Primary Site Of Inflammation Research Articles

Forsythiaside A Alleviates Lipopolysaccharide-Induced Acute Liver Injury through Inhibiting Endoplasmic Reticulum Stress and NLRP3 Inflammasome Activation.

The liver is the primary site of inflammation caused by bacterial endotoxins in sepsis, and septic acute liver injury (SALI) is usually associated with poor outcomes in sepsis. Forsythiaside A (FTA), an active constituent of Forsythia suspensa, has been reported to have anti-inflammatory properties, antioxidant properties, and protective properties against neuroinflammation, sepsis, and edema. Therefore, the purpose of the present study was to examine FTA's potential effects on lipopolysaccharide (LPS)-induced SALI in mice. Our results indicated that pretreatment with FTA significantly attenuated aspartate aminotransferase (AST) and aminoleucine transferase (ALT) levels in plasma, ameliorated histopathological damage, inhibited hepatocyte apoptosis, diminished the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the liver from mice exposed to LPS. Furthermore, our data showed that the administration of LPS resulted in robust endoplasmic reticulum (ER) stress response, as evidenced by glucose-regulated protein 78 (GRP78) upregulation, phosphorylated-protein kinase R-like ER kinase (p-PERK) activation, elF2α phosphorylation, and activating transcription factor 4 (ATF4) and CHOP overexpression in the liver. This, in turn, led to nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome activation, including the cleavage of caspase-1, secretion of IL-1β, and pyroptotic cell death in the liver specimens. Importantly, the ER stress response induced by the LPS challenge was blocked by FTA administration. Correspondingly, NLRP3 inflammasome activation was significantly ameliorated by the pretreatment with FTA. Thus, we demonstrated that FTA pretreatment could protect mice from LPS-induced SALI, and its protective effects were possibly mediated by inhibiting ER stress response and subsequent NLRP3 inflammasome activation.

Commentary: Optical coherence angiography in intermediate uveitis: What is the scope?

Intermediate uveitis is a subset of uveitis where the vitreous is the primary site of inflammation. It is associated with an infection or systemic disease.[1] The disease affects individuals in all age groups but predominantly affects the third to the fourth decade.[2] In India, the incidence of intermediate uveitis is 1.4/100,000 and its prevalence is 0.25%.[3] Ocular inflammation can cause vascular occlusion, ischemia, capillary leak, and alteration of cellular mediators. Due to the sequalae of uveitis, sight-threatening ocular complications such as macula edema are seen. Early identification, treatment, and monitoring play a crucial role in visual recovery. Regardless of the anatomical location of uveitis, the most common complication of uveitis is macula edema. This is due to the release of inflammatory cytokines that disrupt the inner and outer blood-retina barrier. These changes occur even in anterior uveitis, presumably due to diffusion of inflammatory mediators in the vitreous. Imaging in uveitis is a game changer in the practice patterns of uveitis. Pro-imaging strategies have helped the clinician improvise the quality of eye care and play an important tool in management of ocular inflammation. With the advent of optical coherence tomography angiography (OCTA), an insight into the retinal microvascular changes provides additional information in the pathophysiological changes in uveitis.[4] Based on the definition of intermediate uveitis, the primary site of inflammation is in the vitreous and peripheral retina.[1] Acquiring images of the pars plana, ciliary body, and the peripheral retina is beyond the reach of OCTA. Though there are numerous studies on the microvasculature changes on OCTA in various retinal diseases, little is known about the changes in intermediate uveitis. However, a recent study analyzed the quantitative analyses of macular vascular structures in intermediate uveitis. They demonstrated significantly reduced vascular density in both superficial and deep retinal layers in intermediate uveitis patients [Table 1].[5]Table 1: Studies on OCTA in intermediate uveitisIn a case–control study on intermediate uveitis, reduced vascular density and complexity in superficial as well as deep retinal layers and altered choriocapillaris perfusion were detected. These alterations in OCTA indicates an impairment of the macular microvasculature even in the absence of macular edema.[6] Tian et al.[7] also reported that intermediate uveitis and vasculitis presented with reduced central vessel density. On OCTA, capillary non-perfusion and reduced perfusion was observed more in the choroid, choriocapillaris, and deep capillary plexus than in the superficial capillary plexus. Intermediate uveitis with vasculitis presented more with non-perfusion and hypoperfusion in the deep capillary plexus and superficial capillary plexus than intermediate uveitis without vasculitis. Ischemia on fluorescein angiogram was associated with non-perfusion on wide-field OCTA in superficial and deep capillary plexus. Tian et al.[8] reported another prospective: a cross-sectional study to evaluate vascular changes in patients with intermediate uveitis with or without vasculitis (wide-field montage and central 3 × 3 mm slabs). Though the wide-field images gave important information about peripheral vascular changes, their lower resolution limited the detectability of flow alterations compared to the high resolution of the central scans. Microvascular changes in eyes with intermediate uveitis were found at the level of the superficial capillary plexus, deep capillary plexus, the choriocapillaris, and the choroid. Also, a change of central vascular density found in the central scans did not correlate to alterations found on wide-field OCTA. They also concluded that rather than the presence of an epiretinal membrane and a macula edema, intermediate uveitis had an alteration on the foveal avascular zone size. Capillary changes may be also found beyond the posterior pole on wide-field OCTA. The differences in capillary density and morphology that was detected in uveitis patients shows that the effects of intraocular inflammation can be quantitatively measured even within a 3 × 3 mm2 parafoveal window.[8] Along with investigating the gross changes in the peripheral retina with wide-field imaging studies, OCTA assessment of changes in the parafoveal capillary density and branching complexity provides a unique assessment of disease severity that is not otherwise available. Surprisingly, not only the retinal vasculature is altered but also the choriocapillaris and the choroid is affected in intermediate uveitis. This definitely indicates that long-term studies on this domain are needed. Data on active eyes with intermediate uveitis are sparse. Hence, we would need to evaluate the disease activity which can be visualized using OCTA.

