Uveal Involvement Research Articles

Uveal involvement in children with hemifacial scleroderma

Uveal involvement in children with hemifacial scleroderma

Uveal involvement in children with hemifacial scleroderma

Background. Linear scleroderma of the head (LSH) is a devastating disease of childhood since it is associated with a deep deformation of the face and head tissues, neurological disorders, organ of vision injury, and prognosis-defining uveal tract involvement. Aim. To establish the prevalence and features of the uveal tract lesion in children with LSH. Materials and methods. Ten cases with uveal tract lesions were retrospectively reviewed in 110 children with LSH. A comprehensive clinical, laboratory, and instrumental examination was carried out, including magnetic resonance imaging of the brain, electroencephalography, and an ophthalmologist's examination, including viscometry, biomicroscopy, and ophthalmoscopy. Results. In 9 patients, only the anterior segment of the eye was affected (iridocyclitis); 2 patients had the posterior segment involved, 1 had peripheral chorioretinitis, and 1 patient had a combination of iridocyclitis with central chorioretinitis. The lesion developed immediately after the LSH onset or 6–10 years after the onset of the disease, and half of the children had a recurrent course of the disease. In all children, changes in the uveal tract were detected on the side of the lesion of the scalp and face. In 3 out of 10 patients, iridocyclitis was bilateral. Simultaneously, epileptic syndrome and focal lesions of brain tissue were noted in 2 children with eye lesions. Persistent vision loss in the outcome of the disease was observed in 3 children. Conclusion. Uveal tract involvement was detected in 0.9% of our group of examined children with LSH, mostly in the form of anterior iridocyclitis. The lesion of the uveal tract can develop both at the onset of scleroderma and after many years of illness, which makes it necessary to perform at least an annual routine examination of the eyes using basic ophthalmological techniques – visometry, biomicroscopy, and ophthalmoscopy. Also, an eye examination is necessary in case of disease recurrence.

Bilateral hypopyon uveitis in carcinoma of breast: Masquerade syndrome and review of literature

Maquerade syndromes are a group of ocular diseases that mimic inflammation but are due to neoplastic or less commonly non- neoplastic diseases. Metastatic choroidal disease is the most frequent clinical feature in carcinoma breast. We report a rare presentation of simultaneous uveal and orbital involvement in a 60- year-old lady with invasive ductal carcinoma. She had masquerade syndrome with acute hypopyon uveitis, angle closure glaucoma and panophthalmitis due to breast carcinoma. Anterior uveitis was due to an immune response which rapidly progressed to panophthalmitis because of orbital metastasis.

Rosai-Dorfman Disease involving the eye and ocular adnexa. Clinicopathologic series of 17 patients.

To describe the clinical features and histopathologic findings of Rosai-Dorfman disease (RDD) with ophthalmic involvement diagnosed at a Mexican ophthalmologic referral center in a period of 62 years. A total of 17 cases of RDD with ophthalmologic manifestations in Mexican-mestizo patients were collected. Female predominance was observed in 12 of 17 patients. The mean age was 36 years with a range of 12-76 years. The median age at presentation was 32 years. The orbit was the most affected location with 15 cases. Conjunctival disease was seen in 4 cases: two as isolated lesions, the rest with orbital or uveal involvement . One case suggested choroidal RDD associated to conjunctival and orbital lesion. Three cases presented multifocal disease. A patient with orbital affection developed extranodal disease elsewhere. No concurrent lymphadenopathy was observed in any patient.Histopathological examination revealed classic RDD findings in all cases: A polymorphous cellular infiltrate composed by lymphocytes, plasma cells and large histiocytes with emperipolesis hallmark of the disease. Immunohistochemically, histiocytes were positive for S-100 protein and CD68 in 15 cases. RDD of the eye and ocular adnexa in Mexican-mestizo patients is common in middle-aged women frequently as an isolated orbital lesion. Histopathology is necessary for accurate diagnosis. Most patients had a favourable outcome after medical and surgical treatment. To the best of our knowledge this is the largest case series of RDD of the eye and ocular adnexa in Latin-American patients.

Primary vitreoretinal involvement and immunopositivity for BRAFV600E help distinguish metastatic from primary intraocular melanoma: a detailed histopathologic study of metastatic cutaneous melanoma to the eye.

