●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients wi...●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients with newly diagnosed uveitis and scleritis over a 4-year period,from Jan.1,2017 to Dec.31,2020,were analysed.Data was collected at the presentation and included a follow-up period of one year.●RESULTS:A total of 288 patients were recruited during the study period.Anterior uveitis was the most common anatomical diagnosis(50.0%)followed by panuveitis(25.0%),scleritis(13.5%),posterior uveitis(6.9%),and intermediate uveitis(4.5%).Viral Herpes was the most common cause of infectious cases,while Vogt-Koyanagi-Harada(VKH)disease and human leucocyte antigen(HLA)B27 spondyloarthropathy were the leading causes of identifiable non-infectious cases.Majority of patients presented with unilateral,non-granulomatous uveitis with an absence of hypopyon.Anatomical locations like posterior uveitis and panuveitis,and visual acuity worse than 3/60 at presentation were the factors associated with poor visual outcomes(P<0.05).About 60%of patients had an identifiable cause for the uveitis and scleritis,with nearly equal distribution of infectious(n=85,29.5%)and noninfectious causes(n=84,29.2%).About 14.5%of patients were clinically blind at 1y of follow-up.The most common complication in our uveitis patients was glaucoma(47.5%),followed by cystoid macula oedema(18.9%)and cataract(13.9%).●CONCLUSION:Uveitis and scleritis are important causes of ocular morbidity.They are potentially blinding diseases which can have a good outcome if diagnosed and treated early.展开更多
One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing prom...One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.展开更多
AIM:To report the clinical characteristics,treatment and outcomes of active syphilitic uveitis in human immunodeficiency virus(HIV)positive patients and compare them with the previously published data.METHODS:Retrospe...AIM:To report the clinical characteristics,treatment and outcomes of active syphilitic uveitis in human immunodeficiency virus(HIV)positive patients and compare them with the previously published data.METHODS:Retrospective analysis of the case series from an infectious disease center in southern China was conducted.Comprehensive review of previously published cases of HIV positive syphilitic uveitis was conducted using the PubMed and Web of Science databases and the references listed in the identified articles.RESULTS:Twelve HIV positive patients with active syphilitic uveitis were collected.All were male,with age of 36.3y(range 27 to 53y).Five(41.7%)had a history of syphilis,and three of them had received anti-syphilis treatment.Ocular manifestations included corneal epithelial defect(13%),complicated cataract(17.4%),vitreous opacity(82.6%),optic disc edema(26.1%),macular edema(30.4%),neuro-retinitis(43.5%),and retinal hemorrhage(26.1%).After standardized syphilitic treatment,intraocular inflammation was reduced and vision improved in all cases.The literature review summarizes 105 previously reported cases of HIV positive syphilitic uveitis.High serum rapid plasma regain(RPR)titers may be associated with severe uveitis and poor vision.Treatment with penicillin,ceftriaxone sodium,or penicillin plus benzylpenicillin instead of using benzylpenicillin alone can significantly improve bestcorrected visual acuity(BCVA)in HIV positive ocular syphilis patients.CONCLUSION:For HIV positive syphilitic uveitis patients,prompt diagnosis and appropriate treatment and follow-up are paramount.In our series,the clinical manifestations are diverse.Syphilis patients treated by penicillin G or long-acting penicillin before may still develop syphilitic uveitis.Patients who relapse after long-term penicillin treatment can still benefit from penicillin G.展开更多
AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time t...AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020.Detailed information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our centre.Compliance with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and symptoms.RESULTS:The mean age of the study group was 35.35±14.1y and gender composition was 59.7%males and 40.3%females.Anterior uveitis was observed in 45.3%of patients,intermediate uveitis in 31.8%of patients,posterior uveitis in 14.9%of patients and panuveitis in 8.0%of patients.Association with a systemic disease was evident in 17.9%of patients.When compared with standard guidelines and uveitis patterns,systemic investigations were identified to be relevant only in 38.3%of patients.Non-compliance to treatment was documented in 22.4%of patients.Common reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7%of patients and a busy schedule at work/school in 22.2%of patients.CONCLUSION:Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the care.About a quarter of patients in this study are found to be non-compliant with the treatment.Compliance is more challenging to achieve in school-going children and working adults.The availability of comprehensive,periodically updated,evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment,respectively,in patients with uveitis.展开更多
BACKGROUND Tuberculous uveitis caused by tuberculosis infection factors is common,but tuberculous uveitis caused by Mycobacterium tuberculosis found in the intraocular fluid is rare.This report describes the use of in...BACKGROUND Tuberculous uveitis caused by tuberculosis infection factors is common,but tuberculous uveitis caused by Mycobacterium tuberculosis found in the intraocular fluid is rare.This report describes the use of intraocular fluid in the diagnosis of tuberculous uveitis in a patient and reviews the relevant literature.CASE SUMMARY A 24-year-old woman who was 31-wk pregnant visited Hebei Chest Hospital due to intermittent chest pain,fever,and decreased vision for 3 mo.The hydrothorax test suggested“tuberculous pleurisy”,and yellow effusion was extracted from the chest tube twice resulting in a total volume of approximately 800 mL.The patient chose to continue the pregnancy without treatment,and was hospitalized again due to high fever.Following 2 mo of anti-tuberculosis treatment,a healthy boy was delivered by cesarean section.Tuberculous uveitis was diagnosed using tuberculosis Xpert,and intraocular infection was detected by second-generation gene sequencing.Following systemic treatment,the patient gradually improved,and the corrected visual acuity of the left eye gradually increased from 0.08 to 1.0.CONCLUSION The etiology of uveitis is complex,and it is necessary to assess the patient’s general condition and apply molecular biology methods to determine the pathogenesis and guide precise treatment,to improve clinicians’awareness and standardize treatment of the disease.展开更多
AIM:To describe the clinical characteristics and surgical outcomes of complicated cataract with pediatric trematodal granulomatous uveitis(TGU).METHODS:Patients of cataract with TGU in the membranous(inactive) stage u...AIM:To describe the clinical characteristics and surgical outcomes of complicated cataract with pediatric trematodal granulomatous uveitis(TGU).METHODS:Patients of cataract with TGU in the membranous(inactive) stage underwent cataract surgery with intraocular lens(IOL) implantation.Preoperative history and ophthalmic examination were conducted for all cases,whereas Schimphlug imaging and corneal topography were done for some patients.Postoperative follow up was done on the 1st,2nd,and 5th postoperative days after surgery.Then,it was done at least at one,three,and six months postoperatively.Intraoperative and postoperative complications and the methods of their management were reported.RESULTS:Twelve eyes of 12 male children were included in this study ranging from 8 to 16y.The mean best corrected Snellen visual acuity(BCVA) was significantly improved from 0.09±0.06 preoperatively to 0.37±0.11 at the final visit 6mo postoperatively(P<0.001).Schimphlug imaging and corneal topography showed flattening of the anterior surface of the inferior cornea.Intraoperative difficulties and complications included the poor dilatability of the drown down pupil,strong posterior synechia between the anterior lens capsule and the iris at the site of the inferior retrocorneal vascularized membrane and hyphema.All cases underwent primary hydrophobic IOL implantation.CONCLUSION:Surgery for this type of cataract is relatively safe and effective.It is associated with some specific difficulties and complications that should be considered during surgery and follow up.展开更多
Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary ...Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary body. The objective of the study was to identify the epidemiological and etiological determinants of non-traumatic anterior uveitis at the Campus Teaching Hospital of Lomé. Materials and methods: Retrospective cross-sectional study of the records of patients diagnosed with anterior uveitis (AU) without a notion of trauma in the ophthalmology department of CHU Campus of Lomé from January 1, 2010 to December 31, 2019 (10 years). Results: 141 cases of uveitis, representing a prevalence of 0.18%. Female predominance, with a sex ratio of 0.76. Mean age was 34.74 ± 13.20 years. Decreased visual acuity was the primary complaint (34.40%), followed by ocular pain (28%). Non-traumatic anterior uveitis was unilateral in 87.2% of cases. Retro-corneal precipitates were present in all patients. 61.60% of patients had Tyndall in the anterior chamber. The etiology of non-traumatic AU was undetermined in 76.80% of cases. Toxoplasmosis, tuberculosis and syphilis were the main etiologies found. Conclusion: Non-traumatic anterior uveitis is relatively rare but serious, often affecting young subjects. It is a pathology that engages eye health professionals, not only because of the difficulties involved in diagnosing the etiology, but also because of its progression which sometimes leads to blindness.展开更多
Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary ...Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary body. The objective of the study was to identify the epidemiological and etiological determinants of non-traumatic anterior uveitis at the Campus Teaching Hospital of Lomé. Materials and methods: Retrospective cross-sectional study of the records of patients diagnosed with anterior uveitis (AU) without a notion of trauma in the ophthalmology department of CHU Campus of Lomé from January 1, 2010 to December 31, 2019 (10 years). Results: 141 cases of uveitis, representing a prevalence of 0.18%. Female predominance, with a sex ratio of 0.76. Mean age was 34.74 ± 13.20 years. Decreased visual acuity was the primary complaint (34.40%), followed by ocular pain (28%). Non-traumatic anterior uveitis was unilateral in 87.2% of cases. Retro-corneal precipitates were present in all patients. 61.60% of patients had Tyndall in the anterior chamber. The etiology of non-traumatic AU was undetermined in 76.80% of cases. Toxoplasmosis, tuberculosis and syphilis were the main etiologies found. Conclusion: Non-traumatic anterior uveitis is relatively rare but serious, often affecting young subjects. It is a pathology that engages eye health professionals, not only because of the difficulties involved in diagnosing the etiology, but also because of its progression which sometimes leads to blindness.展开更多
Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease of childhood,and juvenile idiopathic associated uveitis(JIA-U)is the most frequently noted extra-articular manifestation.JIA-U can present asympto...Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease of childhood,and juvenile idiopathic associated uveitis(JIA-U)is the most frequently noted extra-articular manifestation.JIA-U can present asymptomatically and lead to ocular complications,so regular screening and monitoring are needed to prevent potentially sight-threatening sequelae.Topical glucocorticoids such as prednisolone acetate are usually the first line of treatment for anterior uveitis associated with JIA-U,but long-term use may be associated with cataract,ocular hypertension and glaucoma.Disease modifying anti-rheumatic drugs(DMARDs)such as methotrexate allow tapering of the corticosteroids to prevent long-term complications.Biologic therapies have been increasingly used as targeted therapies for JIA-U,particularly monoclonal antibodies targeting the proinflammatory cytokine TNF-αsuch as adalimumab and infliximab.One recent,multicenter,prospective,randomized clinical trial provided evidence of the efficacy of adalimumab with methotrexate for JIA-U compared to methotrexate alone.Another clinical trial studying the interleukin-6 inhibitor tocilizumab for JIA-U showed promise in tapering topical corticosteroids.Additionally,JAK inhibitors are emerging biologic therapies for JIA-U in patients refractory to TNF-αinhibitors,with a clinical trial assessing the efficacy of baricitinib for JIA-U underway.While clinical trials on these novel biologics are limited,further investigation of these agents may provide additional therapeutic options for JIA-U.展开更多
AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. · METHODS: Two hundred and three patients with uveitis as...AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. · METHODS: Two hundred and three patients with uveitis associated with AS followed-up in the Third Military Medical University Daping Hospital between 2005 and 2010 were retrospectively evaluated in this study. Complete ophthalmological examinations were evaluated at baseline and during the follow-up period. The gender, age, follow-up time, mean frequency of uveitis onset, and accompanying eye examination findings, history, demographical parameters were reviewed. All the patients presented complete clinical and radiologic (sacroiliac, lumbar, dorsal and cervical spine, knee, ankle, shoulder, hip, elbow) evaluation. HLA-B27 typing was also searched. · RESULTS: There were 203 patients diagnosed with AS associated uveitis. All showed sacroiliac X-ray changes indicative of AS. There were 184 male and 19 female patients. The average age of patients was 35±12 (range 18-50). Mean follow-up period was 2.4 years (1-5 years). Acute anterior uveitis was the most common type of uveitis in both genders. 121 eyes presented unilateral involvement (55.2%), and 92 eyes presented bilateral involvement (45.3%) with onset alternately. 22 eyes occurred hypopyon, 16 eyes were found anterior vitreous cells, 7 eyes were noted reactive macular edema or exudation, 29 eyes presented posterior synechiae of iris, and 14 eyes presented cataract, 9 eyes presented secondary glaucoma, 2 eyes presented bend corneal degeneration and 1 eyes presented atrophy of eyeball. At the final visit, uveitis was well controlled in most patients. · CONCLUSION: AS associated with uveitis in Chinese patients mainly manifests as acute anterior uveitis. A combination of corticosteroids with other mydriasis agents is effective for most AS associated with uveitis patients. In general, the prognosis is good in these cases.展开更多
Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveiti...Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveitis. Although systemic corticosteroids have been the gold standard of immunosuppressive treatment for uveitis since first introduced in 1950 s,its side effects of long-term use often warrant an adjuvant treatment to reduce the dosage/duration of corticosteroids needed to maintain disease control. Conventional immunosuppressive drugs,classified into alkylating agent,antimetabolites and T cell inhibitors,have been widely used as corticosteroid-sparing agents,each with characteristic safety/tolerance profiles on different uveitis entities. Recently,biologic agents,which target specific molecules in immunopathogenesis of uveitis,have gained great interest as alternative treatments for refractory uveitis based on their favorable safety and effectiveness in a variety of uveitis entities. However,lack of large randomized controlled clinical trials,concerns about efficacy and safety of long-term usage,and economic burden are limiting the use of biologics in non-infectious uveitis. Local administration of immunosuppressive drugs(from corticosteroids to biologics) through intraocular drug delivery systems represent another direction for drug development and is now under intense investigation,but more evidences are needed to support their use as regular alternative treatments for uveitis. With the numerous choices belonging to different treatment modalities(conventional immunosuppressive agents,biologics and local drug delivery systems) on hand,the practice patterns have been reported to vary greatly from center to center. Factors influence uveitis specialists' choices of immunosuppressive agents may be complex and may include personal familiarity,treatment availability,safety/tolerability,effectiveness,patient compliance,cost concerns and suggestions from related specialists such as rheumatologists and pediatricians. The focus of this review is to provide an overview of each treatment modality on safety/tolerability and effectiveness,which are believed to be the two most important factors affecting treatment decision making.展开更多
AIM:To test the therapeutic effects of delayed treatment of mesenchymal stem cells(MSCs) in recurrent experimental autoimmune uveitis(r EAU).METHODS: The efficacy of different regimens of MSC administration in r EAU w...AIM:To test the therapeutic effects of delayed treatment of mesenchymal stem cells(MSCs) in recurrent experimental autoimmune uveitis(r EAU).METHODS: The efficacy of different regimens of MSC administration in r EAU were tested by evaluation of clinical and pathological intraocular inflammation,as well as retinal structural and functional integrity using optical coherence tomography(OCT) and electroretinogram(ERG).The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein(GFAP)and rhodopsin(RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function.Moreover,double therapies with longer interval led to an even better clinical evaluation,as well as a trend of decrease in relapse and amelioration of retinal function.MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina.CONCLUSION: MSC administration can effectively treat developed diseases of rEAU,and multiple therapies can provide additional therapeutic benefits.展开更多
Dear Editor,I am Dr.Daniel Russell Richardson from the West Virginia University Eye Institute in Morgantown,West Virginia,United States.I write to present a case of uveitis associated with nivolumab,which is a promisi...Dear Editor,I am Dr.Daniel Russell Richardson from the West Virginia University Eye Institute in Morgantown,West Virginia,United States.I write to present a case of uveitis associated with nivolumab,which is a promising new immune checkpoint inhibitor(ICI)for metastatic melanoma and non-small cell lung carcinoma with expanding indications.As the use of nivolumab continues to increase,ophthalmologists must be aware of uveitis as an adverse event.Modulating展开更多
AIM: To conduct a systematic review and Meta-analysis to examine the association between uveitis and psoriatic disease, and to evaluate whether one condition predisposes individuals to the other. METHODS: We performed...AIM: To conduct a systematic review and Meta-analysis to examine the association between uveitis and psoriatic disease, and to evaluate whether one condition predisposes individuals to the other. METHODS: We performed a comprehensive search of Pub Med and EMBASE to identify cohort studies examining the association between uveitis and psoriatic disease [psoriasis and/or psoriatic arthritis(Ps A)]. We used a random-effects model to calculate the pooled relative risks(RRs) adjusted for confounders, along with the 95% confidence intervals(CIs). RESULTS: This Meta-analysis included a total of 6 studies and a maximum of 80 178 648 participants. Compared with non-psoriatic controls, uveitis risk was significantly elevated in patients with psoriasis(RR=1.49;95%CI: 1.08-2.07), and Ps A(RR=3.16;95%CI: 2.16-4.63). Furthermore, pre-existing uveitis was associated with a significantly increased risk of psoriasis(RR=1.62;95%CI: 1.44-1.83), and Ps A(RR=4.44;95%CI: 3.52-5.60).CONCLUSION: The results of this systematic review and Meta-analysis suggest an overall positive bidirectional association between uveitis and psoriatic disease(psoriasis and Ps A), warranting increased awareness among clinicians involved in the management of these two conditions.Therefore, there remains a need for more detailed studies of the possible common pathogenesis of psoriatic disease and uveitis.展开更多
AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retro...AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retrospective study conducted for refractory pan-uveitis patients who underwent cataract surgery combined with intravitreal Ozurdex implantation.The main outcome measurements were bestcorrected visual acuity(BCVA),central retinal thickness(CRT),grade of anterior chamber cell(AAC),intraocular pressure(IOP),and systemic/ocular adverse events.RESULTS:Ten eyes of 7 patients were included.BCVA showed significant improvement at 1 mo(P=0.004),3 mo(P=0.0004),and 6 mo(P=0.001)post operation.There were no statistically significant differences in the postoperative CRT among follow-up groups(P>0.05).No significant differences were observed in the baseline IOP when compared to 1,3,and 6 mo(all P>0.05)post operation.One patient developed a transient elevated IOP post injection.Two eyes(20%)developed posterior capsular opacifications and underwent neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy.In six patients(8 eyes,71.4%),the systemic steroid usage was reduced to below 10 mg/d.The patients experienced a mean of 1.4±0.52 recurrences of inflammation in the 6 mo before operation and 0.7±0.48 in the 6 mon post operation.The mean recurrence time was 13±0.58 wk(range 12-14 wk)post operation.In five of seven patients(7 out of 10 eyes),inflammation relapse was developed postoperatively.Only one patient(2 eyes)needed increased amounts of oral corticosteroids.Intraocular inflammation recurrence in the remaining patients was controlled by topical steroids.CONCLUSION:Ozurdex is considered a safe and effective approach to control postoperative inflammation in cataract surgery for patients with refractory uveitis in our study.After the disappearance of Ozurdex’s antiinflammatory effects over time,in most cases the recurrent inflammation can be controlled by topical steroids.展开更多
