RESUMEN

The clinical diagnosis of presumed cytomegalovirus hypertensive anterior uveitis was based on the following criteria: 1) Recurrent episodes of unilateral hypertensive anterior uveitis characterized by acute elevation of intraocular pressure, a few medium-sized or mutton-fat keratic precipitates and mild anterior chamber reaction. These findings might be associated with corneal endotheliitis and iris atrophy. 2) Posterior synechiae and vitreous involvement are typically absent. 3) Intact corneal sensation.

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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.

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Peripapillary pachychoroid syndrome (PPS) is a rare disease characterized by choroidal thickening around the optic disc. Visual acuity might be impaired secondary to the associated peripapillary intraretinal and/or subretinal fluids. We reported a case of a 70-year-old male patient who presented with a gradual bilateral decrease in vision. His best-corrected visual acuity was 20/60 in the right eye and 20/25 in the left eye. Dilated fundus examination showed yellowish peripapillary lesions and intraretinal fluid (IRF) surrounding the optic disc in both eyes. Optical coherence tomography showed that the outer retinal layers were disrupted, and IRF affected the nasal macula. A bilateral increase in the thickness of the choroid around the optic discs was found. The patient was successfully treated with a tapering dose of topical prednisolone acetate (1%). Three months after treatment, his vision improved to 20/25 in the right eye and 20/20 in the left eye. Topical steroid drops might be administered to treat PPS.

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PURPOSE: To investigate the association between pretreatment blood flow velocity in the choroid and optic nerve head (ONH) and retinal oxygen metabolism in the acute uveitic phase and the development of 'sunset glow fundus' in Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective analysis of 41 patients (82 eyes). Laser speckle flowgraphy and retinal oximetry measurements were performed at the presentation. The main outcome measure was the development of 'sunset glow fundus'. RESULTS: Twenty patients (40 eyes) presented in the phase preceding anterior segment inflammation (early presentation), and 21 patients (42 eyes) presented with anterior segment inflammation (late presentation). In ONH, mean blur rate (MBR)-vessel, representing blood flow velocity in retinal vessels, was significantly lower in the late presentation group, while choroidal MBR was not significantly different. The late presentation group had significantly lower oxygen saturation in retinal venules, a higher arteriovenous oxygen saturation difference and a smaller calibre of retinal arterioles compared with the early presentation group. Eyes that subsequently developed 'sunset glow fundus' had significantly lower ONH MBR-vessels, lower oxygen saturation in retinal venules, a higher arteriovenous oxygen saturation difference and a smaller calibre of retinal arterioles compared with eyes without 'sunset glow fundus'. ONH MBR-vessel had a significant negative correlation with arteriovenous oxygen saturation difference and a significant positive correlation with calibre of retinal arterioles. CONCLUSIONS: In the acute uveitic phase of VKH disease, the development of 'sunset glow fundus' is associated with pretreatment reduced retinal blood flow velocity, calibre of retinal arterioles and oxygen saturation in retinal venules, as well as an increased arteriovenous oxygen saturation difference.

Asunto(s)

Coroides , Flujometría por Láser-Doppler , Consumo de Oxígeno , Oxígeno , Flujo Sanguíneo Regional , Vasos Retinianos , Síndrome Uveomeningoencefálico , Humanos , Síndrome Uveomeningoencefálico/fisiopatología , Síndrome Uveomeningoencefálico/metabolismo , Síndrome Uveomeningoencefálico/diagnóstico , Masculino , Estudios Retrospectivos , Femenino , Adulto , Flujo Sanguíneo Regional/fisiología , Oxígeno/metabolismo , Persona de Mediana Edad , Enfermedad Aguda , Coroides/irrigación sanguínea , Coroides/metabolismo , Vasos Retinianos/fisiopatología , Vasos Retinianos/metabolismo , Velocidad del Flujo Sanguíneo/fisiología , Consumo de Oxígeno/fisiología , Oximetría/métodos , Disco Óptico/irrigación sanguínea , Disco Óptico/metabolismo , Angiografía con Fluoresceína/métodos , Saturación de Oxígeno/fisiología , Agudeza Visual , Adulto Joven , Estudios de Seguimiento , Fondo de Ojo

