To assess the clinical characteristics and surgical outcomes of retinal detachment (RD) associated with presumed trematode-induced granulomatous intermediate uveitis (PTIGIU). A review of the medical records of patients diagnosed with RD secondary to PTIGIU over a 3-year period was conducted. Main outcome measures were the type and morphology of RD, final functional and anatomical outcomes. Out of 98 eyes with PTIGIU, 41 eyes (41.8%) were diagnosed with RD secondary to PTIGIU and were operated upon and completed 6-month follow-up period. Mean age was 12.6 years and logMAR corrected distance visual acuity 1.76. All eyes had vitritis of variable grades. Thirty-five eyes (85.4%) had tractional retinal detachment (TRD) and four eyes (9.8%) had combined tractional-rhegmatogenous retinal detachment. According to the extent of retinal detachment, the eyes were grouped into Group 1: 28 eyes, with subtotal peripheral RD, and Group 2: 13 eyes, with total RD or subtotal RD reaching posterior pole. The former group showed better functional and anatomical outcomes ( P = 0.019 and 0.028, respectively). Approximately 80.5% of all eyes showed final anatomical success and visual improvement (median corrected distance visual acuity 0.40, P < 0.001) at the final follow-up. Tractional retinal detachment is a common complication to PTIGIU, and early intervention is essential to avoid devastating ocular complications.

Sympathetic ophthalmia (SO) is a rare bilateral granulomatous uveitis occurring after ocular trauma or intraocular surgery. Pediatric case has special diagnostic challenges due to limited cooperation and overlapping presentations with other inflammatory disorders. An 8-year-old boy presented with progressive bilateral visual impairment 6 months after sustaining a penetrating corneoscleral injury to the right eye caused by a metallic object. At the initial presentation, the right eye showed corneal edema with sutures from the previous corneal repair. The previously uninjured left eye also demonstrated active inflammatory changes. Both eyes showed severe anterior segment inflammation characterized by iris bombe, irregular pupil, pupillary membrane formation, lens opacity, and choroidal thickening consistent with bilateral panuveitis. Based on the history of penetrating trauma, the latent period, and the presence of bilateral granulomatous uveitis, a clinical diagnosis of SO was established. Initial management consisted of topical and systemic corticosteroids, followed by surgical intervention, including corneal wound revision with anterior chamber washout in the right eye and synechiolysis, anterior chamber irrigation–aspiration, posterior capsulotomy, anterior vitrectomy, and foldable intraocular lens implantation in the left eye. Postoperatively, visual acuity did not improve significantly, but the intraocular inflammation and other clinical symptoms were successfully controlled. SO is a case that could occur after penetrating ocular trauma or intraocular surgery. In pediatric patients, the disease often follows a more aggressive pattern with rapid progression and a higher risk of complications. Therefore, early recognition, prompt systemic immunosuppression, and timely surgical intervention remain essential to preserve ocular structure and prevent further deterioration. This case emphasized that every child presenting with bilateral intraocular inflammation after ocular trauma should be promptly evaluated for SO to avoid irreversible vision loss through early multidisciplinary intervention and long-term follow-up.

ABSTRACT Purpose To identify predicators of medical treatment failure in patients with presumed trematode induced granulomatous intermediate uveitis (PTIGIU). Methods A retrospective review of the medical records of children diagnosed with PTIGIU over a 4-year period was conducted. Main outcome measures included the management options and treatment outcomes. Results 98 eyes of 90 patients clinically diagnosed with PTIGIU were initially reviewed with a minimum follow up of 2 years. Mean age was 11 ± 2.38 years and 96.9% were males. All patients reported a history of freshwater exposure with a mean exposure to presentation time of 3 ± 2.822 weeks. UBM detected CB granuloma and confirmed the diagnosis in 53 eyes, 27 of which had an associated AC granuloma. Management options included surgical intervention in the form of parsplana vitrectomy ± lensectomy, or conservative management with systemic, topical or periocular steroids. Surgical interventions were done in 30 eyes, 20 of which had initially received conservative management that subsequently failed and required surgery. Univariate logistic regression revealed that CDVA, degree of vitreous/AC inflammation and lens status at initial presentation were significant predictors for surgical intervention (p < 0.001, 0.008, 0.005 and <0.001 respectively). CDVA, vitritis and degree of AC inflammation were also associated with failure of initial conservative management (p = 0.008, 0.005 and 0.009 respectively). Conclusion Various management options exist for patients with PTIGIU, but patients with lower presenting vision and higher degrees of vitreous inflammation respond better to surgical intervention than medical therapy alone.

