A prospective, population-based, surveillance (BOSU) study of uveal effusion syndrome in the UK.

PURPOSE: To determine the incidence and demographic profile of uveal effusion syndrome (UES), and to describe the visual and anatomic outcome following deep sclerectomy or vortex vein decompression. METHODS: The British Ophthalmological Surveillance Unit (BOSU) mails reporting cards monthly to 1149 senior UK ophthalmologists, who are requested to report incident cases of specified rare diseases. UES was included in the reporting system from October 2009 to October 2011. If UES was identified, ophthalmologists were mailed a questionnaire to collect anonymized clinical data at baseline, and 12 months after. RESULTS: Over 2 years, 29 cases were reported. Two cases were duplicates and 12 failed to meet the eligibility criteria. Of the 15 eligible cases, age ranged from 11 to 91 years (mean 62) and nine were males (60%). Ten patients were hypermetropic; three had an axial length of 19.0 mm or less. Estimated annual incidence was 1.2 per 10 million population. Seven cases were managed nonsurgically, including observation (one case), topical steroids (two cases), systemic steroids (three cases), and cyclodiode laser (one case). Eight cases (11 eyes) underwent full-thickness sclerectomy; the elevated flap was retained in four. The sclera was noted to be thick and rigid during surgery in five cases. Median preoperative visual acuity was 6/18, changing slightly to 6/21.5 at final review, with three eyes showing complete anatomic response, five showing some improvement, and three failing to respond. CONCLUSIONS: UES is extremely rare. It occurs in a range of ages, but is most common in middle-aged, hypermetropic men. Visual acuity can be materially reduced. The most commonly used surgical treatment in the UK is deep sclerectomy.

Implantable collamer lens surgery in patients with primary iris and/or ciliary body cysts.

BACKGROUND: The prevalence of primary iris and/or ciliary body cysts is common in myopia, though asymptomatic in nearly all cases. It's a very valuable thing to study the clinical safety and reliability of implantable collamer lens (ICL) surgery in patients with primary iris and/or ciliary body cysts. METHODS: A total of 108 patients (201 eyes) were included in this retrospective study. All eyes had been implanted with V4c implantable collamer lens (ICLV4c). According to the eyes with or without primary iris and/or ciliary body cysts, all eyes were divided into two groups. We observed preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity)(CDVA), intra-ocular pressure(IOP), anterior chamber volume(ACV), anterior chamber depth(ACD), trabecular-iris angle (TIA), angle opening distance at 500 µm (AOD500),vertical central distance between the corneal endothelium and the front surface of ICL(CE-ICL), and the central vault. The follow-up periods covered 12 months. RESULTS: Among all the 201 eyes, primary iris and/or ciliary body cysts were detected in 54 eyes (26.87%),but the prevalence was account to 36.11%(18males,21females).There were 30 eyes (55.56%) with unilateral single cyst, 12 eyes (22.22%) with unilateral double cysts, 12 eyes (22.22%) eyes with unilateral multiple and/or multi-quadrants cysts, the mean size of cysts was (0.714 ± 0.149)mm(range from 0.510 to 1.075 mm).30.4% of the cysts were located at iridociliary sulcus, 65.5% in pars plicata, and 4.1% in midzonal iris, which showed a characteristic distribution pattern, with cysts found predominantly in the inferior and temporal quadrants.The postoperative size and the number of cysts showed nearly no changes. The postoperative ACV, AOD500 and TIA showed a statistical reduction in both two groups (P < 0.05), but with no statistical significant between the two groups (P > 0.05), the parameters of postoperative IOP,CE-ICL and central vault also showed the same results as which. We did not observe serious complication and IOP elevating in the whole follow-up periods. CONCLUSION: Primary iris and/or ciliary body cysts are not absolutely contraindication for ICL surgery. For some single cyst smaller than 1.075 mm or single quadrant cysts located at ciliary body are rare to lead some serious complications. But, for some multiple cysts, especially multi-quadrants cysts located at iridociliary sulcus, we still should remain cautions.

Uveal cysts in domestic cats: a retrospective evaluation of thirty-six cases.