· AIM: To evaluate the safety and efficacy of dexamethasone implant in patients with non-infectious posterior uveitis with cystoid macular edema(CME).·METHODS: Retrospective analysis of patients reports with...· AIM: To evaluate the safety and efficacy of dexamethasone implant in patients with non-infectious posterior uveitis with cystoid macular edema(CME).·METHODS: Retrospective analysis of patients reports with CME secondary to non-infectious uveitis treated with dexamethasone implant. Data included type of posterior uveitis, any systemic immunosuppressive therapy, Early Treatment Diabetic Retinopathy Study(ETDRS) best-corrected visual acuity(BCVA), central macular thickness(CMT) on optical coherence tomography(OCT) and signs of intraocular inflammation at baseline and then at 2wk postoperatively and monthly thereafter. Follow-up is up to 10 mo. Any per-operative and post-operative complications were recorded.·RESULTS: Six eyes of 4 patients with CME due to non-infectious posterior uveitis treated with dexamethasone implant. Diagnosis included idiopathic panuveitis, birdshot chorioretinopathy and idiopathic intermediate uveitis. At baseline mean ETDRS BCVA was63 letters and mean CMT 556 μm at 2wk postoperatively mean ETDRS BCVA improved to 70 letters and mean CMT decreased to 329 μm. All eyes showed clinical evidence of decreased inflammation. The duration of effect of the implant was 5 to 6mo and retreatment was required in 2 eyes. Two patients required antiglaucoma therapy for increased intraocular pressures.·CONCLUSION: In patients with non-infectious posterior uveitis dexamethasone implant can be a short-term effective treatment option for controlling intraocular inflammation.展开更多
AIM: To describe and compare corneal sensation and morphological changes of sub-basal corneal nerves by in vivo laser scanning confocal microscopy(LSCM) in herpes simplex virus(HSV) keratitis/uveitis and contralateral...AIM: To describe and compare corneal sensation and morphological changes of sub-basal corneal nerves by in vivo laser scanning confocal microscopy(LSCM) in herpes simplex virus(HSV) keratitis/uveitis and contralateral, clinically unaffected eyes. METHODS: A prospective clinical study included 30 HSV eyes and 30 contralateral eyes of 30 patients, diagnosed with unilateral HSV keratitis/uveitis. Both eyes underwent a complete ophthalmological examination, Cochet-Bonnet aesthesiometry and LSCM of the central cornea, using the Heidelberg Retina Tomograph III Rostock Cornea Module. After 6 mo, the same examination of the HSV affected and contralateral, clinically unaffected eyes was performed.RESULTS: HSV eyes, as compared to contralateral eyes, demonstrated a significant decrease in mean corneal sensation(3.1±1.6 vs 5.3±0.8 cm), total nerve fibres number(5.7±4.4 vs 15.1±5.4), nerve branches(3.4±3.0 vs 8.4±4.7), main nerve trunks(2.3±1.6 vs 5.8±2.2), and nerve fibres density(7.5±5.6 vs 18.1±5.3 mm/mm2, P<0.05). There was no significant difference between keratitis and uveitis eyes in mean corneal sensation and nerve fibres parameters. After 6 mo, corneal sensation and sub-basal nerve fibres parameters were increased significantly, but did not reach the parameters of contralateral, clinically unaffected eyes.CONCLUSION: Corneal aesthesiometry and LSCM in HSV affected eyes reveals a significant decrease of corneal sensation and sub-basal nerve fibres which recovers at6 mo but does not reach the normal level.展开更多
AIM: To investigate the characteristics of uveitis in a secondary hospital in southern China.METHODS: We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December2011. Demographic ...AIM: To investigate the characteristics of uveitis in a secondary hospital in southern China.METHODS: We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December2011. Demographic data, past history, ophthalmic examinations and other laboratory tests were analyzed.RESULTS: One hundred and ninety-nine uveitis patients were enrolled in this study, including 134(67.3%) males and 65 females(32.7%) with an average age of 41.0 ±15.1y. The anatomical distribution included103(51.8%) cases of anterior uveitis, followed by panuveitis(65, 32.7%), posterior uveitis(29, 14.6%) and intermediate uveitis(2, 1.0%). Of the 98(49.2%) non-idiopathic cases, there were 10.1% Behcet's disease,9.5% Vogt-Koyanagi-Harada(VKH) syndrome, 7.5%infectious uveitis, 7.5% traumatic uveitis and 3.5%postoperative uveitis.CONCLUSION: Idiopathic anterior and posterior uveitis,Behcet's disease, VKH syndrome, infectious uveitis and traumatic uveitis are the most common uveitis entities in a secondary hospital in southern China. Additional measures should be taken to prevent infectious and traumatic uveitis.展开更多
AIM:To quantitatively evaluate the risk of anxiety and depression in patients with uveitis via performing a Metaanalysis.METHODS:Three electronic database(Pub Med,Embase,and Cochrane Library databases)were searched fo...AIM:To quantitatively evaluate the risk of anxiety and depression in patients with uveitis via performing a Metaanalysis.METHODS:Three electronic database(Pub Med,Embase,and Cochrane Library databases)were searched for studies recording data about uveitis and anxiety as well as depression simultaneously up to January 2021.The incidence rate and standard mean difference(SMD)with a 95%confidence interval(95%CI)were calculated to analyse the association using random-effects models based on heterogeneity tests.RESULTS:In total,12 observational studies containing 874 patients with uveitis were included.The results showed that there was a significant association between uveitis and anxiety(SMD=0.97,95%CI:0.39 to 1.54,P=0.0009)and depression(SMD=0.79,95%CI:0.51 to 1.07,P<0.00001).The overall morbidities of anxiety and depression in patients with uveitis were 39%and 17%,respectively.With subgroup analysis,the heterogeneity actually came from different kinds of uveitis.Specifically,the incidence rates of both anxiety and depression were relatively low in patients with anterior uveitis(33%and 15%),moderate in patients with infectious uveitis(46%and 22%),and high in patients with unspecified uveitis(59%and 35%).CONCLUSION:It is preliminarily indicated that patients with uveitis may have a high risk of anxiety and depression.Ophthalmologists and psychologists should pay more attention to the psychological state when dealing with patients with uveitis.Further high-quality studies with detailed direct data are needed to draw more precise conclusions.展开更多
Dear Editor,Cytomegalovirus(CMV) uveitis is typically characterized by anterior segment inflammation with coin-shaped or linear keratic precipitates(KPs), mild cells and aqueous flare in the aqueous humor, corneal end...Dear Editor,Cytomegalovirus(CMV) uveitis is typically characterized by anterior segment inflammation with coin-shaped or linear keratic precipitates(KPs), mild cells and aqueous flare in the aqueous humor, corneal endothelial cell loss。展开更多
文摘●AIM:To determine the common causes and visual outcome after treatment among uveitis and scleritis patients.●METHODS:This is a retrospective cohort observational study.All consecutive clinical records of patients with newly diagnosed uveitis and scleritis over a 4-year period,from Jan.1,2017 to Dec.31,2020,were analysed.Data was collected at the presentation and included a follow-up period of one year.●RESULTS:A total of 288 patients were recruited during the study period.Anterior uveitis was the most common anatomical diagnosis(50.0%)followed by panuveitis(25.0%),scleritis(13.5%),posterior uveitis(6.9%),and intermediate uveitis(4.5%).Viral Herpes was the most common cause of infectious cases,while Vogt-Koyanagi-Harada(VKH)disease and human leucocyte antigen(HLA)B27 spondyloarthropathy were the leading causes of identifiable non-infectious cases.Majority of patients presented with unilateral,non-granulomatous uveitis with an absence of hypopyon.Anatomical locations like posterior uveitis and panuveitis,and visual acuity worse than 3/60 at presentation were the factors associated with poor visual outcomes(P<0.05).About 60%of patients had an identifiable cause for the uveitis and scleritis,with nearly equal distribution of infectious(n=85,29.5%)and noninfectious causes(n=84,29.2%).About 14.5%of patients were clinically blind at 1y of follow-up.The most common complication in our uveitis patients was glaucoma(47.5%),followed by cystoid macula oedema(18.9%)and cataract(13.9%).●CONCLUSION:Uveitis and scleritis are important causes of ocular morbidity.They are potentially blinding diseases which can have a good outcome if diagnosed and treated early.
