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Mpox virus infection is a significant public health concern worldwide due to its potential severity and the likelihood of outbreaks occurring across different regions. Ophthalmic manifestations of the disease have been linked with more severe cases, leading to the need for hospitalization and antiviral therapy. A systematic review and meta-analysis were conducted following PRISMA guidelines to summarize the literature available on this topic. The review revealed that ophthalmic manifestations, such as conjunctivitis and periocular umbilicated lesions, are the most common in Mpox virus infections. However, severe manifestations, such as corneal opacity, that can potentially cause blindness may also occur. Antiviral treatment with tecovirimat and topical management for conjunctivitis can be considered for severe cases. However, the evidence quality is poor due to the predominance of case reports and imprecise characterization of the ophthalmic manifestations. Overall, ophthalmologists and healthcare professionals should be aware of these manifestations for early diagnosis and timely treatment.

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INTRODUCTION: Despite HLA-B27-associated uveitis is one of the most frequent etiologies of uveitis worldwide, there are scarce studies on the clinical spectrum of this disease and the implications of therapeutic strategies used in the Latin-American population, with none conducted in Colombia. Thus, this study aimed to describe the clinical characteristics of a cohort of patients with positive HLA-B27-associated uveitis in Colombia and evaluate the impact of systemic treatment on the recurrence rate. METHODS: We retrospectively reviewed 490 clinical charts of patients with uveitis, searching for those with positive HLA-B27-associated uveitis over eight years in a referral center in Bogotá, Colombia. We used descriptive statistics to summarize demographic and clinical characteristics and conducted a Chi-square test, Fisher Exact test, Spearman correlation, and Mann-Whitney test to assess associations between treatment strategies and the recurrences rate. RESULTS: We analyzed 39 patients (59% females) with positive HLA-B27-associated uveitis, with a median age at the first consultation of 44.5 years (Range: 2-80) and a mean follow-up time of 86.4 weeks (1.65 years). Most patients had unilateral uveitis (53.8%) and an anterior anatomical diagnosis (76.6%); two had anterior chamber fibrinous reaction, and only one had hypopyon. Most patients did not show associated systemic symptoms (66.7%). Topical corticosteroids, NSAIDs, methotrexate, mydriatics, and adalimumab were the most used treatments. The most common complications included cataracts, posterior synechiae, and macular edema. We identified that the rate of recurrences decreases over time (r = -0.6361, P = 0.002571), and this decrease seems to be associated with the initiation of disease-modifying antirheumatic drugs (DMARDs) in chronic and recurrent cases. CONCLUSION: The clinical spectrum of HLA-B27-associated uveitis in Colombian patients is distinct from other latitudes. Notably, we found a female predominance, older age at presentation, higher frequency of bilateral and vitreous involvement, and lower frequency of concomitant systemic diseases. Additionally, our results suggest that DMARDs such as methotrexate and biologic agents are good therapeutic options to avoid recurrences in chronic and recurrent cases.

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Triamcinolone acetonide (TA) is a powerful anti-inflammatory drug used in the treatment of inflammatory ocular disorders; however, its poor aqueous solubility and ocular anatomical barriers hinder optimal treatment. The aim of this work was to obtain triamcinolone acetonide nanocrystals (TA-NC) to improve ocular corticosteroid therapy. Self-dispersible TA-NC were prepared by the bead milling technique followed by spray-drying, exhaustively characterized and then evaluated in vivo in an ocular model of endotoxin-induced uveitis (EIU). Self-dispersible TA-NC presented an average particle size of 257 ± 30 nm, a narrow size distribution and a zeta potential of -25 ± 3 mV, which remained unchanged for 120 days under storage conditions at 25 °C. In addition, SEM studies of the TA-NC showed uniform and spherical morphology, and FTIR and XRDP analyses indicated no apparent chemical and crystallinity changes. The subconjunctival administration of TA-NC in albino male white rabbits showed no clinical signs of ocular damage. In vivo studies proved that treatment with self-dispersible TA-NC alleviated the inflammatory response in the anterior chamber and iris in EUI rabbit eyes. Dispersible TA-NC are a promising approach to obtaining a novel nanometric TA formulation for ocular disorders.