This study aimed to determine the national incidence, characterize clinical features, and evaluate the treatment outcomes of primary vitreoretinal lymphoma (PVRL) in Slovenia. We conducted a population-based, retrospective case series of all patients diagnosed with PVRL at the Eye Hospital, University Medical Center Ljubljana, between January 2013 and May 2024. The diagnosis was histopathologically confirmed, and primary central nervous system involvement was excluded. Clinical presentation, diagnostic delay, treatment modality, and adverse events were analyzed. Progression-free survival (PFS), overall survival (OS), and lymphoma-specific survival (LSS) were calculated. Twelve patients were diagnosed with PVRL (four men, eight women; median age of 76 years). The average annual incidence was 0.52 cases per million. The median time from symptom onset to diagnosis was 238 days. The two most common symptoms were decreased visual acuity (75%) and floaters (58%). Vitreous cellular infiltration was the predominant clinical sign and was observed in 92% of patients. Five patients presented with unilateral disease, seven with bilateral disease, and three with unilateral disease that progressed to bilateral involvement. The median follow-up was 31.5 months. Eleven patients received one or more treatment modalities: intravitreal rituximab and/or methotrexate, local radiotherapy, and/or systemic chemotherapy. Local remission was achieved in all treated eyes. Two cases of granulomatous uveitis occurred during intravitreal rituximab therapy. The median PFS was 12 months; the two- and three-year PFS rates were 37.5% and 18.8%, respectively. The median OS was not reached; the two- and three-year OS rates were 70% and 56%, respectively. The LSS was 80% at two years and 64% at three years. This Slovenian population-based study provides real-world insights into PVRL management. In elderly and medically fragile patients, local treatment modalities provided effective ocular disease control with acceptable toxicity.

Blau syndrome (BS) is an early-onset autoinflammatory disease, typically characterized by a clinical triad of granulomatous polyarthritis, uveitis and skin lesion. Tumor necrosis factor (TNF) antagonists (TNF inhibitor, TNFi) are used routinely according to treatment guidelines for several refractory BS therapy. However, peripheral nervous system demyelination related to TNFi is being increasingly recognized. Here, we report a case of Guillain-Barré syndrome probably secondary to an TNFi, Yisaipu, one kind of etanercept biosimilars, which is a rare and usually unpredictable adverse drug reaction of TNFi in BS patients. A 10-year-old girl was diagnosed with BS due to present with skin rash, multiple joint activity limits, NOD2 gene mutation, granulomatous disorders identified from the pathology of skin and synovium biopsy 6 years ago, and treated by corticosteroids and methotrexate (MTX). Then, she discontinued all treatments and follow-up by herself in 2021. Due to a recurrence of BS, Yisaipu and MTX were given again. After 9 months treatment, the patient developed limb pain, a mouth askew with slurred speech, positive nuchal vigidity, muscle weakness, absent knee jerk and ankle reflexes. Laboratory investigations showed a raised protein level and normal cellular count of CSF, positive anti-sulfatides antibody IgM in CSF and peripheral nerve damage of electromyography. Imaging investigations illustrated enhancement signal of ventral roots, dorsal roots and cauda equina of lumbar MRI. TNFi therapy is increasing every year, so more attention should be paid to the safety of TNF inhibitor therapy, especially nervous system demyelination. The assessment about nervous system should be recommended in regular follow-up among patients receiving TNFi therapy.