文摘One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.
基金Supported by the“Zhujiang Talent Program”High Talent Project of Guangdong Province(No.2019QN01Y162)the Natural Science Foundation of Guangdong Province(No.2020A1515010072,No.2023A1515010167)。
文摘AIM:To report the clinical characteristics,treatment and outcomes of active syphilitic uveitis in human immunodeficiency virus(HIV)positive patients and compare them with the previously published data.METHODS:Retrospective analysis of the case series from an infectious disease center in southern China was conducted.Comprehensive review of previously published cases of HIV positive syphilitic uveitis was conducted using the PubMed and Web of Science databases and the references listed in the identified articles.RESULTS:Twelve HIV positive patients with active syphilitic uveitis were collected.All were male,with age of 36.3y(range 27 to 53y).Five(41.7%)had a history of syphilis,and three of them had received anti-syphilis treatment.Ocular manifestations included corneal epithelial defect(13%),complicated cataract(17.4%),vitreous opacity(82.6%),optic disc edema(26.1%),macular edema(30.4%),neuro-retinitis(43.5%),and retinal hemorrhage(26.1%).After standardized syphilitic treatment,intraocular inflammation was reduced and vision improved in all cases.The literature review summarizes 105 previously reported cases of HIV positive syphilitic uveitis.High serum rapid plasma regain(RPR)titers may be associated with severe uveitis and poor vision.Treatment with penicillin,ceftriaxone sodium,or penicillin plus benzylpenicillin instead of using benzylpenicillin alone can significantly improve bestcorrected visual acuity(BCVA)in HIV positive ocular syphilis patients.CONCLUSION:For HIV positive syphilitic uveitis patients,prompt diagnosis and appropriate treatment and follow-up are paramount.In our series,the clinical manifestations are diverse.Syphilis patients treated by penicillin G or long-acting penicillin before may still develop syphilitic uveitis.Patients who relapse after long-term penicillin treatment can still benefit from penicillin G.
文摘AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020.Detailed information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our centre.Compliance with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and symptoms.RESULTS:The mean age of the study group was 35.35±14.1y and gender composition was 59.7%males and 40.3%females.Anterior uveitis was observed in 45.3%of patients,intermediate uveitis in 31.8%of patients,posterior uveitis in 14.9%of patients and panuveitis in 8.0%of patients.Association with a systemic disease was evident in 17.9%of patients.When compared with standard guidelines and uveitis patterns,systemic investigations were identified to be relevant only in 38.3%of patients.Non-compliance to treatment was documented in 22.4%of patients.Common reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7%of patients and a busy schedule at work/school in 22.2%of patients.CONCLUSION:Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the care.About a quarter of patients in this study are found to be non-compliant with the treatment.Compliance is more challenging to achieve in school-going children and working adults.The availability of comprehensive,periodically updated,evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment,respectively,in patients with uveitis.
基金Supported by the Medical Science Research Project of Hebei Province,No.20191029。
文摘BACKGROUND Tuberculous uveitis caused by tuberculosis infection factors is common,but tuberculous uveitis caused by Mycobacterium tuberculosis found in the intraocular fluid is rare.This report describes the use of intraocular fluid in the diagnosis of tuberculous uveitis in a patient and reviews the relevant literature.CASE SUMMARY A 24-year-old woman who was 31-wk pregnant visited Hebei Chest Hospital due to intermittent chest pain,fever,and decreased vision for 3 mo.The hydrothorax test suggested“tuberculous pleurisy”,and yellow effusion was extracted from the chest tube twice resulting in a total volume of approximately 800 mL.The patient chose to continue the pregnancy without treatment,and was hospitalized again due to high fever.Following 2 mo of anti-tuberculosis treatment,a healthy boy was delivered by cesarean section.Tuberculous uveitis was diagnosed using tuberculosis Xpert,and intraocular infection was detected by second-generation gene sequencing.Following systemic treatment,the patient gradually improved,and the corrected visual acuity of the left eye gradually increased from 0.08 to 1.0.CONCLUSION The etiology of uveitis is complex,and it is necessary to assess the patient’s general condition and apply molecular biology methods to determine the pathogenesis and guide precise treatment,to improve clinicians’awareness and standardize treatment of the disease.
文摘AIM:To describe the clinical characteristics and surgical outcomes of complicated cataract with pediatric trematodal granulomatous uveitis(TGU).METHODS:Patients of cataract with TGU in the membranous(inactive) stage underwent cataract surgery with intraocular lens(IOL) implantation.Preoperative history and ophthalmic examination were conducted for all cases,whereas Schimphlug imaging and corneal topography were done for some patients.Postoperative follow up was done on the 1st,2nd,and 5th postoperative days after surgery.Then,it was done at least at one,three,and six months postoperatively.Intraoperative and postoperative complications and the methods of their management were reported.RESULTS:Twelve eyes of 12 male children were included in this study ranging from 8 to 16y.The mean best corrected Snellen visual acuity(BCVA) was significantly improved from 0.09±0.06 preoperatively to 0.37±0.11 at the final visit 6mo postoperatively(P<0.001).Schimphlug imaging and corneal topography showed flattening of the anterior surface of the inferior cornea.Intraoperative difficulties and complications included the poor dilatability of the drown down pupil,strong posterior synechia between the anterior lens capsule and the iris at the site of the inferior retrocorneal vascularized membrane and hyphema.All cases underwent primary hydrophobic IOL implantation.CONCLUSION:Surgery for this type of cataract is relatively safe and effective.It is associated with some specific difficulties and complications that should be considered during surgery and follow up.
