Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.763
Filtrar
3.
Ophthalmologie ; 120(1): 108-122, 2023 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-36633629

RESUMO

Acute anterior uveitis (AAU) associated with human leukocyte antigen (HLA) B27 is the most common form of noninfectious intraocular inflammation and is considered to be a separate clinical entity. Young adults between the ages of 20 and 40 years are predominantly affected. The HLA-B27 positive AAU typically presents as a unilateral, fulminant disruption of the blood-aqueous humor barrier, which is accompanied by pronounced cellular infiltration and fibrinous exudation. Other characteristics are reduced intraocular pressure and a high tendency to relapse, which can also involve the partner eye. Patients with HLA-B27 positive AAU share a high risk for other genetically associated diseases, especially spondylarthritis, chronic inflammatory bowel diseases and psoriasis. As up to 40% of those affected have a systemic disease that has not yet been diagnosed, the ophthalmologist is of major importance for early detection.


Assuntos
Espondilartrite , Uveíte Anterior , Uveíte , Adulto Jovem , Humanos , Adulto , Antígeno HLA-B27/genética , Uveíte Anterior/diagnóstico , Inflamação , Doença Aguda
4.
Sci Rep ; 13(1): 1256, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36690619

RESUMO

Undifferentiated uveitis (intraocular inflammation, IOI) is an idiopathic sight-threatening, presumed autoimmune disease, accountable for ~ 10% of all blindness in the developed world. We have investigated the association of uveitis with inflammatory bowel disease (IBD) using a mouse model of spontaneous experimental autoimmune uveoretinitis (EAU). Mice expressing the transgene (Tg) hen egg lysozyme (HEL) in the retina crossed with 3A9 mice expressing a transgenic HEL-specific TCR spontaneously develop uveoretinitis at post-partum day (P)20/21. Double transgenic (dTg TCR/HEL) mice also spontaneously develop clinical signs of colitis at ~ P30 with diarrhoea, bowel shortening, oedema and lamina propria (LP) inflammatory cell infiltration. Single (s)Tg TCR (3A9) mice also show increased histological LP cell infiltration but no bowel shortening and diarrhoea. dTg TCR/HEL mice are profoundly lymphopenic at weaning. In addition, dTg TCR/HEL mice contain myeloid cells which express MHC Class II-HEL peptide complexes (MHCII-HEL), not only in the inflamed retina but also in the colon and have the potential for antigen presentation. In this model the lymphopenia and reduction in the absolute Treg numbers in dTg TCR/HEL mice is sufficient to initiate eye disease. We suggest that cell-associated antigen released from the inflamed eye can activate colonic HEL-specific T cells which, in a microbial micro-environment, not only cause colitis but feedback to amplify IOI.


Assuntos
Apresentação de Antígeno , Doenças Autoimunes , Colite , Uveíte , Animais , Camundongos , Antígenos , Diarreia , Antígenos de Histocompatibilidade Classe II , Camundongos Transgênicos , Receptores de Antígenos de Linfócitos T
6.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 39(1): 81-87, 2023 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-36631019

RESUMO

Uveitis is a common ocular disease and may cause serious damage of visual function. The pathogenesis of uveitis is closely related to its autoimmune response. The Th1 cells and Th17 cells were identified to play a key role in the occurrence of autoimmune uveitis and experimental autoimmune uveitis, whilst the Th17 cells were found to be closely associated with disease recurrence. The regulatory T cells (Tregs) were found to be involved in the regression of inflammation. The dysfunction and ratio of Tregs were the major causes for persistence and recurrence of uveitis. Th17 cells and Tregs can also interconvert with each other under certain conditions. Regulating the Th17/Tregs balance might be a potential novel approach to alleviating inflammation and hence providing the treatment for uveitis.


