Adult; Bacterial Infections; Biopsy; Humans; Male; Retina; Retinitis
PubMed: 2658616
DOI: 10.1016/0002-9394(89)90258-4 -
Eye (London, England) Nov 2020
Topics: Carrier Proteins; Humans; Mutation; Retinal Diseases; Retinaldehyde; Retinitis
PubMed: 32001820
DOI: 10.1038/s41433-020-0777-4 -
Progress in Retinal and Eye Research Jul 2011T lymphocytes play a decisive role in the course and clinical outcome of viral retinal infection. This review focuses on aspects of the adaptive cellular immune response... (Review)
Review
T lymphocytes play a decisive role in the course and clinical outcome of viral retinal infection. This review focuses on aspects of the adaptive cellular immune response against viral pathogens in the retina. Two distinct models to study adaptive cell mediated immune responses in viral retinitis are presented: (i) experimental retinitis induced by murine cytomegalovirus (MCMV), where the immune system prevents necrotizing damage to the retina and (ii) retinitis induced by the non-cytopathic lymphocytic choriomeningitis virus (LCMV), where the retinal microanatomy is compromised not by the virus, but by the immune response itself. From these studies it is clear that, in the context of viral infections, the cytotoxic T cell response against a pathogen in the retina does not differ from that seen in other organs, and that once such a response has been initiated, clearing of virus from retinal tissue has priority over preservation of retinal architecture and function. Furthermore, implications drawn from these models for gene therapy in retinal diseases are discussed.
Topics: Animals; Dendritic Cells; Disease Models, Animal; Genetic Vectors; Green Fluorescent Proteins; Humans; Lymphocytic choriomeningitis virus; Macrophages; Mice; Mice, Inbred C57BL; Mice, Transgenic; Muromegalovirus; Retina; Retinitis; T-Lymphocytes
PubMed: 21550416
DOI: 10.1016/j.preteyeres.2011.04.001 -
American Journal of Ophthalmology Aug 1977We studied two adult patients with fulminating, necrotizing vaso-occlusive retinitis, and documented the progressive course of retinal necrosis, vitreoretinal interface...
We studied two adult patients with fulminating, necrotizing vaso-occlusive retinitis, and documented the progressive course of retinal necrosis, vitreoretinal interface contraction, and consequent retinal detachment. The systemic criteria for Behçet's disease were present in one patient, and partially fulfilled in the second.
Topics: Adult; Aged; Behcet Syndrome; Diagnosis, Differential; Female; Humans; Keratitis, Dendritic; Male; Necrosis; Retina; Retinitis
PubMed: 888891
DOI: 10.1016/0002-9394(77)90854-6 -
Indian Journal of Ophthalmology Sep 2019A 43-year-old male presented with left eye foveal retinits causing an acute visual loss following influenza virus type A infection (H1N1 infection or Swine flu)....
A 43-year-old male presented with left eye foveal retinits causing an acute visual loss following influenza virus type A infection (H1N1 infection or Swine flu). Considering viral (influenza) etiology, a prompt treatment with oral corticosteroids was started. But an initial poor response prompted an immediate diagnostic vitrectomy, which revealed Candida albicans. The retinitis healed with scar formation following anti-fungal therapy. This case highlights that even in the setting of an acute retinitis in an immunocompetent patient with recent history of viral systemic illness, a high index of suspicion of a fungal (rather than viral) infection should be kept in mind.
Topics: Adult; Antifungal Agents; Eye Infections, Fungal; Fluorescein Angiography; Fundus Oculi; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Male; Retina; Retinitis; Tomography, Optical Coherence; Vitrectomy
PubMed: 31436207
DOI: 10.4103/ijo.IJO_1691_18 -
BMC Ophthalmology Jun 2022To report a very rare acute cystoid macular oedema following ganciclovir injection in patients receiving allogeneic haematopoietic stem cell transplantation.
BACKGROUND
To report a very rare acute cystoid macular oedema following ganciclovir injection in patients receiving allogeneic haematopoietic stem cell transplantation.
CASE PRESENTATION
A 44-year-old male patient experienced vision loss in his left eye eight months after allogeneic stem cell transplantation. Ophthalmologic examination showed posterior retinopathy with retinal haemorrhage, a yellow necrotic border, and a vascular white sheath involved in the superior temporal retina but not the posterior pole. Cytomegalovirus DNA results in both plasma and ocular fluid were positive. All tests combined with the patient's medical history suggested that his ocular disease was cytomegalovirus retinitis. Consequently, he received a weekly ganciclovir vitreous injection. The disease was visibly controlled, and the fundus condition improved after the first three treatments. However, the patient had severe vision loss in his left eye and acute cystic oedema in the macula, while the original lesion was stable two hours after the fourth treatment. The macular oedema subsided significantly on the first day. Over the next week, daily OCT findings indicated that the patient's macular oedema gradually subsided and resolved completely by the second week, and his left eye vision partially improved.
CONCLUSION
Macular oedema may occur in patients with cytomegalovirus retinitis, but it rarely occurs during treatment. In this case, the patient's macular oedema appeared and resolved quickly. Macular oedema in patients with cytomegalovirus retinitis receiving vitreous cavity injections of ganciclovir needs to be further studied and discussed.
Topics: Adult; Cytomegalovirus Retinitis; Ganciclovir; Humans; Macula Lutea; Macular Edema; Male; Retina
PubMed: 35764964
DOI: 10.1186/s12886-022-02500-0