文摘Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary body. The objective of the study was to identify the epidemiological and etiological determinants of non-traumatic anterior uveitis at the Campus Teaching Hospital of Lomé. Materials and methods: Retrospective cross-sectional study of the records of patients diagnosed with anterior uveitis (AU) without a notion of trauma in the ophthalmology department of CHU Campus of Lomé from January 1, 2010 to December 31, 2019 (10 years). Results: 141 cases of uveitis, representing a prevalence of 0.18%. Female predominance, with a sex ratio of 0.76. Mean age was 34.74 ± 13.20 years. Decreased visual acuity was the primary complaint (34.40%), followed by ocular pain (28%). Non-traumatic anterior uveitis was unilateral in 87.2% of cases. Retro-corneal precipitates were present in all patients. 61.60% of patients had Tyndall in the anterior chamber. The etiology of non-traumatic AU was undetermined in 76.80% of cases. Toxoplasmosis, tuberculosis and syphilis were the main etiologies found. Conclusion: Non-traumatic anterior uveitis is relatively rare but serious, often affecting young subjects. It is a pathology that engages eye health professionals, not only because of the difficulties involved in diagnosing the etiology, but also because of its progression which sometimes leads to blindness.
文摘Background: Uveitis is a serious disease which dangerous complications can jeopardize the visual prognosis. Anterior uveitis (AU) is the inflammation of the anterior uvea which is composed of the iris and the ciliary body. The objective of the study was to identify the epidemiological and etiological determinants of non-traumatic anterior uveitis at the Campus Teaching Hospital of Lomé. Materials and methods: Retrospective cross-sectional study of the records of patients diagnosed with anterior uveitis (AU) without a notion of trauma in the ophthalmology department of CHU Campus of Lomé from January 1, 2010 to December 31, 2019 (10 years). Results: 141 cases of uveitis, representing a prevalence of 0.18%. Female predominance, with a sex ratio of 0.76. Mean age was 34.74 ± 13.20 years. Decreased visual acuity was the primary complaint (34.40%), followed by ocular pain (28%). Non-traumatic anterior uveitis was unilateral in 87.2% of cases. Retro-corneal precipitates were present in all patients. 61.60% of patients had Tyndall in the anterior chamber. The etiology of non-traumatic AU was undetermined in 76.80% of cases. Toxoplasmosis, tuberculosis and syphilis were the main etiologies found. Conclusion: Non-traumatic anterior uveitis is relatively rare but serious, often affecting young subjects. It is a pathology that engages eye health professionals, not only because of the difficulties involved in diagnosing the etiology, but also because of its progression which sometimes leads to blindness.
基金This project was supported by unrestricted departmental grant from Research to Prevent Blindness,Inc.to the Emory Eye Center,Emory University School of Medicine,National Eye Institute/National Institutes of Health core grant P30-EY06360(Department of Ophthalmology,Emory University School of Medicine)National Eye Institute of the National Institutes of Health under award number K23 EY030158(Shantha),R01EY030521(STAH),and R01 EY029594(SY)The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the views or policies of the Department of Health and Human Services,nor does mention of trade names,commercial products,or organizations imply endorsement by the U.S.Government.
文摘Juvenile idiopathic arthritis(JIA)is the most common rheumatic disease of childhood,and juvenile idiopathic associated uveitis(JIA-U)is the most frequently noted extra-articular manifestation.JIA-U can present asymptomatically and lead to ocular complications,so regular screening and monitoring are needed to prevent potentially sight-threatening sequelae.Topical glucocorticoids such as prednisolone acetate are usually the first line of treatment for anterior uveitis associated with JIA-U,but long-term use may be associated with cataract,ocular hypertension and glaucoma.Disease modifying anti-rheumatic drugs(DMARDs)such as methotrexate allow tapering of the corticosteroids to prevent long-term complications.Biologic therapies have been increasingly used as targeted therapies for JIA-U,particularly monoclonal antibodies targeting the proinflammatory cytokine TNF-αsuch as adalimumab and infliximab.One recent,multicenter,prospective,randomized clinical trial provided evidence of the efficacy of adalimumab with methotrexate for JIA-U compared to methotrexate alone.Another clinical trial studying the interleukin-6 inhibitor tocilizumab for JIA-U showed promise in tapering topical corticosteroids.Additionally,JAK inhibitors are emerging biologic therapies for JIA-U in patients refractory to TNF-αinhibitors,with a clinical trial assessing the efficacy of baricitinib for JIA-U underway.While clinical trials on these novel biologics are limited,further investigation of these agents may provide additional therapeutic options for JIA-U.
基金Supported by National Natural Science Foundation of China (No. 30400487)International Cooperation Project of Guangdong Province, China (No. 2004B50301002)"1135" Talent Doctor Foundation of Daping Hospital, China(2008-2012)
文摘AIM: To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. · METHODS: Two hundred and three patients with uveitis associated with AS followed-up in the Third Military Medical University Daping Hospital between 2005 and 2010 were retrospectively evaluated in this study. Complete ophthalmological examinations were evaluated at baseline and during the follow-up period. The gender, age, follow-up time, mean frequency of uveitis onset, and accompanying eye examination findings, history, demographical parameters were reviewed. All the patients presented complete clinical and radiologic (sacroiliac, lumbar, dorsal and cervical spine, knee, ankle, shoulder, hip, elbow) evaluation. HLA-B27 typing was also searched. · RESULTS: There were 203 patients diagnosed with AS associated uveitis. All showed sacroiliac X-ray changes indicative of AS. There were 184 male and 19 female patients. The average age of patients was 35±12 (range 18-50). Mean follow-up period was 2.4 years (1-5 years). Acute anterior uveitis was the most common type of uveitis in both genders. 121 eyes presented unilateral involvement (55.2%), and 92 eyes presented bilateral involvement (45.3%) with onset alternately. 22 eyes occurred hypopyon, 16 eyes were found anterior vitreous cells, 7 eyes were noted reactive macular edema or exudation, 29 eyes presented posterior synechiae of iris, and 14 eyes presented cataract, 9 eyes presented secondary glaucoma, 2 eyes presented bend corneal degeneration and 1 eyes presented atrophy of eyeball. At the final visit, uveitis was well controlled in most patients. · CONCLUSION: AS associated with uveitis in Chinese patients mainly manifests as acute anterior uveitis. A combination of corticosteroids with other mydriasis agents is effective for most AS associated with uveitis patients. In general, the prognosis is good in these cases.