To evaluate the clinicopathologic characteristics of metastatic cutaneous melanoma to the eye and identify potential distinguishing characteristics from the more common primary uveal melanoma; particularly, tumour location within the eye, cytomorphology and immunohistochemical/specific molecular genetic features. A retrospective observational case series using surgical enucleation and diagnostic vitrectomy cytologic specimens from seven patients with suspected intraocular melanoma, eventually diagnosed as metastatic melanoma, was conducted. Haematoxylin and eosin-stained sections of tumour and immunohistochemical (IHC) stains for BRAFV600E and Ki-67 were critically reviewed; BAP1 IHC was also evaluated in cases where additional tissue was available. Clinical imaging studies and medical records were reviewed. The majority of patients (86%) with metastatic melanoma have primary vitreoretinal (not uveal) involvement and epithelioid, highly malignant cytomorphology (100%); many (50%) harbour BRAFV600E mutations, a finding not seen in large cohorts of primary uveal melanoma. Characteristics favouring or defining metastatic intraocular melanoma over primary uveal melanoma include high-grade epithelioid cytology, predominant involvement of the vitreous cavity and/or retina, and presence of positive immunostaining for BRAFV600E.

Case study on the clinical and anatomopathological descriptions of dog with primary uveal lymphoma

Intraocular lymphoma is a malignant neoplasm, which commonly affects the uveal tract of dogs, most of the time, a consequence of the multicentric by the hematogenous spread of neoplastic lymphocytes. The symptoms are varied and the chronicity can cause serious eye problems such as glaucoma and loss of visual acuity. In view of the unusual occurrence of primary ocular lymphoma in dogs, the objective was to discuss the case of a dog with uveal involvement, presenting conjunctival congestion, increased episcleral vessels, hypopyon, hyphema and increased intraocular pressure. After seven days of conservative treatment, symptoms worsened, especially the intraocular pressure. The tutor returned only two months after the consultation with the sonographic report of neoplasia in the uvea. There was an increase in the ocular bulb, vascularization and corneal edema, posterior synechia, discomfort, loss of visual acuity and neoformation in the iris. Was opted for enucleation and the histopathology suggested large cell lymphoma in the uveal tract. Two years after surgery, no metastases were observed. It is concluded that lymphoma can affect the uveal tract primarily in dogs, demonstrating different clinical signs and, in addition, early diagnosis and correctly instituted treatment favor quality of life and survival of the affected.

Ocular manifestations of COVID-19 infection: A review of available information

Ocular signs and symptoms have been reported in COVID-19 patients, and there is increasing recognition of conjunctivitis as a prodromal symptom of this disease. There is also a surge of information about corneal, uveal, retinal, and neuroophthalmological involvement in COVID-19 infection. This review attempts to determine from various researches published during the time of the pandemic, the various ocular presentations of COVID-19 infection, its significance, correlation to the severity of systemic disease, and its importance as a mode of transmission of the disease. An extensive search strategy was employed to retrieve articles of ocular manifestations of COVID-19 published from January 2020 to date. Conjunctivitis was found to be the most common ocular manifestation, and viral RNA was noted in conjunctiva and tears, posing a risk for ophthalmologists. Other less commonly seen findings in COVID-19 infections include keratoconjunctivitis, blepharitis, retinal changes, and ophthalmoparesis. However, recent studies show increasing reports of retinal and neuroophthalmological manifestations of the COVID-19 infection.

Retinal manifestations of COVID-19 disease - A review of available information

Ocular signs and symptoms have been reported in COVID-19 patients, and there is a surge of information about corneal, uveal, retinal, and neuro-ophthalmological involvement in COVID-19 infection. This review attempts to determine from various researches published during the time of the pandemic, the retinal manifestations of COVID-19 infection, and its significance and correlation to severity of systemic disease. An extensive search strategy was employed using keywords “novel corona virus”, “COVID-19”, “SARS CoV2,” or “retina,” either singly or variably combined, to retrieve the articles of retinal manifestations of COVID-19 published from January 2020 till date. Retinal manifestations are ubiquitous and include microangiopathy, occlusive vascular conditions, alterations in vascular caliber, and capillary density, among others. They seem to correlate with disease severity and reflect on similar changes in other parts of the body as well. Newer studies are bringing out more and more evidence of hitherto unknown retinal manifestations of COVID-19 disease.

Ocular Manifestations in Late Onset Behçet's Disease.

