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Journal articles on the topic 'Uveitis'
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Verma, Ashutosh, S. R. Rathinam, C. Gowri Priya, V. R. Muthukkaruppan, Brian Stevenson, and John F. Timoney. "LruA and LruB Antibodies in Sera of Humans with Leptospiral Uveitis." Clinical and Vaccine Immunology 15, no. 6 (April 9, 2008): 1019–23. http://dx.doi.org/10.1128/cvi.00203-07.
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ABSTRACT Uveitis can be a serious complication of leptospirosis. Previous studies indicated that the leptospiral lipoproteins LruA and LruB are expressed in the eyes of uveitic horses and that antibodies directed against those proteins show in vitro cross-reactivity with components of equine lens, ciliary body, and/or retina. We now demonstrate that sera from a significant proportion of humans who have leptospiral uveitis also contain antibodies against LruA and LruB. Different categories of nonleptospiral uveitis and autoimmune uveitis were also screened; patients diagnosed with Fuchs uveitis or Behçet's syndrome produced antibodies that cross-reacted with LruA and LruB, suggesting similarities of the autoimmune responses in those diseases with those of leptospiral uveitis.
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Lorenz, Lea, Barbara Amann, Sieglinde Hirmer, Roxane L. Degroote, Stefanie M. Hauck, and Cornelia A. Deeg. "NEU1 is more abundant in uveitic retina with concomitant desialylation of retinal cells." Glycobiology 31, no. 7 (February 23, 2021): 873–83. http://dx.doi.org/10.1093/glycob/cwab014.
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Abstract Desialylation of cell surface glycoproteins carried out by sialidases affects various immunological processes. However, the role of neuraminidase 1 (NEU1), one of the four mammalian sialidases, in inflammation and autoimmune disease is not completely unraveled to date. In this study, we analyzed the retinal expression of NEU1 in equine recurrent uveitis (ERU), a spontaneous animal model for autoimmune uveitis. Mass spectrometry revealed significantly higher abundance of NEU1 in retinal Müller glial cells (RMG) of ERU-diseased horses compared to healthy controls. Immunohistochemistry uncovered NEU1 expression along the whole Müller cell body in healthy and uveitic states and confirmed higher abundance in inflamed retina. Müller glial cells are the principal macroglial cells of the retina and play a crucial role in uveitis pathogenesis. To determine whether higher expression levels of NEU1 in uveitic RMG correlate with the desialylation of retinal cells, we performed lectin-binding assays with sialic acid-specific lectins. Through these experiments, we could demonstrate a profound loss of both α2-3- and α2-6-linked terminal sialic acids in uveitis. Hence, we hypothesize that the higher abundance of NEU1 in uveitic RMG plays an important role in the pathogenesis of uveitis by desialylation of retinal cells. As RMG become activated in the course of uveitis and actively promote inflammation, we propose that NEU1 might represent a novel activation marker for inflammatory RMG. Our data provide novel insights in the expression and implication of NEU1 in inflammation and autoimmune disease.
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Smeller, Lilla, Viktória Sümegi, Edit Tóth-Molnár, and Nicolette Sohár. "A biológiai terápia helye a gyermekkori uveitis ellátásában." Orvosi Hetilap 163, no. 35 (August 28, 2022): 1402–8. http://dx.doi.org/10.1556/650.2022.32578.
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Bevezetés: A gyermekkori uveitisek kezelésében 2016 óta van lehetőség biológiai terápia alkalmazására. Szemészeti indikáció esetén adalimumabbal indítható terápia, mely egy tumornekrózisfaktor-ellenes monoklonális antitest. Célkitűzés: Klinikánk uveitisambulanciáján a gyermekkori uveitis miatt kezelt betegek adatainak retrospektív feldolgozása alapján a nem fertőzéses eredetű uveitis esetén alkalmazott adalimumabkezelésről szerzett tapasztalataink összefoglalása. Betegek és módszerek: Restrospektív módon elemeztük a Szegedi Tudományegyetem Szemészeti Klinikáján 2017. 01. 01. és 2021. 05. 31. között uveitis miatt gondozott gyermekek adatait. Eredmények: 2017 és 2021 között 46 uveitises gyermeket vizsgáltunk klinikánkon. A 23 lány és 23 fiúgyermek átlagéletkora 11 év volt. Közülük 21 gyermek szenvedett juvenilis idiopathiás arthritisben, 14 gyermeknél igazolódott infekció, 3 gyermeknél hematológiai betegség okozta az elváltozást, 8 gyermeknél idiopathiás eredetű volt a gyulladás. Krónikus, súlyos uveitis miatt 11 gyermeknél indítottunk biológiai terápiát az Európai Gyógyszerügynökség engedélye alapján. 3 fiúgyermek és 8 lánygyermek részesült adalimumabkezelésben, átlagéletkoruk 10 év volt. 6 gyermeknél anterior, 5 gyermeknél panuveitis indikálta a kezelést. Az adalimumab alkalmazási leirata szerint 2 évnél idősebb gyermekeknél a krónikus, nem fertőzéses eredetű szemgyulladás kezelésére alkalmazható, amikor a gyulladás a szem elülső részét érinti. Panuveitises betegeink esetén gyermekreumatológus segítségét kértük a biológiai terápia engedélyezéséhez. Következtetés: A gyermekkori uveitisek és azok terápiájának jelentősége kiemelkedő. A szemészeti kezelés célja a gyermekek látásélességének megőrzése és a szemészeti szövődmények megelőzése mellett a betegek megfelelő életminőségének biztosítása. Kiemelkedő fontosságú a korai diagnózis, a megfelelő terápia, a rendszeres kontrollvizsgálat. Az adalimumab hatékonyságát mutatja, hogy a kezelt gyermekek jelentős százalékánál sikerült a teljes látásélességet elérni, valamint a kezelés mellett újabb szemészeti szövődmény nem alakult ki. Orv Hetil. 2022; 163(35): 1402–1408.
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Al-Ani, Haya H., Joanne L. Sims, Oren Tomkins-Netzer, Susan Lightman, and Rachael L. Niederer. "Vision loss in anterior uveitis." British Journal of Ophthalmology 104, no. 12 (April 3, 2020): 1652–57. http://dx.doi.org/10.1136/bjophthalmol-2019-315551.
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AimsTo evaluate the long-term risk of permanent vision loss in subjects with anterior uveitis.MethodsRetrospective study of subjects attending uveitis clinic at Auckland District Health Board and Moorfields Eye Hospital between 2008 and 2018. Main outcome measures were: best corrected visual acuity (BCVA); moderate vision loss (MVL ≤20/50); and severe vision loss (SVL ≤20/200).Results2526 eyes of 1814 subjects were included with a mean follow-up of 6.8 years (17 235.4 eye-years of follow-up). MVL occurred in 240 eyes (9.5%) during the follow-up period, of which 97 (3.8%) had permanent MVL due to uveitis. The incidence of permanent MVL due to uveitis was 0.006 per eye-year with a cumulative risk at 10 years of 6.6% (5.2%–8.4%). The most common cause of permanent MVL due to uveitis was uveitic glaucoma (31.3%), followed by cystoid macular oedema (27.1%) and corneal scar (21.9%). SVL occurred in 80 eyes (3.2%) during the follow-up period, of which 39 (1.5%) had permanent SVL due to uveitis. The incidence of permanent SVL due to uveitis was 0.002 per eye-year with a cumulative risk at 10 years of 2.6% (1.8%–3.7%). Multivariate analysis showed older age at presentation, chronic anterior uveitis (CAU), infectious aetiology and poor presenting BCVA were all risk factors for permanent MVL due to uveitis.ConclusionsAlthough vision loss is an uncommon complication in anterior uveitis, the risk is greatest in those with CAU, infectious aetiology and poor presenting BCVA. Uveitic glaucoma is the most common cause of vision loss.
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Juhong, Jakkrit, Krit Pongpirul, Somtaporn Ueathaweephol, Thanapong Somkijrungroj, and Wijak Kongwattananon. "The patterns of uveitis and the factors affecting visual outcome from Chulalongkorn University Uveitis Cohort (CU2C): A 5-year longitudinal study protocol." PLOS ONE 17, no. 10 (October 6, 2022): e0275666. http://dx.doi.org/10.1371/journal.pone.0275666.
