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Recurrent Choroidal Neovascular Membrane as the Initial Presentation of Mycobacterium chimaera-Associated Serpiginoid Choroiditis. 复发性脉络膜新生血管膜是奇异分枝杆菌相关丝状脉络膜炎的最初表现。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-06-18 DOI: 10.1080/09273948.2024.2367654
Kalpana Babu, P G Padmapriya, Sunitha M N Gowda, Praveen R Murthy

Purpose: To report a rare presentation of a proven case of Mycobacterium chimaera infection presenting as multifocal choroiditis with recurrent choroidal neovascular membrane (CNVM) in one eye, initially misdiagnosed as punctate inner choroidopathy and later developed serpiginous-like choroiditis in the other eye.

Methods: Retrospective case report with a review of existing literature.

Results: A 30-year-old women presented with metamorphopsia (OD) and best-corrected visual acuity (BCVA) of 6/24 (OD) and was diagnosed to have punctate inner choroidopathy with CNVM (OD). Since then, she had received four intravitreal anti-vascular endothelial growth factor injections over 3 years. Two years later, she developed a slowly progressing choroidal lesion radiating from the disc in a serpiginoid manner in the left eye. There was no vitritis. Labs revealed a positive QuantiFERON-TB Gold test. High-resolution computed tomography of the thorax showed sub-centimetre noncalcified lymph nodes in subcarinal and perivascular regions, minimal pleural thickening in left lower zone, minimal pericardial effusion, bronchiectatic changes, and fibrotic strands in right middle and left lower lobes. Bronchoalveolar lavage grew M. chimaera intracellularae (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). She was given a course of clarithromycin, moxifloxacin, rifampicin, and doxycycline for 12 months. Though the right eye remained stable, choroidal lesion in the left eye continued to progress threatening the fovea, requiring oral steroids, methotrexate, and an intravitreal dexamethasone implant. At the last follow-up, her BCVA was 6/18 (OD) and 6/6 (OS). Both eyes were stable.

Conclusion: This case highlights a rare presentation of proven M. chimaera infection presenting as multifocal choroiditis with recurrent CNVM in one eye and serpiginous-like choroiditis in the other eye, requiring aggressive treatment to salvage the vision.

目的:报告一例罕见的已证实的奇异分枝杆菌感染病例,该病例表现为多灶性脉络膜炎,其中一只眼伴有复发性脉络膜新生血管膜(CNVM),最初被误诊为点状内脉络膜病变,后来在另一只眼发展为浆液性脉络膜炎:方法:回顾性病例报告,并回顾现有文献:一名30岁的女性患者出现变形性视力(OD),最佳矫正视力(BCVA)为6/24(OD),被诊断为点状内脉络膜病变伴CNVM(OD)。此后,她在 3 年内接受了 4 次玻璃体内抗血管内皮生长因子注射。两年后,她的左眼出现了缓慢进展的脉络膜病变,病变从椎间盘向外辐射,呈锯齿状。没有玻璃体炎。实验室检查显示,QuantiFERON-TB Gold检测呈阳性。胸部高分辨率计算机断层扫描显示,心包下和血管周围有厘米以下未钙化的淋巴结,左下区胸膜极度增厚,心包积液极少,支气管扩张,右中叶和左下叶有纤维化条索。支气管肺泡灌洗培养出了细胞内的奇马菌(基质辅助激光解吸/电离飞行时间质谱法)。她接受了为期 12 个月的克拉霉素、莫西沙星、利福平和强力霉素治疗。虽然右眼的情况保持稳定,但左眼的脉络膜病变继续发展,威胁到了眼窝,需要口服类固醇、甲氨蝶呤和玻璃体内地塞米松植入。最后一次随访时,她的BCVA为6/18(OD)和6/6(OS)。双眼视力稳定:本病例突出显示了一种罕见的病例,即经证实的绒毛膜霉菌感染,表现为多灶性脉络膜炎,其中一只眼睛复发性CNVM,另一只眼睛为浆液性脉络膜炎,需要积极治疗才能挽救视力。
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引用次数: 0
Widespread Adoption of Microincision Vitrectomy Surgery Improves Visual Outcomes in Endogenous Endophthalmitis with Poor Initial Vision: A 21-Year Experience in Taiwan. 广泛采用微切口玻璃体切割手术可改善初始视力不佳的内源性眼内炎患者的视觉效果:台湾 21 年的经验。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-01 DOI: 10.1080/09273948.2024.2338272
Shih-Chou Chen, Tsung-Tien Wu, Chun-Hao Yin, Jin-Shuen Chen, Yao-Shen Chen

Purpose: To review the presentation and visual prognostic factors of patients with endogenous endophthalmitis before and after the introduction of microincision vitrectomy surgery (MIVS), at a tertiary referral hospital in Taiwan, over a 21-year period.

Methods: We retrospectively analyzed medical records of patients diagnosed with endogenous endophthalmitis before and after the introduction of MIVS between January 2002 and December 2022.

