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Indian Journal of Ophthalmology Mar 2017Ophthalmia nodosa with vitreoretinal involvement is rare and may cause permanent loss of eye due to persistent inflammation of the eye. A young female patient having...
Ophthalmia nodosa with vitreoretinal involvement is rare and may cause permanent loss of eye due to persistent inflammation of the eye. A young female patient having multiple caterpillar hair in the eye including cornea, anterior chamber, sclera, and pars plana presented with recurrent vitritis and pars planitis. Ultrasound biomicroscopy played a vital role and helped in localizing the hair embedded in the pars plana region which were managed by pars plana vitrectomy leading to complete recovery.
Topics: Anterior Chamber; Eye Foreign Bodies; Female; Hair; Humans; Microscopy, Acoustic; Vitrectomy; Young Adult
PubMed: 28440257
DOI: 10.4103/ijo.IJO_985_15 -
Graefe's Archive For Clinical and... Jun 2017The purpose of this study was to evaluate the characteristics and outcomes of cataract surgery with/without vitrectomy in patients with pars planitis who received... (Observational Study)
Observational Study
BACKGROUND
The purpose of this study was to evaluate the characteristics and outcomes of cataract surgery with/without vitrectomy in patients with pars planitis who received immunosuppressive therapy.
METHODS
This was a retrospective case series, single-center study. Twenty-two patients with pars planitis who received immunosuppressive therapy were included, with a median age at presentation of 9.5 years, having had cataract surgery. The following data was collected: age at presentation and at cataract surgery, time of follow-up, best-corrected visual acuity (BCVA) before the surgery and at 1 week, 1 and 6 months after the procedure, immunosuppressive therapy, complications and causes for failed visual improvement. The variables associated with an improvement in visual acuity were evaluated.
RESULTS
All patients had phacoemulsification with intraocular lens implantation. The most common immunosuppressive therapy used for the patients was methotrexate in nine patients (40.9%). The BCVA improved from a median of 20/400 to 20/100 after 6 months of follow-up (p = 0.0005); 14 patients (63.6%) improved two lines of vision or more. No significant risk factors were found for the association with improvement in visual acuity after the surgery. No improvement in visual acuity was attributed to posterior segment manifestations or amblyopia; the most common complication was posterior capsule opacification in 11 eyes (50%). The median follow-up after the surgery was 32 months.
CONCLUSION
Phacoemulsification was the procedure for all the patients. Visual acuity improved in patients with pars planitis treated with immunosuppressive drugs who underwent cataract surgery, except for the patients with posterior segment complications or amblyopia.
Topics: Adolescent; Adult; Cataract; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Lens Implantation, Intraocular; Male; Pars Planitis; Phacoemulsification; Retrospective Studies; Treatment Outcome; Visual Acuity; Vitrectomy; Young Adult
PubMed: 28396945
DOI: 10.1007/s00417-017-3658-1 -
International Ophthalmology Apr 2018To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey.
PURPOSE
To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey.
METHODS
Medical records of patients with pars planitis were retrospectively reviewed. The data including demographic and ocular features and treatment outcomes were recorded. The distribution of clinical findings and complications were evaluated according to age and gender groups. The changes in final BCVA compared to the initial BCVA were noted. Statistical analysis was performed using SPSS software (Version 18.0, SPSS Inc., Chicago, USA).
RESULTS
Twenty-seven patients (54 eyes) were included in this study. 16 patients were male (59.3%), and 11 were female (40.7%). Mean age at diagnosis was 12.84 ± 8.26 (range 4-36) years. Mean follow-up period was 61.3 ± 52.15 (range 9-172) months. Mean BCVA was 0.58 ± 0.36 (range 0.03-1.00) (0.40 ± 0.45 logMAR) at presentation, and 0.81 ± 0.28 (range 0.10-1.00) (0.14 ± 0.27 logMAR) at final visit (P = 0.001). Vitreous inflammation (100%), vitreous haze (92.6%), snowballs (74.1%), snowbanks (66.7%), anterior chamber cells (66.7%) and peripheral retinal vascular sheathing (48.1%) were the most common presentations. Ocular complications included vitreous condensation (51.9%), cystoid macular edema (22.2%), cataract (18.5%), inferior peripheral retinal detachment (11.1%), glaucoma (5.6%) and vitreous hemorrhage (3.7%). Treatments included topical, periocular, intravitreal and systemic corticosteroids, immunosuppressives, peripheral laser photocoagulation and pars plana vitrectomy when needed.