Assuntos
Doenças Autoimunes , Uveíte , Humanos , Animais , Uveíte/patologia , Inflamação , Linfócitos T Reguladores , Células Th1 , Células Th17 , Modelos Animais de Doenças
7.
Zhonghua Yan Ke Za Zhi ; 59(1): 63-67, 2023 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-36631061

RESUMO

Uveitis is a common sight-threatening ocular disease that has multiple heterogeneous clinical entities, complicated pathogenesis, and a high complication rate. The visual impairment caused by uveitis, the side effects of long-term systemic therapy, and the economic burden due to the high cost of treatment have a significant impact on the patient's physical, psychological, and social functions, resulting in a decrease in the quality of life of uveitis sufferers. Accurate assessment of patients' quality of life is helpful to guild treatment, enhance compliance and improve patients' overall quality of life. This article reviews the current progress on the quality of life assessment scales and psychological assessment tools to evaluate overall quality of life in patients with uveitis, thereby to provide reference and theoretical basis for selecting and developing the quality of life assessment tools for uveitis patients.


Assuntos
Uveíte , Baixa Visão , Humanos , Qualidade de Vida , Uveíte/tratamento farmacológico , Visão Ocular , Baixa Visão/complicações , Acuidade Visual
8.
Sci Rep ; 13(1): 277, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609436

RESUMO

Polycystic ovary syndrome (PCOS) is a common endocrine disease in young women. It has been reported that increased proinflammatory cytokines can induce systemic inflammation. However, the association between PCOS and uveitis remains elusive. In this study, we investigate the possible association between PCOS and uveitis using Korean National Health Insurance Service-National Sample Cohort. The incidence of non-infectious uveitis was compared between patients with and without PCOS before and after propensity score matching. Hazard ratios were determined using univariate and multivariate Cox regression models. Of 558,302 female participants, 2039 had PCOS and 8122 had non-infectious uveitis. The incidence of non-infectious uveitis was 35.1 per 10,000 person-years in the PCOS patients compared to 16.6 in non-patients (P < .001). This tendency remained after 1:3 propensity score matching. The hazard ratio of PCOS using a multivariate Cox regression model was 2.79 (95% CI, 1.92-4.05; P < .001) and 2.87 (95% CI, 1.77-4.67; P < .001) before and after matching, respectively. Our results suggests that PCOS is associated with non-infectious uveitis, particularly in women of reproductive age. This may be due to hormonal changes and proinflammatory factors. Future investigations should examine the clinical features and underlying mechanisms.


Assuntos
Síndrome do Ovário Policístico , Uveíte , Feminino , Humanos , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Fatores de Risco , Modelos de Riscos Proporcionais , Uveíte/etiologia , Uveíte/complicações
9.
Asia Pac J Ophthalmol (Phila) ; 12(1): 44-57, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36588192

RESUMO

PURPOSE: The purpose of this study is to present the diagnostic and therapeutic algorithms, complications, and final outcome in the management of uveitic patients at a tertiary academic referral center. DESIGN: Observational study. METHODS: Analysis of the archives of 6191 uveitic patients at the Ocular Inflammation Service of the Department of Ophthalmology of the University Hospital of Ioannina in Greece from 1991 to 2020. RESULTS: During the 30 years of the study, the diagnostic ability climbed from 45.43% (1991-1995) to 73.4% (2016-2020). This improvement was linked to several factors including the increase in the number of diagnostic paracenteses for the analysis of intraocular fluids, the range and quality of laboratory blood tests, the multimodal ophthalmic imaging, the proper use of nonophthalmic imaging, and the multidisciplinary approach. The degree of uveitis-related complications was related to the severity and cause of inflammation, the recurrence rate, inappropriate treatment, and the prolonged or initially inactive inflammation. The 3 most common complications included cataract, macular edema, and glaucoma. Apart from the modern treatments and surgical techniques, the 3-month preoperative control of inflammation played a critical role in the surgical outcomes. The percentage of patients with a successful outcome increased from 72% (2001-2005) to 90.50% (2016-2020). The center's experience, prompt referral, patient's compliance, and regular follow-ups are associated with a better outcome. The analysis of the results allowed the development of diagnostic and therapeutic algorithms. CONCLUSIONS: Developing diagnostic and therapeutic algorithms allows for the efficient management of uveitis, leading to better visual outcome and therefore a better quality of life.