Behçet's disease is frequent in Tunisia and potentially serious, which can endanger both the vital and visual prognosis. Late occurrence of the disease is uncommon and less frequently investigated. ; Aims: The aim of this study was to analyse the demographic characteristics and ocular manifestations of patients with late-onset Behçet disease in Tunisia, North Africa. ; Methods: A retrospective study was performed on 38 eyes of 21 oculo-Behçet patients over a seven- year period. ; Results: The mean age of our patients was 54.81 years. The sex ratio M/F was 2.5. The period between the onset of the first symptom and diagnosis of Behçet's disease varied from 3 days to 2 years. The primary complaint was a decrease in visual acuity, reported in 8 patients. Ocular involvement revealed Behçet's disease in 2 patients, bilateral in 17 patients, and active in 31 eyes. The ocular manifestations in late-onset Behçet's disease were dominated by uveal involvement (30 eyes). The most frequent form of uveitis was panuveitis noted in 13 eyes. Ocular complications were dominated by macular involvement in 8 patients (14 eyes). Blindness was noted in 4 eyes of 4 patients (10.5%). Topical corticosteroids were used in 30 eyes. Three patients were treated only with oral corticosteroid and 9 patients with a combination of oral corticosteroid and immunosuppressive agents. ; Conclusion: Since the course of the ocular involvement in late-onset Behçet's disease is regarded to be relatively mild, it is noteworthy that our study revealed that blindness was noted in 10,5% and posterior uveitis and panuveitis were the most common uveal lesion.

Ocular Adnexal Amyloidosis: A Mass Spectrometric Analysis

Ocular adnexal amyloidosis (OAA) may represent localized manifestation of an underlying systemic process. Accurate identification of the amyloid fibrils can guide the systemic evaluation and treatment. The aim of this study was to characterize subtypes of OAA using immunohistochemistry and mass spectrometric analysis and to correlate with ocular involvement and systemic association. Retrospective case series. Review of patients with OAA subtyped by immunohistochemistry and mass spectrometric analysis at the Cleveland Clinic from June 1995 to June 2017. While immunohistochemistry identified AL amyloid protein in 67% (4/6) of specimens tested, mass spectrometry identified AL amyloid protein in all specimens (10/10). AL lambda was identified in 5 (50%) samples, kappa in 3 (30%), and both kappa and lambda light chains in 2 (20%). The 5 cases of conjunctival amyloidosis were either AL lambda only (3 cases) or both lambda and kappa (2 cases). There were 3 cases that had associated systemic involvement. Two of these had eyelid skin involvement and AL kappa amyloidosis and the other patient had uveal involvement and AL lambda amyloidosis. Primary amyloidosis-AL is the most common form diagnosed by mass spectrometric analysis in patients with OAA. Immunohistochemistry is ineffective in the characterization of the amyloid deposits in a significant number of cases. Evaluation to exclude systemic involvement or associated underlying lymphoproliferative disorder is warranted.

Primary bilateral uveal melanoma: a population-based study and systematic review.

Primary bilateral uveal melanoma (UM) is a rare and incompletely described entity. It is not known how these patients compare to those with unilateral UM. We sought to comprehensively characterize and compare patients with primary bilateral and unilateral UM. Retrospective, population-based and systematic review. Patients with bilateral (n = 52) and unilateral UM (n = 8915). We analysed cases of primary bilateral UM from three data sources: (i) the University Hospitals Cleveland Medical Center pathology database from 1996 to 2016 (n = 1); (ii) the Surveillance, Epidemiology and End-Results (SEER)-18 database from 1973 to 2013 (n = 5) and (iii) a systematic review of the English language literature (n = 46). Cases of unilateral UM were obtained from the SEER-18 database from 1973 to 2013 for comparison (n = 8915). Demographics, clinicopathological characteristics, treatments and survival. There were no differences in sex, race, mean age at diagnosis, site of uveal involvement, metastases at diagnosis, or treatment among patients with bilateral as compared to unilateral UM. Additionally, there were no clinicopathological differences between the two UMs in each patient with bilateral disease. Overall survival did not differ between unilateral and bilateral UM patients, or between bilateral UM patients who presented with, or subsequently developed, bilateral disease. Bilateral and unilateral UM patients share similar demographics, clinicopathological characteristics, treatments and prognoses. Moreover, the development of bilateral disease does not portend a poorer prognosis and patients should be treated similarly to those with unilateral disease.