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PURPOSE: To investigate the prognostic value of pretreatment indocyanine green angiographic (ICGA) features in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective analysis of 84 patients (168 eyes). Main outcome measures were final visual acuity, development of 'sunset glow fundus' (SGF) and progression to chronic recurrent evolution. RESULTS: Thirty-eight patients (76 eyes) presented in the phase preceding anterior segment (AS) inflammation (early presentation) and 46 patients (92 eyes) had AS inflammation at presentation (late presentation). The mean number of hypofluorescent dark dots (HDDs) and frequency of disc hyperfluorescence were more in the late presentation group (p < 0.001 for both comparisons), whereas the early presentation group showed higher frequencies of peripapillary punctate choroidal hyperfluorescence (p < 0.001) and hypofluorescent patches involving macula corresponding to the areas of exudative retinal detachment (p = 0.012). The mean number of HDDs and the frequency of disc hyperfluorescence were higher among eyes that developed SGF (p < 0.001 for both comparisons) and eyes that progressed to chronic recurrent evolution (p < 0.001; p = 0.001, respectively). The frequencies of peripapillary punctate choroidal hyperfluorescence and hypofluorescent patches corresponding to the areas of exudative retinal detachment were less in the eyes that developed SGF (p = 0.019; p = 0.003, respectively). Punctate choroidal hyperfluorescence elsewhere was less frequent in the eyes that developed SGF (p < 0.001) and eyes that progressed to chronic recurrent evolution (p = 0.002). CONCLUSIONS: Pretreatment ICGA has a prognostic value in initial-onset acute uveitis associated with VKH disease.

Asunto(s)

Colorantes , Angiografía con Fluoresceína , Verde de Indocianina , Síndrome Uveomeningoencefálico , Agudeza Visual , Humanos , Síndrome Uveomeningoencefálico/diagnóstico , Síndrome Uveomeningoencefálico/complicaciones , Verde de Indocianina/administración & dosificación , Masculino , Femenino , Angiografía con Fluoresceína/métodos , Estudios Retrospectivos , Adulto , Colorantes/administración & dosificación , Pronóstico , Enfermedad Aguda , Persona de Mediana Edad , Adulto Joven , Fondo de Ojo , Adolescente , Anciano , Estudios de Seguimiento

RESUMEN

OBJECTIVES: Acute central serous chorioretinopathy (CSC) and Vogt-Koyanagi-Harada (VKH) disease in the acute uveitic phase are characterized by serous retinal detachment caused by dysfunction of the choroid. The aim of this study is to compare blood flow velocity and pulse waveform parameters in the choroid between these two diseases. METHODS: In this study, 25 patients (50 eyes) with VKH disease, 21 patients (27 eyes) with CSC and 15 healthy controls (30 eyes) were studied. Laser speckle flowgraphy (LSFG) was performed at presentation. RESULTS: Choroidal mean blur rate (MBR), representing blood flow velocity in choroidal vessels, was significantly lower in the eyes affected by VKH disease compared with the healthy control and CSC eyes. CSC eyes had a significantly higher MBR compared with healthy controls. Among the analyzed pulse waveform parameters, blow-out time (BOT), falling rate (FR) and flow acceleration index (FAI) changed significantly. BOT value was significantly lower in CSC eyes than in healthy control and VKH eyes. FR and FAI values were significantly lower in VKH eyes than in healthy control and CSC eyes. There was a strong positive correlation between MBR and FAI. CONCLUSIONS: Our findings confirm different pathophysiology of these two diseases. Assessment of choroidal blood flow velocity and haemodynamics with LSFG provides useful information to differentiate acute CSC and initial-onset acute uveitis associated with VKH disease.

