1/14. Acute posterior multifocal placoid pigment epitheliopathy associated with a systemic necrotizing vasculitis.PURPOSE: The authors present a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with a systemic necrotizing vasculitis with mixed features of wegener granulomatosis and polyarteritis nodosa (PAN). methods: Case report. RESULTS: A 29-year-old woman developed a severe nosebleed, followed by a low-grade fever, night sweats, and a productive cough. One month later, she began experiencing high fevers, headache, myalgia, neck stiffness, and abdominal pain as well as bilateral blurred vision from APMPPE. Systemic evaluation revealed nasal ulcerations, bilateral pleural effusions, and a bilateral maxillary and ethmoid sinusitis, consistent with wegener granulomatosis. However, ANCA testing was negative, and a renal and mesenteric angiogram showed aneurysmal dilatations suggestive of PAN. Her ocular and systemic symptoms markedly improved with systemic corticosteroids. CONCLUSIONS: The cause of APMPPE is unknown. This case of APMPPE associated with systemic necrotizing vasculitis provides support for the choroid as being primarily involved by a diffuse vasculitic process that interrupts choroidal perfusion and causes the characteristic fundus findings in APMPPE.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
2/14. Recurrent anterior uveitis and healed retinal vasculitis associated with multiple sclerosis.We describe the occurrence of anterior uveitis with healed retinal vasculitis in an Asian-Indian woman. She had features of anterior uveitis and healed retinal vasculitis. This rare disease in india may be associated with intraocular inflammation.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
3/14. Human T-cell lymphotropic virus type 1-associated retinal vasculitis in children.PURPOSE: To describe predominant retinal vasculitis in children carrying human T-cell lymphotropic virus type 1 (HTLV-1). methods: The authors examined clinical records of patients with HTLV-1-associated uveitis between 1987 and 2001 in Kagoshima University Hospital and reviewed cases of extensive, smoldering retinal vasculitis. RESULTS: Three previously healthy teenagers noted mild visual symptoms and presented with extensive sheathing of retinal vessels, complicated by mild anterior segment inflammation. The retinal vascular disease responded poorly to systemic corticosteroids, had a smoldering course with persistent sheathing of retinal vessels, and eventually resulted in diffuse chorioretinal degeneration. Results of laboratory studies were unremarkable except for the presence of serum antibodies to HTLV-1. One patient developed HTLV-1-associated myelopathy 11 years after the onset of ocular disease. CONCLUSIONS: The retinal vasculitis differed from the retinal vascular changes commonly seen in HTLV-1-associated uveitis. The authors suggest a clinical disease HTLV-1-associated retinal vasculitis that affects young HTLV-1 carriers, characterized by smoldering retinal vasculitis with ultimate retinal degeneration.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
4/14. Two cases of uveitis with tubulointerstitial nephritis in HTLV-1 carriers.BACKGROUND: Although the tubulointerstitial nephritis and uveitis (TINU) syndrome has been reported, there are only a few reports in the ophthalmological literature. The ocular findings usually appear later than the renal findings, and a renal biopsy is required for a definitive diagnosis. CASES: Case 1 was a 15-year-old Japanese girl who was a carrier of the human T lymphotropic virus, type 1 (HTLV-1). She had tubulointerstitial nephritis, anterior uveitis, posterior retinal edema in the right eye, and peripheral vasculitis OU. Case 2 was a 56-year-old Japanese woman who was also a carrier of HTLV-1. Previously she had been diagnosed with Graves' disease, anterior uveitis, and vitreous opacity. Several years later tubulointerstitial nephritis was diagnosed. OBSERVATIONS: In both patients interstitial nephritis was diagnosed and systemic steroid therapy was effective. CONCLUSIONS: It is difficult for ophthalmologists to diagnose the TINU syndrome because the renal biopsy is performed by a pediatrician or an internist. This may be why ophthalmologic descriptions are rare in cases of TINU syndrome, even though the ocular findings reported in the literature are characteristic. This is the first case report of TINU syndrome in patients with HTLV-1. Ophthalmologists should pay more attention to the uveitis in the TINU syndrome.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
5/14. Sympathetic ophthalmia associated with ocular and cerebral vasculitis: an angiographic and radiologic study.PURPOSE: To describe a case of sympathetic ophthalmia (SO) associated with ocular and cerebral vasculitis. methods: The authors report a 38-year-old woman who presented with bilateral uveitis 7 years after a penetrating trauma to the right eye. Ocular examination included fundus fluorescein and indocyanine green angiography. Medical history disclosed an episode of dysarthria and right-sided weakness. RESULTS: Anterior uveitis was present in the previously injured pseudophakic right eye, which harbored a piece of glass stuck in the lower temporal iris. In the left eye, vitreal inflammation with retinal sheathing and subretinal lesions was predominant. Besides retinal vasculitis, fundus angiography showed choroidal vasculitis. Neurologic studies were compatible with cerebral vasculitis. CONCLUSIONS: In SO, choroidal vasculitis that is invisible clinically can be demonstrated angiographically. Although rare, inflammation can also affect the nervous system.- - - - - - - - - - ranking = 5keywords = ocular (Clic here for more details about this article) |
