1/3. Precise monitoring and differentiation of inflammatory events by indocyanine green (ICG) angiography in a case of recurrent posterior sarcoid uveitis.PURPOSE: By providing information on choroidal lesions, indocyanine green (ICG) angiography is complementary to fluorescein angiography in the workup of posterior uveitis. The aim here was to illustrate practically the suitability of performing dual fluorescein/ICG angiograms in a demonstrative case of recurrent presumed posterior sarcoid uveitis. methods: Sequential dual fluorescein/ICG angiograms were performed for the workup and follow-up of a case of recurrent presumed sarcoid uveitis. RESULTS: Dual fluorescein and ICG angiograms performed during the first recrudescence of inflammation showed mainly retinal involvement with cystoid macular edema, diffuse posterior pole retinal hyperfluorescence, and papillitis, whereas the second recurrence after tapering oral corticosteroid therapy showed new choroidal lesions of the posterior pole in the absence of significant retinal involvement. CONCLUSIONS: Dual fluorescein/ICG angiography clearly allowed the differentiation of two different inflammatory events, one involving the retina and the other involving the choroid, at the origin of similar clinical manifestations.- - - - - - - - - - ranking = 1keywords = papillitis (Clic here for more details about this article) |
2/3. High dose intravenous steroid therapy for severe posterior segment uveitis in Behcet's disease.AIM: To evaluate the safety and effectiveness of high dose intravenous steroid therapy (HDIST) in Behcet's disease patients with severe posterior segment uveitis attacks. methods: Five patients with ocular Behcet's disease were treated with HDIST for severe posterior segment attacks. Two patients had vasculitis, one patient had papillitis, and the other two had retinitis; four patients also had accompanying severe vitritis. The visual acuities and improvement in ocular signs after HDIST were evaluated. RESULTS: During HDIST, patients had no systemic complications caused by treatment. All patients responded to HDIST with evidence of a decrease in intraocular inflammatory activity and improved visual acuities within a mean time of 7 (1-15) days of commencing treatment. During follow up three out of five patients had new posterior segment attacks. CONCLUSION: HDIST is effective in controlling severe, vision threatening acute posterior segment Behcet's uveitis attacks and in improving visual function in a short period of time- - - - - - - - - - ranking = 1keywords = papillitis (Clic here for more details about this article) |
3/3. Posterior segment ocular manifestations in patients with HLA-B27-associated uveitis.PURPOSE: To describe a series of patients with seronegative arthritic syndromes and HLA-B27-associated uveitis with severe, sight-threatening, posterior segment ocular manifestations. methods: The authors reviewed the records of 29 patients (17.4%) with posterior segment involvement from a cohort of 166 patients with HLA-B27-associated uveitis. The inclusion criteria included individuals with a positive HLA-B27 who had at least one of the following findings: (1) severe vitreous inflammation; (2) papillitis; (3) retinal vasculopathy; or (4) pars plana exudates. The study population comprised 13 men and 16 women with a mean age at onset of uveitis of 35.2 years. The average duration of the uveitis was 5.3 years, and the median follow-up time was 26 months. FINDINGS: Posterior segment involvement occurred in 34 eyes of the 29 patients. The most common findings included severe and diffuse vitritis in 93.1% of the patients and papillitis in 24 patients (82.7%). retinal vasculitis occurred in seven patients (24.1%), and pars plana exudates were present in two patients (6.8%). Cystoid macular edema (37.9%) and epiretinal membrane (17.2%) were common causes of visual impairment. Systemic immunosuppressive therapy was required for control of inflammation in 32% of the patients. CONCLUSION: HLA-B27-associated uveitis may be related to severe, sight-threatening posterior segment manifestations in some patients; this is an under-recognized phenomenon. These patients may require the use of aggressive systemic immunosuppressive therapy to control inflammation and preserve vision.- - - - - - - - - - ranking = 2keywords = papillitis (Clic here for more details about this article) |