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Barriers to Adherence with Corticosteroid Eye Drops in Patients with Uveitis.

PURPOSE: To assess the patient barriers to adherence with corticosteroid eye drops in patients with ocular inflammatory disorders across the United States. METHODS: This was a multicenter study of adult and pediatric patients with uveitis undergoing treatment with corticosteroid eye drops. Sites included the Johns Hopkins Wilmer Eye, the University of Texas at Austin, the University of Wisconsin-Madison, the University of Minnesota, the Minneapolis Veterans Administration Hospital, and the Washington University of St. Louis. Eligible patients completed a self-reporting survey to assess barrie…

The use of Janus kinase inhibitors to treat noninfectious uveitis.

OBJECTIVE: To present a case series of eight patients with noninfectious chronic uveitis treated at a single institution with one of two JAK inhibitors (Jakinibs), upadacitinib or tofacitinib. SUBJECTS/METHODS: A retrospective chart review of patients seen by the uveitis service from 2015 to 2022 treated with upadacitinib and/or tofacitinib was performed. All patients included had previously failed alternative immunomodulatory therapy (IMT), had consistent ophthalmic evaluations for at least 6 months, and stayed on the Jakinib for at least 3 months. Eight patients were included. Demographic i…

Neopterin Levels and Immune Response in Autoimmune Uveitis in an Experiment.

PURPOSE: To study and compare the immune response and neopterin levels in the blood in experimental autoimmune uveitis (EAU). METHODS: A model of EAU was created in 30 Chinchilla rabbits. Intravenous and intravitreal injections of normal horse serum were administered for this purpose. Clinical examinations and blood tests were conducted on days 3, 7, 10, 14, and 21. The blood investigation included the determination of neopterin (NP) level, white blood cell counts, lymphocytes, CD3+, CD4+, CD8+, and CD16+. RESULTS: The peak in white blood cell count was observed on days 7 and 10 (6.4 ± 0.4 g…

A Comprehensive Review of Tubulointerstitial Nephritis and Uveitis (TINU) Syndrome.

Background: Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare autoimmune disorder, characterized by acute tubulointerstitial nephritis and uveitis. It poses diagnostic challenges due to the mostly asynchronous onset of renal and ocular manifestations, as well as the variety of differential diagnoses. This review provides an overview of the epidemiology, pathogenesis, clinical features, diagnostic criteria, and management strategies. Methods: A comprehensive review of the peer-reviewed literature, including studies and case reports, was conducted. Results: The etiology of TINU …

Множественные роли GM-CSF в аутоиммунном и автовоспалительном увейтете.

Увеит — это воспалительное расстройство глаза, которое вызывает серьезную потерю зрения. В аутоиммунных и автоматических воспламеняющихся заболеваниях, таких, как множественный склероз (MS) и ревматоидный артрит (RA), был отмечен значительный патогенный фактор, зависящий от клеточной иммунной реакции. Появляющиеся данные как экспериментальных моделей, так и клинических исследований увеита свидетельствуют о том, что ГМ-КСФ играет гораздо более сложную роль, чем его первоначально описываемая функция как гематопоэтический фактор роста, способствующий дифференциации гранулоцитов и макрофазов из по

Совпадение в аннотации оригинала
Uveitis is an inflammatory disorder of the eye that causes severe vision loss. In autoimmune and autoinflammatory diseases, such as multiple sclerosis (MS) and rheumatoid arthritis (RA), granulocyte-macrophage colony-stimulating factor (GM-CSF) has been indicated to play a significant pathogenic role that depends on cellular immune responses. Emerging eviden…

Systemic Fluoroquinolone Use and Risk of Uveitis or Retinal Detachment.

IMPORTANCE: Fluoroquinolone use has been associated with increased risk of uveitis and retinal detachment in noninterventional studies, but the findings have been conflicting and causality is unclear. OBJECTIVE: To estimate the association of systemic fluoroquinolone use with acute uveitis or retinal detachment, using multiple analyses and multiple databases to increase the robustness of results. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the Clinical Practice Research Datalink Aurum and GOLD UK primary care records databases, which were linked to hospital admissions…

Progressive Uveitis as a Diagnostic and Therapeutic Challenge in Whipple's Disease.

A caucasian male in his 60s presented with a several-month history of weight loss and recurrent fever, accompanied by bilateral sensorineural hearing loss and progressive uveitis. Initial investigations were inconclusive, including Pet CT and duodenal biopsy with Tropheryma whipplei polymerase chain reaction (PCR). Based on a suspicion of autoimmune disease, immunosuppressive treatment was initiated without clinical improvement. Whipple disease (WD) was finally disclosed through positive PCR identification of Trophyrema whipplei in vitreous biopsy and repeated stool sampling. The patient was t…

A Rare Association of Disseminated Granuloma Annulare With Recurrent Uveitis.

Granuloma annulare is a benign chronic inflammatory granulomatous dermatosis with a variable clinical presentation. The disseminated form of the disease is characterized by a widespread papular eruption, primarily affecting the trunk, neck, and extremities. The development of granuloma annulare in patients with systemic diseases, such as diabetes mellitus, malignancy, or dyslipidemia, has been extensively documented. Still, only a few cases of granuloma annulare associated with recurrent uveitis have been reported. Herein, we present a rare case of generalized granuloma annulare that was assoc…

Update on the systemic management of noninfectious uveitis in children and adolescents.