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This scoping review examined the relationship between Dry Eye Disease (DED) and Uveitis. We searched Pubmed, Embase, and LILACS databases for articles in which at least one patient had DED and uveitis concomitantly. The search produced 2381 records, and 24 studies were included in the qualitative synthesis. We concluded that DED and uveitis of any etiology could appear concomitantly in patients of any age. However, both diseases seem to coexist more frequently in middle-aged women and cases of anterior uveitis. Therefore, it is crucial that ophthalmologists actively look for the coexistence of ocular surface abnormalities, especially in patients with these characteristics. Future studies should establish and quantify the risk factors and pathophysiological mechanisms of this coexistence to achieve an early diagnosis of both etiologies and comprehensive management of these patients.

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El lupus eritematoso sistémico es una enfermedad autoinmune, de curso crónico con afectación multisistémica. Las manifestaciones oculares del lupus eritematoso sistémico pueden afectar cualquier estructura del ojo. La formación de catarata y la aparición de la diabetes secundaria asociada con el tratamiento esteroideo prolongado es frecuente en estos pacientes. Se presenta el caso de una paciente femenina de 69 años, con antecedentes de lupus eritematoso sistémico de más de 20 años de evolución, tratada con 5 mg diarios de prednisona oral en dosis de mantenimiento. Refiere, además, diabetes mellitus tipo 2 controlada de más de 10 años de evolución. Asiste a la consulta de Oftalmología por disminución de la visión y se diagnostica catarata en el ojo derecho. Se realiza facoemulsificación con implante de lente intraocular plegable, previa profilaxis para la endoftalmitis. La catarata asociada a la diabetes secundaria en los pacientes con lupus eritematoso sistémico justifica el uso de profilaxis antinflamatoria con esteroides tópicos y sistémicos para asegurar una mínima inflamación posoperatoria y mejorar el pronóstico visual(AU)

Systemic lupus erythematosus is a chronic autoimmune disease of multisystemic involvement. Ocular manifestations of systemic lupus erythematosus may present in any structure of the eye. Cataract formation and the appearance of secondary diabetes associated to prolonged steroid therapy are common in these patients. A case is presented of a female 69-year-old patient with a history of systemic lupus erythematosus of more than 20 years' evolution, treated with 5 mg daily of oral prednisone at maintenance doses. The patient also reports controlled diabetes mellitus type 2 of more than ten years' evolution. Her main concern in attending Ophthalmology consultation is vision reduction. Cataract is diagnosed in her right eye. The treatment indicated is phacoemulsification with foldable intraocular lens implantation following prophylaxis for endophthalmitis. Cataract associated to secondary diabetes in patients with systemic lupus erythematosus justifies the use of anti-inflammatory prophylaxis with topical and systemic steroids to ensure minimum postoperative inflammation and improve visual prognosis(AU)

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Objetivo: Caracterizar las uveítis asociadas a la artritis idiopática juvenil. Métodos: Se realizó un estudio observacional, descriptivo, de corte transversal, donde se evaluaron las variables edad, raza, sexo, lateralidad de la uveítis, clasificación anatómica, agudeza visual mejor corregida, presencia de complicaciones y tratamiento. Resultados: Predominaron los mayores de seis años, el sexo femenino y la raza blanca. En cuanto a la lateralidad hubo mayor predominio de las bilaterales, con localización anatómica anterior. En los resultados visuales sobresalieron los que presentaban una agudeza visual mejor corregida ≥ 0,5. Las complicaciones más frecuentes fueron: la pérdida visual, la hipertensión ocular y la queratopatía en banda. Con respecto al tratamiento, la mayoría de los pacientes tenían asociado metotrexate al tratamiento tópico y oral con esteroides. Conclusión: La uveítis asociada a la artritis idiopática juvenil sigue siendo un problema importante de salud en la infancia a pesar de los avances en los programas de atención a esta enfermedad; por tanto, el diagnóstico precoz, el seguimiento estricto y el tratamiento adecuado son los pilares para una mejor evolución(AU)