Results: Data were collected from 147 patients. Diabetes mellitus was the most common comorbidity (59.9%). Liver abscess (32.7%) was the leading source of infection, followed by urinary tract infection (15.0%), and infective endocarditis (5.4%). Klebsiella pneumoniae (50.4%) was the most common pathogen, followed by Staphylococcus aureus (13.5%), and Candida albicans (8.3%). Poor initial visual acuity worse than counting fingers (CF) (p < 0.001) and diabetes mellitus (p = 0.008) were significantly associated with poor visual outcomes. In the treatment of 98 patients with poor initial visual acuity worse than CF, the proportion of vitrectomy surgeries performed increased from 13/56 (23.2%) to 24/42 (57.1%) (p = 0.001) after the introduction of MIVS. Final visual acuity of CF or better increased from 7/56 (12.5%) to 12/42 (28.6%) after the introduction of MIVS (p = 0.046). Vitrectomy was a better prognostic factor for final visual outcome in patients with poor initial visual acuity of worse than CF (p = 0.011) than other factors.

Conclusion: In endogenous endophthalmitis patients presenting with poor initial visual acuity, vitrectomy was a better visual prognostic factor. MIVS has allowed more patients to undergo vitrectomy and improved visual outcomes.

目的:回顾台湾一家三级转诊医院在引入微切口玻璃体切割手术(MIVS)前后21年间内源性眼内炎患者的表现和视觉预后因素:我们回顾性分析了 2002 年 1 月至 2022 年 12 月期间引入 MIVS 前后确诊为内源性眼内炎患者的病历:我们收集了 147 名患者的数据。糖尿病是最常见的合并症(59.9%)。肝脓肿(32.7%)是最主要的感染源,其次是尿路感染(15.0%)和感染性心内膜炎(5.4%)。肺炎克雷伯菌(50.4%)是最常见的病原体,其次是金黄色葡萄球菌(13.5%)和白色念珠菌(8.3%)。初始视力差于数指(CF)(p p = 0.008)与视力不良有显著相关性。在对初始视力差于数指(CF)的 98 名患者的治疗中,引入 MIVS 后进行玻璃体切除手术的比例从 13/56(23.2%)增至 24/42(57.1%)(p = 0.001)。引入 MIVS 后,最终视力达到 CF 或更好的患者从 7/56(12.5%)增加到 12/42(28.6%)(p = 0.046)。与其他因素相比,对于初始视力差于 CF 的患者来说,玻璃体切除术是最终视力结果的更好预后因素(p = 0.011):结论:对于初始视力较差的内源性眼内炎患者,玻璃体切割术是更好的视觉预后因素。MIVS 使更多患者接受了玻璃体切除术,并改善了视力预后。
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引用次数: 0
Long-Term Outcome of Tofacitinib Treatment for Systemic Autoimmune Disease-Associated Refractory Scleritis. 托法替尼治疗系统性自身免疫病相关难治性巩膜炎的长期疗效
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-31 DOI: 10.1080/09273948.2024.2359001
Chung Young Kim, Eun Bong Lee, Joo Youn Oh

Purpose: To report the long-term outcome of three refractory anterior scleritis cases successfully treated with tofacitinib, a Janus-associated kinase inhibitor.

Methods: Three patients with systemic autoimmune disease-associated anterior scleritis (two with rheumatoid arthritis and one with systemic lupus erythematosus), resistant to conventional immunomodulatory therapy, were subsequently treated with tofacitinib (10 mg/day).

Results: Tofacitinib resulted in complete resolution of scleritis in all patients. During the 39-78 months of follow-up, no recurrence of scleritis occurred, and no adverse effects associated with tofacitinib were noted. At the last follow-up, all patients were free of scleritis with two patients receiving tofacitinib monotherapy and one without.

Conclusion: Tofacitinib can be a safe and effective treatment for noninfectious refractory scleritis, warranting further investigation in large clinical trials.

目的:报告使用 Janus 相关激酶抑制剂托法替尼成功治疗三例难治性前部硬膜炎的长期疗效:三名患有系统性自身免疫性疾病相关的前部巩膜炎的患者(两名患有类风湿性关节炎,一名患有系统性红斑狼疮)对常规免疫调节疗法耐药,随后接受了托法替尼(10毫克/天)的治疗:结果:托法替尼使所有患者的巩膜炎症完全消退。在39-78个月的随访期间,巩膜炎没有复发,也没有发现与托法替尼相关的不良反应。在最后一次随访中,所有患者均摆脱了巩膜炎,其中两名患者接受了托法替尼单药治疗,一名患者未接受治疗:结论:托法替尼是治疗非感染性难治性巩膜炎的一种安全有效的方法,值得在大型临床试验中进一步研究。
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引用次数: 0
Monocular Tuberculosis-Related Serpiginous-Like Choroiditis with Acute Posterior Multifocal Placoid Pigment Epitheliopathy-Like Presentation in a Danish Patient. 一名丹麦患者的单眼结核相关性浆液性脉络膜炎伴急性后部多灶性浆液性色素上皮病变样表现
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-08-08 DOI: 10.1080/09273948.2024.2367678
Ditte-Marie Leegaard Holm, Miklos Schneider, Oliver Niels Klefter

Purpose: To report a case of tuberculosis-related serpiginous-like choroiditis (TB-SLC) in Denmark in a patient with few risk factors.