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Background In Thailand, several novel laboratory investigations are recently available to help differentiate the uveitic etiologies. The update on uveitis epidemiological data in Thailand is necessary to better understand the disease burden and provide guidance on management. The current study aims to describe the prevalence and identify factors associated with poor visual outcomes of uveitis patients at a tertiary center in Thailand. Methods A 5-year-prospective study of uveitis cases presented at a tertiary referral center in the central region of Thailand is conducted.
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Al-Dhibi, Hassan, Issam H. Hamade, Ali Al-Halafi, Maan Barry, Charbel Bou Chacra, Vishali Gupta, and Khalid F. Tabbara. "The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema." Journal of Ophthalmology 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/729465.
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Background/Aims.To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides.Design.Retrospective interventional case series.Methods.A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted.Results.The mean age of patients was41±16years with a mean followup of4±1months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from0.8±0.8at baseline to0.4±0.5at 1 month and0.3±0.5at 3 months (P<0.002, at 3 months). The mean macular thickness was430±132 μm at baseline. Following IVBI macular thickness improved to286±93 μm at 1 month and to265±88 μm at 3 months of followup (P<0.001, at 3 months).Conclusion.Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.
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Iannetti, Ludovico, Paolo Tortorella, Enzo D’Ambrosio, Rossela Spena, Roberta Zito, and Magda Gharbiya. "Epiretinal Membranes in Patients with Uveitis: Morphological and Functional Analysis with Spectral Domain Optical Coherence Tomography." BioMed Research International 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/284821.
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Purpose. To correlate the uveitic epiretinal membrane (ERM) features using spectral-domain optical coherence tomography (SD-OCT) with visual acuity (VA).Methods. Forty-one eyes of 32 patients were included in this retrospective study. SD-OCT was performed in all patients and data were collected at the time of ERM diagnosis and at the final visit. Both best corrected visual acuity (BCVA) and ERM thickness were correlated with the morphological and clinical features.Results. Final BCVA was positively correlated with male sex and the focal pattern of ERM attachment and negatively correlated with IS/OS photoreceptor junction disruption . BVCA change showed a positive correlation with the age of ERM onset but a negative correlation with IS/OS photoreceptor disruption at the ERM diagnosis and the increase of central subfield thickness (CST) . Final ERM thickness correlated with the duration of uveitis and the duration of ERM . During the follow-up, ERM thickening correlated with male sex , posterior uveitis , uveitis duration , and broad attachment pattern .Conclusions. In the uveitic ERM, VA negatively correlates with IS/OS photoreceptor junction disruption and the increase of CST. ERM thickness is influenced by longer duration of both uveitis and ERM.
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Thorne, J., D. Jabs, R. Belfort, A. Dick, S. Gangaputra, R. Nussenblatt, A. Okada, J. Rosenbaum, and B. Trusko. "The Standardization of Uveitis Nomenclature (SUN) Project." Methods of Information in Medicine 52, no. 03 (2013): 259–65. http://dx.doi.org/10.3414/me12-01-0063.
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SummaryBackground: Given the recent increased focus on evidence-based medicine, it is critical that diseases and syndromes have accurate and complete descriptions, including standardized and widely accepted terminologies. Standardizing these descriptions and terminologies is necessary to develop tools such as computerized data entry forms and classification criteria. This need is especially true for diseases that are relatively uncommon, such as uveitis.Objectives: To develop a standardized and internationally accepted terminology for the field of uveitis.Methods: The Standardization of Uveitis Nomenclature (SUN) Working Group (WG) is an international group of 79 uveitis experts from 18 countries and 62 clinical centers. Initial terminology was developed utilizing a “modified” green field approach, which was enhanced through web-based surveys and teleconferences via a “modified” Delphi technique. Terms were mapped provisionally into ontologic dimensions for each syndrome. The Working Group then met and utilized nominal group techniques as a formalized method of finalizing the mappings.Results: Mapping of terms into dimensions to describe 28 major uveitic diseases was confirmed using nominal group techniques (achieving super-majority consensus) for each of the diseases at a meeting of the entire WG.Conclusions: The SUN WG utilized an informatics-based approach to develop a stand ardized and internationally accepted terminology for the uveitides.
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Conrady, Christopher D., and Steven Yeh. "A Review of Ocular Drug Delivery Platforms and Drugs for Infectious and Noninfectious Uveitis: The Past, Present, and Future." Pharmaceutics 13, no. 8 (August 8, 2021): 1224. http://dx.doi.org/10.3390/pharmaceutics13081224.
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Uveitis refers to a broad group of inflammatory disorders of the eye that often require medical and surgical management to improve or stabilize vision and prevent vision-threatening pathological changes to the eye. Drug delivery to the eye to combat inflammation and subsequent complications from uveitic conditions is complex as there are multiple barriers to absorption limiting availability of the needed drug in the affected tissues. As such, there has been substantial interest in developing new drugs and drug delivery platforms to help reduce intraocular inflammation and its complications. In this review, we discuss the challenges of drug delivery, novel technologies recently approved for uveitis patient care and promising drug delivery platforms for uveitis and sequelae of ocular inflammation.
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Du, Lin, Yolanda Wong Ying Yip, Him Kwan Ng, Bo Man Ho, Jing-Na He, Sun On Chan, Chi Pui Pang, and Wai Kit Chu. "Ruxolitinib Alleviates Uveitis Caused by Salmonella typhimurium Endotoxin." Microorganisms 9, no. 7 (July 11, 2021): 1481. http://dx.doi.org/10.3390/microorganisms9071481.
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Uveitis is characterized by inflammatory lesions of intraocular structures. It is one of the important manifestations in patients with Reiter’s syndrome, an inflammatory arthritis, which is caused by enteric infection with bacteria, including Salmonella typhimurium. Corticosteroids remain the most frequently used therapies against uveitis associating with inflammatory arthritis. However, the long-term administration of steroids results in many side effects, and some uveitis patients do not respond to steroid treatment. Non-steroidal treatments are needed for uveitis patients. Our previous study found that Janus kinase (JAK) 1/2 inhibitor, ruxolitinib could suppress the expression of proinflammatory mediators in the ciliary body and iris. However, the impacts of ruxolitinib on ophthalmic features in uveitic eyes are still unknown. In this study, Salmonella typhimurium endotoxin-induced uveitis (EIU) was induced in Sprague Dawley rats by the injection of lipopolysaccharide (LPS). Compared with LPS-induced rats treated with water, ruxolitinib significantly attenuated the clinical manifestations, infiltrating cells and protein exudation in the aqueous humor, and retina–choroid thickening. Amplitudes of b-wave in both scotopic and photopic electroretinogram (ERG), and the amplitude of a-wave in scotopic ERG in EIU animals were alleviated by ruxolitinib. Collectively, we propose ruxolitinib could attenuate endotoxin-induced uveitis and rescue visual functions in rats by inhibiting the JAK2-STAT3 pathway.
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Verma, Ashutosh, Sergey Artiushin, James Matsunaga, David A. Haake, and John F. Timoney. "LruA and LruB, Novel Lipoproteins of Pathogenic Leptospira interrogans Associated with Equine Recurrent Uveitis." Infection and Immunity 73, no. 11 (November 2005): 7259–66. http://dx.doi.org/10.1128/iai.73.11.7259-7266.2005.
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ABSTRACT Recurrent uveitis as a sequela to Leptospira infection is the most common infectious cause of blindness and impaired vision of horses worldwide. Leptospiral proteins expressed during prolonged survival in the eyes of horses with lesions of chronic uveitis were identified by screening a phage library of Leptospira interrogans DNA fragments with eye fluids from uveitic horses. Inserts of reactive phages encoded several known leptospiral proteins and two novel putative lipoproteins, LruA and LruB. LruA was intrinsically labeled during incubation of L. interrogans in medium containing [14C]palmitic acid, confirming that it is a lipoprotein. lruA and lruB were detected by Southern blotting in infectious Leptospira interrogans but not in nonpathogenic Leptospira biflexa. Fractionation data from cultured Leptospira indicate that LruA and LruB are localized in the inner membrane. Uveitic eye fluids contained significantly higher levels of immunoglobulin A (IgA) and IgG specific for each protein than did companion sera, indicating strong local antibody responses. Moreover, LruA- and LruB-specific antisera reacted with equine ocular components, suggesting an immunopathogenic role in leptospiral uveitis.