Objective: Characterize uveitis associated to juvenile idiopathic arthritis. Methods: A cross-sectional observational descriptive study was conducted based on evaluation of the following variables: age, race, sex, laterality of uveitis, anatomical classification, best corrected visual acuity, presence of complications and treatment. Results: A predominance was observed of patients aged over six years, female sex and white race. Bilateral uveitis prevailed, with anterior anatomical location. Patients with a best corrected visual acuity ≥ 0.5 stood out for their visual results. The most common complications were visual loss, ocular hypertension and band keratopathy. Most patients had methotrexate associated to topical and oral treatment with steroids. Conclusion: Uveitis associated to juvenile idiopathic arthritis continues to be an important health problem in childhood, despite the progress in the care of this condition. Therefore, early diagnosis, strict follow-up and appropriate treatment are the pillars of a better evolution(AU)

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Resumen Justificación: La uveítis idiopática y la asociada a artritis idiopática juvenil son condiciones oculares que llevan a deterioro visual. En Costa Rica, la incidencia en pediatría se desconoce; aunque existe una clínica especializada en el Hospital Nacional de Niños para el manejo de estas patologías, no hay guías ni recomendaciones de manejo que hayan sido publicadas. Objetivos: Resumir las recomendaciones de manejo vigentes para uveítis no infecciosas y ofrecer una guía adaptada a la realidad costarricense, específicamente para población pediátrica. Métodos: Se efectuó una revisión no sistemática de bibliografía médica indexada en las plataformas PubMed y Scielo, sobre el diagnóstico y manejo de uveítis no infecciosa orientado a población pediátrica y en artritis idiopática juvenil. Se revisaron las guías recomendadas en Europa y se ajustaron a lo que se realiza en la Clínica de Uveítis del Hospital Nacional de Niños. Conclusiones: Se realiza una propuesta de manejo que incluye una valoración oftalmológica oportuna, diagnóstico certero, y tratamiento temprano y agresivo para prevención de complicaciones y minimizar secuelas.

Summary Importance: Idiopathic uveitis and that associated with juvenile idiopathic arthritis are ocular conditions that lead to visual impairment. In Costa Rica, the incidence in pediatric population is unknown; although there is a specialized clinic at the National Children's Hospital for the management of these pathologies, there are no guidelines or recommendations published in our country. Aims: To summarize the current management recommendations for non-infectious uveitis and offer a guide adapted to the Costa Rican reality, specifically for the pediatric population. Methods: A non-systematic review of indexed medical literature on PubMed and Scielo platforms was carried out on the diagnosis and management of non-infectious uveitis aimed to pediatric patients and in juvenile idiopathic arthritis. The recommended guidelines in Europe were reviewed and adjusted to what is done at the Uveitis Clinic of the National Children's Hospital. Conclusions: A management proposal is made that includes a timely ophthalmological evaluation, accurate diagnosis; early and aggressive treatment to prevent complications and minimize sequelae

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To evaluate the use of tenecteplase in transoperative phacoemulsification in healthy rabbits, the study was carried out with fifteen New Zealand rabbits, divided into three groups: control group (CG), untreated group (UG) and treated group (TG). UG and TG were operated by phacoemulsification and TG received 50 µg / 0.3 mL of intracameral tenecteplase. The postoperative evaluations were 24 h, 72 h, 7 days, 15 days and 21 days. In TP21 the animals were submitted to euthanasia and aqueous humor samples were collected. No significant differences were observed in the clinical evaluations between CG and TG in relation to incidence rates of intraocular pressure (IOP), corneal edema, fibrin deposits, hyphema, aqueous flare and synechia. In the physicochemical evaluation of the aqueous humor, there were no significant differences between the three groups in relation to pH values and concentrations of chloride ions. The aqueous humor density values were statistically different between CG and the other groups. In the histological evaluation, there were no significant differences between the groups. The use of tenecteplase in transoperative phacoemulsification in rabbits did not present significant differences in terms of clinical, physicochemical and histological parameters.(AU)

