Mild Anterior Chamber Reaction Research Articles

Authors’ Reply to Letter to the Editor– in Response to: Comment on Dheyab AM et al. “Long-Term Efficacy of Oral Valganciclovir in Presumed Cytomegalovirus Unilateral Hypertensive Anterior Uveitis”

ABSTRACT The clinical diagnosis of presumed cytomegalovirus hypertensive anterior uveitis was based on the following criteria: 1) Recurrent episodes of unilateral hypertensive anterior uveitis characterized by acute elevation of intraocular pressure, a few medium-sized or mutton-fat keratic precipitates and mild anterior chamber reaction. These findings might be associated with corneal endotheliitis and iris atrophy. 2) Posterior synechiae and vitreous involvement are typically absent. 3) Intact corneal sensation.

Uveitic Flare-Ups After Gonioscopy-Assisted Transluminal Trabeculotomy (GATT) in Patients with Uveitic Glaucoma

ABSTRACT Purpose To assess the risk of gonioscopy-assisted transluminal trabeculotomy (GATT) inducing an uveitic flare-up in patients with uveitic glaucoma (UG). Methods This retrospective study included consecutive UG patients who underwent GATT at a single medical center between June 2020 and September 2022. The main outcome measure was the occurrence of a surgery-related uveitic complication defined as either an uveitic flare-up defined by the Standardization of Uveitis Nomenclature (SUN) criteria, or the appearance of cystoid macular edema (CME) from 2 weeks to 3 months after surgery. Results A total of 25 eyes of 22 patients were included in the study. Age ranged from 10–78 and 64% were women. The most common uveitic etiologies were juvenile idiopathic arthritis (JIA, 24%) and herpetic infection (24%). A total of 48%of the patients were on systemic immunosuppressants prior and unrelated to surgery. Eight eyes (32%) had severe glaucomatous damage prior to surgery, and 20% of the patients had undergone previous glaucoma surgery. Two cases (8%) demonstrated uveitic flare-up in the early postoperative period: a case of mild anterior chamber reaction and a case of CME with persistent edema prior to surgery. Average intraocular pressure (IOP) was reduced from 26.7 mm Hg on four medications to 12.2 on 1.1 after 1 year. One patient required reoperation for IOP control. Conclusions With careful pre and postoperative care, GATT seems to be a low-risk procedure for uveitic flare-ups in patients with UG.

Bilateral Ocular Ischaemic Syndrome due to Carotid Artery and Cardiovascular Disease: A Case Report

Introduction : Ocular ischemic syndrome (OIS) is a rare but potentially blinding and fatal condition caused by carotid artery disease or other systemic condition results in ocular hypoperfusion.
 Case Illustration : A 62-year-old male with sudden bilateral vision loss, swelling, redness and pain of both eye for 7 days. There were dilated conjunctival and episcleral vessels, visual acuity of the right eye was hand movement and 0.05 for left eye, intraocular pressure (IOP) was 33 mmHg in right eye and 37 mmHgfor left eye. Anterior segment evaluation revealed rubeosis iris, mild anterior chamber reaction, and temporal angle neovascularization on gonioscopy. Both direct and consensual light reflexes were sluggish. Fundus examination showed normal optic disc, minimal hemorrhages at mid-periphery, narrowed arterioles, and minimal cotton wool spot. Macular OCT demonstrated discrete hyperreflectivity of inner retinal layers. From Macular Angiography OCT, ETDRS Central vessel density were 11.2% and 17.6% for the right eye and left eye, respectively. In both eyes, paracentesisof anterior chamber, intravitreal and intracameral injections of anti-VEGF were performed. Brain Magnetic Resonance Angiography Imaging revealed moderate stenosis of both distal carotid artery circulation. Percutaneous Coronary Angiography showed extensive stenosis in coronary artery, with low Ejection Fraction.
 Discussion : For the cardiovascular management, a pacemaker was implanted. One week after procedure, BCVA were 1/60 and 0.15, and IOPs of 17 and 18 mmHg, for the right and left eye, respectively. The patient was scheduled to have laser retinal photocoagulation.
 Conclusion : Quick clinical diagnosis, targeted workup for systemic associations, and prompt treatment might preserve life and sight in OIS.

EFFICACY OF INTRACAMERAL MOXIFLOXACIN VERSUS TOPICAL MOXIFLOXACIN IN PREVENTING ACUTE ENDOPHTHALMITIS AFTER CATARACT SURGERY BY PHACOEMULSIFICATION.