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Oka, Ngurah Dwi, I. Gusti Ayu Ratna Suryaningrum, I. Gusti Ayu Made Juliari, I. Made Agus Kusumadjaja, Ni Kompyang Rahayu, Ni Ketut Niti Susila, and A. A. Mas Putra Triningrat. "Uveitic glaucoma management with recurrent uveitis episode." Bali Journal of Ophthalmology 4, no. 1 (June 1, 2020): 6. http://dx.doi.org/10.15562/bjo.v4i1.35.
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Géhl, Zsuzsanna, Zsuzsanna Szepessy, and Zoltán Zsolt Nagy. "A TNFα-gátló szemészeti alkalmazása: adalimumabkezelés uveitisben." Orvosi Hetilap 162, no. 34 (August 22, 2021): 1370–75. http://dx.doi.org/10.1556/650.2021.32188.
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Összefoglaló. Bevezetés: Az adalimumab egy TNFα-gátló monoklonális antitest; számos indikációja közül a nem fertőzéses eredetű intermedier, posterior és panuveitisek kezelésében is általánosan alkalmazható készítmény. Célkitűzés: A felnőttkori nem fertőzéses eredetű uveitis miatt adalimumabkezelést kapó betegekkel szerzett tapasztalataink összefoglalása. Betegek és módszerek: Retrospektív esetsorozatban vizsgáljuk a budapesti Uveitis Centrumban (a Semmelweis Egyetem Szemészeti Klinikájának Uveitis Ambulanciáján) 2018 és 2020 között adalimumabbal kezelt felnőtt, nem fertőzéses eredetű uveitises eseteinket. Eredmények: 13 beteget mutatunk be (8 nő, 5 férfi), átlagéletkor 45 (26–80) év. Az adalimumabot 12 beteg Humira, 1 beteg Amgevita készítmény formájában kapja. Az uveitis eredete 2 esetben ’birdshot’ chorioretinitis, 2 esetben Behçet-kór, 1 esetben sarcoidosis, 3 esetben retinalis vasculitis, 1 esetben Vogt–Koyanagi–Harada-betegség volt, és 4 esetben idiopathiás eredetűnek bizonyult. Az adalimumabkezelést 7 betegnél kellett elhagyni, elsősorban terápiás elégtelenség miatt, míg 6 betegnél jelenleg is eredményesen folyik a kezelés. Következtetés: Tapasztalataink alapján az adalimumab biztonságos, kevés mellékhatással bíró, hatékony kezelés számos uveitisformában önmagában adva vagy kis dózisú szteroiddal kiegészítve. Korábbi terápiákra (szteroid, immunszuppresszió) rezisztens esetekben is alkalmazható. A szemészetben a szisztémás biológiai terápia, az adalimumab bevezetése az uveitises betegek kezelésében a látóélesség megőrzése szempontjából sorsdöntő jelentőségű. Orv Hetil. 2021; 162(34): 1370–1375. Summary. Introduction: Adalimumab is a monoclonal antibody that inhibits TNFα and among other indications it can be a systemic treatment in the non-infectious intermediate, posterior and panuveitis. Objective: To summarize our experience in patients receiving adalimumab for adult non-infectious uveitis. Patients and methods: We investigate our adult cases of non-infectious uveitis treated with adalimumab between 2018 and 2020 in a retrospective case series at the Uveitis Center in Budapest (Semmelweis University, Department of Ophthalmology, Uveitis Department). Results: We present 13 patients (8 females, 5 males) with a mean age of 45 (26–80) years. Adalimumab is given to 12 patients as Humira and 1 patient as Amgevita. The etiology of uveitis was in 2 cases birdshot chorioretinitis, 2 Behçet’s disease, 1 sarcoidosis, 3 retinal vasculitis, 1 Vogt–Koyanagi–Harada disease, and 4 of idiopathic origin. Adalimumab treatment had to be discontinued in 7 cases, mainly due to therapeutic insufficiency, while in 6 cases we are still successfully treating patients. Conclusion: According to our experience, adalimumab is a safe and effective treatment, with minimal side effect in many forms of uveitis alone, or in combination with a low-dose steroid. It can also be used in cases where traditional immunosuppressive therapies are ineffective. In ophthalmology, systemic biologic therapy, availability of adalimumab in the treatment of uveitis is crucial for maintaining visual acuity at affected patients. Orv Hetil. 2021; 162(34): 1370–1375.
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Jabs, Douglas A., Andrew Dick, John T. Doucette, Amod Gupta, Susan Lightman, Peter McCluskey, Annabelle A. Okada, et al. "Interobserver Agreement Among Uveitis Experts on Uveitic Diagnoses: The Standardization of Uveitis Nomenclature Experience." American Journal of Ophthalmology 186 (February 2018): 19–24. http://dx.doi.org/10.1016/j.ajo.2017.10.028.
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Liaboe, Chase A., Michael S. Lee, and Justin J. Y. Yamanuha. "Simultaneous Presentation of Uveitic Disc Edema and Papilledema in an Adult." Case Reports in Ophthalmological Medicine 2020 (July 8, 2020): 1–5. http://dx.doi.org/10.1155/2020/8829124.
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Purpose. To present a case of simultaneous uveitic disc edema and increased intracranial pressure (IICP) in an adult. Methods. Retrospective case report. Patients. A 29-year-old woman affected by bilateral optic disc edema from bilateral posterior uveitis complicated by IICP with papilledema. Results. Laboratory workup was negative for infectious and systemic inflammatory causes of uveitis. Computed Tomography scan of the chest was negative for Sarcoidosis. Magnetic Resonance Imaging of the brain and orbits revealed a partially empty sella, bilateral posterior globe flattening without optic nerve sheath enhancement, masses, white matter lesions, or meningeal enhancement. Cerebral Magnetic Resonance Venography showed narrowing of the right and left transverse sinuses without thromboses. Prednisone was initiated for the uveitis which improved the vision but caused weight gain. Neurology evaluation with a lumbar puncture in the lateral decubitus position revealed elevated opening pressure and otherwise normal cerebrospinal fluid. Ocular ultrasonography was considered but not available to measure optic nerve sheath diameter. Oral acetazolamide 1000 mg twice daily was started for papilledema as prednisone was tapered. Periocular steroid and intravitreal bevacizumab injections were used for sight threatening cystoid macular edema and choroidal neovascularization, respectively. Discussion. While previously described in children, we report the first known case of bilateral uveitic disc edema and papilledema in an adult. This report will discuss recommendations for evaluation of these rarely concurrent conditions and therapy for both uveitic disc edema and papilledema.
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Gupta, Sharad, Dev Narayan Shah, Sagun Narayan Joshi, Manoj Aryal, and Lila Raj Puri. "Patterns of Macular Edema in Uveitis as Diagnosed by Optical Coherence Tomography in Tertiary Eye Center." Nepalese Journal of Ophthalmology 10, no. 1 (November 20, 2018): 39–46. http://dx.doi.org/10.3126/nepjoph.v10i1.21687.
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Aim: The aim of the study is to classify the patterns of uveitic macular edema using Optical Coherence Tomography as a diagnostic tool.Methodology: It is the Descriptive, cross-sectional study. All patients fulfilling the diagnostic criteria with Optical coherence tomography diagnosed macular edema were enrolled from 1 January 2012 to 30 June 2013. Patterns of uveitic macular edema were classified.Results: A total of 65 eyes of 47 patients were included. Twenty eight (59.57%) were male. The male to female ratio was 1.5:1. The mean age was 38 years (SD 14.68). Twenty nine patients (61.71%) had unilateral involvement and 18 (38.29%) had bilateral involvement. Forty five eyes of 33 cases (69.23%, 70.21%) had intermediate uveitis, followed by 10 eyes of 7 cases (15.38, 14.9%) of posterior uveitis, 6 eyes of 5 cases (9.23%, 10.63 %) of anterior uveitis and 4 eyes of 2 cases (6.16%,4.2%) of pan-uveitis. Patterns of macular edema were classified: diff use macular edema (DME), cystoid macular edema (CME) and serous retinal detachment (SRD) of which 35 (53.84%) eyes had CME. The etiological diagnosis was found in 7(14.90 %) out of 47 patients.Conclusion: A significant percentage of cases were idiopathic. Macular edema may go unnoticed unless OCT is performed. Macular detachment is an important feature of macular edema that affects visual acuity and is not readily detected by Fundus Fluorescein Angiography (FFA). Optical coherence tomography (OCT) is safe and non-invasive technique and has the potential for measuring changes in retinal thickness and axial extent of edema.
