首页 > 最新文献

Ocular Immunology and Inflammation最新文献

英文 中文
Seroreversion in HIV-Associated Bilateral CMV Retinitis: A Challenging Case Report. 艾滋病毒相关性双侧 CMV 视网膜炎的血清转换:具有挑战性的病例报告
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-02-01 Epub Date: 2024-08-09 DOI: 10.1080/09273948.2024.2385606
Radhika Sriram, Padmamalini Mahendradas, Prathiba Hande, Aditya Patil, Ankush Kawali, Sai Bhakti Mishra, Sara Rizvi, Rohit Shetty

Purpose: To report a case of seroreversion in a patient with HIV-associated bilateral CMV retinitis and the challenges associated with detection of this phenomenon in late stages of HIV.

Method: Retrospective single case report.

Results: The clinical picture of the patient on presentation was suggestive of viral retinitis. PCR confirmed a diagnosis of CMV retinitis. Serology for HIV-1 & 2 was negative. A viral load of HIV and CD-4 count confirmed his sero status to be positive for HIV. Improvement in visual acuity and slow resolution of the lesion was noted with both anti-viral for CMV and HIV. A repeat HIV-1 testing was positive with an improvement in CD4 count.

Conclusion: In highly suspicious individual, with a negative serology (post screening test) for HIV, the disease status should be confirmed by testing the individual for HIV viral load and CD4 count.

目的:报告一例 HIV 相关性双侧 CMV 视网膜炎患者的血清转换病例,以及在 HIV 晚期发现这一现象所面临的挑战:方法:回顾性单病例报告:结果:患者发病时的临床表现提示病毒性视网膜炎。PCR确诊为CMV视网膜炎。HIV-1 和 2 血清学检测呈阴性。HIV 病毒载量和 CD-4 细胞计数证实其血清 HIV 阳性。在对 CMV 和 HIV 进行抗病毒治疗后,视力有所改善,病变也慢慢消退。再次进行的 HIV-1 检测呈阳性,CD4 细胞计数也有所改善:结论:对于艾滋病毒血清学(筛查后检测)呈阴性的高度可疑患者,应通过检测艾滋病毒病毒载量和 CD4 细胞计数来确认疾病状态。
{"title":"Seroreversion in HIV-Associated Bilateral CMV Retinitis: A Challenging Case Report.","authors":"Radhika Sriram, Padmamalini Mahendradas, Prathiba Hande, Aditya Patil, Ankush Kawali, Sai Bhakti Mishra, Sara Rizvi, Rohit Shetty","doi":"10.1080/09273948.2024.2385606","DOIUrl":"10.1080/09273948.2024.2385606","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of seroreversion in a patient with HIV-associated bilateral CMV retinitis and the challenges associated with detection of this phenomenon in late stages of HIV.</p><p><strong>Method: </strong>Retrospective single case report.</p><p><strong>Results: </strong>The clinical picture of the patient on presentation was suggestive of viral retinitis. PCR confirmed a diagnosis of CMV retinitis. Serology for HIV-1 & 2 was negative. A viral load of HIV and CD-4 count confirmed his sero status to be positive for HIV. Improvement in visual acuity and slow resolution of the lesion was noted with both anti-viral for CMV and HIV. A repeat HIV-1 testing was positive with an improvement in CD4 count.</p><p><strong>Conclusion: </strong>In highly suspicious individual, with a negative serology (post screening test) for HIV, the disease status should be confirmed by testing the individual for HIV viral load and CD4 count.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"303-307"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Severe Occlusive Retinal Vasculitis in an Immunocompetent Patient with Chronic CMV Anterior Uveitis. 慢性 CMV 前葡萄膜炎免疫功能正常患者的严重闭塞性视网膜血管炎
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-02-01 Epub Date: 2024-08-08 DOI: 10.1080/09273948.2024.2389460
Marko Chi-Wei Tien, Alexander J Kaplan

Purpose: We report a unique case of non-necrotizing occlusive retinal vasculitis presenting two years following chronic hypertensive uveitis.

Methods: Case Report.

Results: A 32-year-old Iraqi woman with a history of Posner-Schlossman Syndrome diagnosed 10 years prior presented with blurred vision and redness in her left eye. Examination demonstrated ocular hypertension, keratic precipitates, and inflammatory cells in the anterior chamber. Quantitative real-time PCR confirmed the presence of cytomegalovirus in the aqueous humor, and dilated posterior segment examination was negative for any signs of intraocular inflammation, retinitis, or vasculitis. Her uveitis workup was otherwise negative, and she was treated with valganciclovir for 6 months. Two years after her initial presentation, she was noted to have a new vitreous hemorrhage in the left eye. Fluorescein angiography demonstrated an occlusive retinal vasculitis with extensive neovascularization without retinitis. Quantitative real-time PCR again demonstrated the presence of cytomegalovirus in the anterior chamber. Her uveitis workup was repeated, which has now returned positive for HLA-B51. She otherwise did not demonstrate any systemic signs of Behcet's Disease. She was restarted on valganciclovir and oral prednisone and referred to rheumatology for consideration of adalimumab initiation. Thus far she has responded very well to treatment.

