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Uveitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Many times, a cause of uveitis cannot be identified but causes can include an autoimmune disease (sarcoidosis, ankylosing spondylitis), inflammatory disorder (Crohn's disease or ulcerative colitis), infection (herpes zoster, TB, Lyme disease, West Nile virus, etc.), or eye injury. Uveitis can lead to permanent vision loss. A painful red eye with sensitivity to light signals the need to see an ophthalmologist as soon as possible.
Uveitis
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
De-Kuang Hwang, Yih-Shiou Hwang
Uveitis is typically diagnosed on the basis of history-taking, system review, and intraocular signs observed through various ophthalmic examination techniques, including slit-lamp examination, indirect ophthalmoscopy, and numerous ophthalmological imaging studies. Uveitis can be classified into four anatomical types: anterior, when the primary inflammatory site is located in the anterior chamber; intermediate, when the inflammatory site is located in the vitreous body and ciliary body; posterior, when the uveitis is restricted to the retina and choroid; and panuveitis, when the inflammation is not restricted to any of the uveal tissues. According to most epidemiological studies, anterior uveitis is the most common type of uveitis across the world, whereas the proportions of intermediate uveitis, posterior uveitis, and panuveitis vary by country. One reason for this is that the incidence of uveitis due to certain etiologies differs greatly according to country and geographic location.
Uveitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Treatment of uveitis depends on the underlying condition. If an infectious diagnosis is not confirmed but cannot be ruled out, empirical therapy is sometimes needed, especially in the light of immunosuppressive co-medication that is often indicated to suppress the inflammatory process and subsequent scarring.
Syphilis-related Ocular Inflammation in HIV-positive and HIV-negative Patients
Published in Ocular Immunology and Inflammation, 2023
Victoria Ly, Abdelrahman M. Elhusseiny, Ahmed B. Sallam
Uveitis is the most commonly described presentation of ocular syphilis.1,11,27–29 We found that the most common form of uveitis was posterior uveitis followed by panuveitis and anterior uveitis. Anterior uveitis was the most common uveitis seen in HIV-negative patients while posterior uveitis was the most common form in HIV-positive patients. In contrast, Matthew and Smit reported 40/92 HIV-negative eyes had posterior uveitis, and 61/123 HIV-positive eyes had panuveitis.11 Fonollosa and colleagues retrospectively evaluated 50 patients with syphilis-associated uveitis in northern Spain and reported that optic papillitis was the most frequent manifestation (33.3%).28 In our cohort, we found papillitis to occur in 29.4% of the eyes. Scleritis is a rare finding in ocular syphilis. We found it to be present in only 4 eyes (5.8%). A similar lower rate was reported by Akpek and colleagues who evaluated 243 patients with scleritis and only 0.4% of which were associated with syphilitic infection.30
Comparison of pediatric patients with idiopathic uveitis, and uveitis due to juvenile idiopathic arthritis and Behçet’s disease
Published in Postgraduate Medicine, 2023
Deniz Gezgin Yıldırım, Murat Hasanreisoğlu, Sevcan A. Bakkaloğlu
Uveitis, inflammation of the uvea comprising the iris, ciliary body, and choroid, can lead to visual loss when left untreated [1]. Uveitis is classified by the layer of the inflammation including anterior uveitis (iris and ciliary body), intermediate uveitis (vitreous), posterior uveitis (choroid and retina), and pan-uveitis (all layers of the uvea) [2]. Uveitis is a rare disease and approximately 10–15% of patients present in the childhood period. The main symptoms of uveitis are pain, redness, excessive tearing, photophobia, and blurred vision. Complications of uveitis are more common in children than those in adults because of the delayed diagnosis due to more insidious course and less self-expression in young children [3]. Topical corticosteroids are the initial treatment in anterior uveitis patients. Systemic corticosteroids and/or disease-modifying anti-rheumatic drugs (DMARDs) are prescribed to patients with posterior segment involvement and who do not get into remission with topical corticosteroids. In recent years, biological therapies have provided a significant benefit for uveitis patients who are unresponsive to traditional therapies [4].
Surgical Outcomes of Modified CO2 Laser-assisted Sclerectomy for Uveitic Glaucoma
Published in Ocular Immunology and Inflammation, 2022
Junyan Xiao, Chan Zhao, Yang Zhang, Anyi Liang, Yi Qu, Gangwei Cheng, Meifen Zhang
Postoperatively, the patients were treated with topical antibiotics and prednisolone eye drops, the doses of which were gradually adjusted and tapered to the preoperative maintenance dose by uveitis specialists. In addition, 2% pilocarpine was used each night for at least 4 weeks. Adjustable sutures were released transconjunctivally under a slit lamp at an early stage (<14 days) after the operation. The inner wall of the TM was assessed via gonioscopy at each visit. An experienced investigator performed ultrasound biomicroscopy (UBM) at 1 month, 3 months, and 12 months postoperatively. The probe frequency was 50 MHz, and the dB gain was adjusted to obtain the optimal image resolution and quality in the sclerectomy area. The size of the intrascleral lake at 1 month was compared with that at follow-up visits, and the morphological changes were divided into the following 4 types (Figure 1): stable (no change), mild reduction (≤30% change), moderate reduction (30% to 50% change), and severe reduction (>50% change, impending closure). If IOP exceeded 21 mm Hg and UBM revealed a severe reduction in the size of the intrascleral lake, then a needling procedure was performed, followed by a subconjunctival or subscleral injection of 5-FU (0.2 mL, 50 mg/mL). If the target IOP was not achieved, then laser goniopuncture (LGP) was performed with a Microruptor II neodymium: YAG (Nd:YAG) laser after severe PAS or iris incarceration was excluded postoperatively.