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Ghadiri, Nima, Ian R. Reekie, Iris Gordon, Sare Safi, Gareth Lingham, Jennifer R. Evans, and Stuart Keel. "Systematic review of clinical practice guidelines for uveitis." BMJ Open Ophthalmology 8, no. 1 (January 2023): e001091. http://dx.doi.org/10.1136/bmjophth-2022-001091.
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To facilitate the integration of eye care into universal health coverage, the WHO is developing a Package of Eye Care Interventions (PECI). Development of the PECI involves the identification of evidence-based interventions from relevant clinical practice guidelines (CPGs) for uveitis.A systematic review of CPGs published on uveitis between 2010 and March 2020 was conducted. CPGs passing title and abstract and full-text screening were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and data on recommended interventions extracted using a standard data extraction sheet.Of 56 CPGs identified as potentially relevant from the systematic literature search, 3 CPGs underwent data extraction following the screening stages and appraisal with the AGREE II tool. These CPGs covered screening for, monitoring and treating juvenile idiopathic arthritis (JIA)-associated uveitis, the use of adalimumab and dexamethasone in treating non-infectious uveitis, and a top-level summary of assessment, differential diagnosis and referral recommendations for uveitis, aimed at primary care practitioners. Many of the recommendations were based on expert opinion, though some incorporated clinical study and randomised controlled trial data.There is currently sparse coverage of the spectrum of disease caused by uveitis within CPGs. This may partially be due to the large number of conditions with diverse causes and clinical presentations covered by the umbrella term uveitis, which makes numerous sets of guidelines necessary. The limited pool of CPGs to select from has implications for clinicians seeking guidance on clinical care strategies for uveitis.
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Muñoz-Negrete, Francisco J., Javier Moreno-Montañés, Paula Hernández-Martínez, and Gema Rebolleda. "Current Approach in the Diagnosis and Management of Uveitic Glaucoma." BioMed Research International 2015 (2015): 1–13. http://dx.doi.org/10.1155/2015/742792.
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Uveitic glaucoma (UG) typically is associated with very high intraocular pressure (IOP) and more intense optic nerve damage than other glaucoma types. This secondary glaucoma requires an early diagnosis and adequate management of both uveitis and glaucoma. It is mandatory to identify the mechanisms of IOP elevation that in many eyes have multiple combined mechanisms. Management of these patients commonly requires an interdisciplinary approach that includes a glaucoma specialist and rheumatologist to control the inflammation and IOP. Glaucoma surgery is required early in these patients due to the high IOP usually present and is less successful than in primary open-angle glaucoma. Recurrent uveitic episodes, multiple mechanism, and the complications associated with uveitis make surgical management of UG challenging. In this review, the management and treatment of UG are updated to clarify the pathogenesis and prevent optic nerve damage.
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Lee, Joo Hwang, Yong Hoon Seo, and Eun Chul Lee. "Presumed Latent Tuberculosis-related Intermediate Uveitis Manifesting as Recurrent Vitreous Hemorrhage." Journal of the Korean Ophthalmological Society 63, no. 3 (March 15, 2022): 314–19. http://dx.doi.org/10.3341/jkos.2022.63.3.314.
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Purpose: We report a case of recurrent vitreous hemorrhage in a patient with presumed latent tuberculosis-related intermediate uveitis, and we review the literature.Case summary: A 58-year-old male visited our clinic complaining of ocular pain, conjunctival hyperemia, decreased vision, and uncontrolled intraocular pressure (IOP) in the left eye. The best-corrected visual acuity (BCVA) was 0.4 and the IOP of the left eye was 34 mmHg. Slit lamp examination revealed conjunctival hyperemia, corneal edema, and inflammatory cells in the anterior chamber and anterior vitreous; fundus examination revealed mild vitreous opacity attributable to vitritis. The high IOP and the intraocular inflammation were treated with antiglaucoma agents and corticosteroids under the impression of chronic anterior uveitis and uveitic glaucoma. Of the tests performed to identify the cause of the uveitis-related vitreous hemorrhage, the interferon-gamma release assay was positive. A presumptive diagnosis of latent tuberculosis-related uveitis was made after pulmonary tuberculosis was excluded by our respiratory internal medicine department. Isoniazid was administered for 9 months. The vitreous hemorrhage recurred 1 month after antituberculosis therapy commenced but, at 2 months, all of the hemorrhage was absorbed and the BCVA improved to 1.0 without further recurrence.Conclusions: Intraocular tuberculosis can present with various clinical manifestations. If tuberculosis-related uveitis is presumed, tests for latent and manifest tuberculosis should be scheduled to allow of early diagnosis and immediate antituberculosis therapy.
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Sonin, D. V., and S. A. Kochergin. "Features of primary IOL implantation in patients with history of chronic uveitis." Modern technologies in ophtalmology, no. 2 (June 15, 2021): 89–93. http://dx.doi.org/10.25276/2312-4911-2021-2-89-93.
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Purpose. To determine possible postoperative complications and methods of their prevention in patients with history of chronic uveitis who underwent Phacoemulsification of cataract with primary IOL implantation. Material and methods. In this article we give clinical analysis of complications after phacoemulsification with primary IOL implantation in patients with history of chronic uveitis. 5 patients with this pathology were hospitalized during 2020. Results. In this work, we provide literature data on the topic of primary IOL implantation in such patients. Currently there is no united opinion on managing such patients. Nevertheless, many authors agree that by using acrylic lenses, prolonged pharmacotherapy, uveitis remission of more than 3 months primary IOL implantation can be safe, and we can get high visual acuity [14]. In hard cases, some authors used primary IOL implantation with primary posterior capsulorhexis, which helped them to lower rate of postoperative complications [2, 3, 11, 21, 24]. Nevertheless, there are cases where IOL cause untreatable uveitis and therefore the question of lens explanation arises [8]. Conclusion. When solving the question of primary IOL implantation during extracting cataract in patients with chronic uveitis for maximum safety we should consider the following: history of the patient's background disease and systemic treatment he is getting, frequency of former uveitic attacks, laboratory data at the time of operation. The patient needs preliminary sanitation of all possible sources of inflammation and infection, pharmacotherapeutical preparation (both topical and general). After operation patient is needed prolonged anti-inflammatory therapy (NAIDS and Corticosteroids) and dynamic observation despite calm eye condition. Key words: uveitis, cataract phacoemulsification, iol implantation.
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Komatsu, Kaori, Yosuke Harada, Tomona Hiyama, Ikuyo Sada, Kazuyuki Hirooka, and Yoshiaki Kiuchi. "Corneal Endothelial Cell Loss after Ciliary Sulcus Placement of Ahmed Glaucoma Valve in Patients with Noninfectious Uveitic Glaucoma." Journal of Personalized Medicine 12, no. 12 (December 16, 2022): 2075. http://dx.doi.org/10.3390/jpm12122075.
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This study was performed to investigate the corneal endothelial cell density (CECD) reduction and treatment efficacy in patients with uveitic glaucoma treated by the ciliary sulcus placement of the Ahmed glaucoma valve (AGV). This retrospective study included 27 eyes of 27 patients with noninfectious uveitis who underwent the sulcus placement of the AGV. Each patient underwent a clinical assessment including a CECD measurement before surgery and at 3, 6, 9, and 12 months after surgery. The mean CECD was 2431.4 ± 367.5 cells/mm2 at preoperative baseline and 2360.5 ± 391.3 cells/mm2 at 12 months (p = 0.074), with a reduction rate of 2.73 ± 9.29%. The CECD reduction was significantly greater in patients with unilateral uveitis than that with bilateral uveitis. The rate of successful intraocular pressure control was 88% at 12 months, and the number of intraocular pressure-lowering medications was significantly reduced (p < 0.001). The current study showed that the implantation of an Ahmed tube into the ciliary sulcus provided stable intraocular pressure control in patients with glaucoma secondary to noninfectious uveitis, and CECD reduction was moderate in most patients at 12 months.