Endophthalmitis is an acute infection of anterior and posterior segment of the eye involving aqueous humour and vitreous cavity along with the other structures. It is classified into many types including bacterial, Fungal, protozoal, viral and atypical forms. Most common route of infection is exogenous either after the surgery or traumatic perforation Objectives were of evaluate the efficacy of intracameral moxifloxacin versus topical moxifloxacin in preventing postoperative acute endophthalmitis after cataract surgery by phacoemulsification. Patients undergoing cataract surgery by phacoemulsification are divided into two groups. Group A and group B. Cataract surgery was performed by phacoemulsification in both the groups by the same consultant. Group A was given 0.5% intracameral moxifloxacin 0.1ml undiluted at the end of surgery and Group B received topical moxifloxacin eyedrops and no intracameral medicine at the end of surgery. Post-operative medicine in both the groups was same for 1st twenty-four hours that is topical dexamethasone 0.1%. Postoperative assessment was made on the next day or after twenty-four hours of surgery Our primary outcome was incidence of postoperative acute endophthalmitis. The study comprised 150 eyes of patients. There were 75 patients in Group A (intracameral moxifloxacin) and 75 patients in Group B (Topical group). Mean age of the patients was 58 years. No case of endophthalmitis was reported in group A (intracameral moxifloxacin). Three cases in group A had acute toxic anterior segment with moderate corneal oedema and severe anterior chamber reaction which resolved in a week time without intravitreal medication. Group B (Topical Moxifloxacin) did not report any case of endophthalmitis. The difference between the two groups was very mild anterior chamber reaction in intracameral group as compared to topical group. 0.1 ml undiluted intracameral moxifloxacin 0.5% can be given as a last step in cataract surgery by phacoemulsification to prevent postoperative acute endophthalmitis infection. This drug administration is not totally safe as our three cases developed drug reaction with moderate corneal oedema and anterior chamber reaction that resolved in a week time.

A Case of Hypertensive Anterior Uveitis with Endotheliitis of the Cornea Following COVID-19 Pneumonia

Purpose: We report a patient diagnosed with COVID-19-associated hypertensive anterior uveitis and endotheliitis of the cornea.Case Summary: A 71-year-old male visited our hospital with decreased visual acuity, ocular pain, eyelid swelling of in his right eye, and headache for 8 days. He had been diagnosed with COVID-19 pneumonia 10 days before the visit. The best-corrected visual acuity was 0.04 in his right eye and 0.15 in his left eye. Severe conjunctival injection, moderate corneal edema with Descemet membrane folding, diffuse keratic precipitates and mild anterior chamber reaction were observed in the right eye, which were not present in the previous examination. Pupils in both eyes were moderately dilated and slow to react in response to direct light. The density of endothelial cells in the right eye was 711 cells/mm<sup>2</sup> and an owl’s eye morphology of endothelial cells was observed via specular microscopy. During follow up, elevated intraocular pressure (IOP) in the right eye was noted. Polymerase chain reaction (PCR) examination of the aqueous humor for cytomegalovirus was negative. After 2 weeks of applying prednisolone eye drops and anti-glaucoma eye drops, corneal edema decreased, and his vision improved to 0.5. However, the density of the corneal endothelium remained low.Conclusions: Although there have been worldwide case reports of conjunctivitis, keratitis, or uveitis after COVID-19 infection, this study presents the first reported case of COVID-19 associated hypertensive anterior uveitis and endotheliitis of the cornea.

Keratitis fugax hereditaria ‐ useful to consider when you have a child with non‐specific corneal findings and symptoms

AbstractPurpose: To report clinical findings in children diagnosed with the autosomal dominant periodic corneal autoinflammation, keratitis fugax hereditaria (KFH, MIM 148200), and to highlight its geographical distribution.Methods: Patients were clinically examined in the Helsinki University Hospital between February 4, 2006, and December 31, 2021, and genetically verified to be carriers of the c.61G > C (rs200154873) variant in NLRP3 by Sanger sequencing. Variant allele frequencies were determined from Genome Aggregation Database (gnomAD) version 2.1.1.Results: The data consist of 10 children from 8 families; 6 boys and 4 girls. Age of onset varied from 3 to 14 (median, 8) years. Patients had typical KFH symptoms: eye pain, photophobia, conjunctival injection, and foreign body sensation. Five patients had corneal oval opacities, and 3 had a mild anterior chamber reaction. Seven were correctly diagnosed at the first visit based on family history. The remaining three children were diagnosed 1, 3, and 8 years after the first visit. Initial diagnoses were anterior uveitis, corneal erosion, and herpetic keratitis. Additionally, epithelial recurrent erosion dystrophy (ERED) or subepithelial mucinous corneal dystrophy (SMCD) had been suspected. Geographically, KFH concentrates to the bilingual Swedish‐speaking coastal areas of Finland. Allele frequencies are 0.014% in Finland, and 0.011% in Sweden, based on gnomAD.Conclusions: Scandinavian ophthalmologists should be aware of the possibility of KFH in case of suspected anterior uveitis, herpetic keratitis, or recurrent corneal erosion in children. Symptoms of paediatric KFH patients are equal to those in adults, but the typical corneal opacity still might recover between the attacks.

