Cases Of Iritis Research Articles

One-year outcomes and safety assessment of faricimab in treatment-naïve patients with neovascular age-related macular degeneration in Japan

This multicentre retrospective study evaluated the 1-year outcomes and safety profile of faricimab in treatment-naïve patients with neovascular age-related macular degeneration (nAMD). Fifty-five patients (57 eyes) underwent loading therapy comprising three monthly faricimab injections. If dryness was achieved by the third month, subsequent treat-and-extend (TAE) follow-up continued at a minimum 8-week interval thereafter. If wet macula persisted at the third month, a fourth dose was administered, followed by the TAE regimen. After 1 year, improvements in visual acuity (0.44 ± 0.46 [baseline] to 0.34 ± 0.48; p < 0.01) and central foveal thickness (326 ± 149 [baseline] to 195 ± 82 μm; p < 0.0001) were significant. Dry macula, characterised by the absence of intraretinal or subretinal fluid, was achieved in 65% of cases. Treatment intervals varied, ranging from 8 to 16 weeks, with 44% of eyes extending to a 16-week interval, followed by 33% at 8 weeks, 16% at 12 weeks, 5% at 14 weeks, and 2% at 10 weeks. Notably, 50% of the polypoidal choroidal vasculopathy patients exhibited complete regression of polypoidal lesions between 12 and 15 months. Faricimab treatment in nAMD patients induced significant improvements in central vision and retinal morphology. Two cases of retinal pigment epithelial tears and one case of iritis were reported as ocular complications.

Repositioning surgery of different intraocular lens designs in eyes with late in-the-bag intraocular lens dislocation.

To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. Patients referred to Oslo University Hospital Oslo, Norway. Prospective cohort study. The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by 1 surgeon. The following IOL designs were repositioned: 1-piece foldable (n = 17), 3-piece foldable (n = 28), plate-haptic (n = 8), and 1-piece rigid (n = 1) IOLs. Patients were evaluated comprehensively preoperatively and at 6 months (80%), 1 year (67%), and 2 years (61%) postoperatively. The main outcome measures were efficacy regarding corrected distance visual acuity (CDVA) and spherical equivalent (SE) and safety regarding complications. Postoperative visual acuity was similar for different IOL designs. The mean SE change to final observation was -0.08 (95% CI, -0.93 to 0.77) in the 1-piece IOL group (n = 11) and -0.98 (-1.73 to -0.23) in the 3-piece IOL group (n = 18) (P = .11). Regarding safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece IOL group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. Repositioning surgery of 1-piece IOLs seems as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.

Single-pass four-throw technique for pupilloplasty.

To describe a surgical technique for performing pupilloplasty. In this surgical technique for pupilloplasty, after a single pass of needle through the edges of iris defect along the pupillary margin, the suture end is passed through the loop with 4 throws, creating a helical configuration in modified Siepser slipknot technique that is self-retaining and self-locking. The technique was performed in 27 cases and the loop did not open in any of the cases in the 6-month follow-up period. No case of iritis was seen. The iris tissue was seen well approximated to each other in all cases. The single-pass 4-throw technique serves as an effective method to perform pupilloplasty.

Cataract surgery in patients with nanophthalmos: results and complications.

To evaluate phacoemulsification surgery results and complications in patients with nanophthalmos. The records of 9 patients with nanophthalmos who had cataract surgery from January 2011 through January 2015 were retrospectively reviewed. Nanophthalmos was diagnosed by the presence of an eye with an axial length (AL) less than 20.5 mm. The records were reviewed for ocular diagnosis, keratometry, anterior chamber depth (ACD), AL, ocular surgeries, visual acuity, and complications. A total of 14 eyes of 9 patients (8 women, 1 man) with a mean age of 72 years (range 48-86) were reviewed. Mean AL was 18.72 mm and mean ACD was 2.30 mm. Mean preoperative spherical equivalent (+8.55 ± 6.44 diopters (D)) was reduced to +0.30 ± 2.17 D at last follow-up visit. Mean best-corrected visual acuity (BCVA) was +0.68 ± 0.55 logarithm of the minimum angle of resolution (logMAR) preoperatively and improved to +0.55 ± 0.73 logMAR at last follow-up visit. Visual acuity remained stable or improved in 11 eyes. Five eyes did not achieve final BCVA ≥+0.3 logMAR. Complications occurred in 3 eyes (21.4%) and included 1 case of posterior capsule rupture, 1 case of severe iritis and rhegmatogenous retinal detachment 2 weeks postoperatively, and 1 other case of iritis. No postoperative uveal effusion was seen. Although phacoemulsification seems to be relatively safe in nanophthalmic eyes, surgeons need to be aware of the challenges of this procedure in these high-risk eyes. Nevertheless, with careful preoperative evaluation and planning, most cases were uncomplicated and resulted in improvement of BCVA.