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Beretta, G. B., F. Minoia, L. Marelli, C. Mapelli, G. Leone, T. Giani, P. Nucci, E. Miserocchi, and R. Cimaz. "POS1316 VISUAL FUNCTION AND QUALITY OF LIFE: PRELIMINARY RESULTS FROM A PIVOTAL CROSS-SECTIONAL STUDY ON ONE HUNDRED PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS-ASSOCIATED AND IDIOPATHIC UVEITIS." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 940.2–941. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2994.
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Background:Juvenile idiopathic arthritis (JIA) is the main cause of chronic uveitis in childhood and JIA associated uveitis (JIA-U) is the most common extraarticular complication of JIA. Despite continuous improvement in its management, pediatric uveitis still represents a serious condition with potential sight-threatening complications and a significant impact on quality of life (QoL).Objectives:To evaluate visual function (VF) and QoL in children with JIA-U and idiopathic uveitisMethods:A cross-sectional study was conducted in two tertiary Pediatric Rheumatology Centres, enrolling all patients seen with JIA-U, JIA without uveitis and idiopathic uveitis. VF was assessed by a translated form of the available EYE-Q, adapted for cross-cultural feasibility into a 10-question tool, while QoL was evaluated by the Italian version of the Pediatric Rheumatology Quality of Life scale part of the Juvenile Arthritis Multidimensional Report (JAMAR), shortened for feasibility to a 8-question tool. JAMAR section on treatment compliance and school attendance was also included. Parents, and patients when appropriate, were asked to complete each patient/parent-reporting outcome measure, answering on a 4-point Likert scale, with a total score ranging from 0 to 72 (worst condition). Medical charts were reviewed regarding JIA and uveitis features and outcome. Quantitative and qualitative variables were compared by means of Mann-Whitney U test or chi-square/Fisher exact test, as appropriate; correlations among quantitative non-parametric variables were evaluated by Spearman’s test.Results:We herein describe results from the first 100 patients enrolled (76% female), with a median age at study time of 12.8 (9.0-17.6) years. Forty-nine had JIA-U, 37 JIA without uveitis and 14 idiopathic uveitis. Uveitis was active in 14/63 patients (22.2%), with a median of uveitis duration of 9.0 years (3.6-14.8). Almost all children with uveitis were on systemic treatment (58/63, 92%) at the time of interview; 54.0% of patients presented an ocular damage, with 8.0% having a best corrected visual acuity (BCVA) < 4/10. Total score, VF and QoL scores resulted significantly higher in JIA-U patients compared to JIA without uveitis, while no differences were noticed among children with uveitis with or without JIA (Table 1). School absence was reported more frequently in JIA-U compared to JIA only (32.7% vs 10.8%, p 0.0211). VF was significantly worse in patients with ocular damage and BCVA < 4/10 (p 0.0351 and 0.0123, respectively). In patients with uveitis, VF and QoL showed a significant correlation (r 0.50, p <0.0001) especially in patients with idiopathic uveitis (r 0.74, p <0.0001).Conclusion:Visual function is a crucial component of QoL in children with uveitis and it correlates with ocular damage. Since eye involvement significantly affect QoL in patients with JIA, a specific tool widely validated and cross-cultural adapted is highly demanded in the clinical care of JIA-U patients.References:[1]Angeles-Han ST et al. The importance of visual function in the quality of life of children with uveitis. J AAPOS, 2010. Filocamo et al. A New Approach to Clinical Care of Juvenile Idiopathic Arthritis: The Juvenile Arthritis Multidimensional Assessment Report. J Rheumatol, 2011.Table 1.JIA-Un = 49Idiopathic uveitisn = 14JIAn = 37p-value*p-value#Total score5.0 (3.0-11.0)4.5(2-9.8)2.0(0-4.0)0.5739<0.0001VF score2.0 (0-3.0)1.0(0-3.0)0(0-0)0.9098<0.0001QoL score3.0(2.0-6.0)3.5(2.0-4.8)2.0(0-4.0)0.56110.0005Numbers are medians (IQR). * JIA-U vs idiopathic uveitis; #JIA-U vs JIADisclosure of Interests:None declared
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Reddy, Ashvini K., Bryn M. Burkholder, Irfan R. Khan, and Jennifer E. Thorne. "Iluvien Implantation for Uveitis and Uveitic Macular Edema." Ocular Immunology and Inflammation 26, no. 2 (October 13, 2016): 315–16. http://dx.doi.org/10.1080/09273948.2016.1215472.
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WILLERMAIN, F. "B27-associated uveitis, Fuchs uveitis." Acta Ophthalmologica 91 (August 2013): 0. http://dx.doi.org/10.1111/j.1755-3768.2013.1651.x.
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WILLERMAIN, F. "B27-associated uveitis, Fuchs uveitis." Acta Ophthalmologica 92 (August 20, 2014): 0. http://dx.doi.org/10.1111/j.1755-3768.2014.1741.x.
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Willermain, F. "B27-associated uveitis, Fuchs uveitis." Acta Ophthalmologica 93 (September 23, 2015): n/a. http://dx.doi.org/10.1111/j.1755-3768.2015.0212.
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Kiratli, Hayyam, Mehmet C. Mocan, and Murat İrkeç. "In vivo Confocal Microscopy in Differentiating Ipilimumab-Induced Anterior Uveitis from Metastatic Uveal Melanoma." Case Reports in Ophthalmology 7, no. 3 (September 9, 2016): 404–9. http://dx.doi.org/10.1159/000448730.
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This report aims to describe the facilitating role of in vivo confocal microscopy in differentiating inflammatory cells from a metastatic process in a patient with uveal melanoma and multiple systemic metastases who developed anterior uveitis while under ipilimumab treatment. A 43-year-old woman developed systemic metastases 11 months after treatment of amelanotic choroidal melanoma in her right eye with 30 Gy fractionated stereotactic radiotherapy. She first received temozolomide and then 4 cycles of ipilimumab 3 mg/kg/day. After the third cycle, severe anterior uveitis with coarse pigment clumps on the lens was seen in the left eye. Her left visual acuity declined from 20/20 to 20/80. Confocal microscopy revealed globular keratic precipitates with hyperreflective inclusions and endothelial blebs all suggestive of granulomatous uveitis. The uveitic reaction subsided after a 3-week course of topical corticosteroids, and her visual acuity was 20/20 again. Although uveal melanoma metastatic to the intraocular structures of the fellow eye is exceedingly rare and metastasis masquerading uveitis without any identifiable uveal lesion is even more unusual, it was still mandatory to rule out this distant possibility in our particular patient who already had widespread systemic metastases. Confocal microscopy was a useful complementary tool by identifying the inflammatory features of the keratic precipitates.
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Katargina, L. A., E. V. Denisova, and O. V. Novikova. "THE EVALUATION OF THE STATE OF CHOROID IN THE PATIENTS PRESENTING WITH UVEITIS OF DIFFERENT ETIOLOGY BASED ON THE RESULTS OF OPTICAL COHERENCE TOMOGRAPHY." Russian Pediatric Ophthalmology 12, no. 1 (March 15, 2017): 27–34. http://dx.doi.org/10.18821/1993-1859-2017-12-1-27-34.