Asunto(s)

Coriorretinopatía Serosa Central , Coroides , Flujometría por Láser-Doppler , Flujo Sanguíneo Regional , Uveítis , Síndrome Uveomeningoencefálico , Humanos , Síndrome Uveomeningoencefálico/fisiopatología , Síndrome Uveomeningoencefálico/complicaciones , Síndrome Uveomeningoencefálico/diagnóstico , Coriorretinopatía Serosa Central/fisiopatología , Coriorretinopatía Serosa Central/diagnóstico , Masculino , Coroides/irrigación sanguínea , Femenino , Velocidad del Flujo Sanguíneo/fisiología , Enfermedad Aguda , Adulto , Persona de Mediana Edad , Uveítis/fisiopatología , Uveítis/diagnóstico , Flujo Sanguíneo Regional/fisiología , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos , Agudeza Visual/fisiología

RESUMEN

PURPOSE: To provide an overview of pediatric pars planitis. METHODS: Narrative literature review. RESULTS: Pars planitis refers to the idiopathic subset of intermediate uveitis in which there is vitritis along with snowball or snowbank formation occurring in the absence of an associated infection or systemic disease. It is thought to be a T-cell mediated disease with a genetic predisposition. Pars planitis accounts for 5-26.7% of pediatric uveitis cases. Presentation is commonly bilateral but asymmetric, often with insidious onset of floaters and blurred vision. Although pars planitis is known to be a benign form of uveitis in most cases, severe complications secondary to chronic inflammation may arise, with cystoid macular edema being the most common cause of visual morbidity. Mild vitritis in the absence of symptoms, vision loss, or macular edema may be observed. Patients with severe vitritis and/or associated vision-threatening complications require prompt aggressive treatment. A stepladder approach including corticosteroids, immunosuppressive agents, anti­tumor necrosis factor­alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis. CONCLUSION: Timely diagnosis and adequate treatment of pediatric pars planitis and associated complications are crucial in order to improve visual outcomes.

Asunto(s)

Endoftalmitis , Edema Macular , Pars Planitis , Uveítis Intermedia , Uveítis , Humanos , Niño , Pars Planitis/diagnóstico , Pars Planitis/epidemiología , Pars Planitis/terapia , Uveítis Intermedia/complicaciones , Uveítis/complicaciones , Vitrectomía , Corticoesteroides , Edema Macular/diagnóstico , Edema Macular/etiología , Edema Macular/terapia , Endoftalmitis/cirugía , Estudios Retrospectivos

RESUMEN

OBJECTIVE: To describe the reversal of peripheral iris depigmentation associated with Vogt-Koyanagi-Harada (VKH) disease. METHODS: A retrospective report of two cases. RESULTS: Both patients were diagnosed with a chronic recurrent VKH disease and developed bilateral peripheral iris depigmentation (BPID). The first patient is an 8-year-old girl who was treated with systemic corticosteroids, methotrexate and adjuvant rituximab infusions that induced complete remission of uveitis and reversal of peripheral iris depigmentation at the last follow-up. The second was a 6-year-old who was treated with topical and systemic corticosteroids and oral methotrexate that induced complete remission of uveitis and reversal of peripheral iris depigmentation at the last follow-up. CONCLUSIONS: Adequate control of uveitis associated with chronic recurrent VKH disease with appropriate immunomodulatory agents and perhaps adjuvant rituximab can reverse BPID and improve the outcomes.