Facilitated trailing haptic externalization technique for intrascleral intraocular lens fixation.

To describe the facilitated trailing haptic externalization technique for intrascleral intraocular lens (IOL) fixation. In this technique, first the direction of the 4-5 mm tip of the trailing haptic is straightened with the help of forceps. After the second needle enters the posterior chamber, the edge of the IOL optic is pushed towards the opposite scleral tunnel with the needle. The trailing haptic approaching the center from the periphery and the straightened distal part of the haptic towards the direction of the needle facilitate the relatively easily and gently placing of the haptic into the lumen with a one-time use of forceps. This technique was performed on 65 eyes of 58 patients, with a mean patient age of 53.0 ± 14.6 years (range, 22-78). No complications such as endothelial touch, vitreous loss, iris or ciliary body damage, and hyphema were encountered during surgery. The mean operation duration was 14.8 ± 2.3 min (range, 12-20). In the postoperative period, there was only mild postoperative anterior chamber reaction in all eyes. Postoperative transient intraocular pressure (IOP) elevation that responded well to topical antiglucomatous therapy was observed in only two cases (3%). No patient developed haptic exposure, IOL dislocation, iris capture, postoperative hypotony, vitreous hemorrhage, choroidal effusion, cystoid macular edema, or retinal detachment. The facilitated trailing haptic externalization technique provides a safer, simpler, and minimally invasive surgery without significant complications while easing the surgical difficulties of the Yamane technique.

The research progress of cytomegalovirus corneal endotheliitis

Cytomegalovirus(CMV) corneal endotheliitis is an inflammatory disease of corneal endothelium caused by CMV infection. It mainly occurs in middle-aged and elderly immunocompetent people and has a relatively high incidence in Asia. It is characterized by localized corneal edema, coin-shaped or linear keratic precipitates and mild anterior chamber reaction, possibly with raised intraocular pressure or a history of recurrent anterior uveitis. The pathogenesis of this disease is not yet clear. Previous studies suggested it was related to viral infection and immune response; Therefore, the current treatment is empirically using antiviral agents combined with topical corticosteroids. Making an accurate early diagnosis and continuous antiviral therapy are crucial in controlling disease progression and preserving corneal endothelial function. (Chin J Ophthalmol, 2021, 57: 624-629).

Association of Anterior Uveitis With Acute Zika Virus Infection in Adults

Acute anterior uveitis has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies based on systemic clinical signs of ZIKV and positive serologic tests. To describe the ophthalmic findings associated with systemic ZIKV infection during the 2016 ZIKV outbreak in Guadeloupe in the French West Indies. This cohort study assessed adult patients with red eye and virologic or serologic confirmation of acute ZIKV infection who were admitted to the Pointe-à-Pitre University Hospital from January 1, 2016, to January 1, 2017, for a systematic ophthalmologic examination. All patients with anterior uveitis also underwent a complete uveitis workup to rule out other causes of uveitis. Patients were excluded from the study if they had active uveitis and a history of uveitis or positive serology for other infectious diseases including dengue fever virus and chikungunya virus. Data were analyzed from January 1, 2016, to January 1, 2017. Patients with confirmed ZIKV infection underwent full ophthalmic examination at study inception and 3, 6, and 12 months. Description of the presenting ocular characteristics, management, and outcome. Of 62 total patients with a red eye, 32 (51.6%) had no uveitis (mean [SD] age, 27.8 [3.7] years; 26 women [81.3%]) and 30 (48.4%) had anterior uveitis (mean [SD] age, 27.5 [3.8] years; 26 women [86.7%]), which was bilateral in all cases. Acute anterior uveitis was nongranulomatous and without synechiae, exhibiting mild anterior chamber reaction with small keratic precipitates. Ocular hypertension occurred in 25 patients (83.3%) with uveitis at presentation and persisted in 15 patients (50%) at 1 year despite antiglaucoma therapy and control of uveitis. Uveitis responded to topical steroids in all cases. Intraocular pressure was within normal limits for all patients without uveitis throughout the follow-up period. Anterior uveitis was present in almost half of patients with a red eye and acute systemic ZIKV infection; the uveitis was usually bilateral and often associated with increased intraocular pressure. These results suggest that ophthalmic evaluation should be performed in patients with red eye and acute ZIKV infection to potentially detect and manage hypertensive anterior uveitis.