Acute Anterior Uveitis Following Intravitreal Injection of Bevacizumab

To report five cases of iritis after intravitreal injection of bevacizumab. The clinical charts of patients who received intravitreal injections of bevacizumab or ranibizumab from January 2009 to September 2011 by one physician were retrospectively reviewed. A total of 1,097 injections of bevacizumab and 571 of ranibizumab were administered. Five patients developed acute anterior uveitis and presented with severe pain, photophobia, conjunctival injection, and anterior chamber reaction 2 to 24 hours after intravitreal injection of bevacizumab. All five patients were treated with topical corticosteroids with rapid resolution of the inflammation. Although uncommon, acute iritis is a complication of intravitreal injection of bevacizumab.

Assessment of phacoaspiration techniques in clear lens extraction for correction of high myopia

To evaluate various phacoaspiration techniques in clear lens extraction for the incidence of intraoperative difficulties and complications. This was a prospective study in which bilateral clear lens extraction was performed on 40 eyes of 20 patients, to correct high myopia. The patients were divided into 2 groups: group A underwent supracapsular phacoaspiration; group B were the contralateral eyes of the same patient. These patients were operated on with endocapsular phacoaspiration with the divide and conquer (D and C) technique. Preoperative ocular examination data were recorded and tested for significance. Intraoperative difficulties and complications such as nucleus cracking, capsule rupture and vitreous loss, and repeated chamber collapse were recorded. Postoperative examination data were recorded. Mean age was 35.65 +/- 5.85 years. Mean follow-up time was 17.1 +/- 8.56 months. In group A mean myopia was -17.3 +/- 5.07 diopters; in group B myopia was -17.9 +/- 4.20 diopters. Mean preoperative uncorrected visual acuity (UCVA) was 0.04 +/- 0.0167, while the mean postoperative UCVA was 0.435 +/- 0.1442. There was a significant difference in pre- and postoperative BCVA within both groups, but not between the two groups. In both groups endothelial cell count (ECC) showed a significant difference between pre- and postoperative data; however, there was no statistically significant difference between both groups in postoperative ECC. The effective phacoaspiration time for group A was 4.6 +/- 1.6 seconds, and for group B 9.90 +/- 2.27 seconds (P < 0.005). No cases of capsule rupture occurred in group A, but 3 cases occurred in group B (15 %) (not significant, P = 0.231). Nucleus cracking did not occur in group A, but in group B 13 cases occurred (65%). Chamber collapse occurred in 4 cases (20%) in group A and 5 cases (25%) in group B (not significant, P = 1.000). Three cases of moderate postoperative iritis were recorded in group B in (15%), in which posterior capsular rupture also occurred. No cases of iritis were recorded in group A (not significant, P = 0.231). Two cases of cystoid macular edema were recorded in group B (10%) and none in group A (not significant, P = 0.487). Supracapsular phacoaspiration for clear lens extraction in correction of high myopia seems to present no risk for the posterior capsule, although there is a marginal risk to the ECC.