RESUMEN

PURPOSE: To determine relationship between timing of treatment initiation and disease outcomes and whether a therapeutic window of opportunity exists in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada disease. METHODS: Retrospective analysis of 112 patients (224 eyes). Main outcome measures were final visual acuity, progression to chronic recurrent evolution, development of complications, particularly 'sunset glow fundus', and drug-free remission cure of uveitis. RESULTS: Forty-six patients (92 eyes) presented in the phase preceding anterior segment (AS) inflammation (early presentation) and 66 patients (132 eyes) had AS inflammation at presentation (late presentation). In significantly more eyes in the early presentation group (85.9%), final visual acuity of 20/20 was achieved compared with those in the late presentation group (66.7%) (p = 0.001). None of the eyes in the early presentation group progressed to chronic recurrent evolution and none developed 'sunset glow fundus', whereas in the late presentation group, 28.8% of the eyes progressed to chronic recurrent evolution (p < 0.001) and 56.1% developed 'sunset glow fundus' (p < 0.001). Patients in the early presentation group were able to discontinue treatment without relapse of inflammation at significantly shorter time intervals compared to patients in the delayed presentation group (p < 0.001). In the late presentation group, logistic regression analysis demonstrated that presenting clinical features predicting unfavourable outcomes were posterior synechiae (odds ratio = 4.03; 95% confidence interval [CI] = 1.29-12.23), bullous exudative retinal detachment extending to the periphery (odds ratio = 3.35; 95% CI = 1.53-7.32) and female gender (odds ratio = 2.05; CI = 1.08-3.90). CONCLUSIONS: Our findings suggest that the window of opportunity lies in the phase preceding AS inflammation and initiation of effective treatment during this phase results in cure of uveitis and prevents blinding complications.

Asunto(s)

Uveítis , Síndrome Uveomeningoencefálico , Humanos , Femenino , Síndrome Uveomeningoencefálico/complicaciones , Síndrome Uveomeningoencefálico/diagnóstico , Estudios Retrospectivos , Uveítis/complicaciones , Inflamación , Fondo de Ojo

RESUMEN

OBJECTIVES: To investigate the association of optic nerve head (ONH) swelling in the acute uveitic phase of Vogt-Koyanagi-Harada (VKH) disease with blood flow velocity in the choroid and ONH and oxygen saturation and diameter of retinal vessels. METHODS: In this prospective study, 25 patients (50 eyes) were studied. Thirteen patients (26 eyes) had ONH swelling and 12 patients (24 eyes) had no ONH swelling. Laser speckle flowgraphy (LSFG) and retinal oximetry measurements were performed at presentation. RESULTS: In the ONH, mean blur rate (MBR)-vessel, representing blood flow velocity in retinal vessels, was significantly lower in the eyes affected by ONH swelling, while choroidal MBR was not significantly different. Eyes with ONH swelling had a significantly lower oxygen saturation in retinal venules, a significantly higher arteriovenous oxygen saturation difference and a significantly smaller calibre of retinal arterioles compared with eyes without ONH swelling. There were significant positive correlations between the MBR-vessel of the ONH and venular oxygen saturation and calibre of retinal arterioles. In addition, MBR-vessel of the ONH had a significant negative correlation with arteriovenous oxygen saturation difference. CONCLUSIONS: The occurrence of ONH swelling in the acute uveitic phase of VKH disease is associated with lower retinal blood flow velocity and smaller calibre of retinal arterioles as well as lower oxygen saturation in retinal venules and higher arteriovenous difference in oxygen saturation.

Asunto(s)

Disco Óptico , Papiledema , Uveítis , Síndrome Uveomeningoencefálico , Humanos , Disco Óptico/irrigación sanguínea , Oxígeno , Estudios Prospectivos , Velocidad del Flujo Sanguíneo/fisiología , Flujo Sanguíneo Regional/fisiología

RESUMEN

PURPOSE: To investigate the frequency, clinical findings and outcomes of occlusive retinal vasculitis in patients with multiple sclerosis (MS). METHODS: A retrospective case series. RESULTS: During the period between January 2000 and December 2021, we identified 24 patients who were diagnosed to have uveitis associated with MS. Among them, four (16.6%) patients presented with bilateral occlusive retinal vasculitis who were diagnosed to have MS prior to presentation. All patients were treated successfully with a combination of systemic corticosteroids combined with mycophenolate mofetil. In addition, scatter laser photocoagulation was applied to the ischemic retina in all eyes. CONCLUSIONS: Early recognition and prompt treatment with systemic immunosuppressive agents and scatter laser photocoagulation prevent complications and improve outcomes in MS patients with occlusive retinal vasculitis.