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The evaluation of the state of choroid in the patients presenting with uveitis is one of the promising directions in modern ophthalmological diagnostics because it provides the opportunity for obtaining the objective quantitative characteristics of the activity of the inflammatory process and thereby makes it possible to more accurately estimate the effectiveness of the treatment. It has been shown that the thickness of choroid considerably increases during the acute phase of Vogt-Koyanangi-Harada disease, active uveitis associated with Behcet’s disease, sarcoidosis, and toxoplasmosis and returns to the normal value under the influence of the treatment. In certain cases, the thickness of choroid decreases in comparison with that in the healthy eyes. The thinning of choroid was documented also at the stage of the clinical remission of birdshot retinochoroidopathy, Fuchs syndrome-associated uveitis, posterior non-infectious and idiopathic pan-uveites. It can possibly be the result of the atrophy of choroid due to the inflammatory and ischemic processes. Unfortunately, the available literature data have been obtained in disconnected studies of the choroid of the patients suffering from uveitis that involved only the small number of the patients and were confined to a few selected etiological and pathogenetic structural variants of this condition.
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Verma, Ashutosh, James Matsunaga, Sergey Artiushin, Marija Pinne, Dirk J. Houwers, David A. Haake, Brian Stevenson, and John F. Timoney. "Antibodies to a Novel Leptospiral Protein, LruC, in the Eye Fluids and Sera of Horses with Leptospira-Associated Uveitis." Clinical and Vaccine Immunology 19, no. 3 (January 11, 2012): 452–56. http://dx.doi.org/10.1128/cvi.05524-11.
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ABSTRACTScreening of an expression library ofLeptospira interroganswith eye fluids from uveitic horses resulted in identification of a novel protein, LruC. LruC is located in the inner leaflet of the leptospiral outer membrane, and anlruCgene was detected in all tested pathogenicL. interrogansstrains. LruC-specific antibody levels were significantly higher in eye fluids and sera of uveitic horses than healthy horses. These findings suggest that LruC may play a role in equine leptospiral uveitis.
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González-Mazón, I., L. Sanchez-Bilbao, J. Rueda-Gotor, D. Martinez-Lopez, M. A. González-Gay, and R. Blanco. "THU0388 UVEITIS IN AXIAL SPONDYLOARTHRITIS: FREQUENCY AND RELATIONSHIP TO BIOLOGICAL THERAPY. SINGLE CENTER UNIVERSITY STUDY OF 255 PATIENTS." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 428.2–429. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4639.
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Background:Uveitis is one of the most frequent extra articular manifestation of spondyloarthritis (SpA). Biological therapy, especially monoclonal TNF inhibitors, may be useful to prevent and to treat uveitis. However, other biologics had been related to paradoxical uveitis.Objectives:Our aim was to assess a) the epidemiological and clinical features of uveitis associated to SpA and b) its relationship with biological treatment used in SpA.Methods:An observational study of patients who developed uveitis form a cohort of 255 consecutive unselected patients with axial SpA (axSpA) classified according to the ASAS criteria. They were divided into: a) ankylosing spondylitis (AS) according to New York modified criteria (n= 193) b) non-radiographic axSpA (nr-axSpA) (n= 62). All these patients were followed in a single reference University Hospital.Results:We studied 255 patients with axSpA (151 men/104 women); mean age 37.8±10.6 years. In 36 (31 in AS; 5 in nr-axSpA) (14.2%) patients at least one episode of uveitis was observed after a follow-up 12.4±4.5 years. The mean age at onset of uveitis was 45.7±14.2 years. The diagnosis of uveitis preceded SpA diagnosis in 5 patients, but most of them occurred after a median of 6 [2-15] years of follow-up. Pattern of uveitis was anterior and acute in all cases, and unilateral in 83%. Median of anterior chamber cells was 1 [1-2] cells. Comparison of baseline characteristics and clinical features between patients who developed uveitis and those who did not is shown in table. Almost all patients who developed uveitis were HLAB27 positive. In these patients a lower frequency of enthesitis and inflammatory bowel disease was observed.Table.UveitisN= 36Non uveitisN= 219pBaseline general featuresAge, years (mean±SD)45.7 ± 14.244.7 ± 12.10.49Sex, n (m/w) (%)21/15 (58.3/41.7)130/89 (59.4/40.6)0.91HLAB27, positive n (%)35 (97.2)130 (59.4)0.00Anti-TNF, n Adalimumab3530.06 Certolizumab140.79 Golimumab1110.87 Infliximab1290.13 Etanercept0120.31Disease CharacteristicsFollow-up of AxSpa, year (mean±SD)13.64 ± 7.612.16 ± 9.730.33AS, n (%)31 (86.1)162 (74.0)0.12nr-AxSp, n (%)5 (13.9)57 (26.0)0.12Peripheral arthritis, n (%)9 (25.0)67 (30.6)0.49Hip affection, n (%)3 (8.3)15 (6.8)0.97Enthesitis, n (%)9 (25.0)81 (37.0)0.16Dactylitis, n (%)2 (5.5)14 (6.4)0.85Psoriasis, n (%)4 (11.1)24 (11.0)0.79Inflammatory bowel disease, n (%)1 (2.8)15 (6.8)0.57Family history, n (%)12 (33.3)58 (26.5)0.396 patients with uveitis received anti-TNF therapy and suffered from 7 episodes of uveitis after 5.6±4 years of treatment, meanwhile only 1 out of the 3 patients who were treated with anti IL-17 did a single episode of uveitis after 4.2±1.9 of follow-up. Patients treated with secukinumab developed 2.72 episodes of uveitis/100 patients/year, meanwhile those who received monoclonal anti TNF presented 2.53 episodes/100 patients / year.Conclusion:The most frequent clinical pattern of uveitis was acute unilateral anterior. Almost all of them were HLA B27 positive. No differences were found in cumulative incidence between secukinumab and monoclonal anti-TNF.Disclosure of Interests:Iñigo González-Mazón: None declared, Lara Sanchez-Bilbao Grant/research support from: Pfizer, Javier Rueda-Gotor: None declared, David Martinez-Lopez: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD
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Knox, David L. "Uveitis." Pediatric Clinics of North America 34, no. 6 (December 1987): 1467–85. http://dx.doi.org/10.1016/s0031-3955(16)36369-6.
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Dunn, James P. "Uveitis." Primary Care: Clinics in Office Practice 42, no. 3 (September 2015): 305–23. http://dx.doi.org/10.1016/j.pop.2015.05.003.
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Lyle, William M. "UVEITIS." Optometry and Vision Science 65, no. 8 (August 1988): 688. http://dx.doi.org/10.1097/00006324-198808000-00020.
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Egwuagu, Charles E., and Janine A. Smith. "Uveitis." Emerging Therapeutic Targets 4, no. 6 (December 2000): 715–33. http://dx.doi.org/10.1517/14728222.4.6.715.
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Bergaust, Björn. "UVEITIS." Acta Ophthalmologica 40, no. 5 (May 27, 2009): 443–52. http://dx.doi.org/10.1111/j.1755-3768.1962.tb07815.x.
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Doyle, S. J. "Uveitis." Family Practice 16, no. 2 (April 1, 1999): 206—b—207. http://dx.doi.org/10.1093/fampra/16.2.206-b.
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Heinz, C. "Uveitis." Der Ophthalmologe 113, no. 3 (March 2016): 192–93. http://dx.doi.org/10.1007/s00347-016-0218-8.
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Heinz, C. "Uveitis." Der Ophthalmologe 116, no. 10 (October 2019): 916–17. http://dx.doi.org/10.1007/s00347-019-00957-x.
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Muñoz-Fernández, Santiago, and Emilio Martín-Mola. "Uveitis." Best Practice & Research Clinical Rheumatology 20, no. 3 (June 2006): 487–505. http://dx.doi.org/10.1016/j.berh.2006.03.008.
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Rosenbaum, James T. "Uveitis." Archives of Internal Medicine 149, no. 5 (May 1, 1989): 1173. http://dx.doi.org/10.1001/archinte.1989.00390050129026.
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Park, Un Chul, Tae Wan Kim, and Hyeong Gon Yu. "Immunopathogenesis of Ocular Behçet’s Disease." Journal of Immunology Research 2014 (2014): 1–13. http://dx.doi.org/10.1155/2014/653539.