ABSTRACT Purpose To describe clinical characteristics, patterns, and surgical outcomes in the management of presumed trematode-induced granulomatous intermediate uveitis (PTIGIU) Methods Retrospective single-center study in which patients exposed to fresh water canal exposure with PTIGIU were enrolled. Surgery was done after failure of medical treatment in the form of lensectomy and pars plana vitrectomy (PPV). Post-operative functional and anatomical outcomes were assessed. Results 58 eyes of 56 patients were included with mean age of 12.6 ± 3.07 years, 89.3% males. Ciliary body (CB) granulomas were most commonly present inferiorly (41%) and either extend anteriorly to the lens or circumferential along the CB or posteriorly to the retina and were associated with retinal pathologies in 86.2%; the most common of which was tractional retinal detachment (TRD) (60%). According to retinal pathology, eyes were grouped; Group A: 43 eyes, with early disease, having no or localized peripheral retinal detachment (RD) and B: 15 eyes, with advanced cicatricial disease. Inflammation was well controlled 6 months post-surgery in both groups; however, Group A showed better functional (p = 0.003) and anatomical outcomes (p = 0.01). Lens morphology was negatively correlated with retinal pathology (p = 0.036) Conclusion PTIGIU is a potentially blinding disease, with earlier surgical intervention showing better anatomical and functional outcomes.

Background. Sarcoidosis is a multisystem disease of unknown etiology, characterized by the presence of non-necrotizing granulomas in multiple organs. It is a clinical condition capable of mimicking several disorders. For an accurate differential diagnosis, histopathological examination of the affected organ is crucial, in addition to clinical, radiological, and laboratory findings. Case Report. We report the case of a patient with a suspected IgG4-related disease in a differential diagnosis of sarcoidosis. A 25-year-old Pakistani male, smoker, and stable worker was referred to rheumatologic evaluation in January 2025 for progressive, painless, bilateral periorbital and parotid swelling that had developed since November 2024. Ophthalmologic examination and subsequent orbital MRI confirmed the presence of bilateral glandular hypertrophy. The patient denied any infectious episodes preceding symptom onset. His past medical history included only a left-sided Bell’s palsy with lagophthalmos in 2021, occurring after the first dose of the SARS-CoV-2 vaccine, which resolved after a short course of corticosteroids. At the presentation, he denied dry cough, dyspnea, fever or low-grade fever, arthritis/arthralgia, visual impairment, erythema nodosum, cutaneous lesions, or gastrointestinal symptoms. Physical examination revealed painless swelling of the parotid, submandibular, and lacrimal glands, associated with conjunctival hyperemia and lagophthalmos. Palpable, non-tender, mobile lymph nodes were noted in the right retroauricular and left laterocervical regions; no joint inflammation was detected. Given the suspicion of an IgG4-related disease, hospital admission was planned. During hospitalization, the patient underwent • Laboratory tests: ESR 45 mm/h, CRP 0.5 mg/dL, ACE 66 U/L, severe vitamin D deficiency (&lt;4 ng/mL), PTH 36.3 pg/mL; normal serum calcium, phosphate, and 24-hour urinary calcium (145.2 mg). The patient's IgG subclasses were within normal limits, and both autoimmune and infectious serologies were negative. • Whole-body FDG-PET: Increased radiotracer uptake in bilateral parotid glands, bilateral hilar and peribronchovascular regions, and ocular bulbs. • Abdominal ultrasound: Unremarkable. • Ocular immunology evaluation: There were no signs of granulomatous uveitis. Empirical treatment with oral prednisone (50 mg daily) was initiated. Subsequently, a biopsy of the left parotid gland was performed, showing a fibroinflammatory process with granulomas containing small necrotic foci, consistent with sarcoidosis. Chest CT revealed multiple peribronchovascular pulmonary nodules and hilar-mediastinal lymphadenopathy. A diagnosis of sarcoidosis involving the lacrimal and parotid glands, lymph nodes, and pulmonary parenchyma (Stage II) was therefore established. Corticosteroid therapy (prednisone 0.5 mg/kg/day) was maintained, and methotrexate 20 mg weekly was added as a steroid-sparing agent. At follow-up in March 2025, a marked clinical improvement was observed, with significant reduction of parotid and lacrimal gland swelling. This case highlights the importance of an appropriate differential diagnosis among granulomatous diseases and the pivotal role of histopathological confirmation in establishing a definitive diagnosis.

