The Presence of Pigmentation on Central Anterior Lens Capsule in the Human Leukocyte Antigen B27-Associated Anterior Uveitis and Its Value in Clinical Diagnosis.

PURPOSE: To report on the value of presence of pigmentation on central anterior lens capsule (PioLe) in HLA B27- associated anterior uveitis (HLA B27-AU). METHODS: 268 patients (320 eyes) with AU were reviewed. Two diagnostic models to predict probability of HLA-B27-AU were developed. The first model included 6 variables (age, gender, unilaterality, presence of non-granulomatous keratic precipitates, hypopyon, and intraocular pressure (IOP). The second model was developed to investigate the added value of PioLe into the first model. RESULTS:      Unilaterality, presence of hypopyon, IOP <21 mmHg and PioLe were characteristic for HLA-B27 positive patients (P≤0.003 for all). All of 6 variables had area under receiver operating characteristic curves (AuROC) ≤ 60, but PioLe reached even higher value (65.5). Diagnostic model I and II had AuROC 76.3% (95%CI, 68.4%-84.2%) and 80.0% (95%CI, 72.6%-87.5%), respectively. CONCLUSIONS: Unilaterality, hypopyon, IOP <21 mmHg and presence of PioLe are clinical signs suggesting HLA B27- AU.

Blindness and low vision in a tertiary ophthalmologic center in Thailand: the importance of cytomegalovirus retinitis.

PURPOSE: To determine the causes of blindness and low vision in patients consulting a tertiary ophthalmologic center in northern Thailand. METHODS: The study population included 2,951 new consecutive patients from the Department of Ophthalmology at University Hospital in Chiang-Mai, Thailand. Main outcome measures were blindness and low vision, which were defined according to World Health Organization criteria. RESULTS: Of 2,951 patients, 369 (12.5%) had blindness and/or low vision (bilateral blindness in 73, unilateral blindness in 129, bilateral low vision in 77, and unilateral low vision in 90). Of the etiological causes of visual loss, age-related ocular disease was the most frequent (128 patients [35%]) followed by infections (66 patients [18%]) and trauma (43 patients [12%]). Although infections and trauma were the predominant causes of blindness, age-related disorders were frequently found in patients with low vision. Of anatomical sites, the lens (134 patients [36%]) was the main location of visual loss, closely followed by disorders of the retina and/or uvea (126 patients [34%]). Blindness and low vision were considered avoidable in 70% of cases. Of 73 patients with bilateral blindness, 14 had active cytomegalovirus retinitis, accounting for 19% of all patients with bilateral blindness. CONCLUSION: The most common causes of blindness and low vision in a tertiary center in northern Thailand were age-related ocular disorders and infections, which were predominantly cases of cytomegalovirus retinitis in human immunodeficiency virus-infected patients.