Para avaliar o uso da tenecteplase na facoemulsificação transoperatória em coelhos sadios, o estudo foi realizado com quinze coelhos da raça Nova Zelândia, divididos em três grupos: grupo controle (CG) grupo não tratado (UG) e grupo tratado (TG). UG e TG foram operados por facoemulsificação e TG recebeu 50 µg / 0,3 mL de tenecteplase intracameral. As avaliações pós-operatórias foram 24 h, 72 h, 7 dias, 15 dias e 21 dias. No TP21 os animais foram submetidos à eutanásia e amostras de humor aquoso foram coletadas. Não foram observadas diferenças significativas nas avaliações clínicas entre o CG e o TG em relação às taxas de incidência de pressão intraocular (PIO), edema de córnea, depósitos de fibrina, hifema, flare aquoso e sinéquia. Na avaliação físico-química do humor aquoso, não houve diferenças significativas entre os três grupos em relação aos valores de pH e concentrações de íons cloreto. Os valores de densidade de humor aquoso foram estatisticamente diferentes entre CG e os outros grupos. Na avaliação histológica, não houve diferenças significativas entre os grupos. O uso da tenecteplase na facoemulsificação transoperatória em coelho não apresentou diferenças significativas em termos de parâmetros clínicos, físico-químicos e histológicos.(AU)

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Justificación: Las uveítis no infecciosas constituyen una importante causa de pérdida visual a nivel mundial; por su complejidad y gravedad de complicaciones requieren un abordaje temprano y multidisciplinario. En Costa Rica se desconoce hasta el momento la incidencia global de estas entidades y todavía no existe ningún consenso en cuanto a su manejo. Objetivos: Resumir las recomendaciones terapéuticas vigentes para uveítis no infecciosas en adultos y ofrecer una guía adaptada a la realidad costarricense. Métodos: Se efectuó una revisión no sistemática de bibliografía médica indexada en las plataformas PubMed y Scielo, sobre el manejo médico de las uveítis no infecciosas. De igual manera, se compararon los esquemas terapéuticos recomendados actualmente en América y Europa con el abordaje realizado en los centros hospitalarios costarricenses, para crear una guía adaptada a la realidad nacional. En la elaboración de estas recomendaciones participaron médicos especialistas de todas las clínicas multidisciplinarias especializadas en uveítis del país. Conclusiones: En Costa Rica se cuenta con la mayoría de las opciones disponibles para el tratamiento de uveítis idiopáticas en el sistema público de salud. Se logró la creación de algoritmos de tratamiento para las diferentes patologías.

Summary Background: Noninfectious uveitis represents an important cause of visual loss worldwide, which in view of the severity and complexity of complications demands an early and multidisciplinary approach to therapy. In Costa Rica there is no statistical records of incidence nor consensus of management of these entities to this date. Objectives: To summarize the therapeutic recommendations for non-infectious uveítis according to the scientific evidence and adapt them to the Costa Rican conditions. Methods: A non-systematic review of medical literature indexed on PubMed and Scielo, concerning medical and surgical management of non-infectious uveitis was carried out. Likewise, the recommended therapeutic schemes in America and Europe were compared to the approach used in the Costa Rican hospital centers. In the elaboration of these recommendations participated physicians, specialists of all multidisciplinary clinics for uveitis of the country. Conclusions: In Costa Rica, the majority of alternatives available for the treatment of idiopathic uveitis in the public health system are available. It was possible to create therapeutic algorithms for the different diseases.

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To evaluate the use of tenecteplase in transoperative phacoemulsification in healthy rabbits, the study was carried out with fifteen New Zealand rabbits, divided into three groups: control group (CG), untreated group (UG) and treated group (TG). UG and TG were operated by phacoemulsification and TG received 50 µg / 0.3 mL of intracameral tenecteplase. The postoperative evaluations were 24 h, 72 h, 7 days, 15 days and 21 days. In TP21 the animals were submitted to euthanasia and aqueous humor samples were collected. No significant differences were observed in the clinical evaluations between CG and TG in relation to incidence rates of intraocular pressure (IOP), corneal edema, fibrin deposits, hyphema, aqueous flare and synechia. In the physicochemical evaluation of the aqueous humor, there were no significant differences between the three groups in relation to pH values and concentrations of chloride ions. The aqueous humor density values were statistically different between CG and the other groups. In the histological evaluation, there were no significant differences between the groups. The use of tenecteplase in transoperative phacoemulsification in rabbits did not present significant differences in terms of clinical, physicochemical and histological parameters.