Conclusion: This case highlights the importance of serial posterior segment examinations and HLA-B51 testing in individuals with cytomegalovirus anterior uveitis.

目的:我们报告了一例在慢性高血压葡萄膜炎两年后出现的非颈部闭塞性视网膜血管炎的独特病例:方法:病例报告:一名 32 岁的伊拉克妇女在 10 年前被诊断出患有波斯纳-施洛斯曼综合征,当时她出现视力模糊和左眼发红。检查显示眼压过高、角膜沉淀物和前房炎症细胞。定量实时聚合酶链式反应(real-time PCR)证实她的眼房中存在巨细胞病毒,后节扩张检查未发现任何眼内炎症、视网膜炎或血管炎的迹象。其他葡萄膜炎检查结果均为阴性,她接受了为期 6 个月的缬更昔洛韦治疗。初次就诊两年后,她发现左眼出现新的玻璃体出血。荧光素血管造影显示她患有闭塞性视网膜血管炎,并伴有广泛的新生血管,但没有视网膜炎。定量实时 PCR 再次证明前房存在巨细胞病毒。她又做了葡萄膜炎检查,结果显示 HLA-B51 呈阳性。除此之外,她没有出现任何白塞氏病的全身症状。她重新开始服用缬更昔洛韦和口服泼尼松,并转到风湿免疫科考虑使用阿达木单抗。到目前为止,她对治疗反应良好:本病例强调了对巨细胞病毒前葡萄膜炎患者进行连续后段检查和HLA-B51检测的重要性。
{"title":"Severe Occlusive Retinal Vasculitis in an Immunocompetent Patient with Chronic CMV Anterior Uveitis.","authors":"Marko Chi-Wei Tien, Alexander J Kaplan","doi":"10.1080/09273948.2024.2389460","DOIUrl":"10.1080/09273948.2024.2389460","url":null,"abstract":"<p><strong>Purpose: </strong>We report a unique case of non-necrotizing occlusive retinal vasculitis presenting two years following chronic hypertensive uveitis.</p><p><strong>Methods: </strong>Case Report.</p><p><strong>Results: </strong>A 32-year-old Iraqi woman with a history of Posner-Schlossman Syndrome diagnosed 10 years prior presented with blurred vision and redness in her left eye. Examination demonstrated ocular hypertension, keratic precipitates, and inflammatory cells in the anterior chamber. Quantitative real-time PCR confirmed the presence of cytomegalovirus in the aqueous humor, and dilated posterior segment examination was negative for any signs of intraocular inflammation, retinitis, or vasculitis. Her uveitis workup was otherwise negative, and she was treated with valganciclovir for 6 months. Two years after her initial presentation, she was noted to have a new vitreous hemorrhage in the left eye. Fluorescein angiography demonstrated an occlusive retinal vasculitis with extensive neovascularization without retinitis. Quantitative real-time PCR again demonstrated the presence of cytomegalovirus in the anterior chamber. Her uveitis workup was repeated, which has now returned positive for HLA-B51. She otherwise did not demonstrate any systemic signs of Behcet's Disease. She was restarted on valganciclovir and oral prednisone and referred to rheumatology for consideration of adalimumab initiation. Thus far she has responded very well to treatment.</p><p><strong>Conclusion: </strong>This case highlights the importance of serial posterior segment examinations and HLA-B51 testing in individuals with cytomegalovirus anterior uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"308-309"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corneal Perforation Associated with Pembrolizumab - A Case Report with Literature Review.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-30 DOI: 10.1080/09273948.2025.2456647
Dharshini Balasubaramaniam, Lim Yi Wen, Nurul Najieha Amir, Sujaya Singh

Purpose: To shed light on one of the ocular adverse effects related to pembrolizumab.

Method: Case report and literature review.

Result: A 53-year-old gentleman with underlying Stage III B renal cell carcinoma with lung metastasis and gout presented in June 2021 with bilateral red eyes following Coronavirus disease (COVID-19) vaccination. He had undergone a nephrectomy for renal cell carcinoma and was on Pembrolizumab therapy for 5 years. Examination showed right eye injected conjunctiva with diffuse punctate epithelial erosions over the cornea, which was treated with topical steroids. The left eye is suspected to have infective keratitis, which is treated with topical antibiotics and subsequently steroids for the ocular surface inflammation. However, he developed a left eye paracentral sterile corneal melt which rapidly progressed to perforation measuring 1 mm in size. The perforation was temporarily sealed with tissue glue, but he eventually required a full thickness corneal patch graft. Patient has been doing well post-operatively for the last 3 years.