OBJECTIVE: The aim of this retrospective study was to investigate uveal cysts in domestic cats by identifying prevalence, predispositions, location, presumed etiologies, and sequelae. ANIMALS STUDIED: The clinical databases of two referral hospitals (The Animal Health Trust in the UK and Animal Eye Care in Australia) were searched to identify cats that had been diagnosed with uveal cysts, either as an incidental finding or as the reason for referral. Thirty-six cases were found. PROCEDURES: The signalment of the patients was recorded, along with any relevant previous clinical history, treatment, follow-up, and sequela. The data were compared with the unaffected feline populations examined by ophthalmologists in the two hospitals over the same 10-year time period. RESULTS: Thirty-six cats were affected, from a total examined population of 5017 (prevalence 0.72%). Twenty-one of the 36 cats were Burmese. The two centers examined 516 Burmese cats in the same time period, giving an incidence in Burmese cats of 4.1%. The mean age of affected cats at presentation was 10.25 years (SD = 4.12 years), and female cats accounted for 23 of 36 of the cases. Only 2 of 36 cats had concurrent intraocular disease. CONCLUSIONS: Uveal cysts in domestic cats are rare ophthalmic findings, and in most cases, they do not cause any clinical problems The Burmese breed is overrepresented in the data, with a relatively high prevalence of uveal cysts.

Prevalence of uveal cysts and pigmentary uveitis in Golden Retrievers in three Midwestern states.

OBJECTIVE: To determine the prevalence of uveal cysts and pigmentary uveitis (PU) in Golden Retrievers in 3 Midwestern states. DESIGN: Prospective cross-sectional study. ANIMALS: 164 American Kennel Club-registered Golden Retrievers in the states of Illinois, Indiana, and Michigan. PROCEDURES: For all dogs, biomicroscopic and binocular indirect ophthalmoscopic examinations of both eyes were performed after pupillary dilation. A finding of pigment deposition in a radial pattern or in zones on the anterior aspect of the lens capsule of 1 or both eyes was required for a diagnosis of PU. RESULTS: Eighty of the 328 (24.4%) eyes and 57 of the 164 (34.8%) dogs had visible uveal cysts. Of those 80 eyes with cysts, 41 (51.3%) had a single cyst located nasally and posterior to the iris, 33 (41.3%) had multiple uveal cysts, and 6 (75%) had a single, free-floating cyst. A diagnosis of PU was made for 9 (5.5%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Prevalences of uveal cysts (34.3%) and PU (5.5%) in the examined Golden Retrievers were both higher than prevalences reported previously (5.4% for uveal cysts and 1.5% for PU) in the Canine Eye Registry Foundation's 2009 All-Breeds Report. Study findings have indicated that PU is not a rare condition and should be considered as a differential diagnosis for Golden Retrievers with ocular disease.

[Visual impairment and blindness in children in a Malawian school for the blind]. / Sehbehinderung und Blindheit bei Kindern in einer malawischen Blindenschule.

PURPOSE: The aim of this study was to determine the anatomic sites of severe visual impairment and blindness in children in an integrated school for the blind in Malawi, and to compare the results with those of previous Malawian blind school studies. METHODS: Children attending an integrated school for the blind in Malawi were examined in September 2011 using the standard WHO/PBL eye examination record for children with blindness and low vision. Visual acuity [VA] of the better eye was classified using the standardised WHO reporting form. RESULTS: Fifty-five pupils aged 6 to 19 years were examined, 39 (71 %) males, and 16 (29 %) females. Thirty eight (69%) were blind [BL], 8 (15 %) were severely visually impaired [SVI], 8 (15 %) visually impaired [VI], and 1 (1.8 %) was not visually impaired [NVI]. The major anatomic sites of visual loss were optic nerve (16 %) and retina (16 %), followed by lens/cataract (15 %), cornea (11 %) and lesions of the whole globe (11 %), uveal pathologies (6 %) and cortical blindness (2 %). The exact aetiology of VI or BL could not be determined in most children. Albinism accounted for 13 % (7/55) of the visual impairments. 24 % of the cases were considered to be potentially avoidable: refractive amblyopia among pseudophakic patients and corneal scaring. CONCLUSIONS: Optic atrophy, retinal diseases (mostly albinism) and cataracts were the major causes of severe visual impairment and blindness in children in an integrated school for the blind in Malawi. Corneal scarring was now the fourth cause of visual impairment, compared to being the commonest cause 35 years ago. Congenital cataract and its postoperative outcome were the commonest remedial causes of visual impairment.