Herein, we describe ocular abnormalities in an adult male Crested Capuchin (Sapajus robustus) with partial unilateral loss of vision. On necropsy, there was a white, firm, and homogeneous plaque expanding the ciliary body of the left eyeball. White, irregular and firm nodules were observed in skeletal muscles, lymph nodes, lungs, heart, spleen, ileum, cecum, pancreas, and testes. Microscopically, diffuse severe pyogranulomatous endophthalmitis in the left eyeball and mild granulomatous posterior uveitis in the right eyeball, both with intralesional yeasts, were noted. Immunohistochemistry revealed strong labeling with anti-Paracoccidiodes spp. Fungal culture and molecular examination were performed, and confirmed P. brasiliensis infection. Based on the marked differences in lesion severity between the two eyes, we suggest that choroidal vessels may play a crucial role in the ocular dissemination of P. brasiliensis.

Visual Acuity Outcomes After Medical Treatment of Pediatric Anterior Granulomatous Uveitis at Minia University Hospital

BackgroundMajor histocompatibility complex (MHC) Class I deficiency is a rare form of primary immunodeficiency that typically presents with recurrent sinopulmonary infections, bronchiectasis, and granulomatous skin lesions during late childhood or adolescence.MethodsThis retrospective study describes the clinical, immunological, and long-term follow-up data of 11 patients diagnosed MHC Class I deficiency.ResultsThe cohort included 11 patients (6 males, 5 females) with a median age of 26 years (range 19–44). The median age at diagnosis was 19 years, with a diagnostic delay of 14 years. Bronchiectasis was seen in 10 patients, granulomatous skin lesions in 6, uveitis in 5, and nasal septum perforation in 3. All but one patient survived during a median follow-up of 11 years. HLA-ABC expression ranged from 0% to 73%, with persistently low mean fluorescence intensity (0.4–3.8). IgM levels were reduced in 7 patients. Ten patients were persistently positive for anti-rubella IgM, including all six with granulomatous skin lesions. Immunophenotyping revealed reduced CD3+ (n=2), CD4+ (n=3), CD8+ (n=3), CD19+ (n=5), CD3−CD16+CD56+ (n=3), CD19+ IgM-27+ IgD- (switched memory B cells) (n=7), and CD19+ IgM-27+ IgD+ (marginal zone B cells) (n=8). All patients had elevated γδ+ T cells, and NK cells were reduced in three. Seven patients had TAP1 and four had TAP2 mutations, with no significant genotype–phenotype differences.ConclusionMHC Class I deficiency presents a broad clinical spectrum from asymptomatic to life-threatening disease. Granulomatous tissue damage and uveitis contributed to morbidity. Persistent rubella-specific IgM in most patients, including those without granulomas, is a novel serologic finding that may reflect altered antiviral immunity. Its clinical significance remains uncertain and, further studies with tissue-based viral detection are needed to clarify this observation.

PurposeTo investigate the safety and efficacy of rituximab in patients with refractory noninfectious uveitis and scleritis.MethodsA retrospective review of 24 patients (47 eyes) treated with rituximab for refractory noninfectious uveitis and scleritis in the period between January 2018 and December 2024. The diagnosis of these patients included chronic recurrent uveitis associated with Vogt-Koyanagi-Harada disease (n = 16), idiopathic granulomatous uveitis (n = 3), multiple sclerosis-associated uveitis (n = 2), progressive subretinal fibrosis (n = 1) and scleritis (n = 2). The primary outcomes were disease quiescence and improvement in best-corrected visual acuity (BCVA). Secondary outcomes included reduction in corticosteroid and immunosuppressive therapy and adverse events.ResultsRituximab was successful in inducing and maintaining disease quiescence and significantly improved visual acuity in patients presenting with uveitis and scleritis. After starting rituximab therapy, BCVA improved at 1 year from 0.93 ± 0.67 logMAR (Snellen: 20/160) to 0.63 ± 0.83 logMAR (Snellen: 20/80) (p < 0.001). Follow-up period ranged from 12 to 80 months (mean 41 ± SD 20.5). At the last follow-up, BCVA continued to improve to 0.46 ± 0.73 logMAR (Snellen: 20/60) (p < 0.001). Nine of twenty-four patients (37.5%) required more than 3 rituximab doses for disease control. Rituximab successfully reduced corticosteroid use, allowing 87.5% (21/24) of patients to discontinue steroids completely, with the remaining needing ≤ 7.5 mg/day. Mycophenolate mofetil dosage significantly decreased from a mean of 1840 ± SD 323 mg to 1045 ± SD 688 mg daily (p < 0.001), with two patients discontinuing all medications. All patients were flare-free at last follow-up.ConclusionsRituximab is an effective and safe treatment for refractory noninfectious uveitis and scleritis. It offers significant visual improvement, disease quiescence which potentially reduces reliance on corticosteroids and immunomodulatory therapy.

