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Uveitis
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
De-Kuang Hwang, Yih-Shiou Hwang
More than 60 diseases are associated with or directly cause the inflammation of uveal tissue.13 These etiologies can be categorized into three groups: infectious, noninfectious, and idiopathic. Infectious uveitis refers to intraocular inflammation caused mainly by pathogens, which can be identified intraocularly. Pathogens, including viruses, bacteria, parasites, and mycobacteria, may directly infect intraocular tissues or trigger host immune responses, leading to various degrees of uveal inflammation. Noninfectious uveitis results from the immune-mediated inflammation associated with systemic or intraocular rheumatological diseases. Systemic rheumatological disorders such as seronegative spondyloarthropathy, Behçet’s disease, sarcoidosis, Vogt–Koyanagi–Harada (VKH) disease, juvenile idiopathic arthritis, and multiple sclerosis have been reported to be strongly associated with uveitis. In several situations, the autoimmune or autoinflammatory response can occur with specific presentations that are all restricted to the eyes, such as multifocal choroiditis, birdshot chorioretinopathy, serpiginous choroiditis, and sympathetic ophthalmia (Table 16.1). Exogenous stimulation such as trauma to the eyeball, intraocular surgical procedures, and medications may also induce uveitis. Uveitis cases in which the exact etiologies cannot be identified on the basis of recent knowledge are categorized under “idiopathic uveitis” or “uveitis with unidentified etiology.” Idiopathic uveitis is more commonly noninfectious, but could occasionally be infectious with unidentifiable pathogens.
Visual impairments
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
The eyeball consists of three layers. The first layer consists of a protective covering made up of the cornea and sclera (white). As light enters, it passes through the middle layer (uvea), which is responsible for transporting blood to the (1) iris (which gives color to the eye), (2) ciliary body (which produces fluid for aqueous humor) and allows vision to be adjusted (accommodation), and (3) the choroid, or the blood supply for the retina.
Bacteriology of Ophthalmic Infections
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
Arumugam Priya, Shunmugiah Karutha Pandian
Uveitis, the inflammation of the uveal tissue that encompasses iris, choroid, and ciliary body is a major blinding disorder (Biziorek et al., 2001). It is usually found in all age groups, but the severity of the disease is much higher in pediatrics than adult disease. Pediatric uveitis is usually asymptomatic, which results in inability to detect the disease in earlier stage subsequently and leads to permanent vision loss (Curragh et al., 2017). Neither simple clinical examination nor the noninvasive investigation clearly state the causation of disease and the etiology remains unknown in maximum cases. The association of trauma, infection, systemic diseases such as tuberculosis, sarcoidosis, spondylarthropathies, Bechet’s disease, Whipple’s disease, Koyanagi-Harada syndrome, and inflammation can critically lead to uveitis (Biziorek et al., 2001).
Vitreous Humor: Composition, Characteristics and Implication on Intravitreal Drug Delivery
Published in Current Eye Research, 2023
Deepakkumar Mishra, Shilpkala Gade, Katie Glover, Ravi Sheshala, Thakur Raghu Raj Singh
Uveitis, an anti-inflammatory disease of the uvea, the layers of the eye underneath the sclera (ciliary body, iris, and choroid), requires the long-term intravitreal injection of anti-inflammatory agents. Triamcinolone is a synthetic glucocorticoid with anti-inflammatory properties and injected through intravitreal injections to patients unresponsive to topical treatment. A suspension is available in two strengths 40 mg/ml (Kenalog®, Bristol-Myers Squibb Company) and 80 mg/ml (Trivaris®, Allergan).7 Trivaris® is an 80 mg/ml triamcinolone acetonide suspension for intravitreal injection for the treatment of uveitis. Whereas Kenalog® is an injectable TA suspension for intramuscular and intra-articular injection for the ocular diseases sympathetic ophthalmia, temporal arteritis and uveitis. Ocriplasmin (JETREA®, Inceptua) a recombinant form of human plasmin approved in the year 2012 for the intravitreal treatment of vitreomacular adhesion. However, the use of Ocriplasmin has been discontinued due to the observed adverse side effects such as vitreous floaters, eye pain post injection and photopsia.
The Pattern of Uveitis in a Pediatric Population at a Tertiary Center in Thailand
Published in Ocular Immunology and Inflammation, 2023
Usanee Seepongphun, Wantanee Sittivarakul, Wantanee Dangboon, Rassamee Chotipanvithayakul
Uveitis is a group of sight-threatening inflammatory diseases that affect the uveal tract and adjacent ocular structures and can affect individuals of all ages; however, the prevalence is much lower in children than in adults. The overall incidence and prevalence of uveitis in children is estimated to be 4.3–6.9% and 30 per 100,000 cases, respectively, in the United States,1 and it has been found to account for 5–17% of all uveitic cases at most tertiary centers.2–8 Despite the much lower prevalence of uveitis in children compared to adult-onset uveitis, the management of these children poses distinct challenges. Specifically, there is the potential for 1) a delayed diagnosis due to preverbal age and a lack of significant symptoms, 2) difficulty in performing eye examinations and investigations, 3) limited medications to be used due to adverse effects, and 4) the risk of amblyopia.
Systematic Review of MIGS and Non-Penetrating Glaucoma Procedures for Uveitic Glaucoma
Published in Seminars in Ophthalmology, 2022
Trung Thanh Bui, Jullia A. Rosdahl
The uvea is comprised of the iris, ciliary body, and choroid. When the body’s immune system attacks any of these structures, they become inflamed, resulting in uveitis. The etiology of uveitis can be idiopathic (34.9%), non-infectious (35.2%), and infectious (29.9%).1 7.6% of the patients with acute uveitis (3–12 months) and 6.5–11.1% of the patients with chronic uveitis (1–5 years) develop glaucoma.2 Management of uveitic glaucoma has proven to be a clinical conundrum because the glucocorticoid therapy that is used to control the inflammation can exacerbate the glaucoma. As such, many patients with uveitic glaucoma have elevated IOP while being treated with maximum tolerated medical therapy. These patients may eventually require surgery to achieve adequate management of uveitic glaucoma.