Conclusion: The diagnosis and management of irAEs are challenging and necessitate continuously updated diagnostic and monitoring tools. As checkpoint inhibitors become more promising in the management of malignancies, it is crucial for both the oncologist and ophthalmologist to be aware of the potential ocular adverse effects of these drugs.

{"title":"Corneal Perforation Associated with Pembrolizumab - A Case Report with Literature Review.","authors":"Dharshini Balasubaramaniam, Lim Yi Wen, Nurul Najieha Amir, Sujaya Singh","doi":"10.1080/09273948.2025.2456647","DOIUrl":"https://doi.org/10.1080/09273948.2025.2456647","url":null,"abstract":"<p><strong>Purpose: </strong>To shed light on one of the ocular adverse effects related to pembrolizumab.</p><p><strong>Method: </strong>Case report and literature review.</p><p><strong>Result: </strong>A 53-year-old gentleman with underlying Stage III B renal cell carcinoma with lung metastasis and gout presented in June 2021 with bilateral red eyes following Coronavirus disease (COVID-19) vaccination. He had undergone a nephrectomy for renal cell carcinoma and was on Pembrolizumab therapy for 5 years. Examination showed right eye injected conjunctiva with diffuse punctate epithelial erosions over the cornea, which was treated with topical steroids. The left eye is suspected to have infective keratitis, which is treated with topical antibiotics and subsequently steroids for the ocular surface inflammation. However, he developed a left eye paracentral sterile corneal melt which rapidly progressed to perforation measuring 1 mm in size. The perforation was temporarily sealed with tissue glue, but he eventually required a full thickness corneal patch graft. Patient has been doing well post-operatively for the last 3 years.</p><p><strong>Conclusion: </strong>The diagnosis and management of irAEs are challenging and necessitate continuously updated diagnostic and monitoring tools. As checkpoint inhibitors become more promising in the management of malignancies, it is crucial for both the oncologist and ophthalmologist to be aware of the potential ocular adverse effects of these drugs.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of AQP4-IgG Neuromyelitis Optica Presenting with Orbital Inflammatory Syndrome.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-30 DOI: 10.1080/09273948.2022.2075762
Lucy A Bailey, Roy F Riascos, Ore-Ofe O Adesina

A 45-year-old healthy African-American man experienced 2 months of right-eye soreness followed by acute onset of right painful vision loss with binocular, oblique diplopia. Visual acuity was count fingers OD and 20/20 OS. He had a partial, right, pupil-involving cranial nerve III palsy with a right relative afferent pupillary defect and optic disc edema with tortuous vessels. Magnetic resonance imaging showed increased T2 signal with tortuosity and thickening of the retrobulbar right optic nerve with associated restricted diffusion and enhancement, enhancement of orbital fat adjacent to the optic nerve sheath, and relative right proptosis. Workup was positive for aquaporin-4 antibody (AQP4-IgG) consistent with neuromyelitis optica spectrum disease (NMOSD). Our patient presented with signs and symptoms of orbital inflammation with optic neuritis and, to our knowledge, this is the first reported case of AQP4-IgG NMOSD presenting with orbital inflammatory syndrome.

{"title":"A Case of AQP4-IgG Neuromyelitis Optica Presenting with Orbital Inflammatory Syndrome.","authors":"Lucy A Bailey, Roy F Riascos, Ore-Ofe O Adesina","doi":"10.1080/09273948.2022.2075762","DOIUrl":"https://doi.org/10.1080/09273948.2022.2075762","url":null,"abstract":"<p><p>A 45-year-old healthy African-American man experienced 2 months of right-eye soreness followed by acute onset of right painful vision loss with binocular, oblique diplopia. Visual acuity was count fingers OD and 20/20 OS. He had a partial, right, pupil-involving cranial nerve III palsy with a right relative afferent pupillary defect and optic disc edema with tortuous vessels. Magnetic resonance imaging showed increased T2 signal with tortuosity and thickening of the retrobulbar right optic nerve with associated restricted diffusion and enhancement, enhancement of orbital fat adjacent to the optic nerve sheath, and relative right proptosis. Workup was positive for aquaporin-4 antibody (AQP4-IgG) consistent with neuromyelitis optica spectrum disease (NMOSD). Our patient presented with signs and symptoms of orbital inflammation with optic neuritis and, to our knowledge, this is the first reported case of AQP4-IgG NMOSD presenting with orbital inflammatory syndrome.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-World Efficacy and Safety of Escalation to Weekly Adalimumab for Chronic Non-Infectious Uveitis: A Multicenter Study Involving Pediatric and Adult Patients.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-27 DOI: 10.1080/09273948.2025.2456637
Murat Oklar, Merve İnanç Tekin, Kübra Özdemir Yalçınsoy, Nilüfer Zorlutuna Kaymak, Burak Tanyildiz, Pınar Çakar Özdal

Purpose: To evaluate the efficacy and safety of weekly adalimumab (ADA) treatment in non-infectious uveitis (NIU) patients, including both pediatric and adult populations, and identify factors influencing treatment efficacy.

