The Pattern of Uveitis in a Pediatric Population at a Tertiary Center in Thailand.

PURPOSE: To describe the clinical characteristics and longitudinal pattern of visual acuity (VA) of pediatric patients with uveitis at a tertiary center in Thailand. METHODS: We retrospectively reviewed the records of children with uveitis ≤16 years who presented to the clinic between January 2010 and June 2020. RESULTS: The mean age at onset was 9.1(±4.3) years; the main characteristics were chronic (64.4%), unilateral (68.6%), and panuveitis (39%). The common etiologies were ocular toxoplasmosis (11.9%), herpetic uveitis (10.2%), and ocular toxocariasis (6.8%). Further, 40% of the eyes presented with VA of ≤20/200; mean VA at baseline improved from 0.93 to 0.72 logMAR at 3 months after presentation (P < .001), the baseline VA of ≤20/200 was significantly associated with poor VA outcome at 1 year. CONCLUSION: Chronic, unilateral, and panuveitis represented the majority of our children with uveitis. Infectious etiology was common. Significant VA improvement can be achieved with optimum management.

Clinical features and incidence of visual improvement following systemic antibiotic treatment in patients with syphilitic uveitis.

To describe the clinical features, longitudinal pattern, and incidence rate of improvement of visual acuity (VA) following antibiotic therapy in patients with syphilitic uveitis. A total of 36 patients were included in this retrospective study from 2009 to 2020. The longitudinal patterns of mean VA values during follow-up were analyzed using a linear mixed model. Most patients were men with HIV coinfection (81%) and presented with panuveitis (49%). The mean VA at baseline improved from 0.97 to 0.39 logMAR at 6 months and remained stable thereafter. The cumulative incidence of VA ≥ 20/25 achieved by 2 years was 70%. Receiving antibiotic therapy within four weeks of the onset of ocular symptoms (adjusted hazard ratio [aHR] 3.4, P = 0.012), absence of HIV coinfection (aHR 8.2, P < 0.001), absence of neurosyphilis (aHR 6.5, P = 0.037), better presenting VA (aHR 5.0, P = 0.003), and intermediate uveitis as opposed to panuveitis (aHR 11.5, P = 0.013) were predictive of achieving VA ≥ 20/25. Men with HIV coinfection represented the majority of our patients. Visual outcomes, in response to antibiotics, were favorable. Delayed treatment, poor presenting VA, presence of HIV coinfection, and concomitant neurosyphilis decreased the likelihood of VA restoration.

Outcomes of a postoperative perfluorocarbon liquid tamponade for complex retinal detachments: 12 years of experience in southern Thailand.

BACKGROUND: The study evaluates both functional and anatomical outcomes of retinal detachment (RD) repair by vitrectomy and perfluorocarbon liquid (PFCL) tamponade. METHODS: A retrospective chart review of patients who underwent vitrectomy using PFCL tamponade for RD repair from causes such as giant tear, chronic RD, or RD with previously failed surgery. RESULTS: This study included 122 eyes from 121 patients. One-hundred fourteen eyes (93.5%) had baseline vision worse than 20/200. The median duration of intraocular PFCL retainment was 14 days before gas or silicone oil replacement. The retinal reattachment rate was 80.3%. At 1 year, the retention probability of retinal reattachment was 0.84 (95% confidence interval, 0.77-0.91). Although visual improvement was found in 45.9% of patients, the median of final vision was not different between baseline and the last visit. CONCLUSION: The rate of retinal reattachment operated with a short- to medium-term PFCL tamponade achieved a high satisfaction rate. However, postoperative hypotony was a predictor for unfavorable visual and anatomical outcomes.

Incidence Rates and Risk Factors for Vision Loss among AIDS-Related Cytomegalovirus Retinitis Patients in Southern Thailand.

PURPOSE: To describe the incidence of and risk factors for visual acuity (VA) loss in patients with AIDS and cytomegalovirus (CMV) retinitis. METHODS: A total of 132 patients were included. The main outcome measurements were the incidences of VA loss to ≤20/50 and ≤20/200. RESULTS: The incidences of VA loss to ≤20/50 and ≤20/200 were 0.22/eye-year (EY) and 0.12/EY, respectively. Risk factors for the incidence of VA loss to ≤20/50 were low nadir CD4+ T-cell count (adjusted hazard ratio [aHR], 3.1), large area of retinitis (aHR, 3.7), and no immune recovery (IR) (aHR, 13.9). Risk factors for the incidence of VA loss to ≤20/200 were not receiving highly active antiretroviral therapy (HAART) (aHR, 4.4) and large retinitis area (aHR, 2.1). CONCLUSIONS: The incidence of VA loss in eyes affected by CMV retinitis was high. The use of HAART, particularly with subsequent immune recovery, substantially reduced the incidence of VA loss.