Ophtec iris reconstruction lens United States clinical trial phase I

Purpose To determine the safety and efficacy of the Ophtec model 311 iris reconstruction lens for treatment of visual disturbances, such as glare or photophobia, related to partial or total absence of the human iris. Design Phase I multicenter, nonrandomized, investigational device study. Participants Ten iris reconstruction lenses were placed in 10 subjects at 6 sites. Methods Iris reconstruction lenses were placed in 9 patients who had lost all or part of their iris from trauma and in 1 patient who lacked iris pigmentation due to congenital albinism. Patients were examined preoperatively, intraoperatively, and postoperatively at day 1; week 1; and months 1, 3, 6, and 12. Main outcome measures Efficacy measures were uncorrected visual acuity (UCVA), glare, starbursts, and photophobia. Safety measures were best-corrected visual acuity (VA), surgical complications, and adverse events. Results Uncorrected VA improved in all eyes after implantation of the iris reconstruction lens. Best-corrected VA did not change significantly ( P = 0.24). Postoperative photophobia was reduced in all 9 eyes that experienced moderate to severe preoperative photophobia. Likewise, postoperative glare was reduced in all 6 eyes with moderate to severe preoperative glare. There were no surgical complications. Adverse events included 2 cases of iritis and 1 case of macular edema. Conclusions Preliminary results suggest that the Ophtec model 311 iris reconstruction lens can improve UCVA and reduce glare and photophobia in patients with partial or total absence of the iris or iris pigmentation.

Iritis and hypotony after treatment with intravenous cidofovir for cytomegalovirus retinitis.

To describe intraocular inflammation due to treatment with intravenous cidofovir dihydrate for cytomegalovirus retinitis. Retrospective cohort. Three university outpatient ophthalmology clinics. All patients treated with intravenous cidofovir therapy before October 31, 1996. Treatment with intravenous cidofovir was given according to standardized protocols. Intraocular inflammation was treated according to the best medical judgment. The presence of new intraocular inflammation, the severity of inflammation, visual acuity, and intraocular pressure. Eleven cases of iritis (26%) occurred among 43 patients. In 6 cases, the iritis was bilateral. Patients who experienced iritis were more likely to have been previously treated for cytomegalovirus retinitis (P = .03), to be diabetic (P = .05), or to be receiving protease inhibitors (P < .001). Four patients and 15 control subjects had also taken rifabutin (P = .70). The onset of iritis occurred at a mean (+/-SD) of 4.9 +/- 1.8 days after a cidofovir dose and after a mean (+/-SD) of 4.2 +/- 1.6 doses of cidofovir. Six eyes of 4 patients had hypotony. Five eyes of 5 patients had a persistent decrease in visual acuity of at least 2 Snellen lines. Acute intraocular inflammation may occur with or without hypotony after intravenous cidofovir therapy, similar to the reactions seen after intravitreous administration. Although the manifestations may be severe, they are manageable with topical corticosteroid therapy in most cases. Cidofovir therapy can be continued in some patients if medical necessity warrants, but recurrent inflammation or permanent hypotony may occur.

Anterior Nongranulomatous Uveitis after Intravitreal HPMPC (Cidofovir) for the Treatment of Cytomegalovirus Retinitis: Analysis and Prevention

The authors characterize and analyze the incidence of a previously reported mild anterior nongranulomatous uveitis associated with intravitreal injections of (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC), also termed cidofovir (Vistide, Gilead Sciences, Foster City, CA). This is an acyclic nucleoside phosphonate analogue with a potent anticytomegalovirus effect. The authors also analyzed the effects of probenecid therapy, as well as prophylaxis with probenecid plus topical corticosteroids and cycloplegics on the course and outcome of the uveitis. Prospective case series from a tertiary referral center, which included 46 consecutive patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis. There was a total of 130 injections in 69 eyes treated with 20 micrograms of intravitreal HPMPC. Forty-one patients (119 injections) received oral probenecid, 5 patients (11 injections) did not, and 21 patients (53 injections) received topical corticosteroids and cycloplegics as an adjuvant to probenecid in the prophylaxis of iritis. Mild to moderate nongranulomatous iritis was seen in 26% of patients after their first injection (n = 12). Patients receiving probenecid prophylaxis after first injection had a significantly lower frequency of iritis versus patients who did not receive probenecid at the time of first injection (P = 0.0089). In contrast, treatment with topical corticosteroid and cycloplegics after injection did not statistically significantly affect the frequency of iritis in patients (P = 0.44). The development of iritis after a second injection of HPMPC was more likely if it had occurred after the initial injection (P = 0.015; Fisher's exact test). All cases of iritis were treated with topical corticosteroids and cycloplegics, and there was no permanent impairment of vision secondary to iritis after HPMPC injection in any eyes. Anterior uveitis was seen in 26% of patients after first-time HPMPC injection. Concomitant use of probenecid appears to decrease the frequency of the iritis from 71% to 18% in patients with AIDS and CMV retinitis after the first intravitreal injection of HPMPC. Topical corticosteroid administration after injection (before iritis) was ineffective in preventing iritis treatment with topical corticosteroids and cycloplegics resulted in resolution of all iritis cases.

