ABSTRACT
ABSTRACT This report aims to describe the effectiveness of a unilateral intravitreal dexamethasone implant (Ozurdex®) used for the treatment of cystoid macular edema in a patient with recurrent intermediate uveitis. Bearing in mind the adverse effects of the prolonged use of systemic corticosteroids, the objective here was to provide a less damaging form of intervention, and also to demonstrate the safety of the dexamethasone implant for patients who fail to respond to conventional treatment. In the present case, there was bilateral improvement in retinal anatomy and function with use of the unilateral intravitreal dexamethasone implant (Ozurdex®).
RESUMO Neste estudo, o objetivo foi descrever, a partir de um relato de caso, a eficácia do uso de implante de dexametasona intravítrea (Ozurdex®) unilateral, para o tratamento de edema macular cistoide, em um paciente com quadro de uveíte intermediária recorrente, visando uma terapêutica menos lesiva, diante dos efeitos colaterais do uso prolongado de corticoesteroides sistêmicos, demonstrando também a segurança desse tratamento alternativo para aqueles pacientes que se apresentam refratários a terapêutica tradicional. No caso relatado, vale ressaltar a melhora bilateral da anatomia e função retiniana com o implante unilateral de dexametasona intravítrea (Ozurdex®).
Subject(s)
Humans , Female , Middle Aged , Dexamethasone/administration & dosage , Uveitis, Intermediate/complications , Macular Edema/etiology , Macular Edema/drug therapy , Visual Acuity , Uveitis, Intermediate/diagnosis , Macular Edema/diagnosis , Tomography, Optical Coherence , Drug Implants/administration & dosage , Intravitreal InjectionsABSTRACT
Intermediate uveitis (IU) is described as inflammation in the anterior vitreous, ciliary body and the peripheral retina. In the Standardization of Uveitis Nomenclature (SUN) working group's international workshop for reporting clinical data the consensus reached was that the term IU should be used for that subset of uveitis where the vitreous is the major site of the inflammation and if there is an associated infection (for example, Lyme disease) or systemic disease (for example, sarcoidosis). The diagnostic term pars planitis should be used only for that subset of IU where there is snow bank or snowball formation occurring in the absence of an associated infection or systemic disease (that is, “idiopathic”). This article discusses the clinical features, etiology, pathogenesis, investigations and treatment of IU.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Cryotherapy/methods , Diagnosis, Differential , Fluorescein Angiography/methods , Fundus Oculi , Humans , Immunity, Cellular/immunology , Immunosuppressive Agents/therapeutic use , Microscopy, Acoustic/methods , Ophthalmoscopy/methods , Prognosis , T-Lymphocytes/immunology , Uveitis, Intermediate/diagnosis , Uveitis, Intermediate/etiology , Uveitis, Intermediate/therapy , Vitrectomy/methodsABSTRACT
The aim of current study was to evaluate the incidence and characteristics of ocular sarcoidosis in a Korean population. We conducted a retrospective study of 104 consecutive patients with biopsy-proven sarcoidosis seen at Asan Medical Center in Seoul, Korea, from 1993 to 2007. Medical records, photographs, and fluorescein angiograms were reviewed. Of 104 patients, 22 (21%) had intraocular involvement with female predominance (86%, M:F=3:19). Of the 39 eyes with ocular involvement, 16 (41%) eyes had isolated anterior uveitis, 12 (31%) eyes had intermediate uveitis, 6 eyes (15%) had panuveitis with retinal vasculitis, and 5 (13%) eyes had panuveitis with punched multifocal choroiditis. Mean duration of ophthalmologic follow-up was 62 months. All ocular inflammation was well managed with topical steroid and/or systemic steroid with relatively good final visual outcomes. Ocular complications such as cataract (12 eyes, 30%), glaucoma (6 eyes, 15%), vitreous opacity (1 eye, 3%), cystoid macular edema (3 eyes, 7%), neovascularization (2 eye, 5%), and epiretinal membrane (4 eye, 10%) were related to ocular sarcoidosis. In Korea, where sarcoidosis is very rare, our study indicates relatively low ocular and predominantly non posterior segment involvement with relatively good visual prognosis.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Age Factors , Asian People , Choroiditis/diagnosis , Eye Diseases/diagnosis , Fluorescein Angiography , Retinal Vasculitis/diagnosis , Retrospective Studies , Sarcoidosis/diagnosis , Steroids/therapeutic use , Uveitis, Anterior/diagnosis , Uveitis, Intermediate/diagnosisABSTRACT
The aim of current study was to evaluate the incidence and characteristics of ocular sarcoidosis in a Korean population. We conducted a retrospective study of 104 consecutive patients with biopsy-proven sarcoidosis seen at Asan Medical Center in Seoul, Korea, from 1993 to 2007. Medical records, photographs, and fluorescein angiograms were reviewed. Of 104 patients, 22 (21%) had intraocular involvement with female predominance (86%, M:F=3:19). Of the 39 eyes with ocular involvement, 16 (41%) eyes had isolated anterior uveitis, 12 (31%) eyes had intermediate uveitis, 6 eyes (15%) had panuveitis with retinal vasculitis, and 5 (13%) eyes had panuveitis with punched multifocal choroiditis. Mean duration of ophthalmologic follow-up was 62 months. All ocular inflammation was well managed with topical steroid and/or systemic steroid with relatively good final visual outcomes. Ocular complications such as cataract (12 eyes, 30%), glaucoma (6 eyes, 15%), vitreous opacity (1 eye, 3%), cystoid macular edema (3 eyes, 7%), neovascularization (2 eye, 5%), and epiretinal membrane (4 eye, 10%) were related to ocular sarcoidosis. In Korea, where sarcoidosis is very rare, our study indicates relatively low ocular and predominantly non posterior segment involvement with relatively good visual prognosis.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Age Factors , Asian People , Choroiditis/diagnosis , Eye Diseases/diagnosis , Fluorescein Angiography , Retinal Vasculitis/diagnosis , Retrospective Studies , Sarcoidosis/diagnosis , Steroids/therapeutic use , Uveitis, Anterior/diagnosis , Uveitis, Intermediate/diagnosisABSTRACT
Os autores relatam um caso de paciente do sexo feminino de meia idade, com uveíte intermediária idiopática e edema de cistóide bilateral, além da ausência de "snow banks" ou "snow balls" na pars plana deste paciente. Näo foram detectados, no caso descrito, associaçäo com HLA-BB, B51, DR2 nem com patologia sistêmica. Sugerem que este caso apresentado faça parte de um grupo especial de pacientes, recentemente relatado, a partir da análise do caso por Folk, J.,um dos autores desta recente série sobre este grupo de pacientes, predominantemente de mulheres da IOWA University.
Subject(s)
Humans , Female , Adult , Macular Edema , Uveitis, Intermediate/diagnosis , Uveitis, Intermediate/rehabilitation , Fluorescein Angiography , Visual AcuityABSTRACT
Os autores estudaram 60 pacientes portadores de uveíte intermediária, analisando os dados obtidos em relaçäo ao sexo, idade, lateralidade das lesöes, comprometimento vítreo e presença de vasculite e maculopatia. Foi também realizada uma correlaçäo entre vitreite, exsudaçöes periféricas e maculopatia.