Methods: Single case report.

Results: A 54-year-old Caucasian male with no relevant travel history presented with unilateral light placoid confluent elements in the macula of the right eye with a best-corrected visual acuity of 0.2 Snellen. The left eye was normal. Wide-field Fluorescein and Indocyanine green-angiography were performed, and findings were consistent with acute posterior multifocal placoid pigment epitheliopathy. Since the condition was considered sight-threatening, and the patient had no recognizable risk factors for tuberculosis (TB), he was prescribed 50 mg of oral prednisolone. Blood tests and an X-ray were ordered to exclude infectious causes. The first interferon-ỿ release assay (IGRA) test was inconclusive and a new test was ordered. Over the following weeks new white dots appeared in the retina. After the patient had been treated for seven weeks with prednisolone, the second IGRA came back positive, and he was diagnosed with TB-SLC. Upon repeated questioning two months after baseline, the patient remembered that ten years ago he had been in a workplace with 50 different nationalities, and seven years ago he had been in contact with a friend who was treated for latent TB, thus supporting relevant exposure.

Conclusion: TB-SLC may occur even in a patient with few recognizable risk factors and in a setting that is not TB endemic. It is imperative to continuously reassess differential diagnoses and initiate or repeat paraclinical testing in cases with atypical features.

目的:报告丹麦一例与结核病相关的血清样脉络膜炎(TB-SLC)病例,该患者几乎没有危险因素:方法:单个病例报告:结果:一名 54 岁的白种男性,无相关旅行史,右眼黄斑出现单侧轻度浆液性混浊,最佳矫正视力为 0.2 Snellen。左眼正常。对其进行了宽视野荧光素和吲哚菁绿血管造影检查,结果与急性后多灶性斑块状色素上皮病变一致。由于该病被认为会危及视力,而且患者没有可识别的结核病(TB)风险因素,因此医生给他开了 50 毫克口服泼尼松龙的处方。为了排除感染性病因,医生给他做了血液化验和 X 光检查。第一次干扰素ỿ释放测定(IGRA)检测没有得出结论,于是又做了一次新的检测。随后几周,视网膜上出现了新的白点。患者接受了为期七周的泼尼松龙治疗后,第二次 IGRA 检测结果呈阳性,被诊断为 TB-SLC。在基线两个月后的重复询问中,患者回忆起十年前他曾在一个有 50 个不同国籍的人的工作场所工作,七年前他曾与一位接受过潜伏肺结核治疗的朋友有过接触,因此证明了相关的接触:结论:TB-SLC 甚至可能发生在一个几乎没有可识别风险因素的病人身上,也可能发生在一个非结核病流行的环境中。当务之急是不断重新评估鉴别诊断,并对具有非典型特征的病例启动或重复进行临床辅助检查。
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引用次数: 0
Drug Retention Time of Immunosuppressive Therapy in Behcet's Uveitis. 白塞氏葡萄膜炎免疫抑制疗法的药物保留时间
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-02-27 DOI: 10.1080/09273948.2024.2315205
Donald Tran, Sophie Rogers, Lyndell L Lim

Purpose: Behcet's Disease is a chronic multisystem vasculitis associated with a blinding uveitis. Few comparative studies exist between conventional disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs in Behcet's uveitis (BU). We therefore used drug retention time (DRT), an accepted surrogate measure of pharmacological efficacy and tolerability, to compare these treatments in patients with BU.

Methods: Retrospective chart review of patients who met the revised International Criteria for Behcet's Disease (ICBD) treated at the Royal Victorian Eye and Ear Hospital, Australia, between 1985-2021. DRT was analysed with Kaplan-Meier plots and defined as total time on drug in the first medication-period for each DMARD in each patient.

Results: Forty-eight patients (37 males) with median age of 28.6 years were followed-up for a median of 8.0 years. At initial presentation, half had bilateral disease and median logMAR visual acuity was 0.176 (Snellen 6/9) in 62 uveitic eyes (16 anterior uveitis, 11 intermediate, 2 posterior, and 33 panuveitis). Thirty-three patients met ICBD initially. Prescribed corticosteroid-sparing agents were Cyclosporin (N = 24), Mycophenolate (N = 22), Azathioprine (N = 22), Methotrexate (N = 16), and Adalimumab (N = 15). Median DRT was 14.0, 27.4, 8.3, 24.0, and 52.0 months, respectively. DMARDs were discontinued 116 times and adverse effects (N = 37) were the main reason for cessation. Over time, patients were switched from Cyclosporin to Adalimumab earlier in the disease course due to poorer tolerance of adverse events.