Surgically Induced Astigmatism in Cataract Surgery

A study of 144 extracapsular cataract extractions (ECCE) was undertaken to investigate the long-term development of postoperative astigmatism. The study was prospective with seven postoperative controls. The results were stored and evaluated after 1 year by computer. Specifically, the importance of incision configuration and wound closure were investigated. In the incision configuration study 36 eyes with scleral tunnel incision were compared with 36 age- and sex-matched eyes with corneoscleral incision. Scleral incisions were found to have significantly less surgically induced astigmatism (SIA) after 1, 3 and 6 months, but the difference was not statistically significant at the final control. In the wound closure study we compared the effect of 10-0 nylon interrupted sutures with 10-0 nylon shoelace sutures on the surgically induced astigmatism. Interrupted sutures showed significantly higher levels of surgically induced astigmatism than shoelace sutures in the early postoperative period, but from 3 to 12 months postoperatively there was no statistical difference. Surgically induced astigmatism was found to have a significant negative influence on the uncorrected visual acuity, whereas the astigmatism did not affect the corrected visual acuity. The configuration of the incision appears to be of more importance for the early surgically induced astigmatism than the type of wound closure. Surprisingly, two cases of iritis and one case of vitritis developed in the scleral tunnel group: these complications were not encountered in the other groups.

Uveitis in Children

in children, though relatively uncommon, may be a very distressing problem. The literature on the subject is scant and for the most part incidental to reports concerned with toxoplasmosis,* sarcoidosis.6 or juvenile rheumatoid arthritis (Still's disease).\s=d The only series of children with uveitis was reported by Thomson13 (1928), whose 10 cases had in common a chronic course, uveal tract disturbance without visible fundus change or iritis, and unilateral involvement ; apparently the etiology was unknown. Ravin14 (1944) described a case of iritis following measles in a 3-year-old girl; Hallett15 reported a case of iridocyclitis coincident with chickenpox in a 7-year-old boy, and Wilder16 (1950) reported the finding of nematode larvae in the granulomatous lesions of a series of eyes enucleated from children. The purpose of the present study was to analyze all the cases of childhood uveitis seen in connection with the uveitis survey being conducted by the staff of the Francis I. Proctor Foundation for Research in Ophthalmology and the Department of Oph¬ thalmology, University of California Medical Center. A total of 810 cases of uveitis have been surveyed in a five-and-a-half-year period, and 47 of them, or 5.8%, were in patients under 16 years of age. This figure is unquestionably higher than the general average which is probably closer to 2 or 3%. Blegvad 1T (1941) found in Denmark that 2.2% of 896 cases of uveitis were in children under 15 years of age. The higher percentage in our series was probably due to the special interest of one of us (M. J. H.) in toxoplasmosis ; many cases of healed chorioretinitis were referred for study which might otherwise have been ignored. The records of all cases were drawn from the files of the uveitis clinic, to which both clinic and private patients are referred. They were studied as outpatients or hospital patients, and each was examined by at least one of us. Since many cases were referred because of suspected toxoplasmosis, and most other cases for diag¬ nostic opinion because of recurrence, unusually severe, and/or special therapeutic problems, the series must be regarded as highly selected and unsuited to statistical

Uveitis in children.