Abstract Presumed trematode-induced uveitis (PTIU) is a parasitic ocular inflammation seen predominantly in children from regions with freshwater exposure, particularly in South Asia and North Africa. Unilateral granulomatous anterior uveitis is the most frequent presentation, usually accompanied by nodules in the anterior chamber. Due to the lack of conclusive parasitological confirmation in most cases, diagnosis is still difficult despite its unique clinical presentation. Research has progressively confirmed trematode larvae as the causative agents. DNA from Procerovum varium and other trematodes has been found in ocular tissue. Topical corticosteroids, antiparasitic medications, and, in certain situations, surgical or laser-based anterior chamber granuloma excision are also modalities of treatment. With timely and adequate intervention, the prognosis is usually excellent; nevertheless, delayed therapy may lead to vision-threatening complications. Increasing awareness of PTIU among clinicians is essential to ensure timely diagnosis and reduce unnecessary morbidity in endemic populations. In this review, the epidemiology, clinical features, diagnostic approaches, pathogenesis, prognosis, and management approaches of PTIU are summarized. Future directions should prioritize molecular diagnostics, epidemiological mapping, and public health interventions to reduce disease burden.

Sarcoidosis is characterized by the proliferation of noncaseating granulomas and presents as a complex chronic inflammatory disease. It extensively affects multiple organ systems, with 30-60% of patients experiencing ocular complications, predominantly bilateral granulomatous uveitis. Fatty acid degradation, a fundamental metabolic process, is crucial for cellular energy homeostasis, involving the breakdown of fatty acids to produce acetyl-CoA, NADH, and FADH2, which then enter the citric acid cycle and electron transport chain to generate ATP. Despite its importance, the role of fatty acid degradation genes (FADGs) in the pathophysiology of Ocular sarcoidosis (OS) remains unclear. To identify candidates potentially involved in OS, we intersected differentially expressed genes (DEGs) with a curated list of 177 FADGs. Advanced methodologies, including Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA), were employed to explore biological functions. Further refinement using Lasso regression and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) allowed for the identification of key hub genes and assessment of their diagnostic potential for OS. Our investigation identified two FADGs, ADH1B and ECI1, closely associated with OS. Functional analyses revealed their involvement in processes such as fatty acid metabolic processes, small molecule catabolic processes, and fatty acid oxidation. Importantly, the diagnostic capabilities of these FADGs demonstrated significant efficacy in distinguishing OS from unaffected states. Through rigorous bioinformatics analyses, this study identifies ADH1B and ECI1 as novel biomarker candidates for OS, elucidating their potential roles in the disease's pathogenesis. These findings offer new insights into the molecular mechanisms underlying OS and highlight the diagnostic potential of FADGs in differentiating OS from unaffected conditions.