Role of Mesenchymal Stem Cells and Their Paracrine Mediators in Macrophage Polarization: An Approach to Reduce Inflammation in Osteoarthritis.

Osteoarthritis (OA) is a low-grade inflammatory disorder of the joints that causes deterioration of the cartilage, bone remodeling, formation of osteophytes, meniscal damage, and synovial inflammation (synovitis). The synovium is the primary site of inflammation in OA and is frequently characterized by hyperplasia of the synovial lining and infiltration of inflammatory cells, primarily macrophages. Macrophages play a crucial role in the early inflammatory response through the production of several inflammatory cytokines, chemokines, growth factors, and proteinases. These pro-inflammatory mediators are activators of numerous signaling pathways that trigger other cytokines to further recruit more macrophages to the joint, ultimately leading to pain and disease progression. Very few therapeutic alternatives are available for treating inflammation in OA due to the condition's low self-healing capacity and the lack of clear diagnostic biomarkers. In this review, we opted to explore the immunomodulatory properties of mesenchymal stem cells (MSCs) and their paracrine mediators-dependent as a therapeutic intervention for OA, with a primary focus on the practicality of polarizing macrophages as suppression of M1 macrophages and enhancement of M2 macrophages can significantly reduce OA symptoms.

A study to analyze the pattern of synovial lesions from synovial biopsies in a tertiary care centre.

Synovium has been documented as a primary site of inflammation and a major effector organ in a variety of joint diseases. Study of simple technique like synovial biopsy can help in early diagnosis and treatment of diseases significantly improving outcome of patient in cases of rheumatoid arthritis, osteoarthritis, etc., Only limited data exist on utility of synovial biopsies. To analyze the pattern of synovial lesions to differentiate between different kinds of arthritis. Also, to identify early stages of arthritis so as to prevent unnecessary invasive surgical procedure. It's a retrospective study to analyze 103 cases of synovial lesions diagnosed in last five years at a tertiary care orthopedic center. All synovial biopsies obtained mainly by open method and few by arthroscopic method, that came to the Dept of Pathology were included. Lesions were classified into four categories that is, inflammatory joint diseases, degenerative joint diseases, tumor-like conditions and tumors. Age group most affected was between 61 and 70 years, with male predominance. Osteoarthritis (OA) was the most common histopathological diagnosis. Early OA tissues showed greater lining layer thickness, vessel proliferation, and inflammation, while surface fibrin deposition along with fibrosis was noted in later stages. The histo-morphological observations made in this study may have important therapeutic implications for some patients during the early evolution of arthritis and could prevent unnecessary operative intervention of later stages.