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Esclerosis Múltiple , Vasculitis Retiniana , Humanos , Vasculitis Retiniana/diagnóstico , Vasculitis Retiniana/etiología , Vasculitis Retiniana/tratamiento farmacológico , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/tratamiento farmacológico , Estudios Retrospectivos , Inmunosupresores/uso terapéutico , Retina

RESUMEN

PURPOSE: To investigate the outcomes of initial-onset acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease that occurred during pregnancy. METHODS: This is a retrospective case series. RESULTS: During the period between January 2001 and December 2021, we identified 112 patients with initial-onset acute uveitis associated with VKH disease, 67 (59.8%) were females. Among the female patients, 10 (14.9%) patients (20 eyes) were pregnant. Of these patients, 5 patients presented in the first trimester, 3 in the second trimester and 2 in the third trimester. The follow-up period ranged from 8 to 108 months (mean 35.2 ± 28.3 months). At presentation, 8 (80%) patients had initial-onset acute VKH disease with anterior segment (AS) inflammation and 2 (20%) initial-onset acute VKH disease without AS inflammation. All patients were initially treated with systemic corticosteroids combined with cyclosporine. During follow-up period, none of the patients with initial-onset acute VKH disease without AS inflammation developed any complications. Complications including "sunset glow fundus" in 8 (40%) eyes, cataract in 2 (10%) eyes and subretinal fibrosis in 1 (5%) eye were recorded in patients with initial-onset acute VKH disease with AS inflammation. Four (40%) patients developed pregnancy-related complications, including abortion in 1 patient, systemic hypertension in 1 patient and premature rupture of membrane in 2 patients. There were no documented congenital anomalies in all born babies. Best-corrected visual acuity of ≥ 20/20 was achieved in 16 (80%) eyes at the final follow-up. CONCLUSION: Primary treatment with combined systemic corticosteroids and cyclosporine in initial-onset acute uveitis associated with VKH disease was safe and effective.

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Uveítis , Síndrome Uveomeningoencefálico , Humanos , Femenino , Embarazo , Masculino , Síndrome Uveomeningoencefálico/complicaciones , Síndrome Uveomeningoencefálico/diagnóstico , Síndrome Uveomeningoencefálico/tratamiento farmacológico , Estudios Retrospectivos , Uveítis/complicaciones , Inflamación , Corticoesteroides , Ciclosporina , Enfermedad Aguda

RESUMEN

To report the clinical and multimodal imaging findings of presumed tuberculous optic nerve head (ONH) infiltration in 3 patients at a tertiary eye care center. In addition to unilateral presumed tuberculous ONH infiltration, all patients had clinical findings suggestive of tuberculous choroidal involvement which was confirmed by Indocyanine green angiography (ICGA). All patients were treated successfully with a combination of antituberculous regimen and systemic corticosteroids.

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Disco Óptico , Tuberculosis Ocular , Uveítis , Humanos , Tuberculosis Ocular/diagnóstico , Coroides , Imagen Multimodal

RESUMEN

Chronic myeloid leukemia (CML) is a malignant proliferative disorder involving the bone marrow and lymphatic system. Retinal involvement is a rare form of presentation in patients with CML. We report a case of a 49-year-old woman who presented with an acute bilateral visual disturbance. Her initial visual acuity was 20/20 in both eyes. Fundus examination revealed multiple yellowish retinal infiltrates, vascular sheathing, and peripheral sclerosed blood vessels. Fundus fluorescein angiography revealed bilateral peripheral retinal ischemia. Optical coherence tomography of the macula showed varying sizes of hyperreflective lesions distributed within the inner and outer retinal layers and in the subretinal space. Systemic workup revealed marked leukocytosis, and bone marrow biopsy revealed CML. Patients with CML can rarely present with ocular symptoms. Early recognition and prompt referral are crucial in lifesaving.