Methods: A retrospective cohort study at two hospitals in Türkiye included 51 NIU patients (29 children, 22 adults) who escalated from bi-weekly to weekly ADA due to inadequate disease control. Data on six clinical parameters (anterior chamber reaction, vitreous haze, visual acuity, central macular thickness [CMT], prednisone use, uveitis flare-up frequency), adverse effects, and treatment-related factors were collected. Statistical analyses involved non-parametric tests and regression models.

Results: Weekly ADA led to clinical improvement in 88.2% of patients, with uveitis control achieved in 76.4% by the 6th month. Escalation to weekly dosing significantly improved all clinical parameters compared to the 6-month period before ADA initiation (p < 0.001). Patients on combined weekly ADA and DMARD therapy experienced fewer uveitis attacks (B = - 2.272, 95% CI = [-4.289, -0.254], p = 0.028). Starting ADA as first-line treatment reduced uveitis attacks (p = 0.002) and increased the likelihood of inactive uveitis (OR = 10.349, 95% CI = [1.379, 77.687], p = 0.023). Patients resistant to multiple biologics had worse preADA visual acuity (p = 0.011).

Conclusion: Weekly ADA is effective and safe for controlling NIU when bi-weekly dosing is insufficient. Combining ADA with DMARDs enhances outcomes and reduce uveitis attacks. Poor preADA visual acuity may suggest resistance to biologics. Prospective studies should validate these findings, explore anti-ADA antibody development, and assess how DMARD addition affects immunological parameters and treatment efficacy.

{"title":"Real-World Efficacy and Safety of Escalation to Weekly Adalimumab for Chronic Non-Infectious Uveitis: A Multicenter Study Involving Pediatric and Adult Patients.","authors":"Murat Oklar, Merve İnanç Tekin, Kübra Özdemir Yalçınsoy, Nilüfer Zorlutuna Kaymak, Burak Tanyildiz, Pınar Çakar Özdal","doi":"10.1080/09273948.2025.2456637","DOIUrl":"10.1080/09273948.2025.2456637","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of weekly adalimumab (ADA) treatment in non-infectious uveitis (NIU) patients, including both pediatric and adult populations, and identify factors influencing treatment efficacy.</p><p><strong>Methods: </strong>A retrospective cohort study at two hospitals in Türkiye included 51 NIU patients (29 children, 22 adults) who escalated from bi-weekly to weekly ADA due to inadequate disease control. Data on six clinical parameters (anterior chamber reaction, vitreous haze, visual acuity, central macular thickness [CMT], prednisone use, uveitis flare-up frequency), adverse effects, and treatment-related factors were collected. Statistical analyses involved non-parametric tests and regression models.</p><p><strong>Results: </strong>Weekly ADA led to clinical improvement in 88.2% of patients, with uveitis control achieved in 76.4% by the 6th month. Escalation to weekly dosing significantly improved all clinical parameters compared to the 6-month period before ADA initiation (<i>p</i> < 0.001). Patients on combined weekly ADA and DMARD therapy experienced fewer uveitis attacks (B = - 2.272, 95% CI = [-4.289, -0.254], <i>p</i> = 0.028). Starting ADA as first-line treatment reduced uveitis attacks (<i>p</i> = 0.002) and increased the likelihood of inactive uveitis (OR = 10.349, 95% CI = [1.379, 77.687], <i>p</i> = 0.023). Patients resistant to multiple biologics had worse preADA visual acuity (<i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>Weekly ADA is effective and safe for controlling NIU when bi-weekly dosing is insufficient. Combining ADA with DMARDs enhances outcomes and reduce uveitis attacks. Poor preADA visual acuity may suggest resistance to biologics. Prospective studies should validate these findings, explore anti-ADA antibody development, and assess how DMARD addition affects immunological parameters and treatment efficacy.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bilateral Choroidal Metastases from Primary Cutaneous Melanoma Following Nivolumab Discontinuation: A Case Report.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-25 DOI: 10.1080/09273948.2025.2456646
Fabio Daniel Padilla-Pantoja, Fernando Godin, Fernando Rojas-Rojas, Jennifer Camargo-González, David Ancona-Lezama

Purpose: To present the case of a young patient with BRAF V600E-mutant cutaneous melanoma who developed bilateral choroidal metastases complicated by neovascular glaucoma (NVG) in both eyes following the interruption of nivolumab therapy.

Methods: A 28-year-old female with primary cutaneous melanoma of the left hand underwent surgical resection and adjuvant nivolumab. Immunotherapy was discontinued due to immune-related acute interstitial nephritis. Three months after cessation, she presented with bilateral decreased vision, pain, and redness.