Assuntos
Glaucoma , Uveíte , Humanos , Qualidade de Vida , Uveíte/diagnóstico , Uveíte/terapia , Uveíte/complicações , Glaucoma/cirurgia , Olho , Inflamação , Estudos Retrospectivos , Resultado do Tratamento
10.
RMD Open ; 9(1)2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36635002

RESUMO

BACKGROUND/PURPOSE: The manifestations of uveitis are well established in axial spondyloarthritis (ax-SpA), but not in psoriatic arthritis (PsA). We aimed to assess, in a large unselected series of PsA: (A) the frequency and clinical features of uveitis; (B) its association with PsA activity, the impact of disease and functional disability, and (C) its relationship with the biological treatment. In addition, a literature review was performed. METHODS: Retrospective longitudinal study of PsA patients from a single referral hospital. PsA was classified according to the CASPAR criteria, and uveitis was diagnosed by experienced ophthalmologists. RESULTS: We studied 406 patients with PsA (46.3±12.3 years). Uveitis was observed in 20 (4.9%). Uveitis was acute in all cases, anterior (80%), unilateral (80%) and recurrent (50%). Patients with uveitis had a higher prevalence of HLA-B27 (45% vs 7.5%, p<0.0001), sacroiliitis on MRI (25% vs 8.3% p=0.027), ocular surface pathology (10% vs 0.8%, p=0.021), and median PsA impact of Disease Score (5.9 (2.1-6.8) vs 1.25 (0.0-3.0), p=0.001) and Bath Ankylosing Spondylitis Functional Index (4 (1.6-5) vs 1.0 (0.0-3.5), p=0.01) than patients without uveitis.The exposure adjusted incidence rate (episodes/100 patients-year) of uveitis before versus after biological treatment decreased with anti-TNFα monoclonal antibodies (56.3 vs 9.4) and increased with etanercept (ETN) (6.03 vs 24.2) and secukinumab (SECU) (0 vs 50) (including only one patient treated in the last two cases). CONCLUSION: The prevalence of uveitis in patients with PsA was about 5%. The pattern was similar to that observed in ax-SpA. Uveitis was associated with a worse quality of life and greater functional disability. The uveitis exposure adjusted incidence rate decreased with anti-TNFα monoclonal antibodies and increased with ETN and SECU.


Assuntos
Artrite Psoriásica , Uveíte , Humanos , Artrite Psoriásica/complicações , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/tratamento farmacológico , Qualidade de Vida , Estudos Longitudinais , Estudos Retrospectivos , Universidades , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/epidemiologia , Etanercepte/uso terapêutico
11.
Cochrane Database Syst Rev ; 1: CD010469, 2023 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-36645716

