Study of association of CTLA4 gene variants to non-anterior uveitis.

This study was undertaken to investigate the possible genetic association of functional CTLA4 polymorphisms with susceptibility to non-anterior uveitis. Four hundred and seventeen patients with endogenous non-anterior uveitis and 1517 healthy controls of Spanish Caucasian origin were genotyped for the CTLA4 polymorphisms rs733618, rs5742909 and rs231775, using predesigned TaqMan(©) allele discrimination assays. PLINK software was used for the statistical analyses. No significant associations between the CTLA4 polymorphisms and susceptibility to global non-anterior uveitis were found. It was also the case when the potential association of these genetic variants with the anatomical localization of the disease, such as intermediate, posterior or panuveitis, was assessed. Our results do not support a relevant role of these CTLA4 polymorphisms in the non-anterior uveitis genetic predisposition.

[OCT in acute anterior uveitis]. / OCT en uveítis anteriores agudas.

PURPOSE: To evaluate macular thickening, the state of the optic disc and retinal nerve fibers layer (RFNL) in patients with an actual episode of acute anterior uvetis (AAU) by optical coherence tomography (OCT), and compare them with a control group. METHODS: In this prospective, cross-sectional, observational and controlled study we recruited 27 consecutive eyes of 20 patients with an actual episode of AAU, age and sex-matched with 40 healthy eyes of 20 volunteers. The age ranged between 8 and 78 years old, and all were evaluated by the <>, <> and <> scans by OCT. The patients were evaluated twice in a period of 1 month in order to obtain an average between the two measurements by OCT. RESULTS: We found a statistically significant increase in macular volume in AAU eyes compared with control eyes. Total macular volume in uveitic eyes was 7.3 SD 0.6 mm(3) and in healthy eyes was 7.01 SD 0.3 mm(3) (mean SD standard deviation) (p<0.001). Indeed, we found a statistically significant increase in the superior RFNL thickness compared with controls. The Smax/Imax measurement was 1.05 SD 0.1 in pathological eyes and in healthy eyes it was 0.97 SD 0.1 (p<0.02). CONCLUSION: We found by OCT that patients suffering an AAU showed an increase in macular volume and superior RFNL thickness versus control eyes in the acute episode.

[Spontaneous primary uveal effusion syndrome]. / Síndrome de efusión uveal espontáneo.

CLINICAL CASE: This was a 73 year-old male patient who developed an apparent uveal effusion syndrome in his right eye one year after cataract surgery. Once possible associated conditions were discarded, a diagnosis of spontaneous uveal effusion syndrome was reached. With appropriate systemic steroid therapy, a favourable response occurred. DISCUSSION: The diagnosis of uveal effusion may sometimes be difficult to establish. In order to diagnose and manage these patients, a detailed clinical examination along with fluorescein angiography, ultrasonography, ultrasound biomicroscopy (UBM) and magnetic resonance imaging (MRI) tests, must be carried out.

Anterior uveitis and meningococcemia: a case report.

PURPOSE: To describe a case of meningococcemia with anterior uveitis. METHODS: Observational case report. RESULTS: A 38-year-old woman developed meningococcal septicemia caused by Neisseria meningitidis type B. During her admission, she had pain in her left eye, inflammatory cells, and a fibrinous exudate in the anterior chamber and multiple posterior synechiae, all in the context of an anterior uveitis. She was treated with topical steroids and mydriatics with resolution of ocular inflammation. CONCLUSIONS: This case illustrates the possible association between anterior uveitis and a meningococcal septicemia, and the need for careful ophthalmologic examination when a red eye develops in this clinical context.

[Retinal neovascularization in a traumatic microhyphema]. / Neovascularización retiniana en microhifema traumático.

CLINICAL CASE: This is a case of retinal ischaemia with subsequent neovascularization, in a 13 year-old boy who sustained a traumatic hyphema after blunt trauma. DISCUSSION: Hyphemas can occur after blunt trauma, intraocular surgery, spontaneously and in association with the use of substances that alter platelet or thrombin function (aspirin, ethanol). Associated injuries are traumatic anterior uveitis, iridodialysis, optic atrophy, secondary hemorrhage and a traumatic cataract. This case illustrates the formation of retinal neovascularization in association with a microhyphema and the need for careful and prolonged ophthalmological examination in this clinical context.