Results: Ophthalmic examination and imaging revealed bilateral choroidal thickening with focal nodular lesions consistent with metastatic disease, along with uveitis and NVG in both eyes. This condition required topical anti-inflammatory treatment and cyclophotocoagulation for intraocular pressure (IOP) control. Nivolumab was reinitiated in combination with systemic corticosteroids to manage immune-related toxicity. At the 12-month follow-up, the patient retained visual function in one eye, with no signs of new metastatic lesions.

Conclusions: Bilateral choroidal metastases from cutaneous melanoma are rare and can be complicated by NVG. Interruption of immune checkpoint inhibitors (ICIs) like nivolumab may lead to metastatic recurrence. Prompt resumption of immunotherapy, coupled with appropriate ocular interventions, is crucial for controlling disease progression and preserving vision. Careful management of immune-related adverse effects (irAEs) is essential to prevent treatment discontinuation and subsequent disease relapse.

{"title":"Bilateral Choroidal Metastases from Primary Cutaneous Melanoma Following Nivolumab Discontinuation: A Case Report.","authors":"Fabio Daniel Padilla-Pantoja, Fernando Godin, Fernando Rojas-Rojas, Jennifer Camargo-González, David Ancona-Lezama","doi":"10.1080/09273948.2025.2456646","DOIUrl":"https://doi.org/10.1080/09273948.2025.2456646","url":null,"abstract":"<p><strong>Purpose: </strong>To present the case of a young patient with BRAF V600E-mutant cutaneous melanoma who developed bilateral choroidal metastases complicated by neovascular glaucoma (NVG) in both eyes following the interruption of nivolumab therapy.</p><p><strong>Methods: </strong>A 28-year-old female with primary cutaneous melanoma of the left hand underwent surgical resection and adjuvant nivolumab. Immunotherapy was discontinued due to immune-related acute interstitial nephritis. Three months after cessation, she presented with bilateral decreased vision, pain, and redness.</p><p><strong>Results: </strong>Ophthalmic examination and imaging revealed bilateral choroidal thickening with focal nodular lesions consistent with metastatic disease, along with uveitis and NVG in both eyes. This condition required topical anti-inflammatory treatment and cyclophotocoagulation for intraocular pressure (IOP) control. Nivolumab was reinitiated in combination with systemic corticosteroids to manage immune-related toxicity. At the 12-month follow-up, the patient retained visual function in one eye, with no signs of new metastatic lesions.</p><p><strong>Conclusions: </strong>Bilateral choroidal metastases from cutaneous melanoma are rare and can be complicated by NVG. Interruption of immune checkpoint inhibitors (ICIs) like nivolumab may lead to metastatic recurrence. Prompt resumption of immunotherapy, coupled with appropriate ocular interventions, is crucial for controlling disease progression and preserving vision. Careful management of immune-related adverse effects (irAEs) is essential to prevent treatment discontinuation and subsequent disease relapse.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-4"},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in Axial Length in Patients of Acute Retinal Necrosis Undergoing Vitrectomy.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-23 DOI: 10.1080/09273948.2025.2455960
Boya Lei, Yao Zhou, Xinyi Ding, Ruiping Gu, Qinmeng Shu, Min Wang, Qing Chang, Gezhi Xu, Min Zhou, Rui Jiang

Purpose: To observe the changes in the axial length (AL) in patients of acute retinal necrosis (ARN) undergoing vitrectomy and investigate the correlated factors.

Methods: Retrospective case series. Patients diagnosed as ARN undergoing vitrectomy with silicone oil (SO) tamponade, and with attached retina more than one year after silicone oil removal (SOR) were included. Medical records and AL measured by Zeiss IOLMaster 700 were reviewed before vitrectomy, before SOR, and one year after SOR. Residual retinal index, a parameter reflecting the residual retinal area after vitrectomy was analyzed based on the ultra-wide-field fundus imaging. The AL change (ΔAL) was calculated and clinical factors related to ΔAL were investigated.

Results: In total, 45 eyes from 45 patients were included. The AL at pre-vitrectomy and pre-SOR was 23.84 ± 1.45 and 23.53 ± 1.53 mm among all 45 eyes, with a ΔAL of 0.31 ± 0.62 mm (p < 0.001). Among the 22 eyes with AL measured at one year after SOR, the AL at pre-SOR and one-year post-SOR was 23.82 ± 1.60 and 23.16 ± 0.79 mm, with a ΔAL of 0.67 ± 1.58 mm (p < 0.001). After excluding highly myopic eyes, the ΔAL was 0.31 ± 0.59 mm (n = 42, p < 0.001) between pre-vitrectomy and pre-SOR, and 0.22 ± 0.32 mm (n = 20, p = 0.001) between pre-SOR and one-year post-SOR. Multivariable regression analysis revealed the variable that remained independently associated with ΔAL between pre-SOR and one-year post-SOR was the residual retinal index (β = -0.568, p = 0.006).

