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Posterior uveitis
Published in Gwyn Samuel Williams, Mark Westcott, Carlos Pavesio, Bushra Thajudeen, Practical Uveitis, 2017
Gwyn Samuel Williams, Mark Westcott
It must be remembered that fundal scars from innumerable causes can occur which are totally unrelated to the cause of a posterior uveitis. As previously mentioned this umbrella of posterior uveitis is large and contains many diagnoses. Some conditions have abnormalities that are rarely if ever associated with any actual uveitis. Presumed ocular histoplasmosis syndrome (POHS) by definition has no signs of any uveitis present. Punctate inner choroidopathy (PIC) almost never has detectable inflammation present on examination, though ancillary testing with FFA may reveal some. We next come to the last question we ask in determining the cause of a posterior uveitis, a question which after the previous questions will only apply to people with symptoms but no apparent abnormality.
Longitudinal Retinal Layer Changes and Clinical Outcome in Patients with Multiple Evanescent White Dot Syndrome
Published in Ocular Immunology and Inflammation, 2021
Kaspar Schuerch, Jeffrey H Ma, Sebastian Wolf, Andreas Ebneter, Martin S. Zinkernagel, Marion R. Munk
Twenty patients were included in this retrospective study. All patients were recruited at the Department of Ophthalmology, Bern University Hospital, Bern, Switzerland, and at the Northwestern University, Chicago, USA. The study adhered to the tenets of the Declaration of Helsinki and was approved by the local review boards. Eighteen patients were female. The age ranged from 13 to 43 years (mean 26 ± 8.4 years) (see Table 1). All patients underwent full ophthalmic examination including best-corrected visual acuity (BCVA) in logMAR, slit lamp and dilated fundus examination. In one patient (patient Nr. 4), BCVA and the OCT of the fellow eye were not recorded. Therefore, only the affected eye was included for the analysis. Diagnosis of MEWDS was based on 1. Typical clinical picture with whitish retinal lesions and medical history, 2. Lesions of increased autofluorescence in FAF, 3. Loss of the EZ band on OCT. Patients having other retinal disease, such as punctate inner choroidopathy (PIC), were excluded from the study. Baseline (BL) and follow-up (FU) examinations at 1, 3, and 12 months after the initial presentation included clinical evaluation with BCVA and OCT imaging. All patients that had BL and at least one FU at or after 1-month examination were included in the analysis. The final visit was defined as a restoration of BCVA and normal retinal architecture in the OCT.
Macular Abnormalities in Vogt-Koyanagi-Harada Disease
Published in Ocular Immunology and Inflammation, 2019
Peizeng Yang, Zi Ye, Jing Xu, Liping Du, Qingyun Zhou, Jian Qi, Liang Liang, Chaokui Wang, Chunjiang Zhou, Qingfeng Cao, Lili Wu, Aize Kijlstra
In combination with the fact that VKH is a relatively common uveitis entity in our clinic this provided an opportunity to investigate the prevalence of macular involvement in a large patient group. Due to the large sample size we were able to analyze the risk factors associated with macular involvement in VKH as well as its effect on visual prognosis. In the present study, we found that ME was the most common macular abnormality in VKH, followed by macular CNV, MEM and ME. Macular abnormalities reported here, seem to be less common than those in other inflammatory conditions involving the RPE and choroid, such as birdshot retinochoroidopathy, serpiginous chorioretinitis, multifocal choroiditis and punctate inner choroidopathy.7–14 Previous studies have reported that up to 20% of eyes with birdshot retinochoroidopathy7 and 29.7% of eyes with multifocal choroiditis8-10 were associated with cystoid ME. CNV was observed in 35% of eyes with serpiginous chorioretinitis.11, 162%-22% of eyes with multifocal choroiditis8-10 and 69%-77% of patients with punctate inner choroidopathy (PIC).12,13 However, CNV is less common in multiple evanescent white dot syndrome, acute retinal pigment epitheliitis and acute posterior multifocal placoid pigment epitheliopathy.14 It is worth mentioning that macular exudative retinal detachment is a common ocular finding observed in most of our VKH patients during the early stage of their disease.
Punctate Inner Choroidopathy and Choroidal Neovascularization in Korean Patients
Published in Ocular Immunology and Inflammation, 2020
Ji Hwan Lee, Sung Chul Lee, Seo Jin Park, Christopher Seungkyu Lee
Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory multifocal chorioretinopathy characterized by small, yellow lesions throughout the posterior pole.1,2 It primarily affects young and healthy women with myopia, and the lesions originate at the level of the deep retina and inner choroid in the absence of anterior or vitreous inflammation.3,4 The disease course of PIC is dichotomized into an active phase and an atrophic phase on the basis of the course exhibited by most lesions. The major vision-threatening complication in patients with PIC is the development of choroidal neovascularization (CNV).5 Nonetheless, favorable visual outcomes are achieved in most patients. The etiology of PIC is unknown, and its pathogenesis is unclear.