Purpose:This study aimed to evaluate the efficacy of posterior subtenon injection of interferon alfa-2B (PSII) as a therapeutic option for managing recurrent inflammatory macular edema (IME).Methods:A retrospective study was conducted at a tertiary care eye center in South India. Patients receiving PSII for recurrent infectious or non-infectious IME were included in the study. Recurrent IME was defined as less than 50 µm improvement in central macular thickness (CMT) on spectral-domain optical coherence tomography within 1 month or relapse of IME within 3 months of previous treatment. Patients received a single PSII (1 MIU/mL) under topical anesthesia. Follow-up visits included clinical examinations and CMT measurement, best-corrected visual acuity (BCVA), and intraocular pressure (IOP).Results:The study included 13 patients with a mean age of 46.2 years. Diagnosis varied, including pseudophakic IME, post-endophthalmitis IME, and various forms of uveitis. Mean CMT significantly reduced from 639.0 µm at baseline to 427.45 µm at one week (P < 0.001). But further increased to 500.62 µm at 1–2 months follow-up (P < 0.05). Mean BCVA improved from 20/70 (0.57 logMAR) to 20/40 (0.33 logMAR) at 1-month follow-up. No significant adverse effects were observed, although one patient with post-endophthalmitis IME developed granulomatous anterior uveitis 40 days after the injection.Conclusion:The study demonstrates the potential short-term efficacy of PSII in reducing CMT and improving BCVA in patients with recurrent IME. Further research is needed to optimize dosing protocols and explore long-term efficacy.

ABSTRACT Purpose To fully characterize the clinical and pathological characteristics of PTIGU (Presumed Trematode-Induced Granulomatous) in pediatric patients and therefore enhance its diagnostic accuracy and treatment modalities. Methods A retrospective descriptive observational study was conducted at the specialized uveitis clinic of MIKE (Memorial Institute for Kids' Eye unit), Memorial Institute for Ophthalmic Research, Giza, Egypt. The study involved 125 eyes of 105 children diagnosed with PTIGU. Comprehensive clinical evaluations were performed of both the anterior and posterior segments. Results Granuloma classification by site revealed AC (anterior chamber) granuloma in 56.8%, CB (ciliary body granuloma) in 17.6%, and combined granuloma in 25.6% of cases. Other rare sites were lens (8%), corneal (10.4%), subconjunctival (3.2%), and iris granuloma (8.8%). The morphological patterns were mainly nodular. The pathological characteristics of the removed granuloma exhibit non-caseating granulomatous inflammation composed of marked fibrosis and inflammatory infiltrate composed of lymphocytes, epithelioid cells, and sidero-/melanophages with an eosinophilic infiltrate. The granuloma area and the occurrence of complications were substantially correlated (p-value < 0.001). Comparison of the visual acuity outcomes represents significant differences in pre- and post-treatment. There was no statistically significant difference in the visual acuity outcome between the conservative and surgical treatments. Conclusion Trematode granuloma exhibits several clinical presentations. We documented ciliary body granuloma in the absence of anterior chamber granuloma, and several atypical manifestations, including concomitant episcleral, corneal, iris, and lens granulomas; hypopyon and hyphema. Conservative management should be initiated promptly in all instances. Surgical intervention is warranted solely in complex cases or in eyes unresponsive to conservative care.

To describe a 14-year-old male with probable ocular sarcoidosis and bilateral peripapillary choroidal neovascularization (PCNV). We report a case of a 14-year-old boy with a 2-month history of floaters and gradual vision loss in both eyes. Examination revealed bilateral granulomatous uveitis with peripapillary subretinal lesions. The serum angiotensin-converting enzyme was elevated. Positron emission tomography demonstrated increased metabolic activity in the nasopharynx and small intestine, consistent with diagnosis of sarcoidosis. Despite resolution of vitreous cells and retinal vasculitis, the PCNV progressed slowly in the left eye, which was controlled with combined treatment of immunomodulatory regiment and multiple intravitreal anti-vascular endothelial growth factor injections over a prolonged period. This case highlights the need for a multidisciplinary approach and long-term follow-up in pediatric ocular sarcoidosis with PCNV.