Asunto(s)

Angiografía con Fluoresceína , Isquemia , Leucemia Mielógena Crónica BCR-ABL Positiva , Imagen Multimodal , Tomografía de Coherencia Óptica , Humanos , Femenino , Persona de Mediana Edad , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia Mielógena Crónica BCR-ABL Positiva/complicaciones , Angiografía con Fluoresceína/métodos , Tomografía de Coherencia Óptica/métodos , Isquemia/diagnóstico , Isquemia/etiología , Fondo de Ojo , Agudeza Visual , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Vasos Retinianos/patología , Vasos Retinianos/diagnóstico por imagen

RESUMEN

PURPOSE: The study aims to assess the alterations in retinal oxygen saturation and retinal and choroidal blood flow in lipemia retinalis. METHODS: This was a cross-sectional study on 10 eyes (5 patients) with history of lipemia retinalis. The study comprised 10 eyes with documented history of lipemia retinalis and 10 participants as healthy controls. Patients with a confirmed history of lipemia retinalis were grouped into two cohorts based on their most recent fundus examination: untreated lipemia retinalis (abnormal fundus) and resolved lipemia retinalis (normal fundus). Both retinal arteriolar and venular oxygen saturation were measured using the non-invasive spectrophotometric retinal oximeter (Oxymap T1). The mean blur rate (MBR) of the optic nerve and choroidal blood flow were analyzed using a laser speckle flowgraph (LSFG). RESULTS: Patients with untreated lipemia retinalis had a significantly higher retinal arteriolar and venular oxygen saturation than that of the other two groups (p < 0.001). Moreover, patients with untreated lipemia retinalis had significantly smaller retinal arteriolar and venular diameters (p < 0.001). On LSFG, there was a significant difference in the overall MBR (p = 0.007) and vessel MBR of the optic nerve between the groups (p = 0.011). The patients with history of lipemia retinalis (untreated and resolved) exhibited a high overall MBR and vessel MBR of the optic nerve than that of the control group. There was a significant elevation of the optic nerve (p = 0.002) and choroidal blowout score (p < 0.001), while the resistivity index of the optic nerve (p = 0.001) and choroids (p = 0.002) was significantly lower in patients with resolved and untreated lipemia retinalis. CONCLUSIONS: There was a significant alteration in retinal oximetry, in untreated lipemia retinalis, and in retinal blood flow, in both the resolved and untreated groups. The increase in retinal blood flow and oxygen saturation may elucidate the preservation of visual acuity and function despite the fundus changes observed in lipemia retinalis.

Asunto(s)

Hiperlipidemias , Enfermedades de la Retina , Estudios Transversales , Fondo de Ojo , Humanos , Microcirculación , Oxígeno

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BACKGROUND: At the global level and in Saudi Arabia, COVID-19 remains a major public health problem. The COVID-19 pandemic contributed substantially to a surge in publications on the novel coronavirus responsible for this pandemic. This research is intended to assess the increasing contribution of Saudi Arabia to the global research on COVID-19. METHODS: A bibliometric analysis of all Saudi-affiliated publications on COVID-19 documented between December 2019 and October 2021 was conducted in October 2021 using the Web of Science advanced search builder. RESULTS: A total of 175,615 global publications on COVID-19 were retrieved in the search. Among these, 9118 (5.2%) publications were from Arab nations. Among the Arab nations, Saudi Arabia (n = 3615) had the highest number of COVID-19 publications, followed by Egypt (n = 2053) and the United Arab Emirates (n = 1057), respectively. Globally, Saudi Arabia ranked 15th among the countries with the highest publication productivity, and the rank was 11th after standardization based on the population size and the gross domestic product. International collaborations were mainly with the researchers from Egypt, followed by the United States, India, Pakistan, and the United Kingdom. King Saud University was the most productive among all institutes in terms of COVID-19-related publications at both local and regional levels. CONCLUSION: Saudi Arabia is the leading Arabian nation and one of the top fifteen nations worldwide in terms of COVID-19 research output. Further efforts are warranted from the researchers based in Saudi Arabia in the direction of increasing the quality and the number of publications at the global level. This can be achieved by timely response, proper planning, understating the global research progress, and enhancing the knowledge exchange and collaboration with the other local and international institutes.