Noninfectious uveitis (NIU) in children and adolescents is a rare but treatable cause of visual impairment in children. Treatments for pediatric NIU and their side effects, along with the risks of vision loss and the need for long-term disease monitoring, pose significant challenges for young patients and their families. Treatment includes local and systemic approaches and this review will focus on systemic therapies that encompass corticosteroids, conventional synthetic disease-modifying antirheumatic drugs (csDMARD), and biological disease-modifying antirheumatic drugs (bDMARD). Treatment is…

The pattern of sarcoid uveitis at a tertiary care center in Nepal.

UNLABELLED: Sarcoidosis is an idiopathic, multisystemic granulomatous disorder involving the eye with various ocular presentations, the most common being sarcoid uveitis. The diagnosis was based on typical clinical features, chest radiography, laboratory findings and biopsy based on revised International Workshop on Ocular Sarcoidosis criteria. Here in, the authors aim to present the first report on the trend of cases of sarcoid uveitis in Nepal. MATERIALS AND METHODS: A retrospective quantitative cross-sectional study was conducted at the uveitis clinic of the Institute of Medicine by obtain…

Tubulointerstitial Nephritis and Uveitis Syndrome in the United Arab Emirates.

PURPOSE: To report the first series of tubulointerstitial nephritis (TINU) syndrome from the Middle East. METHODS: We retrospectively included patients with elevated urine beta-2 microglobulin, and a diagnosis of TINU based on anterior uveitis with or without posterior involvement. Multimodal imaging, duration of follow-up, local and systemic treatment used were recorded. RESULTS: 24 eyes of 12 patients (8 male, mean age 20.3 years) met the criteria for TINU. The most common posterior segment clinical finding was optic nerve head edema (41.7%), while on fluorescein angiography 58.3% and 75% …

Relationship between Uveitis and the Differential Reactivity of Retinal Microglia.

Uveitis, a complicated group of ocular inflammatory diseases, can be affected by massive pathogenic contributors such as infection, autoimmunity, and genetics. Although it is well known that many pathological changes, including disorders of the immune system and disruption of the blood-retinal barrier, count much in the onset and progression of uveitis, there is a paucity of safe and effective treatments, which has exceedingly hindered the appropriate treatment of uveitis. As innate immune cells in the retina, microglia occupy a salient position in retinal homeostasis. Many studies have report…

Diagnosis and Management of Non-Infectious Uveitis in Pediatric Patients.

Uveitis in children accounts for 5-10% of all cases. The causes vary considerably. Classically, uveitis is distinguished according to its infectious or inflammatory origin and whether it is part of a systemic disease or represents an isolated ocular disease. It is important to highlight the specificity of certain etiologies among children such as juvenile idiopathic arthritis. The development of visual function can potentially be hindered by amblyopia (children aged < 7 years), in addition to the usual complications (synechiae, macular edema) seen in adult patients. Moreover, the presentation …

Effects of Subcutaneous Methotrexate in Patients with Refractory Uveitis and Chorioretinitis.

PURPOSE: Methotrexate (MTX) is an immunosuppressive agent used to treat noninfectious inflammatory eye conditions and is generally administered orally for ocular inflammatory diseases. When used in rheumatological diseases, subcutaneous administration has been reported to show higher efficacy than oral administration. Therefore, this study aimed to evaluate the effect of subcutaneous MTX in patients with refractory uveitis or choroiditis who did not respond to other immunosuppressive agents. METHODS: A retrospective case series study was performed between January and December 2018. Patients w…

Recurrent uveitis in a patient with CREST syndrome: a case report.

INTRODUCTION: Systemic sclerosis is a connective tissue condition presented with clinical manifestations, including ocular involvement in a small percentage. A few cases of uveitis were described in the literature, especially in CREST syndrome. CASE PRESENTATION: The authors reported a case of a 48-year-old male with a blurred vision in his left eye that diagnosed with recurrent uveitis in the setting of CREST syndrome, treated with prednisolone, methotrexate, and golimumab, with improvement. DISCUSSION: Ocular manifestations of systemic sclerosis include palpebral alterations, keratoconjunc…

A novel mechanism of macular holes in patients with Behçet's uveitis.

To describe two cases of Behçet's retinitis lesions in the macula causing sloughing of retinal tissue forming a full-thickness macular hole. This was a case series study. Case 1 was a 26-year-old presented, known case of Behçet's disease, presented with a large area of retinitis involving the center of the macula with overlying vitritis. One day after the initiation of treatment, vitritis improved, but the retinitis patch sloughed and created a full-thickness macular hole. Case 2 was a 31-year-old male, known case of Behçet's uveitis, who presented vitritis and multiple retinitis patches invol…

Safety of Intravenous Methylprednisolone in Refractory and Severe Pediatric Uveitis.

PURPOSE: To evaluate the safety of intravenous high-dose pulse methylprednisolone succinate (IVHDM) in the management of severe or refractory non-infectious pediatric uveitis. METHODS: We reviewed all uveitis patients who were ≤16 years of age and who received IVHDM with a dose of ≥500 mg per day (1-3 days a month) for at least 3 months during their management at a tertiary care eye hospital. RESULTS: Twenty pediatric patients with severe or refractory uveitis who received IVHDM were identified. Six patients received IVHDM either once, as a preoperative medication, or at a lower dose than 50…

Acute Uveitis in a Background of Streptococcal Sepsis: Infective or Inflammatory?

BACKGROUND: The pathophysiology of uveitis in a patient with post-streptococcal syndrome with evidence of bacterial sepsis may be difficult to classify as being infective or an inflammatory etiology. CASE REPORT: Our patient presented with uveitis with systemic features of reactive arthritis and acute renal failure in a background of sepsis with group A streptococcus. Treatment with topical steroids lead to the resolution of this type of uveitis. CONCLUSION: It is safe to consider uveitis as being inflammatory rather than infectious and treat appropriately, when evidence suggesting other fea…