Conclusion: Adalimumab's drug retention time was found to be similar to and possibly better than cDMARDs in patients with BU, who often suffer from vision-threatening disease at first presentation.

目的:白塞氏病是一种伴有致盲性葡萄膜炎的慢性多系统血管炎。在白塞氏葡萄膜炎(BU)的治疗中,传统的改变病情抗风湿药(DMARDs)和生物DMARDs之间的比较研究很少。因此,我们使用药物保留时间(DRT)--一种公认的药理疗效和耐受性替代指标--来比较这些治疗方法在白塞氏葡萄膜炎患者中的疗效:方法:对1985-2021年间在澳大利亚维多利亚皇家眼耳医院接受治疗的符合修订版国际白塞氏病(ICBD)标准的患者进行回顾性病历审查。DRT 采用 Kaplan-Meier 图进行分析,定义为每位患者每种 DMARD 在第一个用药期的总用药时间:48 名患者(37 名男性)的中位年龄为 28.6 岁,随访时间中位数为 8.0 年。62只葡萄膜炎眼(16只前葡萄膜炎眼、11只中度葡萄膜炎眼、2只后部葡萄膜炎眼和33只泛葡萄膜炎眼)的中位数logMAR视力为0.176(斯奈伦6/9)。33 名患者最初符合 ICBD 标准。处方的皮质类固醇替代药物包括环孢素(24 例)、霉酚酸酯(22 例)、硫唑嘌呤(22 例)、甲氨蝶呤(16 例)和阿达木单抗(15 例)。DRT中位数分别为14.0、27.4、8.3、24.0和52.0个月。DMARDs停药116次,不良反应(37例)是停药的主要原因。随着时间的推移,由于对不良反应的耐受性较差,患者在病程的早期就从环孢素换成了阿达木单抗:结论:阿达木单抗的药物保留时间与cDMARDs相似,甚至可能优于cDMARDs。
{"title":"Drug Retention Time of Immunosuppressive Therapy in Behcet's Uveitis.","authors":"Donald Tran, Sophie Rogers, Lyndell L Lim","doi":"10.1080/09273948.2024.2315205","DOIUrl":"10.1080/09273948.2024.2315205","url":null,"abstract":"<p><strong>Purpose: </strong>Behcet's Disease is a chronic multisystem vasculitis associated with a blinding uveitis. Few comparative studies exist between conventional disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs in Behcet's uveitis (BU). We therefore used drug retention time (DRT), an accepted surrogate measure of pharmacological efficacy and tolerability, to compare these treatments in patients with BU.</p><p><strong>Methods: </strong>Retrospective chart review of patients who met the revised International Criteria for Behcet's Disease (ICBD) treated at the Royal Victorian Eye and Ear Hospital, Australia, between 1985-2021. DRT was analysed with Kaplan-Meier plots and defined as total time on drug in the first medication-period for each DMARD in each patient.</p><p><strong>Results: </strong>Forty-eight patients (37 males) with median age of 28.6 years were followed-up for a median of 8.0 years. At initial presentation, half had bilateral disease and median logMAR visual acuity was 0.176 (Snellen 6/9) in 62 uveitic eyes (16 anterior uveitis, 11 intermediate, 2 posterior, and 33 panuveitis). Thirty-three patients met ICBD initially. Prescribed corticosteroid-sparing agents were Cyclosporin (<i>N</i> = 24), Mycophenolate (<i>N</i> = 22), Azathioprine (<i>N</i> = 22), Methotrexate (<i>N</i> = 16), and Adalimumab (<i>N</i> = 15). Median DRT was 14.0, 27.4, 8.3, 24.0, and 52.0 months, respectively. DMARDs were discontinued 116 times and adverse effects (<i>N</i> = 37) were the main reason for cessation. Over time, patients were switched from Cyclosporin to Adalimumab earlier in the disease course due to poorer tolerance of adverse events.</p><p><strong>Conclusion: </strong>Adalimumab's drug retention time was found to be similar to and possibly better than cDMARDs in patients with BU, who often suffer from vision-threatening disease at first presentation.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"10-17"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983433","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
Anterior Non-Necrotizing Scleritis with Active Uveitis in Cases of Ocular Syphilis. 眼梅毒病例中伴有活动性葡萄膜炎的前非颈部硬化性巩膜炎
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-06-03 DOI: 10.1080/09273948.2024.2358996
Talluri Ronnie Abhishek, Anup Kelgaonkar, Vishal Jadhav, Anamika Patel, Mudit Tyagi, Soumyava Basu, Avinash Pathengay

Purpose: To study clinical characteristics and management outcomes of cases of ocular syphilis co-presenting with scleritis and active uveitis.