Asunto(s)

COVID-19 , Bibliometría , Egipto/epidemiología , Humanos , Pandemias , Arabia Saudita/epidemiología

Asunto(s)

Uveítis , Síndrome Uveomeningoencefálico , Humanos , Terapia de Inmunosupresión , Oxígeno , Retina , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Uveítis/etiología , Síndrome Uveomeningoencefálico/complicaciones , Síndrome Uveomeningoencefálico/diagnóstico , Síndrome Uveomeningoencefálico/tratamiento farmacológico

RESUMEN

BACKGROUND/AIMS: To investigate the incidence, severity of COVID-19 infection and the outcomes in patients with uveitis treated with biologic agents during COVID-19 pandemic. METHODS: In this prospective study, we included all patients with uveitis treated with biologic agents and tested for COVID-19 infection between May 2020 and October 2020. RESULTS: A total of 59 patients were identified. Behçet's disease was the most common diagnosis (64.4%). Infliximab was the most frequent biologic agent used (61%). Nine (15.3%) patients were tested positive for COVID-19. None of the patients with positive COVID-19 test developed any COVID-19-related symptoms during follow-up. Of the nine patients with positive COVID-19 test, only two patients had uveitis flare-up after the biologic suspension. CONCLUSION: Uveitis patients under biologic therapy can be silent carriers for COVID-19.

Asunto(s)

Síndrome de Behçet , Productos Biológicos , COVID-19 , Uveítis , Humanos , Infliximab/uso terapéutico , Estudios Prospectivos , Pandemias , Resultado del Tratamiento , Uveítis/diagnóstico , Uveítis/tratamiento farmacológico , Uveítis/inducido químicamente , Síndrome de Behçet/complicaciones , Productos Biológicos/uso terapéutico , Factores Biológicos

RESUMEN

Anterior scleritis is rarely diagnosed with a peripheral amelanotic subretinal mass. We reported a rare case of a 31-year-old woman who was referred for suspected left eye choroidal melanoma. The patient had granulomatosis with polyangiitis with a history of treated left eye necrotizing anterior scleritis. Her left eye examination revealed 20/60 vision, superotemporal diffuse scleral injection, and thinning. Dilated fundus examination of the left eye showed a large peripheral amelanotic subretinal mass below the area of anterior scleritis, optic disc hyperemia, and subretinal fluid. The patient was successfully treated with intravenous methylprednisolone, rituximab infusions, and oral methotrexate. Two months after treatment, her vision improved to 20/20, with inactive anterior scleritis and a significant reduction in the subretinal mass with complete resolution of optic disc hyperemia and subretinal fluid. High index of suspicion of this atypical presentation of anterior scleritis is important to avoid aggressive modalities of treatment.

Asunto(s)

Granulomatosis con Poliangitis , Hiperemia , Escleritis , Femenino , Humanos , Adulto , Granulomatosis con Poliangitis/complicaciones , Granulomatosis con Poliangitis/diagnóstico , Escleritis/diagnóstico , Escleritis/tratamiento farmacológico , Escleritis/etiología , Hiperemia/complicaciones , Metilprednisolona , Glucocorticoides/uso terapéutico