CONCLUSIONS
Pars planitis is an idiopathic chronic intermediate uveitis mostly affecting children and adolescents. In spite of its chronic nature with high potential of causing ocular complications, adequate treatment and close follow-up lead to favorable visual outcomes.
Topics: Adolescent; Adrenal Cortex Hormones; Adult; Age Factors; Child; Child, Preschool; Female; Humans; Immunosuppressive Agents; Laser Coagulation; Male; Pars Planitis; Retrospective Studies; Sex Factors; Turkey; Visual Acuity; Vitrectomy; Vitreous Body; Young Adult
PubMed: 28389773
DOI: 10.1007/s10792-017-0526-2 -
Archivos de La Sociedad Espanola de... Dec 2017The case is presented of a 42 year-old man with episodes of unilateral uveitis in his right eye. Ophthalmic examination showed a granulomatous anterior uveitis with...
CASE REPORT
The case is presented of a 42 year-old man with episodes of unilateral uveitis in his right eye. Ophthalmic examination showed a granulomatous anterior uveitis with vitritis. Systemic investigations revealed non-nephrotic proteinuria and microhaematuria. A renal biopsy showed IgA nephropathy.
DISCUSSION
Uveitis and glomerulonephritis may have common immunological pathogenesis. IgA nephropathy should be a differential diagnosis in patients with uveitis and nephropathy.
Topics: Adult; Glomerulonephritis, IGA; Humans; Male; Uveitis
PubMed: 28343747
DOI: 10.1016/j.oftal.2017.02.006 -
Ocular Immunology and Inflammation 2018To describe a case of intermediate uveitis caused by chikungunya virus infection in the Western Hemisphere.
PURPOSE
To describe a case of intermediate uveitis caused by chikungunya virus infection in the Western Hemisphere.
METHODS
Case report of a patient diagnosed with chikungunya infection presenting with blurry vision and floaters.
RESULTS
Exam revealed a unilateral intermediate uveitis, with an extensive work-up positive for chikungunya virus immunoglobulin M and G titers. The patient responded to oral corticosteroids with signs and symptoms resolving over the course of 3 months' treatment.
CONCLUSIONS
While anterior uveitis and retinitis are the most common ocular manifestations of chikungunya infection, we report here a case of chikungunya infection presenting as an intermediate uveitis, responding well to oral corticosteroids. This case demonstrates the varied presentation of chikungunya-related uveitis and highlights its consideration in the differential diagnoses of those who have had preceding systemic viral symptoms and uveitis.
Topics: Acute Disease; Adult; Antibodies, Viral; Blotting, Western; Chikungunya Fever; Chikungunya virus; Diagnosis, Differential; Eye Infections, Viral; Female; Fluorescein Angiography; Fundus Oculi; Humans; Tomography, Optical Coherence; Uveitis, Intermediate; Vitreous Body
PubMed: 28010143
DOI: 10.1080/09273948.2016.1263340 -
Journal of Glaucoma Mar 2017The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children.
PURPOSE OF THE STUDY
The purpose of the study was to report long-term outcomes and complications of Baerveldt glaucoma implant (BGI) surgery with pars plana tube insertion in children.
MATERIALS AND METHODS
The medical records of consecutive aphakic and pseudophakic children (<16 y of age) who underwent BGI surgery with pars plana tube insertion between 1990 and 2013 were retrospectively reviewed. Main outcome measures were intraocular pressure and number of glaucoma medications. Postoperative complications were recorded. Failure was defined as an intraocular pressure <5 or ≥21 mm Hg (with or without glaucoma medications), loss of light perception, or need for additional glaucoma surgery.