Sympathetic Ophthalmia; Clinical Findings, Diagnosis, and Treatment

Sympathetic ophthalmia is a rare, bilateral, recurrent, granulomatous panuveitis following penetrating ocular trauma or surgery. Although the etiology is not well understood, it is thought that there is an autoimmune reaction against ocular antigens that are exposed from the inciting eye. Diagnosis is based on history and clinical findings. As well as the primary site of inflammation in the choroid, posterior segment findings such as papillitis, vitritis, exudative retinal detachment, increased choroidal thickness, choroidal infiltrations, and Dalen-Fuchs nodules and granulomatous anterior uveitis especially in chronic recurrent phase are the most important clinical features of the disease. Prompt and effective treatment with corticosteroids and immunosuppressive agents is very important in achieving good visual results. The role of enucleation in the prevention and prognosis of the disease is controversial.

Metabolic Checkpoints in Rheumatoid Arthritis.

Several studies have highlighted the interplay between metabolism, immunity and inflammation. Both tissue resident and infiltrating immune cells play a major role in the inflammatory process of rheumatoid arthritis (RA) via the production of cytokines, adipo-cytokines and metabolic intermediates. These functions are metabolically demanding and require the most efficient use of bioenergetic pathways. The synovial membrane is the primary site of inflammation in RA and exhibits distinctive histological patterns characterized by different metabolism, prognosis and response to treatment. In the RA synovium, the high energy demand by stromal and infiltrating immune cells, causes the accumulation of metabolites, and adipo-cytokines, which carry out signaling functions, as well as activating transcription factors which act as metabolic sensors. These events drive immune and joint-resident cells to acquire pro-inflammatory effector functions which in turn perpetuate chronic inflammation. Whether metabolic changes are a consequence of the disease or one of the causes of RA pathogenesis is still under investigation. This review covers our current knowledge of cell metabolism in RA. Understanding the intricate interactions between metabolic pathways and the inflammatory and immune responses will provide more awareness of the mechanisms underlying RA pathogenesis and will identify novel therapeutic options to treat this disease.

Inflammation of periapical tissues of the teeth, complicated by a fistula of the cheek skin

Inflammation of the periapical tissue may lead to the development of complications involving cooperation between many medical specialists. The cutaneous fistula is a rare complication of chronic alveolus inflammation being diagnostic and therapeutic challenge due to unspecific symptoms. The correct diagnostic protocol may influence correct diagnosis, localization of the primary site of inflammation and the appropriate treatment.

Angiogenesis and VEGF-expressing cells are identified predominantly in the fascia rather than in the muscle during the early phase of dermatomyositis

BackgroundWe previously demonstrated that fasciitis is a common lesion in dermatomyositis (DM) and that DM-associated fasciitis is detectable, as the result of the increased vascularity in the fascia, by power Doppler ultrasonography. We aimed to investigate whether angiogenesis and vascular endothelial growth factor (VEGF)-expressing cells in the fascia are histologically demonstrated during the early phase of DM, and whether inflammation is involved in angiogenesis and an increased number of VEGF-expressing cells.MethodsWe prospectively evaluated 22 patients with DM and 11 patients with polymyositis (PM). Immunohistochemical staining for CD31, VEGF, and tumor necrosis factor-α (TNF-α) were performed on paraffin-embedded sections. The total vascular inflammation score (TVIS), angiogenesis score (AS), and numbers of VEGF-expressing and TNF-α-expressing cells were analyzed in the fascia and muscle.ResultsSignificant fasciitis was detected in most of the patients DM with or without myositis-specific/associated antibodies, while mild fasciitis was detected in four patients with PM, two of whom were positive for anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies. The AS and the number of VEGF-expressing cells in the fascia of patients with DM were significantly greater than those of patients with PM; no significant difference was observed in muscle in patients with DM and PM. The number of VEGF-expressing cells in the fascia correlated with the AS of DM patients. In early-phase DM, the AS, the number of VEGF-expressing cells, and the TVIS in the fascia were significantly higher than in muscle. However, no significant differences were observed in these scores excluding the TVIS between muscle and the fascia in late-phase DM. In DM patients, the TVIS correlated with the AS in the fascia, while the number of TNF-α-expressing cells correlated with the TVIS and the number of VEGF-expressing cells in the fascia.ConclusionAngiogenesis, the number of VEGF-expressing cells, and the degree of inflammation were higher in the fascia in DM than in PM, and were increased predominantly in the fascia rather than in the muscle in early-phase DM. The degree of inflammation correlated with that of angiogenesis in the fascia of DM. The fascia can therefore be a primary site of inflammation and angiogenesis in the pathogenesis of DM.