Conclusion: For ARN patients undergoing vitrectomy, AL decreased significantly both post-vitrectomy and post-SOR. The refractive shift should be considered before intraocular lens implantation.

{"title":"Changes in Axial Length in Patients of Acute Retinal Necrosis Undergoing Vitrectomy.","authors":"Boya Lei, Yao Zhou, Xinyi Ding, Ruiping Gu, Qinmeng Shu, Min Wang, Qing Chang, Gezhi Xu, Min Zhou, Rui Jiang","doi":"10.1080/09273948.2025.2455960","DOIUrl":"https://doi.org/10.1080/09273948.2025.2455960","url":null,"abstract":"<p><strong>Purpose: </strong>To observe the changes in the axial length (AL) in patients of acute retinal necrosis (ARN) undergoing vitrectomy and investigate the correlated factors.</p><p><strong>Methods: </strong>Retrospective case series. Patients diagnosed as ARN undergoing vitrectomy with silicone oil (SO) tamponade, and with attached retina more than one year after silicone oil removal (SOR) were included. Medical records and AL measured by Zeiss IOLMaster 700 were reviewed before vitrectomy, before SOR, and one year after SOR. Residual retinal index, a parameter reflecting the residual retinal area after vitrectomy was analyzed based on the ultra-wide-field fundus imaging. The AL change (ΔAL) was calculated and clinical factors related to ΔAL were investigated.</p><p><strong>Results: </strong>In total, 45 eyes from 45 patients were included. The AL at pre-vitrectomy and pre-SOR was 23.84 ± 1.45 and 23.53 ± 1.53 mm among all 45 eyes, with a ΔAL of 0.31 ± 0.62 mm (<i>p</i> < 0.001). Among the 22 eyes with AL measured at one year after SOR, the AL at pre-SOR and one-year post-SOR was 23.82 ± 1.60 and 23.16 ± 0.79 mm, with a ΔAL of 0.67 ± 1.58 mm (<i>p</i> < 0.001). After excluding highly myopic eyes, the ΔAL was 0.31 ± 0.59 mm (<i>n</i> = 42, <i>p</i> < 0.001) between pre-vitrectomy and pre-SOR, and 0.22 ± 0.32 mm (<i>n</i> = 20, <i>p</i> = 0.001) between pre-SOR and one-year post-SOR. Multivariable regression analysis revealed the variable that remained independently associated with ΔAL between pre-SOR and one-year post-SOR was the residual retinal index (β = -0.568, <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>For ARN patients undergoing vitrectomy, AL decreased significantly both post-vitrectomy and post-SOR. The refractive shift should be considered before intraocular lens implantation.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and Imaging Characteristics of Posterior Scleritis in Children.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-23 DOI: 10.1080/09273948.2025.2455963
Ayala Katzir, Radgonde Amer

Background: Posterior scleritis (PS) is a rare phenotype of scleritis. Comprehensive epidemiological studies on PS in children are limited. We aimed to report on its clinical and imaging features in one of the largest pediatric series to date.

Methods: Retrospective review of medical files.

Results: Included were 12 children (7 girls, mean±SD age at diagnosis 13.75 ± 3.3 years,18 eyes, mean follow-up ±SD of 46.7 ± 45.9 months). All patients presented with eye pain followed by headache. Papillitis was the most common presenting sign (16 eyes, 88.9%). Seven patients (58%) showed laboratory markers of systemic inflammation. One patient had periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA). In 2 other patients, Behҫet disease and inflammatory bowel disease were diagnosed subsequently. Initial echography showed increased posterior scleral thickness (mean±SD 2.9 ± 0.68 mm) with a significant reduction four ± 2 months later (mean±SD 1.85 ± 0.62 mm). Retinal nerve fiber layer (RNFL) was thickened in all examined eyes (mean±SD 136.2 ± 28.4 µm) at presentation and it significantly decreased with treatment (109.8 ± 8.2 µm two months later). In 5 patients (42%), diagnosing PS was prompted by Brain imaging. PS was part of orbital inflammatory syndrome in 4 patients (33.3%). All patients were treated with systemic steroids and 91% required steroid-sparing agent. Adalimumab was added in 2 patients. A chronic course was observed in 63.6%. Remission was achieved in 4 patients. Mean±SD presenting LogMAR VA was 0.23 ± 0.3 with marked improvement to 0.04 ± 0.07 one month later.

Conclusion: Searching for an associated autoinflammatory/autoimmune disease is an important step in patients' triaging. B-scan ultrasound remains the gold standard test. OCT proved to be of practical importance in delineating the magnitude of RNFL thickness and could serve as a potential imaging biomarker of disease activity.