Para avaliar o uso da tenecteplase na facoemulsificação transoperatória em coelhos sadios, o estudo foi realizado com quinze coelhos da raça Nova Zelândia, divididos em três grupos: grupo controle (CG) grupo não tratado (UG) e grupo tratado (TG). UG e TG foram operados por facoemulsificação e TG recebeu 50 µg / 0,3 mL de tenecteplase intracameral. As avaliações pós-operatórias foram 24 h, 72 h, 7 dias, 15 dias e 21 dias. No TP21 os animais foram submetidos à eutanásia e amostras de humor aquoso foram coletadas. Não foram observadas diferenças significativas nas avaliações clínicas entre o CG e o TG em relação às taxas de incidência de pressão intraocular (PIO), edema de córnea, depósitos de fibrina, hifema, flare aquoso e sinéquia. Na avaliação físico-química do humor aquoso, não houve diferenças significativas entre os três grupos em relação aos valores de pH e concentrações de íons cloreto. Os valores de densidade de humor aquoso foram estatisticamente diferentes entre CG e os outros grupos. Na avaliação histológica, não houve diferenças significativas entre os grupos. O uso da tenecteplase na facoemulsificação transoperatória em coelho não apresentou diferenças significativas em termos de parâmetros clínicos, físico-químicos e histológicos.

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Resumo Objetivo: Analisar a distribuição dos casos de uveíte em pacientes atendidos no Setor de Uveíte do Serviço de Oftalmologia do Hospital Federal Servidores do Estado do Rio de Janeiro. Métodos: Estudo epidemiológico retrospectivo, transversal e descritivo pela análise de prontuários de 63 pacientes atendidos no Serviço de Oftalmologia do Hospital Federal dos Servidores do Estado do Rio de Janeiro, no Setor de Uveíte, no período de Março a Outubro de 2016. Resultados: A média de idade foi de 45,54 (±15,8), sendo 50,8% do sexo feminino e 49,2% do masculino. Uveítes anteriores corresponderam à 63,49% dos casos, intermediárias 1,58% posterior 19,04% e panuveíte 15,87%. Apenas 33,3% dos pacientes encontravam-se com processo inflamatório ativo no momento da avaliação. Cerca de 74,6% das uveítes tinham causas não infecciosas e em 12,69% não foi possível a determinação etiológica. A causa isolada mais frequente foi Espondilite Anquilosante, responsável por 28,57% dos casos. Demonstrou-se que 55,5% dos pacientes tinham acometimento bilateral e 71,14% apresentavam uveíte não granulomatosa. Conclusões: Estudos epidemiológicos que tratam de uveíte são, em geral, realizados em centros terciários de atendimento, que por vezes apresentam perfil etiológico destas inflamações intra-oculares diferente da população geral.

Abstract Objective: To analyze the distribution of uveitis in patients at Uveitis Sector of Federal Hospital of Servants of Rio de Janeiro State. Methods: Retrospective epidemiological study of 63 appointments performed by ophthalmologist of Uveitis Sector at Federal Hospital of Servants of Rio De Janeiro State, between March and October of 2016. Results: The mean age was 45.54 (±15.8). 50.5% were female. Anterior uveitis corresponded to 63.49%. Only 33.3% of patient had an active inflammation at the moment of medical avaliation. 74.6% of uveitis had non-infeccious causes, and in 12.69% the etiology could not be determined. Ankylosing spondylitis was the most frequent cause, responsible for 28.57% of cases. 55.5% of patients had a bilateral uveitis, and 71.14% non-granulomatous uveitis. Conclusions: Epidemiological studies about uveitis are usually made in terciary hospitals, which do not reflect the epidemiological profile of population in general.