[Iridociliary cysts on ultrasound biomicroscopic examinations]. / Prevalência de cistos iridociliares em exames de biomicroscopia ultra-sônica.

PURPOSE: To present the prevalence of iridociliary cysts in eyes of patients submitted to UBM examination. METHODS: We analyzed retrospectively the UBM images of 1157 patients in the period from September 1995 to June 2004. The inclusion criterion was the UBM examination had been made on the four quadrants (superior, inferior, nasal and temporal) of the eyes. The cysts were assessed and classified in relation to their number in each quadrant; localization and morphology. Using the UBM Pro 2000 software we took the measurements of the largest diameter, wall thickness and area of the cysts besides the angle recession area (ARA). RESULTS: The prevalence of the cysts was 4.9%. No statistical difference was found between the prevalence of cysts regarding gender or between the right and left eyes. They were more prevalent in the inferior (39.8%) and temporal (29.1%) quadrants. The cysts with the largest diameter and area were located in the temporal and superior quadrants. No difference was found in relation to cysts' wall thickness in all quadrants. CONCLUSIONS: No statistical difference was found between the prevalence of cysts as concerns gender or between the right and left eyes. However, the cysts were more prevalent in the inferior and temporal quadrants. The locations of the largest cysts are preferentially the temporal and superior quadrants. The angle recession area was smaller in the temporal and superior quadrants. The cysts' wall thickness is practically the same in all quadrants. The diagnosis of iridociliary cysts was an occasional finding in 64.3% of the patients.

Prevalência de cistos iridociliares em exames de biomicroscopia ultra-sônica / Iridociliary cysts on ultrasound biomicroscopic examinations

OBJETIVO: Relatar a prevalência de cistos iridociliares em olhos de pacientes submetidos à biomicroscopia ultra-sônica (UBM). MÉTODOS: Analisaram-se retrospectivamente as imagens de UBM de 1.557 pacientes examinados de setembro de 1995 a junho de 2004. O critério de inclusão foi a UBM ter sido realizada nos quatro quadrantes (superior, inferior, nasal e temporal) do globo ocular. Avaliaram-se e classificaram-se os cistos quanto: a) ao número em cada quadrante; b) ao quadrante de localização; c) à morfologia, medindo o maior diâmetro (vertical ou horizontal), a maior espessura da parede e a área da lesão cística; d) à área de recesso angular (ARA) para cada um dos quadrantes em que havia cisto; e) à hipótese diagnóstica e/ou indicação da UBM. Utilizou-se o "software" UBM Pro 2000 para medir o diâmetro, a espessura da parede, a área do cisto e a ARA. RESULTADOS: Foram encontrados 103 cistos em 56 pacientes correspondendo à prevalência de 4,9 por cento numa amostra de 1.132 pacientes selecionados. Dos 1.132 pacientes, 650 (57,4 por cento) eram do sexo feminino e 482 (42,6 por cento) eram do sexo masculino. Dos 56 pacientes com cisto, 37 (66,1 por cento) eram do sexo feminino e 19 (33,9 por cento) eram do sexo masculino. Dos 1.480 olhos examinados, 774 (52,3 por cento) eram olhos direitos e 706 (47,7 por cento) eram olhos esquerdos. Foram encontrados cistos em 38 (64,4 por cento) olhos direitos e 21 (35,6 por cento) olhos esquerdos. Não houve diferença estatisticamente significativa entre os sexos nem entre os olhos direito e esquerdo. Os cistos com maior média de diâmetro e área estavam localizados nos quadrantes temporal e superior, onde foram encontrados os menores valores de grau de abertura do seio camerular. CONCLUSÕES: Os cistos iridociliares são mais prevalentes nos quadrantes inferior e temporal. Os cistos de maior diâmetro e área situam-se nos quadrantes temporal e superior onde encontram-se menores valores médios de grau de abertura do seio camerular.A espessura da parede dos cistos é praticamente a mesma nos quatro quadrantes. Em 64,3% dos pacientes, a presença de cistos foi um achado ocasional do exame de UBM.