{"title":"Clinical and Imaging Characteristics of Posterior Scleritis in Children.","authors":"Ayala Katzir, Radgonde Amer","doi":"10.1080/09273948.2025.2455963","DOIUrl":"https://doi.org/10.1080/09273948.2025.2455963","url":null,"abstract":"<p><strong>Background: </strong>Posterior scleritis (PS) is a rare phenotype of scleritis. Comprehensive epidemiological studies on PS in children are limited. We aimed to report on its clinical and imaging features in one of the largest pediatric series to date.</p><p><strong>Methods: </strong>Retrospective review of medical files.</p><p><strong>Results: </strong>Included were 12 children (7 girls, mean±SD age at diagnosis 13.75 ± 3.3 years,18 eyes, mean follow-up ±SD of 46.7 ± 45.9 months). All patients presented with eye pain followed by headache. Papillitis was the most common presenting sign (16 eyes, 88.9%). Seven patients (58%) showed laboratory markers of systemic inflammation. One patient had periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA). In 2 other patients, Behҫet disease and inflammatory bowel disease were diagnosed subsequently. Initial echography showed increased posterior scleral thickness (mean±SD 2.9 ± 0.68 mm) with a significant reduction four ± 2 months later (mean±SD 1.85 ± 0.62 mm). Retinal nerve fiber layer (RNFL) was thickened in all examined eyes (mean±SD 136.2 ± 28.4 µm) at presentation and it significantly decreased with treatment (109.8 ± 8.2 µm two months later). In 5 patients (42%), diagnosing PS was prompted by Brain imaging. PS was part of orbital inflammatory syndrome in 4 patients (33.3%). All patients were treated with systemic steroids and 91% required steroid-sparing agent. Adalimumab was added in 2 patients. A chronic course was observed in 63.6%. Remission was achieved in 4 patients. Mean±SD presenting LogMAR VA was 0.23 ± 0.3 with marked improvement to 0.04 ± 0.07 one month later.</p><p><strong>Conclusion: </strong>Searching for an associated autoinflammatory/autoimmune disease is an important step in patients' triaging. B-scan ultrasound remains the gold standard test. OCT proved to be of practical importance in delineating the magnitude of RNFL thickness and could serve as a potential imaging biomarker of disease activity.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multicenter Analysis of Acute Retinal Necrosis: Clinical Characteristics, Viral Pathogens, and Diagnostic Predictive Factors.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-23 DOI: 10.1080/09273948.2025.2456642
Panuwat Soitong, Yaninsiri Ngathaweesuk, Noppakhun Panyayingyong, Atchara Amphornphruet, Variya Nganthavee, Boonsub Sakboonyarat, Narumon Keorochana

Purpose: This multicenter study aimed to investigate the clinical characteristics and factors associated with specific viral pathogens in patients with acute retinal necrosis (ARN).

Methods: A retrospective multicenter cohort study included ARN patients who underwent aqueous or vitreous polymerase chain reaction (PCR) testing. Multivariable mixed-effects Poisson regression was used to identify factors associated with viral pathogens.

Results: A total of 56 patients (65 eyes) with ARN were included, with a mean age was 39.9 ± 23.2 years. Anterior chamber cell showed significant inflammation in 89.2%, while vitreous haze was present in 100%. Multifocal retinitis was found in 92.3% of cases. Among these, 49.2% had diffuse or confluent patterns, 15.4% were circumferential, and 23.1% showed satellite lesions. Additionally, 18.5% were ameboid or scalloped shape, while 9.2% had wedge shapes. Varicella zoster virus (VZV) was the most common pathogen (30.8%), followed by Herpes simplex virus (HSV) (13.8%), Cytomegalovirus (CMV) (10.8%), Epstein-Barr virus (EBV) (9.2%), and human herpesvirus (HHV) (3.0%). Co-infections were observed in 20% of eyes. CMV-related ARN was significantly associated with wedge-shaped retinitis (aRR 4.19) and immunocompromised host (aRR 8.8). Younger age and optic disc edema (aRR 5.41) were correlated with HSV-related ARN.

Conclusion: VZV was the predominant viral pathogen, with the increasing prevalence of CMV, EBV, and co-infection. Wedge-shaped retinitis and immunocompromised status were notably associated with CMV-related ARN, findings that may guide antiviral therapy decisions in settings where PCR diagnostics are either unavailable or delayed, ultimately improving visual outcomes.