UVEITIS in children, though relatively uncommon, may be a very distressing problem. The literature on the subject is scant and for the most part incidental to reports concerned with toxoplasmosis,* sarcoidosis. 6 or juvenile rheumatoid arthritis (Still's disease).† The only series of children with uveitis was reported by Thomson 13 (1928), whose 10 cases had in common a chronic course, uveal tract disturbance without visible fundus change or iritis, and unilateral involvement; apparently the etiology was unknown. Ravin 14 (1944) described a case of iritis following measles in a 3-year-old girl; Hallett 15 reported a case of iridocyclitis coincident with chickenpox in a 7-year-old boy, and Wilder 16 (1950) reported the finding of nematode larvae in the granulomatous lesions of a series of eyes enucleated from children. The purpose of the present study was to analyze all the cases of childhood uveitis seen in connection with the uveitis survey being

Uveitis in children.

UVEITIS in children, though relatively uncommon, may be a very distressing problem. The literature on the subject is scant and for the most part incidental to reports concerned with toxoplasmosis,* sarcoidosis,6or juvenile rheumatoid arthritis (Still's disease).† The only series of children with uveitis was reported by Thomson13(1928), whose 10 cases had in common a chronic course, uveal tract disturbance without visible fundus change or iritis, and unilateral involvement; apparently the etiology was unknown. Ravin14(1944) described a case of iritis following measles in a 3-year-old girl; Hallett15reported a case of iridocyclitis coincident with chickenpox in a 7-year-old boy, and Wilder16(1950) reported the finding of nematode larvae in the granulomatous lesions of a series of eyes enucleated from children. The purpose of the present study was to analyze all the cases of childhood uveitis seen in connection with the uveitis survey being

IRITIS, RETINAL HEMORRHAGE AND CHANGES IN THE LENS FOLLOWING INJECTION OF TYPHUS VACCINE

Ocular manifestations following injections of serum have not been common, although cases have been reported. Mason 1 reported 3 cases in which measurable blurring of the optic disks developed during serum sickness, with gradual return to normal. Brown 2 reported 5 cases in which elevation of the disk and edema of the retina developed after administration of diphtheria antitoxin. These signs subsided in a few days. Bedell 3 described severe and extensive bilateral edema of the retina with superficial hemorrhages, which he attributed to serum sickness following the injection of tetanus antitoxin. This condition cleared up rapidly, leaving few vestiges. Theodore and Lewson 4 reported 1 case of iritis following antipneumococcic serum. The case reported here is unusual because it involved damage to the iris, lens, optic nerve and retina without any serum sickness or other prodromal symptoms. A white soldier aged 22 walked into the ophthalmic clinic complaining of

Epinephrine Bitartrate: Uses Other than in the Treatment of Glaucoma

The authors have found this drug effective as a mydriatic when examining the fundus in border-line cases of increased intraocular tension, also in cases of glaucoma under miotics; as a powerful mydriatic for breaking up posterior synechiae in old cases of iritis, and preparatory to operation for congenital soft cataract; also as a successful hemostatic in various operations in which a dry field is essential. From the Division of Ophthalmology, Department of Surgery, University of California Medical School.

The Bacteriological and Immunological Aspects of Iritis: With special reference to its relationship to bacterial allergy

It is urged that advantage should be taken of every available opportunity for bacteriological and experimental study of iris tissue and aqueous humor from cases of iritis which may be due to focal infection. Emphasis is laid on the possibility that iritis and related conditions may be due to soluble exotoxins derived from streptococci or other bacteria in distant foci of infection. From the Research Institute of Cutaneous Medicine, Philadelphia. Read before the Association for Research in Ophthalmology, June 24, 1930. Dr. Kolmer is professor of pathology and bacteriology in the Graduate School of Medicine of the University of Pennsylvania.

A case of iritis due to third molar impaction

A case of iritis due to third molar impaction

A Case of Iritis and Optic Neuritis Following Tonsillitis

A Case of Iritis and Optic Neuritis Following Tonsillitis