6/14. vitrectomy and trabeculectomy combined with interferon alpha treatment in Adamantiades-Behcet's disease: a case report.BACKGROUND: Adamantiades-Behcet's disease is a multisystem disorder with recurrent oral and/or genital ulcerations, skin lesions, and ocular involvement. eye involvement is a common manifestation that affects the patients' quality of life more than any other. Left untreated, it leads to blindness and often to loss of the eye through secondary complications such as phthisis or painful glaucoma. methods: Case report of a 24-year-old patient of Turkish descent living in germany since his birth was admitted to our Department of ophthalmology in 1999 because of visual loss in his right eye. He could only perceive light in that eye and evidenced total retinal detachment. In the left eye he had 20/20 vision but showed signs of retinal vascular inflammation and secondary glaucoma. RESULTS: Treatment with interferon alpha (9x10(6) I.U./3x week s.c.) and prednisolone (100 mg/d p.o.) led to complete regression of the acute inflammation within 2 weeks prior to operation. vitrectomy was then successfully performed in the right eye under the therapy of interferon alpha (9x10(6) I.U./3x week s.c.) and 10 mg prednisolone p.o. The prednisolone therapy was stopped 1 week following operation. The failure of conservative glaucoma treatment necessitated trabeculectomy in the left eye. The patient has had no further recurrence for 4 years under monotherapy with interferon alpha (3x10(6) I.U./3x week s.c.). CONCLUSION: Interferon alpha is a potent therapy for Adamantiades-Behcet's disease with ocular involvement. It also provides a basis for safe and reliable surgical interventions. There was no intra- or perioperative recurrence of inflammation, which is a common finding in these procedures.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
7/14. Frosted branch angiitis and late peripheral retinochoroidal scar in a patient with acquired toxoplasmosis.PURPOSE: To report a case of acute frosted branch angiitis associated with acquired toxoplasmosis in which a late peripheral chorioretinal scar developed. RESULTS: A 32-year-old man without systemic symptoms presented with sudden visual loss in his left eye. Examination demonstrated frosted branch angiitis without necrotizing chorioretinitis. serologic tests showed elevated toxoplasma gondii-specific immunoglobulin m antibody titers. Antitoxoplasmic therapy and oral steroids healed the ocular inflammation. In a follow-up visit one year later, a peripheral chorioretinal scar was noted. CONCLUSIONS: Acute frosted branch angiitis without focal necrotizing chorioretinitis can be a manifestation of acquired toxoplasmosis. This could be an important, and sometimes forgotten, sign of the disease.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
8/14. retinal vasculitis due to secondary syphilis.BACKGROUND: retinal vasculitis is one of the manifestations of ocular syphilis. CASE: A 29-year-old man was referred to our hospital with the complaint of sudden visual loss in the left eye lasting more than three weeks. OBSERVATIONS: Ophthalmoscopic examination showed retinal hemorrhages, edema, and sheathing of large retinal arteries and veins. fluorescein angiography revealed extensive occlusion of the affected retinal arteries, veins, and capillaries. Little evidence of uveitis or vitritis was observed. The fluorescent treponemal antibody-absorption test was positive, and the treponema pallidum hemagglutination titer was 1:10,240. The treatment with penicillin was effective, leading to resolution of the retinal hemorrhages and edema, although occlusion of the retinal vessels persisted. CONCLUSIONS: Vascular occlusion occurred simultaneously in large retinal arteries, arterioles, and capillaries as well as in segments of retinal veins, resulting in irreversible changes in the vascular walls.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
9/14. Frosted branch angiitis: a review.The purpose of this study is to present the first report of a case of primary frosted branch angiitis from the UK and to review the characteristics of this rare disease. Primary frosted branch angiitis causes characteristic florid translucent retinal perivascular sheathing of both arterioles and venules in association with variable uveitis, retinal oedema and visual loss, normally with good recovery. A total of 57 cases have been reported in the world literature. Atypical, typically focal frosted branch angiitis may also occur secondary to other causes of intraocular inflammation, especially cytomegalovirus retinitis. Primary frosted branch angiitis has a characteristic presentation but a variable course, typically affecting children or young adults. The disease is likely to represent a common immune pathway in response to multiple infective agents. The optimal treatment is unclear.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
10/14. retinal vasculitis caused by adult T-cell leukemia/lymphoma.BACKGROUND: To report a case of lymphomatous infiltration and bilateral retinal vasculitis observed among 83 cases of adult T-cell leukemia (ATL) treated in the University Hospital Center in Fort-de-france (martinique, French west indies) between 1984 and 2003. CASE: A complete clinical ophthalmologic examination was performed in this patient along with fluorescein angiography. OBSERVATIONS: After being checked for diffuse adenopathies, myodesopsias, and phosphenes, the 35-year-old patient was diagnosed with ATL. The ocular impairment, present since the onset of ATL as peripheral subretinal infiltrates, spread progressively and afferently to the rest of the retina in the form of an essentially venous vasculitis. Impairment of the vitreous was noted only in the end stages of disease progression. As ocular lesions progressed, the general state of the patient degraded at the same time despite chemotherapeutic measures. CONCLUSION: Among the more than 300 seropositive for human T-cell lymphotropic virus type 1 (HTLV-1) or patients with HTLV-1-associated myelopathy/tropical spastic paraparesis treated at our hospital in the last 20 years, and among the 83 cases of ATL, only this single case of retinal vasculitis associated with HTLV-1 was observed (1/83, 1.2%) in martinique, confirming the geographic variability of the clinical phenotype of HTLV-1 infection. The incidence of retinal vasculitis in ATL patients may signify an even worse prognosis than initially indicated.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
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