Serial Spectral-Domain Optical Coherence Tomography Findings in Acute Retinal Pigment Epitheliitis and the Correlation to Visual Acuity

To evaluate the features of acute retinal pigment epitheliitis (ARPE) at onset and in the course of recovery by serial spectral-domain optical coherence tomography (SD OCT) and the correlation to visual acuity (VA). Retrospective cohort study. Consecutive patients with ARPE. A review of medical records was performed. Integrity of SD OCT retinal bands at onset and in the course of disease, time required to achieve each retinal band restoration, corresponding VA change, and final VA. Four patients were included. Initial SD OCT showed a dome-shaped hyper-reflective lesion at the photoreceptor outer segment layer disrupting the ellipsoid zone (EZ) and interdigitation zone (IZ) (100%). In the early phase, there was also upward displacement of the external limiting membrane (ELM) and mild transient thickening of the retinal pigment epithelium (RPE)/Bruch's complex (Bc). Acute retinal pigment epitheliitis resolved in a sequence of (1) a decrease in height of SD OCT hyper-reflective lesion and the upwardly displaced ELM returning to its normal position with irregularity; (2) complete disappearance of the hyper-reflective lesion; (3) restoration of ELM; (4) restoration of EZ; and (5) restoration of IZ. The average time to restore ELM, EZ, and IZ was 4.3±5.2, 7.3±7.2, and 12.5±12.4 weeks, respectively, and the corresponding logarithm of the minimum angles of resolution (logMAR) VAs were 0.24±0.23, 0.09±0.07, and 0.05±0.06, respectively. Visual acuity improved when IZ was restored. Early SD OCT revealed an inflammatory lesion in the photoreceptor outer segment layer displacing ELM. The RPE was involved only mildly and transiently. Recovery occurred in a sequence of ELM, EZ, and IZ restoration, and VA improved when the IZ was restored. These features suggested that the IZ (i.e., the contact between photoreceptors and RPE) is the primary site of inflammation in ARPE.

Signs and symptoms of uveitis

SummaryUveitis can be a sight‐threatening disease. Inflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Blurred vision, ocular pain, photophobia and floaters are some of the symptoms complained by those who are affected by uveitis. The onset of uveitis can be either acute or insidious, bilateral rather than unilateral. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to evaluate the severity of vitritis. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be present. Uveitis might be complicated by anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

Presentation and Classification of Rare Primary Vasculitides in Children

Primary vasculitides, where blood vessels are the primary site of inflammation, with the exception of Henoch Schonlein purpura (HSP) and Kawasaki’s disease (KD) are rare in childhood but when present, cause significant morbidity and mortality. This review provides an update on classification and presentation of rare vasculitides in children, through considering our experience in three cases in context with the current literature. We have demonstrated the challenges to diagnosis and how diagnosis can easily be missed if vasculitides are not carefully considered and looked for. The introduction of classification criteria has been important to allow more research into rare paediatric vasculitides but development of diagnostic criteria may be useful. Vasculitides should be considered in all patients presenting with multi-system features.

Signs and symptoms of uveitis

SummaryInflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Uveitis can be a sight‐threatening disease. The commonest ocular symptoms are: blurred vision, ocular pain, photophobia and floaters, depending on the type of uveitis. The onset of uveitis can be either acute or insidious, involving one or both eyes. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to grade vitreous involvement. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be associated with several sub‐types of posterior uveitis. Uveitis can present several complications such as, anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

In situ analysis of interleukin-6 expression at different sites of zygapophyseal joints from patients with ankylosing spondylitis in comparison to controls