Posner-Schlossman Syndrome: A Cause of Unilateral Ocular Hypertension: Case Report

A 40 y old immunocompetent male patient admitted, with the complaints of blurry vision, photophobia, red eye, and severe pain in the left eye for the last 2 days. Examination revealed mild anterior chamber reaction, corneal edema, appearance of keratic precipitates and a very high intraocular pressure (52 mmHg) with an unresponsive, semi-dilated pupil in the same eye. Gonioscopy revealed open angles in both eyes. He was treated with topical steroids and topical pressure-lowering agents with oral acetazolamide. The patient was also evaluated for systemic causes of red eye. Investigations carried out included routine blood tests and ESR, the results of which were all within normal limits. In the following 24 month period, the patient had two further episodes of unilateral IOP spikes associated with cyclitis. This is an interesting and a rare uveitic condition. Although the list of differential diagnoses is long, the condition is relatively quickly identifiable by the presence of remarkable signs and symptoms. Medical and surgical treatments are indicated to reduce inflammation and to prevent long-term glaucomatous optic nerve damage related to the high intraocular pressure. Posner-Schlossman Syndrome does not always follow a completely uncomplicated course. Repeated episodes of elevated intraocular pressure can cause long-term sequelae such as glaucoma.

Human Herpesvirus-6 corneal Endotheliitis after intravitreal injection of Ranibizumab

BackgroundTo report the first case of human herpesvirus-6 (HHV-6) corneal endotheliitis that developed after intravitreal ranibizumab injections.Case presentationA 63-year-old man with a medical history of diabetes and systemic steroid treatment for bullous pemphigoid had been receiving intravitreal injections of ranibizumab in the left eye for 2 years according to a Pro Re Nata treatment regimen for macular edema associated with branch retinal vein occlusion. Twenty days after the last injection, the patient presented with pain and decreased visual acuity in his left eye. His best corrected visual acuity in the left eye was 2/200, and intraocular pressure was 45 mmHg with edema of the central stromal cornea, mild conjunctival injection, intermediate keratic precipitates, and mild anterior chamber reaction. HHV-6 DNA was detected in the aqueous humor using multiplex strip polymerase chain reaction, and it was identified as variant A, HHV-6A. A diagnosis of HHV-6A-associated corneal endotheliitis was made. Oral valganciclovir and topical ganciclovir therapy was initiated with good resolution of all symptoms and signs.ConclusionsHHV-6A can be a possible complication of intravitreal ranibizumab therapy. To the best of our knowledge, this is the first reported case of HHV-6A corneal endotheliitis following intravitreal ranibizumab injection.

Unilateral megalocornea associated with Fuchs' heterochromic iridocyclitis

Fuchs' heterochromic iridocyclitis is an atypical form of chronic nongranulomatous anterior uveitis and is almost always unilateral. It presents with cataract, mild anterior chamber reaction, diffuse stellate keratic precipitates, absence of posterior synechiae, iris hypochromia and glaucoma. It is usually bilateral but may be asymmetrical. Unilateral megalocornea has been reported in a case of lamellar icthyosis. Slit lamp evaluation of right eye of a 70 year old revealed diffusely distributed fine, stellate white keratic precipitates, mild anterior chamber reaction and hypermature morgagnian cataract. Examination also revealed large cornea in right eye with normal pachymetry and keratometry values.