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Behçet’s disease (BD) is a chronic recurrent systemic inflammatory disorder of unknown etiology characterized by oral and genital ulcerations, skin lesions, and uveitis. The ocular involvement of BD, or Behçet’s uveitis (BU), is characterized by panuveitis or posterior uveitis with occlusive retinal vasculitis and tends to be more recurrent and sight threatening than other endogenous autoimmune uveitides, despite aggressive immunosuppression. Although pathogenesis of BD is unclear, researches have revealed that immunological aberrations may be the cornerstone of BD development. General hypothesis of BD pathogenesis is that inflammatory response is initiated by infectious agents or autoantigens in patients with predisposing genetic factors and perpetuated by both innate and acquired immunity. In addition, a network of immune mediators plays a substantial role in the inflammatory cascade. Recently, we found that the immunopathogenesis of BU is distinct from other autoimmune uveitides regarding intraocular effector cell profiles, maturation markers of dendritic cells, and the cytokine/chemokine environment. In addition, accumulating evidence indicates the involvement of Th17 cells in BD and BU. Recent studies on genetics and biologics therapies in refractory BU also support the immunological association with the pathogenesis of BU. In this review, we provide an overview of novel findings regarding the immunopathogenesis of BU.
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Nanba, Ken-ichi. "Differential Diagnosis of Sarcoid Uveitis -Nongranulomatous Uveitis-." Japanese Journal of Sarcoidosis and Other Granulomatous Disorders 31, no. 1 (2011): 76–78. http://dx.doi.org/10.7878/jjsogd.31.76.
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Wetarini, Krisnhaliani, Febyan -, and Ni Made Widya Mahayani. "Diagnosis dan Tatalaksana Uveitis Posterior." Cermin Dunia Kedokteran 42, no. 10 (October 1, 2020): 673. http://dx.doi.org/10.55175/cdk.v47i10.1079.
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<p>Uveitis merupakan proses peradangan uvea, yang meliputi iris, badan siliar, dan koroid. Secara anatomi, terdapat empat klasifikasi uveitis, yaitu uveitis anterior, uveitis intermediet, uveitis posterior, dan panuveitis. Uveitis posterior merupakan radang lapisan koroid dan struktur sekitarnya pada posterior mata. Kelainan ini langka, namun paling sering dikaitkan dengan komplikasi kebutaan. Diagnosis uveitis posterior membutuhkan pendekatan komprehensif karena bersifat kompleks dan multifaktorial. Penatalaksanaan yang tepat penting dan terutama untuk menemukan dan mengobati penyebab dasar agar dapat mencegah perburukan dan komplikasi yang lebih berat.</p><p>Uveitis is an inflammatory process in the uvea, consisted of iris, ciliary body, and choroid. Four anatomical types of uveitis include anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis. Posterior uveitis is the inflammation of the choroidal layer and surrounding structures in the posterior eye. This disorder is considered rare, but most commonly related to ocular complications, such as blindness. Diagnosis requires a comprehensive approach because of its complex and multifactorial nature. Appropriate management is important. Causal reatment can prevent the worsening and more severe complications.</p><p> </p>
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Yang, Mingming, Koju Kamoi, Yuan Zong, Jing Zhang, and Kyoko Ohno-Matsui. "Human Immunodeficiency Virus and Uveitis." Viruses 15, no. 2 (February 5, 2023): 444. http://dx.doi.org/10.3390/v15020444.
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Uveitis is one of the most common ocular complications in people living with the Human immunodeficiency virus (HIV) and can be classified into HIV-induced uveitis, co-infection related uveitis, immune recovery uveitis, and drug-induced uveitis. The introduction of antiretroviral therapy has considerably changed the incidence, diagnosis, and treatment of different types of HIV-related uveitis. Furthermore, the specific immune condition of patients infected with HIV makes diagnosing HIV-related uveitis difficult. Recent studies have focused on the growing prevalence of syphilis/tuberculosis co-infection in uveitis. Simultaneously, more studies have demonstrated that HIV can directly contribute to the incidence of uveitis. However, the detailed mechanism has not been studied. Immune recovery uveitis is diagnosed by exclusion, and recent studies have addressed the role of biomarkers in its diagnosis. This review highlights recent updates on HIV-related uveitis. Furthermore, it aims to draw the attention of infectious disease physicians and ophthalmologists to the ocular health of patients infected with HIV.
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Tallouzi, Mohammad O., David J. Moore, Nicholas Bucknall, Philip I. Murray, Melanie J. Calvert, Alastair K. Denniston, and Jonathan M. Mathers. "Outcomes important to patients with non-infectious posterior segment-involving uveitis: a qualitative study." BMJ Open Ophthalmology 5, no. 1 (July 2020): e000481. http://dx.doi.org/10.1136/bmjophth-2020-000481.
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ObjectiveUveitis, a group of disorders characterised by intraocular inflammation, causes 10%–15% of total blindness in the developed world. The most sight-threatening forms of non-infectious uveitis are those affecting the posterior segment of the eye, collectively known as posterior segment-involving uveitis (PSIU). Numerous different clinical outcomes have been used in trials evaluating treatments for PSIU, but these may not represent patients’ and carers’ concerns. Therefore, the aims of this study were to understand the impact of PSIU on adult patients’ and carers’ lives and to explore what outcomes of treatment are important to them.Methods and AnalysisFour focus group discussions were undertaken to understand the perspectives of adult patients (=18) and carers (10) with PSIU. Participants were grouped according to whether or not their uveitis was complicated by the sight-threatening condition uveitic macular oedema. Discussions were audio-recorded, transcribed and analysed using the framework analytical approach. Outcomes were identified and grouped into outcome domains.ResultsEleven core domains were identified as important to patients and carers undergoing treatment for PSIU, comprising (1) visual function, (2) symptoms, (3) functional ability, (4) impact on relationships, (5) financial impact, (6) psychological morbidity and emotional well-being, (7) psychosocial adjustment to uveitis, (8) doctor/patient/interprofessional relationships and access to healthcare, (9) treatment burden, (10) treatment side effects, and (11) disease control.ConclusionThe domains identified represent patients’ and carers’ experience and perspectives and can be used to reflect on outcomes assessed in PSIU. They will directly inform the development of a core outcome set for PSIU clinical trials.
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Caspi, Rachel, Reiko Horai, Jun Chen, Anna Hansen, William McManigle, Rafael Villasmil, and Phyllis Silver. "Retina-specific T regulatory cells accumulate in the eye during autoimmune uveitis and act to control inflammation (115.22)." Journal of Immunology 186, no. 1_Supplement (April 1, 2011): 115.22. http://dx.doi.org/10.4049/jimmunol.186.supp.115.22.
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Abstract Experimental autoimmune uveitis (EAU) induced in mice by immunization with the retinal antigen IRBP is a model of human autoimmune uveitis. We examined whether T regulatory (Treg) cells found in uveitic eyes are (i) IRBP specific, (ii) functionally suppressive, and (iii) may play a role in natural resolution of disease. EAU was induced in B10.RIII FoxP3-GFP reporter mice with IRBP161-180. IRBP-specific T cells were detected by staining with IRBP-MHC class II dimers. In uveitic eyes, progressive increase of FoxP3+ Treg to T effector (Teff) ratio correlated with resolution of disease. At peak disease up to 20% of Treg (CD4+FoxP3+) and up to 60% of Teff (CD4+FoxP3-) in inflamed eyes were IRBP specific by dimer staining, while in lymphoid organs dimer-positive T cells were undetectable. Treg sorted from eyes of mice with EAU efficiently suppressed antigen-driven proliferation not only of naïve IRBP specific T cells (from IRBP TCR transgenic mice), but also of Teff from the same eyes. Importantly, depletion of Treg at the peak of EAU (using FoxP3-diphtheria toxin receptor transgenic mice) delayed resolution of disease. Thus, the T cell infiltrate in uveitic eyes of mice that have a polyclonal T cell repertoire is highly enriched in IRBP-specific Treg and Teff cells. Unlike what has been reported for Treg in other inflammatory sites, Treg in uveitic eyes are unimpaired functionally. Finally, FoxP3+ Treg appear to play a role in the natural resolution of autoimmune ocular disease.
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García-Aparicio, Á., L. Del Olmo Pérez, S. Sánchez Fernandez, L. Alonso Martin, R. López Lancho, R. Quirós Zamorano, R. Jiménez Escribano, F. Gonzalez Del Valle, and S. Muñoz Fernandez. "AB1214 EPIDEMIOLOGY OF UVEITIS IN A SPANISH REGION: PREVALENCE AND ETIOLOGY, UVECAM PROJECT." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1898.1–1898. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1409.