Methods: A retrospective analysis of cases diagnosed with ocular syphilis between January 2020 and December 2023 was conducted at a tertiary eye care centre. Clinical records, investigations, and outcomes were reviewed to identify cases with scleritis with active uveitis. Demographic data, clinical features, treatment modalities, and resolution patterns were analyzed.

Results: Among the 135 eyes of 95 cases of ocular syphilis studied, scleritis with uveitis was observed in 3.70% of eyes (five eyes). All cases with scleritis and uveitis were unilateral and male, with ages ranging from 32 to 61 years. Concurrent features included placoid chorioretinitis, retinal vasculitis, and anterior uveitis. Misdiagnosis with subsequent oral steroid therapy precipitated scleritis as an exacerbation in two cases. Three cases, which were previously undiagnosed, were found to be HIV-positive. Scleritis manifested as anterior, non-necrotizing inflammation, often accompanied by chemosis, and responded rapidly to antibiotic and non-steroidal anti-inflammatory therapy. Scleritis resolution preceded that of chorioretinitis and retinal vasculitis.

Conclusions: Non-necrotizing anterior scleritis with chemosis can be a rare presentation of active syphilitic uveitis. Large placoid chorioretinitis lesions, preceding inadvertent oral steroid and/or undiagnosed HIV status were the possible risk factors for the development of concurrent scleritis.

目的:研究合并巩膜炎和活动性葡萄膜炎的眼梅毒病例的临床特征和治疗结果:一家三级眼科医疗中心对2020年1月至2023年12月期间确诊的眼梅毒病例进行了回顾性分析。研究人员回顾了临床记录、检查和结果,以确定伴有活动性葡萄膜炎的巩膜炎病例。对人口统计学数据、临床特征、治疗方式和缓解模式进行了分析:在研究的95例梅毒患者的135只眼睛中,有3.70%的眼睛(5只眼睛)出现了伴有葡萄膜炎的巩膜炎。所有患有巩膜炎和葡萄膜炎的病例均为单侧,男性,年龄从32岁到61岁不等。并发症特征包括胎膜脉络膜炎、视网膜血管炎和前葡萄膜炎。有两个病例因误诊和随后的口服类固醇治疗导致巩膜炎加重。有三个病例之前未确诊,但后来发现他们是艾滋病病毒阳性患者。巩膜炎表现为前部非坏死性炎症,常伴有化脓,对抗生素和非类固醇抗炎治疗反应迅速。巩膜炎的消退先于脉络膜视网膜炎和视网膜血管炎的消退:结论:非坏死性前部巩膜炎伴有化脓可能是活动性梅毒葡萄膜炎的一种罕见表现。大面积浆液性脉络膜视网膜炎病变、之前不慎口服类固醇和/或未确诊的艾滋病病毒感染者身份是并发巩膜炎的可能风险因素。
{"title":"Anterior Non-Necrotizing Scleritis with Active Uveitis in Cases of Ocular Syphilis.","authors":"Talluri Ronnie Abhishek, Anup Kelgaonkar, Vishal Jadhav, Anamika Patel, Mudit Tyagi, Soumyava Basu, Avinash Pathengay","doi":"10.1080/09273948.2024.2358996","DOIUrl":"10.1080/09273948.2024.2358996","url":null,"abstract":"<p><strong>Purpose: </strong>To study clinical characteristics and management outcomes of cases of ocular syphilis co-presenting with scleritis and active uveitis.</p><p><strong>Methods: </strong>A retrospective analysis of cases diagnosed with ocular syphilis between January 2020 and December 2023 was conducted at a tertiary eye care centre. Clinical records, investigations, and outcomes were reviewed to identify cases with scleritis with active uveitis. Demographic data, clinical features, treatment modalities, and resolution patterns were analyzed.</p><p><strong>Results: </strong>Among the 135 eyes of 95 cases of ocular syphilis studied, scleritis with uveitis was observed in 3.70% of eyes (five eyes). All cases with scleritis and uveitis were unilateral and male, with ages ranging from 32 to 61 years. Concurrent features included placoid chorioretinitis, retinal vasculitis, and anterior uveitis. Misdiagnosis with subsequent oral steroid therapy precipitated scleritis as an exacerbation in two cases. Three cases, which were previously undiagnosed, were found to be HIV-positive. Scleritis manifested as anterior, non-necrotizing inflammation, often accompanied by chemosis, and responded rapidly to antibiotic and non-steroidal anti-inflammatory therapy. Scleritis resolution preceded that of chorioretinitis and retinal vasculitis.</p><p><strong>Conclusions: </strong>Non-necrotizing anterior scleritis with chemosis can be a rare presentation of active syphilitic uveitis. Large placoid chorioretinitis lesions, preceding inadvertent oral steroid and/or undiagnosed HIV status were the possible risk factors for the development of concurrent scleritis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"80-85"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200438","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
Evaluation of Choroidal Thickness and Choroidal Vascularity Index in Patients with Rheumatoid Arthritis. 评估类风湿性关节炎患者的脉络膜厚度和脉络膜血管指数
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-01 DOI: 10.1080/09273948.2024.2345289
Gülce Gökgöz Özışık, Dilek Eker Buyuksireci, Tayfun Şahin, Ayla Caglıyan Turk

Purpose: To evaluate the choroidal vascularity index and choroidal thickness in patients with rheumatoid arthritis.

