Vitamin D status in active and inactive noninfectious uveitis - data from a reference university hospital in Rio de Janeiro, Brazil.

PURPOSE: This study aimed to investigate the correlation between serum vitamin D levels and disease activity in patients with noninfectious uveitis. METHODS: We conducted a prospective case-control study, assessing 51 patients with noninfectious uveitis, categorized into active (n=22) and inactive (n=29) groups, along with 51 healthy controls. Serum 25-hydroxy vitamin D [25(OH)D] levels were measured. The uveitis group also completed a questionnaire regarding sunlight exposure habits and vitamin D supplementation. RESULTS: Patients with inflammation-related uveitis exhibited low serum 25(OH)D levels in 68% of cases. The median 25(OH)D level in patients with active uveitis was 17.8 ng/mL (interquartile range [IQR], 15-21 ng/mL), significantly lower compared to the 31.7 ng/mL (IQR, 25-39 ng/mL) in patients with inactive uveitis (p<0.001) and the 27 ng/mL (IQR, 23-31 ng/mL) in the Control Group (p<0.001). Significantly, nearly all patients with uveitis taking vitamin D supplementation were in the Inactive Group (p<0.005). Moreover, reduced sunlight exposure was associated with active uveitis (p<0.003). Furthermore, patients with 25(OH)D levels below 20 ng/mL had ten times higher odds of developing active uveitis (p=0.001). CONCLUSIONS: This study revealed a prevalent 25(OH)D deficiency among patients with noninfectious uveitis and suggested a link between low 25(OH)D levels and disease activity. To prevent future episodes of intraocular inflammation, vitamin D supplementation and controlled sunlight exposure could be viable options.

Uso de ciclosporina 0.05% tópica no tratamento do olho seco de pacientes portadores do vírus HIV / Topical cyclosporine 0.05% for the treatment of dry eye disease in patients infected with the human immunodeficiency virus

Objetivo: O presente estudo comparou a eficácia do tratamento da síndrome do olho seco em pacientes infectados pelo HIV com suplementação lacrimal (carboximetilcelulose sódica 0,5%) ou com suplementação lacrimal associada à terapia anti-inflamatória (carboximetilcelulose sódica 0,5% e ciclosporina 0,05%). Métodos: Vinte pacientes portadores do vírus HIV provenientes do ambulatório de Infectologia do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro foram selecionados. O diagnóstico de síndrome do olho seco foi baseado no questionário para olho seco (Ocular Surface Disease Index - OSDI®), teste de Schirmer I, tempo de ruptura do filme lacrimal e coloração da superfície ocular com rosa bengala a 1%. Os pacientes foram distribuídos em dois grupos com dez pacientes (20 olhos) e acompanhados durante seis meses. O grupo I foi tratado com colírio de carboximetilcelulose sódica 0,5% e o grupo II foi tratado com a associação decarboximetilcelulose sódica 0,5% e ciclosporina 0,05% tópica. Resultados: Comparando os resultados no início e no final do tratamento, a associação com ciclosporina 0,05% mostrou-se superior (p < 0,05) para o teste de Schirmer I. Conclusão: O presente estudo sugere que o uso de ciclosporina 0,05% tópica melhora a produção lacrimal em pacientes infectados pelo HIV, apresentando um importante papel como adjuvante no tratamento do olho seco nestes pacientes.

Purpose: This study evaluates the use of topical cyclosporine 0.05% and sodium carboxymethylcellulose 0.5% for the treatment of dry eye disease in patientsinfected with the human immunodeficiency virus. Methods: Twenty HIV-positive-patients were selected from the Department of Infectious Diseases of the Federal University of Rio de Janeiro Hospital. Dry eye diagnosis was based on a dry eye questionnaire (Ocular Surface Disease Index - OSDI®), Schirmer I test, break up time and 1% rose bengal staining of the ocular surface. The patients were divided into two groups with ten patients (20 eyes). Group I received sodium carboxymethylcellulose0.5% drops and group II received sodium carboxymethylcellulose 0.5% drops and topical cyclosporine 0.05% for six months. Results: Comparing the results at the beginning and in the end of the treatment, the use of cyclosporine was superior (p < 0.05) for the Schirmer I test. Conclusion:This study suggests that topical cyclosporine improves lacrimal production and has animportant role as an adjuvant therapy for dry eye disease in patients infected with the human immunodeficiency virus.