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Treatment Options for Juvenile Idiopathic Arthritis (JIA) Associated Uveitis.

PURPOSE: To summarize the available published data regarding the treatment of JIA-associated chronic uveitis. METHODS: Available peer-reviewed publications regarding the treatments of JIA-associated uveitis were read by multiple authors (RMA, EM, JET, and DH) and the data from these reports were synthesized for this review. RESULTS: Juvenile idiopathic arthritis (JIA)-associated chronic uveitis is a significant cause of ocular morbidity and visual impairment in children, often resulting in more frequent complications and worse visual outcomes than other types of pediatric uveitis. Since not …

Progressive Hemifacial Atrophy With Contralateral Uveitis: A Case Report.

INTRODUCTION: Progressive hemifacial atrophy, known as Parry-Romberg syndrome (PRS), was first described by Parry in 1825. There is a progressive atrophy of facial tissues including skin, bones and muscles. Ophthalmic disorders are common and include keratitis, uveitis, cataract, ipsilateral enophthalmos, optic neuritis, retinal vasculitis and scleral melting. CASE PRESENTATION: We describe a patient with progressive hemifacial atrophy at right facial side who developed granulomatous uveitis and periferic retinal vasculitis in his left eye. We started topical and systemic steroid therapy. Uve…

Увейт у взрослых: Что нужно знать ревматологам?

Ремуматологам, возможно, потребуется установить этиологическую диагностику и заняться терапевтическим лечением взрослых с увеитом. На сегодняшний день ни одна стратегия диагностики увеита не была подтверждена перспективными исследованиями. Расследования отбираются на основе клинических особенностей и анатомического расположения окулярных аномалий. Инфекции, такие как сифилис, болезнь Лайма, туберкулез и болезнь Уиппла, могут вызывать увейт с сопутствующим воспалением суставов в некоторых случаях. У пациентов с известной историей хронической воспламенительной совместной болезнью к числу причин

Совпадение в аннотации оригинала
Rheumatologists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. To date, no diagnostic strategy for uveitis has been validated by prospective studies. Investigations are selected based on the clinical features and on the anatomic location of the ocular abnormalities. Infections such as syphilis, L…

Anti-TNF therapy for juvenile idiopathic arthritis-related uveitis.

Juvenile idiopathic arthritis-related uveitis is the most common type of uveitis in childhood and one of the main causes of visual impairment in children. The introduction of biological treatment has widened the range of therapeutic options for children with uveitis refractory to standard nonbiologic immunosuppressants. Data from clinical trials suggest that both adalimumab and infliximab have demonstrated effectiveness and safety in open-label studies, although no large, randomized, controlled trials have been reported so far. The role of etanercept in treating juvenile idiopathic arthritis-r…

Factors affecting therapeutic decisions in intermediate and posterior uveitis.

PURPOSE: To evaluate whether cost, insurance prior authorization, pregnancy considerations, and subspecialty practice lead to changes in therapeutic decisions among uveitis and retina specialists in the treatment of intermediate and posterior uveitis. DESIGN: Prospective cross-sectional study. METHODS: A total of 934 uveitis and retina specialists across the United States were surveyed via e-mail regarding their choice in long-term therapy for 3 hypothetical patients with uveitic conditions (Behçet disease, birdshot retinochoroiditis, and intermediate uveitis). Respondents were asked to sele…

Factors predictive of remission of new-onset anterior uveitis.

PURPOSE: To identify factors predictive of remission of inflammation in new-onset anterior uveitis cases treated at tertiary uveitis care facilities. DESIGN: Retrospective cohort study. PARTICIPANTS: Patients seeking treatment at participating academic uveitis clinics within 90 days of initial diagnosis of anterior uveitis. METHODS: Retrospective cohort study based on standardized chart review. MAIN OUTCOME MEASURES: Factors predictive of remission (no disease activity without corticosteroid or immunosuppressive treatments at all visits during a 90-day period). RESULTS: Nine hundred ninet…

Successful treatment of syphilitic uveitis in HIV-positive patients.

We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV)-positive patients at Malaysia's Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3) and panuveitis (case 2). Each patient showed a high Venereal Disease Research Laboratory (VDRL) titer at presen…

Drug-induced uveitis in aids patients: two case reports.

Patients with acquired immunodeficiency syndrome (AIDS) can develop severe uveitis. Although infectious and autoimmune causes must always be considered, drug induced uveitis is also an important etiology. Herein, we present two case reports illustrating the classical presentation of rifabutin and cidofovir induced uveitis. The first case was a 33 year old woman with AIDS treated with anti-protease and anti-tuberculosis drugs (including rifabutin). She presented with a red painful right eye. There was a strong anterior segment inflammation with fibrinous exudates and a dense vitritis. Rifabutin…

{mu}-Crystallin, new candidate protein in endotoxin-induced uveitis.

PURPOSE. micro-Crystallin (CRYM) is a major taxon-specific lens protein. The purpose of this study was to investigate the function of CRYM in eyes of mice with endotoxin-induced uveitis (EIU). METHODS. EIU was induced by an injection of a lipopolysaccharide (LPS) into the footpad of male C57BL/6J, CRYM knockout (CRYM(-/-)), and wild-type (CRYM(+/+)) mice. The expression of CRYM in the iris-ciliary body (ICB) was investigated by Western blot analyses and real-time RT-PCR at 12 hours and 1, 3, and 5 days after the LPS injection. The number of cells that had infiltrated the anterior chamber (AC) …

Enthesis inflammation in recurrent acute anterior uveitis without spondylarthritis.