Method: This study is a case control study. Our study consists of a total of two groups, with 32 individuals diagnosed with rheumatoid arthritis (RA) and 32 healthy volunteers. The thickness of the subfoveal choroid was measured from the 500 micron (µm), 1000 µm, 1500 µm nasal aspect of the fovea, and 500µm, 1000µm, 1500 µm temporal and subfoveal thickness of the fovea. ImageJ version 1.53i (National Institutes of Health, Bethesda, MD, USA) from open access was used for choroidal vascular index calculation.

Results: The mean age (p = 0.064) and gender distribution (p = 0.522) were not statistically different between these two groups. There was no difference between the groups in terms of visual acuity (p = 0.060), intraocular pressures (p=0.056), refractive errors (p = 0.418), and axial lengths (p = 0.280). Temporal 500 µm CT (p = 0.038), temporal 1000 µm CT (p = 0.010), and temporal 1500 µm CT (p = 0.005) differed significantly between the groups. The luminal area was significantly different between the RA group (842.71 ± 192.77) and the control group (957.78 ± 230.83) (p = 0.034). The choroidal vascularity index showed a significant difference between the RA group (64.99 ± 4.71) and the control group (67.34 ± 3.40) (p = 0.026). A significant difference was observed between the seronegative RA and the control group with temporal 1500 µm CT (p = 0.030), temporal 1000 µm CT (p = 0.023), and luminal area (p = 0.034).

Conclusion: We demonstrated thinning in CT and decreased CVI for the first time in RA patients by comparing it with the control group.

目的:评估类风湿性关节炎患者的脉络膜血管指数和脉络膜厚度:本研究为病例对照研究。我们的研究共分为两组,一组是 32 名确诊为类风湿性关节炎(RA)的患者,另一组是 32 名健康志愿者。眼窝下脉络膜的厚度分别从眼窝鼻侧的 500 微米、1000 微米和 1500 微米,以及眼窝颞侧和眼窝下的 500 微米、1000 微米和 1500 微米进行测量。计算脉络膜血管指数时使用了开放获取的 ImageJ 1.53i 版(美国马里兰州贝塞斯达国立卫生研究院):结果:两组患者的平均年龄(p = 0.064)和性别分布(p = 0.522)无统计学差异。两组在视力(p = 0.060)、眼压(p=0.056)、屈光不正(p = 0.418)和轴向长度(p = 0.280)方面没有差异。颞部 500 µm CT(p = 0.038)、颞部 1000 µm CT(p = 0.010)和颞部 1500 µm CT(p = 0.005)在各组之间存在显著差异。RA 组(842.71 ± 192.77)和对照组(957.78 ± 230.83)的管腔面积有明显差异(p = 0.034)。脉络膜血管指数在 RA 组(64.99 ± 4.71)和对照组(67.34 ± 3.40)之间存在显著差异(P = 0.026)。血清阴性 RA 组与对照组在颞部 1500 µm CT(p = 0.030)、颞部 1000 µm CT(p = 0.023)和管腔面积(p = 0.034)方面存在明显差异:结论:通过与对照组进行比较,我们首次发现 RA 患者的 CT 变薄,CVI 减少。
{"title":"Evaluation of Choroidal Thickness and Choroidal Vascularity Index in Patients with Rheumatoid Arthritis.","authors":"Gülce Gökgöz Özışık, Dilek Eker Buyuksireci, Tayfun Şahin, Ayla Caglıyan Turk","doi":"10.1080/09273948.2024.2345289","DOIUrl":"10.1080/09273948.2024.2345289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the choroidal vascularity index and choroidal thickness in patients with rheumatoid arthritis.</p><p><strong>Method: </strong>This study is a case control study. Our study consists of a total of two groups, with 32 individuals diagnosed with rheumatoid arthritis (RA) and 32 healthy volunteers. The thickness of the subfoveal choroid was measured from the 500 micron (µm), 1000 µm, 1500 µm nasal aspect of the fovea, and 500µm, 1000µm, 1500 µm temporal and subfoveal thickness of the fovea. ImageJ version 1.53i (National Institutes of Health, Bethesda, MD, USA) from open access was used for choroidal vascular index calculation.</p><p><strong>Results: </strong>The mean age (<i>p</i> = 0.064) and gender distribution (<i>p</i> = 0.522) were not statistically different between these two groups. There was no difference between the groups in terms of visual acuity (<i>p</i> = 0.060), intraocular pressures (<i>p</i>=0.056), refractive errors (<i>p</i> = 0.418), and axial lengths (<i>p</i> = 0.280). Temporal 500 µm CT (<i>p</i> = 0.038), temporal 1000 µm CT (<i>p</i> = 0.010), and temporal 1500 µm CT (<i>p</i> = 0.005) differed significantly between the groups. The luminal area was significantly different between the RA group (842.71 ± 192.77) and the control group (957.78 ± 230.83) (<i>p</i> = 0.034). The choroidal vascularity index showed a significant difference between the RA group (64.99 ± 4.71) and the control group (67.34 ± 3.40) (<i>p</i> = 0.026). A significant difference was observed between the seronegative RA and the control group with temporal 1500 µm CT (<i>p</i> = 0.030), temporal 1000 µm CT (<i>p</i> = 0.023), and luminal area (<i>p</i> = 0.034).</p><p><strong>Conclusion: </strong>We demonstrated thinning in CT and decreased CVI for the first time in RA patients by comparing it with the control group.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"40-47"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864631","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
Long-term Efficacy of Oral Valganciclovir in Presumed Cytomegalovirus Unilateral Hypertensive Anterior Uveitis. 口服缬更昔洛韦对巨细胞病毒单侧高血压性前葡萄膜炎的长期疗效
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-22 DOI: 10.1080/09273948.2024.2356057
Abdulsalam M Dheyab, Abdulrahman F Albloushi, Asma Al-Zuabi, Sulaiman M AlTariqi, Mohannad F Tobaigy, Abdullah Alfawaz, Ahmed Abu El-Asrar