Unilateral Multiple Serous Retinal Detachments in Polycythemia Vera Patient

Purpose: To report a case with new signs that could be caused by polycythemia vera itself or just a coincidence and managing it with systemic steroids. Methods: This was interventional case report, of a 59-year-old patient with polycythemia vera, presented with acute unilateral vision loss. Ophthalmological investigation revealed multiple serous retinal detachments with mild anterior chamber reaction these signs look similar to ocular signs of Vogt-Koyanagi-Harada disease, but in one eye and without systematic involvement of VKH. Polycythemia vera is a haematological disease that causes an increase number of red blood cells. The patient red blood cells were normal and he was compliance with Polycythemia vera treatment. All infectious tests were negative as well as autoimmune disease markers. Unilateral probable VKH disease was our diagnosis, patient was managed. Results: Polycythemia vera is a haematological disease that have a few ocular symptoms. These signs include multiple serous retinal detachments with uveitis that respond well to corticosteroids. Conclusion: Systematic corticosteroids which show a remarkable improvement in ocular signs and symptoms of Polycythemia vera that mimic VKH.

Keratoendotheliitis Fugax Hereditaria: A Novel Cryopyrin-Associated Periodic Syndrome Caused by a Mutation in the Nucleotide-Binding Domain, Leucine-Rich Repeat Family, Pyrin Domain-Containing 3 (NLRP3) Gene

To describe the phenotype and the genetic defect in keratoendotheliitis fugax hereditaria, an autosomal dominant keratitis that periodically affects the corneal endothelium and stroma, leading in some patients to opacities and decreased visual acuity. Cross-sectional, hospital-based study. Patient Population: Thirty affected and 7 unaffected subjects from 7 families, and 4 sporadic patients from Finland. Ophthalmic examination and photography, corneal topography, specular microscopy, and optical coherence tomography in 34 patients, whole exome sequencing in 10 patients, and Sanger sequencing in 34 patients. Clinical phenotype, disease-causing genetic variants. Unilateral attacks of keratoendotheliitis typically occurred 1-6 times a year (median, 2.5), starting at a median age of 11 years (range, 5-28 years), and lasted for 1-2days. The attacks were characterized by cornea pseudoguttata and haze in the posterior corneal stroma, sometimes with a mild anterior chamber reaction, and got milder and less frequent in middle age. Seventeen (50%) patients had bilateral stromal opacities. The disease was inherited as an autosomal dominant trait. A likely pathogenic variant c.61G>C in the NLRP3 gene, encoding cryopyrin, was detected in all 34 tested patients and segregated with the disease. This variant is present in both Finnish and non-Finnish European populations at a frequency of about 0.02% and 0.01%, respectively. Keratoendotheliitis fugax hereditaria is an autoinflammatory cryopyrin-associated periodic syndrome caused by a missense mutation c.61G>C in exon 1 of NLRP3 in Finnish patients. It is additionally expected to occur in other populations of European descent.

Partially absorbed cataractous lens in the anterior chamber revealing neglected severe ocular contusion: a case report

BackgroundOcular contusion can produce severe lesions, which if not treated appropriately and promptly, can lead to visual impairment. Ocular contusion in childhood may not be reported by children.Case presentationA 27 year old female presented with a partially absorbed cataractous lens that was dislocated into the anterior chamber of her left eye. There was mild anterior chamber reaction. She reported no history of ocular trauma; but associated findings and further investigations were in favour of a post-traumatic aetiology.ConclusionAll ocular injuries require a detailed ophthalmological examination to assess vision and the extent of lesions.

Candida parapsilosis keratitis treated successfully with topical and oral fluconazole

A 73-year-old male patient presented with ocular pain, redness, and blurred vision in the left eye, which had been ongoing for more than 2 months. An oval-shaped paracentral corneal ulcer with stromal infiltration and a mild anterior chamber reaction were found. Despite treatment with empiric antibiotics, the lesion progressed and corneal thinning in the middle area was noted. The culture yielded Candida parapsilosis. We therefore prescribed topical 0.2% fluconazole (FCZ) in combination with oral FCZ as an antifungal treatment, following which the stromal infiltration gradually subsided. Complete epithelialization was noted on the 8th day after initiating FCZ therapy. There was no recurrent disease in the subsequent 2 years. Our case demonstrates that topical FCZ 0.2% in combination with oral FCZ can successfully treat C. parapsilosis keratitis and result in a good visual outcome.

Retained intraocular metallic foreign body causing retinal detachment

A 60 year old farmer presented on 4th Sept, 2015with progressive diminution of vision in the right eye following trauma while hammering about a month previously. His vision was Hand Movement only in the right eye and 6/6 in left eye. The anterior segment showed normal findings, except mild anterior chamber reaction and an early cataract in the right eye. The left eye was normal except for an early age-related cataract. Fundoscopy revealed retained intra-ocular foreign body (ROOFB, subtotal RD with macula off in right eye. Interestingly, no entry wound was found. A B-scan and CT scan of the brain and orbit confirmed RIOFB and RD. On 9th September 23G PPV was done and RIOFB was removed. Fluid-air exchange, endolaser and silicon oil injection were done to attach the RD. On 6th February 2016 a cataract extraction with intraocular lens implantation and silicon oil removal was performed which improved the patient’s vision to 6/18p.