OBJECTIVE: To investigate whether patients with idiopathic recurrent acute anterior uveitis (AAU) have enthesis alterations comparable with those in patients with spondylarthritis (SpA). METHODS: A blinded, controlled study of enthesis evident on ultrasound (US) examination was performed in 100 patients and controls classified into 5 groups, as follows: patients with confirmed SpA (group 1), patients with recurrent AAU who were positive for HLA-B27 and did not have SpA (group 2), patients with recurrent AAU who were negative for HLA-B27 and did not have SpA (group 3), patients with forms of u…

Infectious uveitis in Thailand: serologic analyses and clinical features.

PURPOSE: To determine the seroprevalence of various infectious agents in Thai patients with uveitis. METHODS: Prospective study of 101 consecutive patients with uveitis, 100 HIV-infected retinitis patients, and 100 nonuveitis controls. RESULTS: Antibodies against T. gondii were detected in 31/101 non-HIV patients, mostly with posterior uveitis and focal retinitis, and were significantly higher than in other groups examined. Antibodies for T. pallidum and Leptospira were observed more frequently in patients with HIV-infected retinitis. Active tuberculosis in non-HIV patients was not found. C…

Seasonal hyper acute pan uveitis--recent scenario in Nepal.

Seasonal hyperacute panuveitis (SHAPU), characterized by an unusual form of unilateral severe hyper acute diffused intraocular inflammation, is one of the mysterious eye diseases of which the definite cause and treatment remains yet to be tound out. In this study, a total of six cases were included. Aqueous and vitreous samples were subjected to direct microscopy and culture (bacterial or fungal). Of the six cases included, two yielded Streptococcus pneumoniae and one Acinetobactor sp. on culture. All three culture positive samples showed pus cells in direct microscopic examination (gram stain…

Rubella virus-associated uveitis: clinical manifestations and visual prognosis.

PURPOSE: To investigate the clinical profile of patients with chronic anterior uveitis and intraocular analyses positive for intraocular Rubella virus infection and assess eventual similarities to Fuchs heterochromic uveitis (FHU). DESIGN: Retrospective case-control study. METHODS: Clinical records of 30 patients with anterior uveitis positive for intraocular antibody production against Rubella virus by Goldmann-Witmer coefficient determination and/or polymerase chain reaction were reviewed and compared with clinical records of 13 patients with chronic anterior uveitis of undetermined origin…

[Vitrectomy in vitreo-retinal complications associated with intermediate uveitis].

OBJECTIVE: To investigate the effects of vitrectomy in vitreo-retinal complications associated with intermediate uveitis. METHODS: Retrospective case series of sixteen eyes of 16 patients in vitreo-retinal disease associated with intermediate uveitis in a 3-year period from Mar 2002 to Jun 2005 were included in the study. They were treated with vitrectomy and the mean follow-up was (14.25 +/- 7.90) months (range: 5-32 months). Visual acuity in final follow-up, post-operative complications and the recurrence of intermediate uveitis were retrospectively reviewed. RESULTS: Four patients were as…

Uveitis in children with human immunodeficiency virus-associated arthritis.

PURPOSE: To describe the ocular inflammatory manifestations and clinical characteristics of children with Human Immunodeficiency Virus (HIV)-associated arthritis. METHODS: A retrospective review of the charts of children with chronic uveitis and HIV-associated arthritis seen between June 2004 and September 2006 at Inkosi Albert Luthuli Central Hospital, Durban, South Africa. The following data were analyzed: age at presentation, gender, race/ethnicity, rheumatologic problems, uveitic diagnosis, laboratory findings, and ocular complications. RESULTS: Seven black African males with a mean age …

Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients.

PURPOSE: To describe the clinical presentation of cytomegalovirus (CMV) anterior uveitis in human immunodeficiency virus (HIV)-negative patients. DESIGN: Retrospective, interventional case series. METHODS: HIV-negative patients with anterior uveitis associated with elevated intraocular pressure (hypertensive anterior uveitis) seen at the Singapore National Eye Centre had their aqueous analyzed for viral deoxyribonucleic acid by polymerase chain reaction, and their records were reviewed for demographic data, ocular findings, laboratory results, and treatment. RESULTS: Aqueous was obtained fr…

Aldose reductase inhibition prevents endotoxin-induced uveitis in rats.

PURPOSE: The purpose of the present study was to elucidate the role of the polyol pathway enzyme aldose reductase (AR) in the mediation of ocular inflammation in a rat model of endotoxin-induced uveitis (EIU). METHODS: EIU was induced by a subcutaneous injection of 200 microg lipopolysaccharide (LPS) in male Lewis rats treated with the AR inhibitor, zopolrestat (25 mg/kg body weight, intraperitoneally) or its carrier. The rats were killed 24 hours after LPS injection, the eyes were enucleated immediately, and aqueous humor (AqH) was collected. The number of infiltrating cells, protein concent…

Increased CD40 ligand in patients with acute anterior uveitis.

PURPOSE: The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T-cells. We wanted to evaluate whether the T-cell activation marker CD40 ligand is involved in the AU immunopathogenesis. METHODS: We evaluated the expression of the CD40 ligand on CD4+ T-cells, CD8+ T-cells and CD19+ B-cells on peripheral blood mononuclear cells using flow cytometry in six patients with unilateral AU, six patients with monosymptomatic optic neuritis (ON) as inflammatory controls, and in six healthy controls. The ex vivo induction of the CD40 ligand on T-cell…