Purpose: To describe long-term efficacy and safety of oral valganciclovir in the treatment of presumed cytomegalovirus (CMV) unilateral hypertensive anterior uveitis.

Methods: Retrospective review of 40 patients (40 eyes).

Results: All patients presented with high intraocular pressure (mean 39.35 ± 7.58 mmHg), associated with signs of mild anterior uveitis. Oral valganciclovir resulted in control of the intraocular pressures and inflammation in 35 eyes. At the dose of ≥450 mg twice daily, no relapses were documented. The follow-up period ranged from 12 to 108 months (24.45 ± 14.56). At the final follow-up, the intraocular pressure was reduced to 14.92 ± 2.43 mmHg (<0.001). Drug-related complications in the form of leukopenia and azoospermia were reported in one patient.

Conclusions: Oral valganciclovir effectively and safely controls intraocular pressure and inflammation in presumed CMV anterior uveitis. A long-term treatment course seems necessary.

目的:描述口服缬更昔洛韦治疗推测的巨细胞病毒(CMV)单侧高眼压前葡萄膜炎的长期疗效和安全性:方法:对40例患者(40只眼)进行回顾性研究:结果:所有患者均出现高眼压(平均 39.35 ± 7.58 mmHg),并伴有轻度前葡萄膜炎的症状。口服缬更昔洛韦可控制 35 只眼睛的眼压和炎症。在剂量≥450毫克、每天两次的情况下,没有复发的记录。随访时间从 12 个月到 108 个月不等(24.45 ± 14.56)。在最后的随访中,眼压降至 14.92 ± 2.43 mmHg(结论:口服缬更昔洛韦可降低眼压,但不能降低眼压:口服缬更昔洛韦可有效、安全地控制假定巨细胞病毒前葡萄膜炎患者的眼压和炎症。看来有必要进行长期治疗。
{"title":"Long-term Efficacy of Oral Valganciclovir in Presumed Cytomegalovirus Unilateral Hypertensive Anterior Uveitis.","authors":"Abdulsalam M Dheyab, Abdulrahman F Albloushi, Asma Al-Zuabi, Sulaiman M AlTariqi, Mohannad F Tobaigy, Abdullah Alfawaz, Ahmed Abu El-Asrar","doi":"10.1080/09273948.2024.2356057","DOIUrl":"10.1080/09273948.2024.2356057","url":null,"abstract":"<p><strong>Purpose: </strong>To describe long-term efficacy and safety of oral valganciclovir in the treatment of presumed cytomegalovirus (CMV) unilateral hypertensive anterior uveitis.</p><p><strong>Methods: </strong>Retrospective review of 40 patients (40 eyes).</p><p><strong>Results: </strong>All patients presented with high intraocular pressure (mean 39.35 ± 7.58 mmHg), associated with signs of mild anterior uveitis. Oral valganciclovir resulted in control of the intraocular pressures and inflammation in 35 eyes. At the dose of ≥450 mg twice daily, no relapses were documented. The follow-up period ranged from 12 to 108 months (24.45 ± 14.56). At the final follow-up, the intraocular pressure was reduced to 14.92 ± 2.43 mmHg (<0.001). Drug-related complications in the form of leukopenia and azoospermia were reported in one patient.</p><p><strong>Conclusions: </strong>Oral valganciclovir effectively and safely controls intraocular pressure and inflammation in presumed CMV anterior uveitis. A long-term treatment course seems necessary.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"72-79"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082104","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
Occlusive Vasculitis Following Intravitreal Rituximab Injection for Primary Vitreoretinal Lymphoma. 玻璃体内注射利妥昔单抗治疗原发性玻璃体视网膜淋巴瘤后的闭塞性血管炎
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-06-24 DOI: 10.1080/09273948.2024.2367270
Emily D Cole, Vaidehi Dedania, Hakan Demirci

Purpose: We report three cases of occlusive vasculitis following intravitreal rituximab therapy for biopsy-proven primary vitreoretinal lymphoma (PVRL), one of which was following an injection of the biosimilar Riabni (rituximab-arrx, AmGen) and two of which were following an injection of Rituxan (rituximab, Genentech).