RESULTS
Thirty-seven children were identified with a mean age of 6.0±4.7 years (range, 4 mo to 14.5 y). Mean follow-up after pars plana BGI surgery was 6.5±3.4 years (range, 9 mo to 12.8 y) for patients who met success criteria. Mean intraocular pressure and mean number of glaucoma medications at most recent follow-up for patients with successful intraocular pressure control were 13.8±4.1 and 2.3±1.9 mm Hg, respectively. The Kaplan-Meier survival analysis revealed 1-, 3-, 5-, and 7-year success rates of 94.5%, 74.6%, 65.0%, and 45.8%, respectively. Complications included tube exposure in 1 patient (2.7%), tube obstruction in 8 patients (21.6%), and retinal detachment in 9 patients (24.3%). Seventeen patients (45.9%) failed due to inadequate intraocular pressure control, of whom 9 (24.3%) required additional glaucoma surgery.
CONCLUSIONS
Although pars plana BGI surgery is a reasonable option for managing refractory glaucoma in aphakic and pseudophakic children, surgeons must be aware of the potential need for additional glaucoma surgery and/or posterior segment complications with extended follow-up.
Topics: Adolescent; Antihypertensive Agents; Aphakia; Child; Child, Preschool; Ciliary Body; Female; Glaucoma; Glaucoma Drainage Implants; Humans; Intraocular Pressure; Kaplan-Meier Estimate; Male; Pars Planitis; Postoperative Complications; Prosthesis Implantation; Pseudophakia; Retinal Detachment; Retrospective Studies; Treatment Outcome; Visual Acuity
PubMed: 28002192
DOI: 10.1097/IJG.0000000000000611 -
Journal of Ophthalmology 2016Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods....
Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD) who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1%) and 31 (96.8%) eyes in the pars planitis RRD group and in 167 eyes (92.7%) and 176 eyes (97.7%) in primary RRD group, respectively. Both groups showed significant visual improvement (p < 0.001) and there were no significant differences in final visual acuity. Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR) development (12.5% versus 2.8%, p = 0.031). Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB.
PubMed: 27688907
DOI: 10.1155/2016/4538193 -
Clinical Ophthalmology (Auckland, N.Z.) 2016The aim of this study was to evaluate the characteristics and outcomes of pediatric uveitis cases at a large tertiary referral center in Dallas, TX, USA.
PURPOSE
The aim of this study was to evaluate the characteristics and outcomes of pediatric uveitis cases at a large tertiary referral center in Dallas, TX, USA.
MATERIALS AND METHODS
The authors performed a retrospective chart review between 2001 and 2011 to identify children with uveitis.
RESULTS
A total of 46 children (68 eyes) with uveitis were identified. Sixty-seven percent were Hispanic, and the mean age was 9.2 years. The majority of cases were idiopathic (74%). Anterior uveitis accounted for 42% of cases followed by intermediate uveitis/pars planitis (33%), posterior uveitis/retinitis (7%), and panuveitis (20%). Most patients were treated with corticosteroids (98% topical), 52% with systemic immunosuppression therapy, and 30% with surgery. Complications occurred in 74% of patients, with the most common complication being cataract development (26%), followed by posterior synechiae (24%). Twenty-four percent of patients had recurrences. Hispanic patients had worse visual acuities at presentation (P-value =0.073) and follow-up (P-value =0.057), compared to non-Hispanic patients.
CONCLUSION
Pediatric uveitis cases seen in a large center in Dallas were largely idiopathic, had commonly developed complications, and were associated with worse visual outcomes in Hispanic patients.
PubMed: 27601874
DOI: 10.2147/OPTH.S96323 -
Journal of Glaucoma Sep 2016To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glaucoma (UG).
PURPOSE
To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glaucoma (UG).
MATERIALS AND METHODS
We retrospectively reviewed all cases that underwent trabeculotomy for pediatric UG at our center between 2008 and 2014. Up to 2 trabeculotomies per eye were performed in patients with medically controlled uveitis. Surgical success was defined as final intraocular pressure <22 mm Hg and ≥6 mm Hg after 1 or 2 trabeculotomies, with or without medications. Kaplan-Meier survival analyses were done.