Glaucomatocyclitic crisis, a rare cause of unilateral ocular hypertension

PurposeTo report a case of glaucomatocyclitic crisis which is a rare cause of ocular hypertension.MethodsA 40 ‐year‐ old immunocompetent male patient admited, with the complaints of blurry vision, photophobia,red eye, and severe pain in the left eye for the last 2 days.Examination revealed mild anterior chamber reaction, corneal oedema, appearance of keratic precipitates and a very high intraocular pressure (52 mmHg) with an unresponsive, semi‐dilated pupil in the same eye. Gonioscopy revealed open angles in both eyes.ResultsHe was treated with topical steroids and topical pressure‐lowering agents with oral acetazolamide. The patient was also evaluated for systemic causes of red eye. Investigations carried out included routine blood tests and ESR, the results of which were all within normal limits. In the following 24 month period, the patient had two further episodes of unilateral IOP spikes associated with cyclitis.ConclusionsThis is an interesting and a rare uveitic condition. Although the list of differential diagnoses is long, the condition is relatively quickly identifiable by the presence of remarkable signs and symptoms. Medical and surgical treatments are indicated to reduce inflammation and to prevent long‐term glaucomatous optic nerve damage related to the high intraocular pressure.

Effects of mensenchymal stem cell on infiltration of CD4+ T cell subsets in the eyes of experimental autoimmune uveitis

Objective To observe the therapeutic effect of mensenchymal stem cells (MSCs) for experimental autoimmune uveitis (EAU).Methods MSCs were obtained from Wistar rats and selected by plastic adherence.Lewis rats were divided into treatment group and control group,six rats in each group.EAU models were induced by immunization with an emulsion (0.2 ml) containing 30 μ g interphotoreceptor retinoid-binding protein derived peptide R16 and complete Freund's adjuvant.The clinical manifestations of two groups were observed.Nine to 11 day after modeling,1 ml MSCs suspension,which contained 5 × 106MSCs,were injected into the rats in treatment group via tail vein,and the rats in control group were given equal volume of phosphate buffer solution.Fifteen day after modeling,the eyes were collected to test the proportion of interferon-γ,interleukin-17 and Foxp3 positive cells by flow cytometry.The clinical scores were analyzed by mixed linear model and statistical analysis of variance of repeated measurement data.The results of flow cytometry were analyzed using independent-sample t-test.Results Six days after immunization,mild dilatation and congestion of iris vascular was observed.Nine days after immunization,mild muddy anterior chamber,myosis and absent pupillary reaction to light were observed.Twelve days after immunization,muddy anterior chamber,occlusion of pupil and dimmed or disappeared red reflex were observed,and then inflammation was slowly reduced.From 11 to 15 days after immunization,the clinical score of treatment group was lower than that in control group,the difference was statistically significant (t=2.42,2.21,4.16,5.24,4.03; P＜0.05).The results of flow cytometry showed that MSCs treatment could decrease the proportion of CD4+T cells,Th1 cells and Th17 cells,increase the proportion of Treg cells.Conclusion MSCs treatment can ameliorate EAU,up-regulate the expression of Treg cells and downregulate the expression of CD4+ T cells,Th1 cells and Th17 cells. Key words: Uveitis/therapy; Mesenchymal stem cells; CD4-positive T-lymphocytes; Animal experimentation

PRESUMED SYMPATHETIC OPHTHALMIA AFTER SCLERAL BUCKLING SURGERY

To report an unusual case of sympathetic ophthalmia after successful scleral buckling surgery. The authors reported the clinical manifestation, ocular and systemic workup, and outcome of a 23-year-old woman who presented with reduced vision 3 weeks after successful scleral buckling surgery. Slit-lamp examination showed a mild anterior chamber and vitreous reaction. Fundus examination showed extensive serous retinal detachment in both eyes. Systemic workup was negative for extraocular disease. The patient was treated with intensive systemic steroid and azathioprine. The inflammation was controlled and serous detachment resolved. Sympathetic ophthalmia can occur after successful scleral buckling surgery.