Purpose: The occurrence of Human leukocyte antigen-(HLA-) B27-associated bilateral granulomatous panuveitis in a pediatric patient ultimately diagnosed with oligoarticular juvenile idiopathic arthritis JIA. Case Presentation: A 10-year-old girl was evaluated for redness, pain, and photophobia in both eyes (OU) with no other ocular or systemic symptoms. Her best-corrected visual acuity was measured at 20/20 and 20/40 right (OD) and 20/40 left (OS) eyes, respectively. A slit lamp examination revealed mutton-fat keratic precipitates OU, anterior chamber reaction 1+ and 4+ cells OD and OS, respectively, and anterior vitreous 2+ cells OU. During dilated fundoscopy, 1+ OS haze was observed. Intravenous fluorescein angiography depicted mild disc OS and peripheral vascular leakage OU. Indocyanine green angiography revealed hypocyanescent lesions in choroid OU indicating of choroiditis. All lab work-up were negative or within the normal limits except positive HLA-B27. She was started on aggressive corticosteroids therapy, followed by a gradual taper. A flare-up occurred while she was on a regimen of 10 mg oral prednisolone and two drops of prednisolone OU. Then, immunomodulatory therapy was initiated with adalimumab and oral methotrexate. The eyes remained in remission with this regimen until she developed arthritis in the left knee and wrist, along with bilateral sacroiliitis. The pediatric rheumatology team decided to transition to golimumab, concurrently increasing the dosage of methotrexate. Conclusion: Chronic bilateral panuveitis with an acute onset granulomatous anterior uveitis component may be indicative of HLA-B27 associated JIA. It can be coupled with a delayed onset oligoarticular JIA.

Purpose: To identifyradiological findings on chest CT scan for patients with ocular tuberculosis (TB) that may provide an important aiding diagnostic tool in diagnosing those patients. Study Design: Descriptive observational study. Place and duration of study:Ibn Al-Haitham Eye Teaching Hospital fromOctober 2022 to September 2024. Methods: This study included 32 patients with tuberculosisassociated uveitis. Patients were classified into four subtypes of uveitis based on clinical examination and anatomical location ofinflammation into anterior, intermediate, posterior and panuveitis. Each patient underwent a high-resolution chest CT scan to assess for radiological signs commonly associated with pulmonary tuberculosis. Patients with known causes of pulmonary diseases or surgeries other than tuberculosis were excluded from the study. Results: Out of 32 patients, 24 were males (75%) and 8 were females (25%), with mean age of 50.56±14.04 years. Chest CT indicated that 66.7% of male and 37.5% of female exhibited abnormal findings suggestive of pulmonary TB. Twenty-two patients had chronic panuveitis, 7 had intermediate uveitis, and 3 had anterior granulomatous uveitis. Chronic Tuberculous panuveitis demonstrated the highest frequency of positive pulmonary findings on CT (63.6%), followed by tubercular intermediate uveitis cases (42.9%). Conversely, no positive pulmonary findings were identified among patients with chronic granulomatous tubercular anterior uveitis. Conclusion: Chest CT scan should be considered in the work up for patients with suspected tuberculous uveitis. Chronic TB panuveitis and tubercular intermediate uveitis showed a higher frequency of abnormal chest CT findings, particularly fibrotic lung scarring and nodules. Keywords:Tuberculosis, Ocular tuberculosis, Panuveitis, Pulmonary Fibrosis.

We report a rare case of granulomatous anterior uveitis with hypopyon in a 31-year-old male with quiescent ulcerative colitis. Despite the absence of active gastrointestinal symptoms, the patient presented with acute visual loss and marked anterior chamber inflammation, including fibrin, hypopyon, and an iris nodule. Prompt initiation of topical therapy led to rapid resolution of inflammation and full visual recovery within a week. While extraintestinal manifestations are recognized in inflammatory bowel disease, anterior uveitis—particularly of a granulomatous nature with hypopyon—is uncommon in ulcerative colitis. This case underscores the importance of recognizing ocular complications even during systemic remission.

Blau syndrome (BlauS) is a rare pediatric autoinflammatory disorder due to NOD2 gain-of-function pathogenic variants characterized by a triad of granulomatous dermatitis, arthritis, and uveitis, which can progress to systemic complications if untreated. Skin and joint findings typically emerge by age 2 years, with ocular involvement appearing around age 4 years. Early biologic intervention, particularly with anti-TNF-α therapies, can prevent severe complications like joint destruction and blindness. Systemic corticosteroids serve as bridging therapy, while methotrexate and thalidomide may help but are often insufficient as monotherapy. IL-1 and IL-6 inhibitors, as well as tofacitinib, are options for refractory cases.