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Background:Epidemiologic studies about the distribution of the various types of uveitis and their etiology are important in helping the clinician to investigate, diagnose, and manage these pathologies. Approximating prevalence of uveitis is an important public health challenge, though studies on this purpose are scarce and of low quality. Therefore it is difficult to estimate accurately the impact of this disease in our days.Objectives:To estimate the prevalence of uveitis and to describe its etiologic and anatomical pattern by means of a population study carried out in a Spanish regionMethods:A cross-sectional descriptive, population-based, and multicentre study was conducted. The selection criteria consisted of having a diagnosis of uveitis. All data were collected from existing information in medical records. The clinical information was collected prospectively in all cases with a diagnosis of uveitis regardless its aetiology in the participating centres from the date of the study and during the following year. All patients underwent a complete ophthalmological examination with assessment of visual acuity, biomicroscopy, applanation tonometry and indirect funduscopy.Results:The target population was the 687,892 inhabitants of the province of Toledo (Spain). During the study 389 cases of uveitis were registered. The prevalence was 58.7 (95% CI 53.0-64.9). The mean age was 47.0±20.6 years, and 57.8% were women. The most prevalent anatomical pattern was the anterior uveitis (54.2; 95%CI 48.1-60.8). For adults, idiopathic constitute the group with the highest prevalence (31.7; 95%CI 27.1-36.9), and in children autoimmune etiology was the most frequent (10.6; 95%CI 5.8-17.7).The proportion of cases with autoimmune etiology was 23.3% in adults and 46.7% in children, with overall prevalences of 15.8 x105and 10.6 x105, respectively. Estimates were higher in women than in men, both in adults (17.8 vs. 4.4) and in children (17.1 vs. 13.3). In paediatric population the autoimmune processes most frequently responsible for uveitis are juvenile idiopathic arthritis (JIA; 64.3%) and ankylosing spondylitis (AS; 14.3%), with prevalence’s estimates of 6.8 and 4.5 x105, respectively. In adults, the most common cause was AS (43.2%; 6.6 x105), followed by sarcoidosis (10.7%; 1.7 x105), other spondyloarthritis (SpA) (8.3%; 1.3 x105), psoriasis arthritis and Behçet’s disease (7.1%; 1.1 x105in both cases).Conclusion:It is a precise population study that analyzes uveitis in a Spanish region, analyzing in detail different etiologies and anatomical patterns. The most common causes were idiopathic. Among the autoimmune causes, AS was the most common.TableOverall number and global prevalence by age and sexSample sizeN (%)Cases of uveitisN (%)Prevalence (95% CI)(X 100.000)TOTAL66231938958.7 (53.0-64.9)Population (N=389)•Paediatrics13246431 (8.0)23.4 (15.9-33.2)•Adults529855358 (92.0)67.6 (60.7-74.9)Sex (N=377)•Men337783159 (42.2)47.1 (40.0-55.0)•Women324536218 (57.8)67.2 (58.5-76.7)Age groups in adults (N=358)•18-309007555 (15.4)61.1 (46.0-77.5)•31-4414835994 (26.3)63.4 (51.2-77.5)•45-5410067278 (21.8)77.5 (61.2-96.7)•55-647418050 (14.0)67.4 (50.0-88.9)•≥6511656881 (22.6)69.5 (55.2-86.4)Disclosure of Interests:None declared
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Takayama, Kei, Atushi Tanaka, Sho Ishikawa, Manabu Mochizuki, and Masaru Takeuchi. "Comparison between Outcomes of Vitrectomy in Granulomatous and Nongranulomatous Uveitis." Ophthalmologica 235, no. 1 (November 5, 2015): 18–25. http://dx.doi.org/10.1159/000441255.
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Purpose: The aim of this study was to compare the outcomes of vitrectomy in granulomatous uveitis and nongranulomatous uveitis insufficiently managed by immunosuppressive therapy. Methods: Thirty-eight eyes with granulomatous uveitis and 17 eyes with nongranulomatous uveitis that underwent vitrectomy for ocular complications between July 2006 and August 2012 were reviewed retrospectively. Visual acuity and ocular inflammation scores before and 6 months after surgery were compared. Patients treated with vitrectomy alone and those in whom vitrectomy was combined with phacoemulsification were analyzed separately. Results: The mean visual acuity improved significantly both in granulomatous and nongranulomatous uveitis. In granulomatous uveitis, the mean inflammation scores decreased significantly both in the anterior segment and in the posterior segment. In nongranulomatous uveitis, the mean inflammation score in the posterior segment decreased significantly, although it did not change in the anterior segment. Conclusion: Vitrectomy was effective for treating ocular complications both in granulomatous uveitis and nongranulomatous uveitis, with favorable outcomes of improved visual acuity and decreased uveitis activity.
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Kosec, Goran, Biljana Hacin, Philip G. Sansom, Gereth Weaver, Emma Dewhurst, and James W. Carter. "Prevalence of antibody seroconversion to Toxoplasma gondii in uveitis and non-uveitis dogs." Veterinary Record Open 6, no. 1 (April 2019): e000318. http://dx.doi.org/10.1136/vetreco-2018-000318.
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ObjectivesTo evaluate the prevalence of seroconversion to Toxoplasma gondii in dogs with uveitis and dogs without uveitis.MethodsIn total, 135 dogs were evaluated: 51 dogs were diagnosed with uveitis, and 84 dogs were without uveitis. Latex agglutination tests were performed on all sera, and the results were evaluated.ResultsOverall, 7.8 and 6.0 per cent of sera were positive for the presence of anti-T gondii antibodies (dilution ≥1:64) in the groups with uveitis and non-uveitis dogs, respectively. The frequency distribution of variables (positive and negative results in the uveitis and the non-uveitis group of dogs) was tested with Fisher’s exact test. There was no statistically significant difference between groups (P=0.73).Clinical significanceThese findings suggest that evidence of exposure to T gondii was not significantly different between uveitis and non-uveitis groups of dogs and that the possible association between exposure to T gondii and canine uveitis requires further investigation. This study is the first to report the seroprevalence of anti-T gondii antibodies in dogs in the UK population and the first to report the seroprevalence of anti-T gondii antibodies in dogs with uveitis.
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Rim, Tyler Hyungtaek, Sung Soo Kim, Don-Il Ham, Seung-Young Yu, Eun Jee Chung, and Sung Chul Lee. "Incidence and prevalence of uveitis in South Korea: a nationwide cohort study." British Journal of Ophthalmology 102, no. 1 (June 8, 2017): 79–83. http://dx.doi.org/10.1136/bjophthalmol-2016-309829.
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AimTo evaluate the incidence and prevalence of uveitis and associated risk factors in South Korea.MethodsFor this retrospective national cohort study, approximately 1 000 000 Korean residents were randomly selected from the Korean National Health Insurance Service database. Uveitis was defined according to the Korean Classification of Diseases. The uveitis incidence and prevalence were calculated. Sociodemographic factors and comorbidities associated with uveitis were evaluated via Cox proportional regression models.ResultsA total of 1 094 440 subjects were evaluated over 7 051 346 person-years (mean follow-up: 6.44 years). Overall, 7447 newly developed uveitis cases were identified during the period of 2007–2013; the average incidence of uveitis was 10.6 per 10 000 person-years (95% CI 10.3 to 10.8). The average incidences of anterior and non-anterior uveitis were 9.0 and 1.5 per 10 000 person-years, respectively. The prevalence rates of uveitis, anterior uveitis and non-anterior uveitis were 17.3, 15.0 and 2.3 per 10 000 persons, respectively, during the period of 2007–2013. Increasing age, male sex, residing in a relatively rural area and high income were associated with uveitis, along with Behçet’s disease, juvenile idiopathic arthritis, ankylosing spondylitis, systemic lupus erythematous, ulcerative colitis and tuberculosis.ConclusionsThe overall incidence of uveitis in Korea was similar to those reported in Taiwan and the USA. Despite a potentially inaccurate disease definition, claims data may be useful for monitoring the substantial uveitis burden in South Korea.