Methods: Case series.

Results: Three cases of occlusive vasculitis confirmed with fluorescein angiography are reported 5 days, 8 days, and 3.5 weeks following intravitreal injection of rituximab. The initial vision was poor (20/500, 20/150, and light perception), but vision recovered to baseline in two cases, and remained poor in the case of combined artery and vein occlusion.

Conclusion: Occlusive vasculitis is a rarely reported but potential complication of intravitreal rituximab therapy in patients who have been previously treated with the agent and may have delayed onset. A low threshold for fluorescein angiography as a diagnostic test for post-injection vision loss and prompt treatment with topical and/or oral steroids should be considered.

目的:我们报告了三例经活检证实为原发性玻璃体视网膜淋巴瘤(PVRL)的玻璃体内利妥昔单抗治疗后发生闭塞性血管炎的病例,其中一例是在注射生物仿制药Riabni(利妥昔单抗-arrx,AmGen公司)后发生的,两例是在注射利妥昔单抗(利妥昔单抗,基因泰克公司)后发生的:方法:病例系列:结果:报告了三例经荧光素血管造影证实的闭塞性血管炎病例,分别发生在玻璃体内注射利妥昔单抗后 5 天、8 天和 3.5 周。最初的视力较差(20/500、20/150 和光感),但有两个病例的视力恢复到了基线,而动脉和静脉合并闭塞的病例视力仍然较差:结论:闭塞性脉管炎是一种极少见的潜在并发症,既往接受过玻璃体内利妥昔单抗治疗的患者可能会延迟发病。应考虑采用低门槛的荧光素血管造影作为注射后视力下降的诊断测试,并及时使用局部和/或口服类固醇进行治疗。
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引用次数: 0
Differential Composition and Structure of the Microbiota from Active and Inactive Stages of HLA-B27-associated Uveitis by Paired Fecal Metagenomes. 通过配对粪便元基因组发现HLA-B27相关葡萄膜炎活动期和非活动期微生物群的不同组成和结构
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-06 DOI: 10.1080/09273948.2024.2346818
José Antonio Unzueta-Medina, Susana Aideé González-Chávez, Joan Sebastian Salas-Leiva, Sandra Estela Silva-Sánchez, César Pacheco-Tena

Purpose: To compare the diversities and abundances of bacterial taxa in the microbiome of patients with HLA B27-positive acute anterior uveitis (AAU) in the active and inactive phases.

Methods: An observational descriptive prospective and comparative study was conducted in ten HLA-B27-positive AAU patients (44.6 ± 13.4 years). The microbiome of the stool samples obtained in the active and inactive stages was analyzed by sequencing the V3 region of the 16S rRNA gene.

Results: The differences in the bacteria profile between active and inactive stages in each individual were confirmed (p < 0.0001). Ten OTUs were found exclusively in the active phase of 90% of the individuals, suggesting a proinflammatory association. Blautia OUT_4 and Faecalibacterium OUT_2 abundances showed a direct relationship between abundance and severity of ocular inflammation. Two OTUs were exclusive of the inactive stage, suggesting an anti-inflammatory role.

Conclusion: The metagenomic profile of the fecal microbiota differs in the acute phase of the AAU compared to when the inflammation subsides, despite being the same individual and a short time-lapse. AAU is a fertile field for studying the connection between subtle rapid changes in microbiota and their systemic consequences.

目的:比较 HLA B27 阳性急性前葡萄膜炎(AAU)患者活动期和非活动期微生物组中细菌类群的多样性和丰度:对10名HLA-B27阳性急性前葡萄膜炎患者(44.6 ± 13.4岁)进行了观察性描述前瞻性比较研究。通过对 16S rRNA 基因 V3 区域进行测序,分析了活动期和非活动期粪便样本的微生物组:结果:每个个体在活动期和非活动期的细菌谱差异得到了证实(p Blautia OUT_4 和 Faecalibacterium OUT_2 的丰度与眼部炎症的严重程度有直接关系。有两个 OTU 专属于非活性阶段,这表明它们具有抗炎作用:结论:粪便微生物群的元基因组图谱在 AAU 急性期与炎症消退期有所不同,尽管是同一个人且时间跨度很短。AAU 是研究微生物群微妙的快速变化与其系统后果之间联系的肥沃领域。
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引用次数: 0
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Ocular Immunology and Inflammation
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