文摘Non-infectious uveitis is one of the leading causes of preventable blindness worldwide. Long-term immunosuppressive treatment is generally required to achieve durable control of inflammation in posterior and panuveitis. Although systemic corticosteroids have been the gold standard of immunosuppressive treatment for uveitis since first introduced in 1950 s,its side effects of long-term use often warrant an adjuvant treatment to reduce the dosage/duration of corticosteroids needed to maintain disease control. Conventional immunosuppressive drugs,classified into alkylating agent,antimetabolites and T cell inhibitors,have been widely used as corticosteroid-sparing agents,each with characteristic safety/tolerance profiles on different uveitis entities. Recently,biologic agents,which target specific molecules in immunopathogenesis of uveitis,have gained great interest as alternative treatments for refractory uveitis based on their favorable safety and effectiveness in a variety of uveitis entities. However,lack of large randomized controlled clinical trials,concerns about efficacy and safety of long-term usage,and economic burden are limiting the use of biologics in non-infectious uveitis. Local administration of immunosuppressive drugs(from corticosteroids to biologics) through intraocular drug delivery systems represent another direction for drug development and is now under intense investigation,but more evidences are needed to support their use as regular alternative treatments for uveitis. With the numerous choices belonging to different treatment modalities(conventional immunosuppressive agents,biologics and local drug delivery systems) on hand,the practice patterns have been reported to vary greatly from center to center. Factors influence uveitis specialists' choices of immunosuppressive agents may be complex and may include personal familiarity,treatment availability,safety/tolerability,effectiveness,patient compliance,cost concerns and suggestions from related specialists such as rheumatologists and pediatricians. The focus of this review is to provide an overview of each treatment modality on safety/tolerability and effectiveness,which are believed to be the two most important factors affecting treatment decision making.
基金Supported by the National Natural Science Foundation of China(No.81371005No.81428012)Tianjin Municipal Science and Technology Commission(No.15JCZDJC35600)
文摘AIM:To test the therapeutic effects of delayed treatment of mesenchymal stem cells(MSCs) in recurrent experimental autoimmune uveitis(r EAU).METHODS: The efficacy of different regimens of MSC administration in r EAU were tested by evaluation of clinical and pathological intraocular inflammation,as well as retinal structural and functional integrity using optical coherence tomography(OCT) and electroretinogram(ERG).The retinal sections were also immunostained with antibodies to glial fibrillary acidic protein(GFAP)and rhodopsin(RHO). RESULTS: Delayed treatment of MSCs effectively alleviated the severity of intraocular inflammation with relative intact of outer retinal structure and function.Moreover,double therapies with longer interval led to an even better clinical evaluation,as well as a trend of decrease in relapse and amelioration of retinal function.MSC therapies also effectively reduced GFAP expression and increased RHO expression in the retina.CONCLUSION: MSC administration can effectively treat developed diseases of rEAU,and multiple therapies can provide additional therapeutic benefits.
文摘Dear Editor,I am Dr.Daniel Russell Richardson from the West Virginia University Eye Institute in Morgantown,West Virginia,United States.I write to present a case of uveitis associated with nivolumab,which is a promising new immune checkpoint inhibitor(ICI)for metastatic melanoma and non-small cell lung carcinoma with expanding indications.As the use of nivolumab continues to increase,ophthalmologists must be aware of uveitis as an adverse event.Modulating
基金Supported by the National Natural Science Foundation of China(No.81570847)the Natural Science Foundation of Hunan Province(No.2016JJ4095)the Programs of Science-Technology Commission of Hunan Province(No.2015JC3036)。
文摘AIM: To conduct a systematic review and Meta-analysis to examine the association between uveitis and psoriatic disease, and to evaluate whether one condition predisposes individuals to the other. METHODS: We performed a comprehensive search of Pub Med and EMBASE to identify cohort studies examining the association between uveitis and psoriatic disease [psoriasis and/or psoriatic arthritis(Ps A)]. We used a random-effects model to calculate the pooled relative risks(RRs) adjusted for confounders, along with the 95% confidence intervals(CIs). RESULTS: This Meta-analysis included a total of 6 studies and a maximum of 80 178 648 participants. Compared with non-psoriatic controls, uveitis risk was significantly elevated in patients with psoriasis(RR=1.49;95%CI: 1.08-2.07), and Ps A(RR=3.16;95%CI: 2.16-4.63). Furthermore, pre-existing uveitis was associated with a significantly increased risk of psoriasis(RR=1.62;95%CI: 1.44-1.83), and Ps A(RR=4.44;95%CI: 3.52-5.60).CONCLUSION: The results of this systematic review and Meta-analysis suggest an overall positive bidirectional association between uveitis and psoriatic disease(psoriasis and Ps A), warranting increased awareness among clinicians involved in the management of these two conditions.Therefore, there remains a need for more detailed studies of the possible common pathogenesis of psoriatic disease and uveitis.
基金Supported by National Natural Science Foundation of China(No.81870651No.81671642)。
文摘AIM:To report the effectiveness of intravitreal implantation of dexamethasone implant(Ozurdex)after phacoemulsification and intraocular lens implantation in refractory uveitis patients.METHODS:This single-center retrospective study conducted for refractory pan-uveitis patients who underwent cataract surgery combined with intravitreal Ozurdex implantation.The main outcome measurements were bestcorrected visual acuity(BCVA),central retinal thickness(CRT),grade of anterior chamber cell(AAC),intraocular pressure(IOP),and systemic/ocular adverse events.RESULTS:Ten eyes of 7 patients were included.BCVA showed significant improvement at 1 mo(P=0.004),3 mo(P=0.0004),and 6 mo(P=0.001)post operation.There were no statistically significant differences in the postoperative CRT among follow-up groups(P>0.05).No significant differences were observed in the baseline IOP when compared to 1,3,and 6 mo(all P>0.05)post operation.One patient developed a transient elevated IOP post injection.Two eyes(20%)developed posterior capsular opacifications and underwent neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy.In six patients(8 eyes,71.4%),the systemic steroid usage was reduced to below 10 mg/d.The patients experienced a mean of 1.4±0.52 recurrences of inflammation in the 6 mo before operation and 0.7±0.48 in the 6 mon post operation.The mean recurrence time was 13±0.58 wk(range 12-14 wk)post operation.In five of seven patients(7 out of 10 eyes),inflammation relapse was developed postoperatively.Only one patient(2 eyes)needed increased amounts of oral corticosteroids.Intraocular inflammation recurrence in the remaining patients was controlled by topical steroids.CONCLUSION:Ozurdex is considered a safe and effective approach to control postoperative inflammation in cataract surgery for patients with refractory uveitis in our study.After the disappearance of Ozurdex’s antiinflammatory effects over time,in most cases the recurrent inflammation can be controlled by topical steroids.