Objectives: Analysis of interleukin (IL)-6 serum levels in patients with ankylosing spondylitis (AS) has indicated that IL-6 might be a pro-inflammatory cytokine involved in AS. However, two placebo-controlled trials with monoclonal antibodies directed against the IL-6 receptor have failed to demonstrate the efficacy of the monoclonal humanized anti-human IL-6 receptor antibody over placebo for the treatment of symptoms of AS. In this study we conducted an in situ analysis of IL-6 expression at different sites of inflammation in zygapophyseal joints of patients with AS in comparison to osteoarthritis autopsy controls (CO).Method: Our immunohistochemical analysis involved 14 patients with AS, 12 autopsy controls (CO), and 11 patients with osteoarthritis (OA). Immunohistochemistry was performed to detect IL-6+ cells at five different sites: within subchondral bone marrow, fibrous tissue replacing subchondral bone marrow, hyaline cartilage, and the subchondral bone plate, and at entheseal sites.Results: Apart from changes in subchondral bone marrow, no significant differences were observed at the sites analysed when comparing AS patients and controls. A significantly lower frequency of IL-6+ cells was evident in AS patients compared to controls (p = 0.0043). In addition, AS patients tended to have even lower percentages of IL-6+ cells than controls at subchondral bone plates and entheseal sites. A significantly lower number of IL-6 expressing cells was also seen within the fibrous tissue of AS compared to OA patients (p = 0.0237).Conclusions: This in situ analysis confirms that IL-6 is not a key player in the pathogenesis of inflammatory processes in spondyloarthritides (SpA). The relevance of pro-inflammatory agents in axial SpA might be studied better in situ in bony specimens at the primary site of inflammation.

Signs and symptoms of uveitis

AbstractInflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Uveitis can be a sight‐threatening disease. The commonest ocular symptoms are: blurred vision, ocular pain, photophobia and floaters, depending on the type of uveitis. The onset of uveitis can be either acute or insidious, involving one or both eyes. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to grade vitreous involvement. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be associated with several sub‐types of posterior uveitis. Uveitis can present several complications such as, anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

Central Role for MCP-1/CCL2 in Injury-Induced Inflammation Revealed by In Vitro, In Silico, and Clinical Studies

The translation of in vitro findings to clinical outcomes is often elusive. Trauma/hemorrhagic shock (T/HS) results in hepatic hypoxia that drives inflammation. We hypothesize that in silico methods would help bridge in vitro hepatocyte data and clinical T/HS, in which the liver is a primary site of inflammation. Primary mouse hepatocytes were cultured under hypoxia (1% O2) or normoxia (21% O2) for 1–72 h, and both the cell supernatants and protein lysates were assayed for 18 inflammatory mediators by Luminex™ technology. Statistical analysis and data-driven modeling were employed to characterize the main components of the cellular response. Statistical analyses, hierarchical and k-means clustering, Principal Component Analysis, and Dynamic Network Analysis suggested MCP-1/CCL2 and IL-1α as central coordinators of hepatocyte-mediated inflammation in C57BL/6 mouse hepatocytes. Hepatocytes from MCP-1-null mice had altered dynamic inflammatory networks. Circulating MCP-1 levels segregated human T/HS survivors from non-survivors. Furthermore, T/HS survivors with elevated early levels of plasma MCP-1 post-injury had longer total lengths of stay, longer intensive care unit lengths of stay, and prolonged requirement for mechanical ventilation vs. those with low plasma MCP-1. This study identifies MCP-1 as a main driver of the response of hepatocytes in vitro and as a biomarker for clinical outcomes in T/HS, and suggests an experimental and computational framework for discovery of novel clinical biomarkers in inflammatory diseases.

Signs and symptoms of uveitis

AbstractUveitis is a potentially sight‐threatening disease and can be categorized into: anterior, intermediate, posterior, and panuveitis. The onset of uveitis can be either acute or insidious, involving one or both eyes. The commonest ocular symptoms are: blurred vision, ocular pain, photophobia and floaters, depending on the type of uveitis. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to grade vitreous involvement. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be associated with several sub‐types of posterior uveitis. Uveitis can present several complications such as, anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.

SAT0014 Synovial Sublining Macrophages: A Sensitive Biomarker for Response to Treatment in Early RA Patients.

BackgroundThe synovial membrane is the primary site of inflammation in rheumatoid arthritis and as such the study of pathobiological synovial specimens has led to a greater understanding of disease pathogenesis....