Novel treatment regimen of Vogt–Koyanagi–Harada disease with a reduced dose of corticosteroids combined with immunosuppressive agents

ABSTRACTPurpose: To investigate the effectiveness, visual outcome, and prognostic factors of Vogt–Koyanagi–Harada (VKH) disease treatment with a reduced dose of corticosteroids combined with immunosuppressive agents.Methods: The clinical characteristics, auxiliary examinations, treatment result, visual outcome, and prognostic factors in VKH patients were analyzed.Results: A total of 998 VKH patients were divided into posterior uveitis group (Group1), anterior uveal involvement group (Group 2), and recurrent granulomatous anterior uveitis group (Group 3). Reduced doses of corticosteroids combined with immunosuppressive agents were used for 1–1.5 years. Uveitis was controlled in 100%, 100%, and 96.8% of these three groups, respectively. Visual improvement and stability was observed in 98.1%, 96.5%, and 88.3%, respectively. Treatment after disease onset, visual acuity at first visit, and 1 month after treatment was positively associated with BCVA at last visit (p < 0.05).Conclusion: A reduced dose of corticosteroids combined with immunosuppressive agents effectively controlled the intraocular inflammation and improved visual acuity in most Chinese VKH patients.

Signs and symptoms of uveitis

SummaryUveitis can be a sight‐threatening disease. In ammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Blurred vision, ocular pain, photophobia and oaters are some of the symptoms complained by those who are a ected by uveitis. e onset of uveitis can be either acute or insidious, bilateral rather than unilateral. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and are 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 classi cation of posterior uveitis depends on the primary site of in ammation, 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.

Can we use the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume values for the diagnosis of anterior uveitis in patients with Behcet's disease?

IntroductionThe purpose of this study was to compare the value of hematological parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV), as indicators of anterior uveal segment involvement in patients with Behcet’s disease (BD).Patients and methodsHospital-based records of a total of 912 patients with BD from the dermatology clinic and healthy volunteers from the checkup clinic were assessed retrospectively. After applying the exclusion criteria of the study, 71 of the BD patients with anterior uveitis, 69 of the BD patients without ophthalmological pathology and 151 healthy volunteers were included in the study. MPV, PLR, and NLR values of patients and healthy volunteers were compared.ResultsAll MPV, PLR, and NLR values of patients who had anterior uveitis were significantly higher than those of other patients and healthy volunteers. Statistically, considering area under curves (ratio): NLR was 0.725 (0.653–0.797), P<0.001; PLR was 0.600 (0.523–0.676), P=0.012, and MPV was 0.358 (0.279–0.437), P<0.001.ConclusionMPV, PLR, and NLR are all valuable for assessment of anterior uveal segment involvement in patients with BD. However, the NLR seems to be better than the PLR and MPV for indicating anterior uveitis due to BD.

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.

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.

Melanoma of the eye: Revealing hidden secrets, one at a time

Melanoma of the eye can involve the uveal tract with iris, ciliary body, or choroid involvement or it can involve the conjunctiva, eyelid, or orbit. Uveal involvement with choroidal melanoma is the most common, found in light complexion Caucasians with an age-adjusted incidence of 4.3 per million persons. Early detection of uveal melanoma is critical. The ABCDEF guide helps to differentiate iris nevus from iris melanoma. The letters represent: A, age young (≤40 years); B, blood in anterior chamber; C, clock hour of mass inferiorly; D, diffuse configuration; E, ectropion; and F, feathery margins. The mnemonic of TFSOM-UHHD (To Find Small Ocular Melanoma—Using Helpful Hints Daily) helps to differentiate choroidal nevus from small melanoma and represents: T, thickness over 2 mm; F, fluid; S, symptoms; O, orange pigment; M, margin within 3 mm of the optic disc; UH, ultrasound hollow; H, halo absent; and D, drusen absent. Patients with 3 or more of these factors are likely to have melanoma. These key clinical features help to identify small melanoma at a time when therapy could be life-saving.Conjunctival melanoma usually arises from primary acquired melanosis, a flat pigmentation that can lead to melanoma. Wide excision using no touch strategy is important to tumor control. Ocular examination is advised annually for all persons for detection of refractive error, cataract, glaucoma, and other conditions, but also for the detection of asymptomatic malignancies like melanoma. One at a time, we have uncovered the secrets of ocular melanoma and we forge ahead with the goal to solve the riddle of this challenging disease.

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.

Iridocorneal endothelial syndrome: Cogan -Reese syndrome. A case report

ICE syndrome is a rare progressive unilateral disease occurring in young middle aged females. Corneal edema with uveal involvement are key features. Secondary glaucoma is main sight threatening complication.Managment depends on severity of ocular findings and is targeted to control corneal edema and secondary glaucoma medically and surgically.

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.