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The infectious keratoconjunctivitis is an ocular disease of great incidence in the ovine, with occurrence in several countries. This disease is propagated quickly to all the herd and it affects the conjunctive and the cornea and, in some cases, all the ocular bulb of the animal. Despite causing low death rate, this disease provokes financial loss by loss of weight and by the costs of the treatment. The microorganisms most frequently involved in outbreaks of this disease are the Mycoplasma conjunctivae, lhe Branhamella ovis and the Staphy/ococcus aureus. Its c1inical diagnosis can be made through the symptoms, and confirmation can be obtained by the isolation of the infectious agent Among the available techniques for diagnosis of this disease are the bacteria raising, the Polimerase Chain Reaction (PCR) and the conjunctival exfoliative cytology is more used by its lower cost, quickness and facility for execution. Despite the available information in the international literature about this disease, there is a need of local studies aiming to find the most frequent causes and establishment of strategies for the treatment and effective control.

A ceratoconjuntivite infecciosa é a enfermidade ocular mais freqüente nos ovinos, com ocorrência em diversos países. Por ser altamente contagiosa, usualmente propaga-se rapidamente por todo o rebanho, afetando a conjuntiva e a córnea e, em alguns casos, todo o bulbo ocular. Apesar de causar baixa mortalidade, provoca prejuízos económicos pela perda de peso dos animais e custos com o tratamento. Os microorganismos mais freqüentemente envolvidos em surtos de ceratoconjuntivite infecciosa ovina são o Mycoplasma conjunctivae, a Branhamella oviii eo Staphylococcus aureus. Seu diagnóstico clínico pode ser realizado através dos sintomas, podendo ser confirmado pelo isolamento do agente. Dentre as técnicas disponíveis para o diagnóstico estão o cultivo bacteriano, a Reação em Cadeia da Poíimerase (PCR) e a citologia esfoliativa conjuntival, que se destaca por seu baixo custo, rapidez e facilidade de execução. Apesar das informações disponíveis na literatura estrangeira, existe escassez de estudos locais, necessários para determinar as causas mais freqüentes e estabelecer estratégias de tratamento e controle eficazes.

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The infectious keratoconjunctivitis is an ocular disease of great incidence in the ovine, with occurrence in several countries. This disease is propagated quickly to all the herd and it affects the conjunctive and the cornea and, in some cases, all the ocular bulb of the animal. Despite causing low death rate, this disease provokes financial loss by loss of weight and by the costs of the treatment. The microorganisms most frequently involved in outbreaks of this disease are the Mycoplasma conjunctivae, lhe Branhamella ovis and the Staphy/ococcus aureus. Its c1inical diagnosis can be made through the symptoms, and confirmation can be obtained by the isolation of the infectious agent Among the available techniques for diagnosis of this disease are the bacteria raising, the Polimerase Chain Reaction (PCR) and the conjunctival exfoliative cytology is more used by its lower cost, quickness and facility for execution. Despite the available information in the international literature about this disease, there is a need of local studies aiming to find the most frequent causes and establishment of strategies for the treatment and effective control.

A ceratoconjuntivite infecciosa é a enfermidade ocular mais freqüente nos ovinos, com ocorrência em diversos países. Por ser altamente contagiosa, usualmente propaga-se rapidamente por todo o rebanho, afetando a conjuntiva e a córnea e, em alguns casos, todo o bulbo ocular. Apesar de causar baixa mortalidade, provoca prejuízos económicos pela perda de peso dos animais e custos com o tratamento. Os microorganismos mais freqüentemente envolvidos em surtos de ceratoconjuntivite infecciosa ovina são o Mycoplasma conjunctivae, a Branhamella oviii eo Staphylococcus aureus. Seu diagnóstico clínico pode ser realizado através dos sintomas, podendo ser confirmado pelo isolamento do agente. Dentre as técnicas disponíveis para o diagnóstico estão o cultivo bacteriano, a Reação em Cadeia da Poíimerase (PCR) e a citologia esfoliativa conjuntival, que se destaca por seu baixo custo, rapidez e facilidade de execução. Apesar das informações disponíveis na literatura estrangeira, existe escassez de estudos locais, necessários para determinar as causas mais freqüentes e estabelecer estratégias de tratamento e controle eficazes.