文摘· AIM: To evaluate the safety and efficacy of dexamethasone implant in patients with non-infectious posterior uveitis with cystoid macular edema(CME).·METHODS: Retrospective analysis of patients reports with CME secondary to non-infectious uveitis treated with dexamethasone implant. Data included type of posterior uveitis, any systemic immunosuppressive therapy, Early Treatment Diabetic Retinopathy Study(ETDRS) best-corrected visual acuity(BCVA), central macular thickness(CMT) on optical coherence tomography(OCT) and signs of intraocular inflammation at baseline and then at 2wk postoperatively and monthly thereafter. Follow-up is up to 10 mo. Any per-operative and post-operative complications were recorded.·RESULTS: Six eyes of 4 patients with CME due to non-infectious posterior uveitis treated with dexamethasone implant. Diagnosis included idiopathic panuveitis, birdshot chorioretinopathy and idiopathic intermediate uveitis. At baseline mean ETDRS BCVA was63 letters and mean CMT 556 μm at 2wk postoperatively mean ETDRS BCVA improved to 70 letters and mean CMT decreased to 329 μm. All eyes showed clinical evidence of decreased inflammation. The duration of effect of the implant was 5 to 6mo and retreatment was required in 2 eyes. Two patients required antiglaucoma therapy for increased intraocular pressures.·CONCLUSION: In patients with non-infectious posterior uveitis dexamethasone implant can be a short-term effective treatment option for controlling intraocular inflammation.
文摘AIM: To describe and compare corneal sensation and morphological changes of sub-basal corneal nerves by in vivo laser scanning confocal microscopy(LSCM) in herpes simplex virus(HSV) keratitis/uveitis and contralateral, clinically unaffected eyes. METHODS: A prospective clinical study included 30 HSV eyes and 30 contralateral eyes of 30 patients, diagnosed with unilateral HSV keratitis/uveitis. Both eyes underwent a complete ophthalmological examination, Cochet-Bonnet aesthesiometry and LSCM of the central cornea, using the Heidelberg Retina Tomograph III Rostock Cornea Module. After 6 mo, the same examination of the HSV affected and contralateral, clinically unaffected eyes was performed.RESULTS: HSV eyes, as compared to contralateral eyes, demonstrated a significant decrease in mean corneal sensation(3.1±1.6 vs 5.3±0.8 cm), total nerve fibres number(5.7±4.4 vs 15.1±5.4), nerve branches(3.4±3.0 vs 8.4±4.7), main nerve trunks(2.3±1.6 vs 5.8±2.2), and nerve fibres density(7.5±5.6 vs 18.1±5.3 mm/mm2, P<0.05). There was no significant difference between keratitis and uveitis eyes in mean corneal sensation and nerve fibres parameters. After 6 mo, corneal sensation and sub-basal nerve fibres parameters were increased significantly, but did not reach the parameters of contralateral, clinically unaffected eyes.CONCLUSION: Corneal aesthesiometry and LSCM in HSV affected eyes reveals a significant decrease of corneal sensation and sub-basal nerve fibres which recovers at6 mo but does not reach the normal level.
基金Supported by National Natural Science Foundation of China(No.81470620)Natural Science Foundation Project of Chongqing(No.cstc2013jcyjA 10015)+1 种基金Dongguan Municipal Science and Technology Projects from the Bureau of Science and Technology of Dongguan City(No.20101051500102)Medical Science Fundation Project of Guangdong Health Department(No.A2011719)
文摘AIM: To investigate the characteristics of uveitis in a secondary hospital in southern China.METHODS: We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December2011. Demographic data, past history, ophthalmic examinations and other laboratory tests were analyzed.RESULTS: One hundred and ninety-nine uveitis patients were enrolled in this study, including 134(67.3%) males and 65 females(32.7%) with an average age of 41.0 ±15.1y. The anatomical distribution included103(51.8%) cases of anterior uveitis, followed by panuveitis(65, 32.7%), posterior uveitis(29, 14.6%) and intermediate uveitis(2, 1.0%). Of the 98(49.2%) non-idiopathic cases, there were 10.1% Behcet's disease,9.5% Vogt-Koyanagi-Harada(VKH) syndrome, 7.5%infectious uveitis, 7.5% traumatic uveitis and 3.5%postoperative uveitis.CONCLUSION: Idiopathic anterior and posterior uveitis,Behcet's disease, VKH syndrome, infectious uveitis and traumatic uveitis are the most common uveitis entities in a secondary hospital in southern China. Additional measures should be taken to prevent infectious and traumatic uveitis.
文摘AIM:To quantitatively evaluate the risk of anxiety and depression in patients with uveitis via performing a Metaanalysis.METHODS:Three electronic database(Pub Med,Embase,and Cochrane Library databases)were searched for studies recording data about uveitis and anxiety as well as depression simultaneously up to January 2021.The incidence rate and standard mean difference(SMD)with a 95%confidence interval(95%CI)were calculated to analyse the association using random-effects models based on heterogeneity tests.RESULTS:In total,12 observational studies containing 874 patients with uveitis were included.The results showed that there was a significant association between uveitis and anxiety(SMD=0.97,95%CI:0.39 to 1.54,P=0.0009)and depression(SMD=0.79,95%CI:0.51 to 1.07,P<0.00001).The overall morbidities of anxiety and depression in patients with uveitis were 39%and 17%,respectively.With subgroup analysis,the heterogeneity actually came from different kinds of uveitis.Specifically,the incidence rates of both anxiety and depression were relatively low in patients with anterior uveitis(33%and 15%),moderate in patients with infectious uveitis(46%and 22%),and high in patients with unspecified uveitis(59%and 35%).CONCLUSION:It is preliminarily indicated that patients with uveitis may have a high risk of anxiety and depression.Ophthalmologists and psychologists should pay more attention to the psychological state when dealing with patients with uveitis.Further high-quality studies with detailed direct data are needed to draw more precise conclusions.
文摘Dear Editor,Cytomegalovirus(CMV) uveitis is typically characterized by anterior segment inflammation with coin-shaped or linear keratic precipitates(KPs), mild cells and aqueous flare in the aqueous humor, corneal endothelial cell loss。