PURPOSE: To present the prevalence of iridociliary cysts in eyes of patients submitted to UBM examination. METHODS: We analyzed retrospectively the UBM images of 1157 patients in the period from September 1995 to June 2004. The inclusion criterion was the UBM examination had been made on the four quadrants (superior, inferior, nasal and temporal) of the eyes. The cysts were assessed and classified in relation to their number in each quadrant; localization and morphology. Using the UBM Pro 2000 software we took the measurements of the largest diameter, wall thickness and area of the cysts besides the angle recession area (ARA). RESULTS: The prevalence of the cysts was 4.9 percent. No statistical difference was found between the prevalence of cysts regarding gender or between the right and left eyes. They were more prevalent in the inferior (39.8 percent) and temporal (29.1 percent) quadrants. The cysts with the largest diameter and area were located in the temporal and superior quadrants. No difference was found in relation to cysts' wall thickness in all quadrants. CONCLUSIONS: No statistical difference was found between the prevalence of cysts as concerns gender or between the right and left eyes. However, the cysts were more prevalent in the inferior and temporal quadrants. The locations of the largest cysts are preferentially the temporal and superior quadrants. The angle recession area was smaller in the temporal and superior quadrants. The cysts' wall thickness is practically the same in all quadrants. The diagnosis of iridociliary cysts was an occasional finding in 64.3 percent of the patients.

Uveal effusion in primary angle-closure glaucoma.

PURPOSE: To determine the prevalence of uveal effusion in acute and chronic primary angle-closure glaucoma (PACG) or primary angle closure (PAC) and to compare it with the prevalence in eyes with open-angle glaucoma (OAG) or ocular hypertension. DESIGN: Prospective consecutive case series. PARTICIPANTS: Five hundred one eyes of 351 consecutive patients with PAC and 156 eyes of 116 randomly selected primary OAG or ocular hypertension patients. The PAC group included 40 eyes of 35 patients with acute PACG and 30 unaffected fellow eyes, 39 eyes and 35 fellow eyes with a history of acute PACG, and 357 eyes with chronic PAC. METHODS: Ultrasound biomicroscopic examination was performed to diagnose uveal effusion and to measure anterior chamber depth (ACD). MAIN OUTCOME MEASURES: Presence of uveal effusion and ACD. RESULTS: Uveal effusion was demonstrated in 23 eyes (58%) with acute PACG and 7 fellow eys (23%) (chi2 = 8.17, P = 0.0043). Among eyes with chronic PAC, uveal effusion was present in 69 [corrected](14%[corrected]), a higher prevalence than was found in open-angle patients (2 eyes [1.3%]) (chi2 = 19.3, P<0.001). In the chronic PAC group, the ACD of phakic eyes with uveal effusion (1.92+/-0.42 mm) was significantly shallower than that of phakic eyes without effusion (2.06+/-0.32 mm) (P = 0.019). CONCLUSIONS: Uveal effusion diagnosed by ultrasound biomicroscopy is a special feature in PAC, and is prevalent in acute PACG. Uveal effusion in phakic eyes with PAC is associated with shallowing of ACD.

[Incidence of the uveal pseudoexfoliation syndrome in patients with diabetes mellitus]. / Incidenta sindromului de pseudoexfoliere uveala la pacientii cu diabet zaharat.

PURPOSE: To study the incidence of the uveal pseudoexfoliation syndrome in diabetic patients with or without diabetic retinopathy. MATERIAL AND METHOD: There were studied a group of diabetic patients with different ages, with or without diabetic retinopathy; the control group was represented by the non-diabetic patients with similar ages. RESULTS: It has been recorded a high incidence of the uveal pseudoexfoliation syndrome in diabetic patients compare with non-diabetic patients at the same age. CONCLUSIONS: It seems that uveal pseudoexfoliation syndrome is determined by a collagen metabolic alteration which is also present in diabetes mellitus, among other metabolic alterations; this will be the explication for high incidence in diabetic patients.

Clinical features of ocular toxocariasis in Japan.