RESULTS
A total of 33 trabeculotomies were performed in 28 eyes of 22 patients. Diagnoses included UG associated with juvenile idiopathic arthritis (68.2%), idiopathic uveitis (22.7%), and pars planitis (9.1%). The average age at surgery was 9.8±3.7 (5 to 17) years. With a mean follow-up of 33.6±18.3 (10 to 78) months, the overall surgical success was 81.8%. The cumulative survival probability after up to 2 trabeculotomies was 0.86 (95% confidence interval, 0.71-0.93) at 12 months and 0.77 (95% confidence interval, 0.60-0.87) at 24 months. Four (11.5%) eyes required a second trabeculotomy to achieve surgical success and 4 (7.7%) required filtrating procedures. Intraocular pressure improved from 31.4±7.6 (18 to 50) mm Hg preoperatively to 15.0±3.6 (8 to 23) mm Hg at final visits, whereas the number of glaucoma medications decreased from 4.2±1.1 (1 to 5) to 0.4±1.0 (0 to 4). Visual acuity and intraocular inflammation remained stable (P>0.05) and there were no major complications.
CONCLUSIONS
Trabeculotomy is a safe and effective surgery for pediatric UG.
Topics: Adolescent; Child; Child, Preschool; Female; Glaucoma; Humans; Intraocular Pressure; Male; Retrospective Studies; Trabeculectomy; Uveitis, Anterior; Visual Acuity
PubMed: 27552504
DOI: 10.1097/IJG.0000000000000516 -
BMC Ophthalmology May 2016The aim of this work is to refine understanding of anatomical and functional alterations in eyes with Intermediate Uveitis (IU), their natural history in mild cases not...
BACKGROUND
The aim of this work is to refine understanding of anatomical and functional alterations in eyes with Intermediate Uveitis (IU), their natural history in mild cases not necessitating treatment and their response to treatment in severely affected eyes with macular edema.
METHODS
61 consecutive patients with IU presenting over a 6-year period were prospectively recruited into the study. Two subgroups of patients with IU were identified on the basis of the need or not for systemic cortico-steroid treatment. A group of healthy volunteers was identified for determining normal average central foveal thickness (CFT) values. Statistical comparisons were sought between patient sub-groups and with the group of normal volunteers for CFT and Best Corrected Visual Acuity (BCVA) at baseline and after 6 months. In a post hoc analysis, a cut-off value of CFT for systemic treatment initiation in IU was statistically identified and its sensitivity and specificity determined.
RESULTS
A statistically significant difference in mean CFT at baseline was observed between patients under systemic treatment and untreated patients (p = 0.0005) as well as between untreated patients and healthy volunteers. (p < 0.001) After six months difference in CFT between the two patients subgroups was no longer significant (p = 0.699). BCVA was worse for patients under systemic treatment. No statistically significant difference could be identified between the subgroup of untreated patients and the group of healthy volunteers either at baseline or after 6 months. Correlation between LogMAR visual acuity and central retinal thickness at baseline was strong (r = 0.7436, p < 0.0001, Pearson's correlation coefficient). The cut-off value of CFT for initiating systemic treatment was determined at 215.5 μm in a post hoc analysis (sensitivity 62.5 %, specificity 96.4 %).
CONCLUSIONS
Subclinical retinal thickening of mildly inflamed eyes with IU can occur though bearing no functional clinical significance and spontaneously resolving within 6 months. A cut-off CFT value for treatment of macular edema in IU, in the presence of other relevant morphological features on Optical Coherence Tomography, seems to emerge from post hoc analysis of collected data demonstrating strong specificity and moderate sensitivity.
Topics: Adrenal Cortex Hormones; Adult; Case-Control Studies; Cross-Sectional Studies; Female; Fluorescein Angiography; Fovea Centralis; Humans; Macular Edema; Male; Middle Aged; Prospective Studies; Tomography, Optical Coherence; Uveitis, Intermediate; Visual Acuity; Young Adult
PubMed: 27188332
DOI: 10.1186/s12886-016-0230-4