{"title":"Multicenter Analysis of Acute Retinal Necrosis: Clinical Characteristics, Viral Pathogens, and Diagnostic Predictive Factors.","authors":"Panuwat Soitong, Yaninsiri Ngathaweesuk, Noppakhun Panyayingyong, Atchara Amphornphruet, Variya Nganthavee, Boonsub Sakboonyarat, Narumon Keorochana","doi":"10.1080/09273948.2025.2456642","DOIUrl":"https://doi.org/10.1080/09273948.2025.2456642","url":null,"abstract":"<p><strong>Purpose: </strong>This multicenter study aimed to investigate the clinical characteristics and factors associated with specific viral pathogens in patients with acute retinal necrosis (ARN).</p><p><strong>Methods: </strong>A retrospective multicenter cohort study included ARN patients who underwent aqueous or vitreous polymerase chain reaction (PCR) testing. Multivariable mixed-effects Poisson regression was used to identify factors associated with viral pathogens.</p><p><strong>Results: </strong>A total of 56 patients (65 eyes) with ARN were included, with a mean age was 39.9 ± 23.2 years. Anterior chamber cell showed significant inflammation in 89.2%, while vitreous haze was present in 100%. Multifocal retinitis was found in 92.3% of cases. Among these, 49.2% had diffuse or confluent patterns, 15.4% were circumferential, and 23.1% showed satellite lesions. Additionally, 18.5% were ameboid or scalloped shape, while 9.2% had wedge shapes. Varicella zoster virus (VZV) was the most common pathogen (30.8%), followed by Herpes simplex virus (HSV) (13.8%), Cytomegalovirus (CMV) (10.8%), Epstein-Barr virus (EBV) (9.2%), and human herpesvirus (HHV) (3.0%). Co-infections were observed in 20% of eyes. CMV-related ARN was significantly associated with wedge-shaped retinitis (aRR 4.19) and immunocompromised host (aRR 8.8). Younger age and optic disc edema (aRR 5.41) were correlated with HSV-related ARN.</p><p><strong>Conclusion: </strong>VZV was the predominant viral pathogen, with the increasing prevalence of CMV, EBV, and co-infection. Wedge-shaped retinitis and immunocompromised status were notably associated with CMV-related ARN, findings that may guide antiviral therapy decisions in settings where PCR diagnostics are either unavailable or delayed, ultimately improving visual outcomes.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Cases of ROSAH-Like Syndrome Restricted to the Ophthalmologic Presentation.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-23 DOI: 10.1080/09273948.2025.2453873
Laurie Mourozeau, Virginie Pichon, Aymane Bouzidi, Majida Charif, Marine Tessarech, Angélique Caignard, Patrizia Amati-Bonneau, Agnès Guichet, Christian Lavigne, Christophe Verny, Philippe Gohier, Guy Lenaers

Purpose: To report the clinical presentation and follow-up, including the optical coherence tomography, angiography and electrophysiology of two individuals from the same family presenting with an isolated retinal dystrophy and optic nerve edema who were diagnosed with ROSAH-like syndrome.

Method: Observational case report of a 55-year-old woman and her 36-year-old son with a genetic analysis of ROSAH, after a long-term follow-up.

Results: Both the mother and her son displayed severe optic nerve infiltration and retinal pigment atrophy with intraocular inflammation, which were not improved by immunosuppressive treatment. Systemic investigations were not relevant of a syndromic presentation. Whole exome sequencing revealed the same ALPK1 missense pathogenic variant c.710C>T; p.(Thr237Met) responsible for ROSAH syndrome.

Conclusion: ALPK1 variant responsible for ROSAH syndrome may cause severe retinal dystrophy and an uveitis-like presentation resistant to conventional immunosuppressive drugs, without the systemic symptoms common to the ROSAH syndrome.

{"title":"Two Cases of ROSAH-Like Syndrome Restricted to the Ophthalmologic Presentation.","authors":"Laurie Mourozeau, Virginie Pichon, Aymane Bouzidi, Majida Charif, Marine Tessarech, Angélique Caignard, Patrizia Amati-Bonneau, Agnès Guichet, Christian Lavigne, Christophe Verny, Philippe Gohier, Guy Lenaers","doi":"10.1080/09273948.2025.2453873","DOIUrl":"https://doi.org/10.1080/09273948.2025.2453873","url":null,"abstract":"<p><strong>Purpose: </strong>To report the clinical presentation and follow-up, including the optical coherence tomography, angiography and electrophysiology of two individuals from the same family presenting with an isolated retinal dystrophy and optic nerve edema who were diagnosed with ROSAH-like syndrome.</p><p><strong>Method: </strong>Observational case report of a 55-year-old woman and her 36-year-old son with a genetic analysis of ROSAH, after a long-term follow-up.</p><p><strong>Results: </strong>Both the mother and her son displayed severe optic nerve infiltration and retinal pigment atrophy with intraocular inflammation, which were not improved by immunosuppressive treatment. Systemic investigations were not relevant of a syndromic presentation. Whole exome sequencing revealed the same <i>ALPK1</i> missense pathogenic variant c.710C>T; p.(Thr237Met) responsible for ROSAH syndrome.</p><p><strong>Conclusion: </strong><i>ALPK1</i> variant responsible for ROSAH syndrome may cause severe retinal dystrophy and an uveitis-like presentation resistant to conventional immunosuppressive drugs, without the systemic symptoms common to the ROSAH syndrome.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Ocular Immunology and Inflammation
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1