PURPOSE: To characterize the clinical features of ocular toxocariasis and to describe the unique aspects of the disease in Japan. METHODS: Thirty-six cases diagnosed as ocular toxocariasis at the uveitis clinic of Tokyo Medical University Hospital were analyzed retrospectively. RESULTS: Thirty-six cases comprised 34 adults (average age: 39 +/- 10 years) and two nine-year-old boys. All cases were classified into two clinical types: posterior pole type (13 cases) and peripheral type (23 cases). Visual acuity was maintained over 20/20 in 50% and less than 20/200 in 14% of the cases. The peripheral type had worse outcomes than the posterior pole type in all of the endpoints examined: final visual outcome, frequency of ocular complications, and effectiveness of vitreous surgery. Antibody titers in intraocular fluids led to a diagnosis of ocular toxocariasis in eight seronegative cases of 33 cases examined for antibodies in both serum and intraocular fluid samples. CONCLUSIONS: The peripheral type had a worse prognosis than the posterior pole type. However, in general, ocular toxocariasis resulted in fair visual outcomes. The antibody titer in intraocular fluid was helpful in the diagnosis.

Frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract.

AIM: To determine the frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract. METHODS: The records of 106 eyes (74 patients) with atopic cataract that underwent cataract extraction were reviewed. The frequency of ciliary body or retinal breaks and retinal detachment was classified by their presence preoperatively and postoperatively, and by cataract type. RESULTS: Breaks were detected preoperatively in 27 eyes (25.5%) of 17 patients in the ciliary body (20 eyes, 18.9%), near the ora serrata (five eyes, 4.7%), and in undefined locations (two eyes, 1.9%). Among these, 16 eyes (15.1%) had already developed retinal detachment. After surgery, a ciliary body break occurred in one eye (0.9%) and retinal detachment in four eyes (3.8%) of three patients. The breaks that caused postoperative retinal detachment were in the ciliary body. When classified by cataract type, the highest frequency of breaks was associated with mature cataracts (35.0%), and all eyes with breaks developed retinal detachment. CONCLUSIONS: One fourth of eyes with atopic cataract had breaks in the ciliary body or ora serrata, or retinal detachment preoperatively. The highest frequency of either breaks or retinal detachment was associated with mature cataract. The frequency of breaks or detachment that occurred postoperatively (approximately 5%) was lower than that present preoperatively.

The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study.

OBJECTIVE: The aim of this study was to determine the prevalence of the major extraintestinal manifestations of inflammatory bowel disease (IBD) and their relation to disease diagnosis and gender. METHODS: We used the population-based University of Manitoba IBD Database, which includes longitudinal files on all subjects of all health system contacts identified by International Classification of Diseases, 9th Revision, Clinical Modification codes for visit diagnosis. We extracted a cohort from our database, which included subjects with a known diagnosis of IBD for at least 10 yr. We then determined how many contacts each subject had for each of the following extraintestinal IBD-associated immune diseases: primary sclerosing cholangitis, ankylosing spondylitis, iritis/uveitis, pyoderma gangrenosum, and erythema nodosum. We calculated the prevalence of the extraintestinal diseases using an administrative definition of having at least five health system contacts for the diagnosis in question. This administrative definition has previously been validated in Crohn's disease and ulcerative colitis (UC). RESULTS: A total of 6.2% of patients with IBD had one of six major extraintestinal diseases studied in this report. Only 0.3% of patients had multiple extraintestinal diseases. Iritis/uveitis was the most common extraintestinal disease of all assessed (2.2% of women and 1.1% of men). Iritis/uveitis was more common among women, particularly those with UC (3.8%). Primary sclerosing cholangitis was most common among men with UC (3%). Ankylosing spondylitis was more common among men, and the highest rate was seen among men with Crohn's disease (2.7%). Pyoderma gangrenosum was more common in Crohn's (1.2%) with no gender predilection. Erythema nodosum was similarly present in Crohn's and UC but was more common among women (1.9%). CONCLUSIONS: The associations of immune mediated diseases in extraintestinal sites may help us to further our understanding of IBD pathogenesis, and it may help us in developing a paradigm of disease subsets.

Ultrasound biomicroscopy of ciliary body cysts.