Secondary choriocapillaritis in infectious chorioretinitis

To analyse the indocyanine green angiography (ICGA) patterns of hypofluorescence that are compatible with choriocapillaritis that occur secondarily to toxoplasmic retinochoroiditis (ToRC), ocular tuberculosis (including tuberculous choroiditis, TuCR and multifocal serpiginoid choroiditis, TMSC) and syphilitic chorioretinitis (SyCR). This was a single centre, retrospective case review study. Patients with a diagnosis of ToRC, TuCR, TMSC or SyCR were identified, their charts were reviewed and fundus photographs, fluorescein angiography (FA) and ICGA pictures were assessed. Indocyanine green angiography was performed at the initial presentation in 63 of the 105 patients with ToRC, in 37 of the 38 patients with TuCR, in six of six patients with TMSC and in two of four patients with SyCR. The following four ICGA patterns indicated choriocapillaritis: extension of hypofluorescence beyond the hypofluorescence of the actual infectious focus as seen on fundus photography or FA (seen only in ToRC and TuCR); small dark dots around the infectious focus (seen only in ToRC); multiple 'confetti-like' hypofluorescent areas or hypofluorescent geographical confluent areas (seen only in TMSC); and widespread areas of nonperfusion visible only in ICGA (seen only in SyCR). Patients with secondary choriocapillaritis have distinct typical ICGA findings. ICGA is thus an important diagnostic tool that can provide an explanation for otherwise obscure visual loss and that might have diagnostic value for specific conditions like ToRC and SyCR.

Symptoms and signs of posterior uveitis

AbstractPurpose Posterior uveitis (PU) is an important anatomic form of uveitis in which the primary site of infl ammation is the choroid or retina, with or without subsequent vitreous involvement.Methods Review of symptoms and signs of PU.Results The onset of PU can be sudden or insidious, involving one or both eyes. Most common ocular symptoms include blurred vision, loss of vision, and floaters. PU is usually associated with vitritis. Both vitreous cells and fl are should be graded according to standardized grading systems. Other vitreous changes may include vitreous strands, vitreous hemorrhage, vitreous traction, and posterior vitreous detachment. Depending on the primary site of inflammation, PU can present in the form of retinitis, choroiditis, retinochoroiditis, or chorioretinitis. Retinal and/or choroidal inflammation can be focal, multifocal, or more diff use, involving the periphery or posterior pole. It is important to distinguish between active and inactive chorioretinal disease. Retinal vasculitis can occur in the setting of several PU entities involving retinal veins or arteries. It appears as focal, multifocal, or diff use vascular cuffing or sheathing. Other retinal vasculitic changes include retinal hemorrhages, features of retinal vascular occlusion, retinal/optic disc neovascularization, and aneurysms. Macular involvement may result from direct inflammatory infiltration, macular edema, serous retinal detachment, retinal ischemia, epiretinal membrane, or macular hole. Optic nerve involvement may include optic disc hyperemia, optic disc edema, optic neuritis, neuroretinitis, optic disc exudate, and optic disc granuloma.Conclusion Clinician should be aware of the array of ocular symptoms of signs and their importance in orienting work‐up.

Symptoms and signs of posterior uveitis

AbstractPurpose Posterior uveitis (PU) is an important anatomic form of uveitis in which the primary site of inflammation is the choroid or retina, with or without subsequent vitreous involvement.Methods Review of symptoms and signs of PUResults The onset of PU can be sudden or insidious, involving one or both eyes. Most common ocular symptoms include blurred vision, loss of vision, and floaters. PU is usually associated with vitritis. Both vitreous cells and flare should be graded according to standardized grading systems. Other vitreous changes may include vitreous strands, vitreous hemorrhage, vitreous traction, and posterior vitreous detachment. Depending on the primary site of inflammation, PU can present in the form of retinitis, choroiditis, retinochoroiditis, or chorioretinitis. Retinal and/or choroidal inflammation can be focal, multifocal, or more diffuse, involving the periphery or posterior pole. It is important to distinguish between active and inactive chorioretinal disease. Retinal vasculitis can occur in the setting of several PU entities involving retinal veins or arteries. It appears as focal, multifocal, or diffuse vascular cuffing or sheathing Other retinal vasculitic changes include retinal hemorrhages, features of retinal vascular occlusion, retinal/optic disc neovascularization, and aneurysms. Macular involvement may result from direct inflammatory infiltration, macular edema, serous retinal detachment, retinal ischemia, epiretinal membrane, or macular hole. Optic nerve involvement may include optic disc hyperemia, optic disc edema, optic neuritis, neuroretinitis, optic disc exudate, and optic disc granuloma.Conclusion Clinician should be aware of the array of ocular symptoms of signs and their importance in orienting work‐up.