PURPOSE: To report the incidence and sector distribution of ciliary body cysts in normal subjects and to assess association with age using ultrasound biomicroscopy. METHODS: We prospectively examined 232 eyes of 116 normal subjects (51 men and 65 women) ranging in age from 15 to 84 years (mean +/- SD, 45.2 +/- 20.1). Complete ophthalmic examination, including gonioscopy and ophthalmoscopy with mydriasis, was performed. In addition, the circumference of the ciliary body was divided into eight sectors, and scanned in transverse and radial sections by high-resolution ultrasound biomicroscope to determine the incidence, distribution, and location of cysts. RESULTS: Based on one randomly chosen eye from each subject, cysts were detected in 63 (54.3%) of the 116 subjects. Cysts were found most frequently and in greater numbers in the inferior and temporal sectors. The incidence and the distribution range, expressed as the number of involved sectors per eye, were 73.1% and 3.8, respectively, for subjects 20 approximately 29 years old; both incidence and the number of involved sectors decreased with age (P = .0001). Cyst diameter ranged from 200 to 2500 microm; mean size decreased with age (P = .001). Gender and refractive error did not affect the incidence and distribution. There was significant bilateral correlation in the number, incidence, and distribution of ciliary body cysts. CONCLUSION: Ultrasound biomicroscopy disclosed a high incidence of ciliary body cysts in normal subjects, which decreased with age. Cysts were multiple and bilateral in many subjects.

Choroideremia. A clinical and genetic study of 84 Finnish patients and 126 female carriers.

The aim of this work was to identify the choroideremia families in northern Finland, form an impression of the incidence of the disease in Finland, construct a picture of its clinical progression and gather new information on relevant genetic questions. A total of 111 choroideremia patients and 188 carriers were traced, members of four families from northern Finland and one from the Savo district. Ophthalmological confirmation was obtained for 84 choroideremia cases and 126 carriers. The largest of the families from northern Finland contained 80 cases of the disease and 146 carriers in eight generations among a total of more than 3000 descendants from one ancestral mother. The clinical picture for choroideremia proved to be more variable than could have been supposed from the literature, including cases of patients under 30 years of age who were already virtually blind and of patients of over 50 who were subjectively symptom-free. Only 7 out of 105 carriers could be shown anamnestically to have had subjective symptoms, but surprisingly, as many as 21 out of 52 carriers examined had changes in the visual field and 13 out of 40 examined showed deterioration in dark adaptation. One carrier was seen to undergo an obvious decline in dark adaptation during a three-year observation period. One indirect indication of the progression of fundus changes in choroideremia carriers was obtained from the fact that these changes, and also alterations in visual field and dark adaptation, were greater in the older carriers. A progression could also be detected by fundus photography in six instances, although the changes involved were fairly mild ones. Considerable variety was noted in the fundus findings for the choroideremia carriers, there being some 80-year-old subjects with quite minor changes and some 20-year-olds with obvious, extensive changes. Practical visual acuity remained normal throughout life in the majority of the carriers, however. Diagnosis within the known choroideremia families was fairly difficult, especially at the early stages in the survey, and even later on a few cases aged up to ten years produced diagnostic problems. Quite often diagnosis was easy, however, and choroideremic fundus changes were even identified in two boys aged 3 and 8 months. No other diseases could be shown to be associated with choroideremia, and the occurrence of dominantly inherited olivopontocerebellar atrophy alongside choroideremia in one branch of a family may be regarded as a coincidence.(ABSTRACT TRUNCATED AT 400 WORDS)

A study of ocular complications in leprosy.

A total of 380 leprosy patients were studied in four different leprosy hospitals. The involvement of eye was found in 18.95% of cases in which 10.97% in lepromatous leprosy and 8.16% in non-lepromatous leprosy cases. In total cases studied 52.63% were of lepromatous leprosy and 47.37% of non lepromatous leprosy cases. Among them 11.05% were males and 18.95% were females. In 72 cases of ocular involvement, males constituted 80.56% and females 19.44% of cases. Maximum cases (52.78%) of ocular involvement were in leprosy patient with 5 to 10 years of duration. Blindness among the total leprosy patients studied was 1.84% which was mainly due to corneal opacity following exposure keratitis and ulceration, iridocyclitis and its complications.