RESUMO

BACKGROUND: Uveitis is a term used to describe a group of intraocular inflammatory diseases. Uveitis is the fifth most common cause of vision loss in high-income countries, with the highest incidence of disease in the working-age population. Corticosteroids are the mainstay of treatment for all subtypes of non-infectious uveitis. They can be administered orally, topically with drops, by periocular (around the eye) or intravitreal (inside the eye) injection, or by surgical implantation. OBJECTIVES: To determine the efficacy and safety of steroid implants in people with chronic non-infectious posterior uveitis, intermediate uveitis, and panuveitis. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE Ovid, Embase, PubMed, LILACS, and three trials registries to November 2021.  SELECTION CRITERIA: We included randomized controlled trials comparing either fluocinolone acetonide (FA) or dexamethasone (DEX) intravitreal implants with standard-of-care therapy or sham procedures, with at least six months of follow-up after treatment. We included studies that enrolled participants of all ages, who had chronic non-infectious posterior uveitis, intermediate uveitis, or panuveitis with vision that was better than hand-motion. DATA COLLECTION AND ANALYSIS: We applied standard Cochrane methodology. MAIN RESULTS: We included data from four trials (683 participants, 907 eyes) that compared corticosteroid implants with either sham or standard-of-care therapy. Study characteristics and risk of bias Of the two trials that compared corticosteroid implants with sham procedure, one examined a 0.18 mg FA implant, and the other, a 0.7 mg DEX implant. The other two trials compared a 0.59 mg FA implant with standard-of-care therapy, which included systemic corticosteroids and immunosuppressive medications, if needed. We assessed the four trials to be at either low risk, or with some concerns of risk of bias across all domains. Findings Using sham procedure as control, combined results at the six-month primary time point suggested that corticosteroid implants may decrease the risk of uveitis recurrence by 60% (relative risk [RR] 0.40, 95% confidence interval [CI] 0.30 to 0.54; 2 trials, 282 participants; low-certainty evidence); and lead to a greater improvement in best-corrected visual acuity (BCVA; mean difference [MD] 0.22 logMAR, 95% CI 0.13 to 0.31; 1 trial, 153 participants; low-certainty evidence). Evidence based on a single-study report (146 participants) suggested that steroid implants may have no effects on visual functioning quality of life, measured on the National Eye Institute 25-Item Visual Function Questionnaire (MD 2.85, 95%CI -3.64 to 9.34; 1 trial, 146 participants; moderate-certainty evidence). Using standard-of care therapy as control, combined estimates at the 24-month primary time point suggested that corticosteroid implants were likely to decrease the risk of recurrence of uveitis by 54% (RR 0.46, 95% CI 0.35 to 0.60; 2 trials, 619 eyes). Combined estimates at 24 months also suggested that steroid implants may have little to no effects on BCVA (MD 0.05 logMAR, 95% CI -0.02 to 0.12; 2 trials, 619 eyes; low-certainty evidence). Evidence based on a single-study report (232 participants) suggested that steroid implants may have minimal clinical effects on visual functioning (MD 4.64, 95% CI 0.13 to 9.15; 1 trial, 232 participants; moderate-certainty evidence); physical functioning (SF-36 physical subscale MD 2.95, 95% CI 0.55 to 5.35; 1 trial, 232 participants; moderate-certainty evidence); or mental health (SF-36 mental subscale MD 3.65, 95% CI 0.52 to 6.78; 1 trial, 232 participants; moderate-certainty evidence); but not on EuroQoL (MD 6.17, 95% CI 1.87 to 10.47; 1 trial, 232 participants; moderate-certainty evidence); or EuroQoL-5D scale (MD 0.02, 95% CI -0.04 to 0.08; 1 trial, 232 participants; moderate-certainty evidence). Adverse effects Compared with sham procedures, corticosteroid implants may slightly increase the risk of cataract formation (RR 2.69, 95% CI 1.17 to 6.18; 1 trial, 90 eyes; low-certainty evidence), but not the risk of cataract progression (RR 2.00, 95% CI 0.65 to 6.12; 1 trial, 117 eyes; low-certainty evidence); or the need for surgery (RR 2.98, 95% CI 0.82 to 10.81; 1 trial, 180 eyes; low-certainty evidence), during up to 12 months of follow-up. These implants may increase the risk of elevated intraocular pressure ([IOP] RR 2.81, 95% CI 1.42 to 5.56; 2 trials, 282 participants; moderate-certainty evidence); and the need for IOP-lowering eyedrops (RR 1.85, 95% CI 1.05 to 3.25; 2 trials, 282 participants; moderate-certainty evidence); but not the need for IOP-lowering surgery (RR 0.72, 95% CI 0.13 to 4.17; 2 trials, 282 participants; moderate-certainty evidence).  Evidence comparing the 0.59 mg FA implant with standard-of-care suggested that the implant may increase the risk of cataract progression (RR 2.71, 95% CI 2.06 to 3.56; 2 trials, 210 eyes; low-certainty evidence); and the need for surgery (RR 2.98, 95% CI 2.33 to 3.79; 2 trials, 371 eyes; low-certainty evidence); along with the risk of elevated IOP (RR 3.64, 95% CI 2.71 to 4.87; 2 trials, 605 eyes; moderate-certainty evidence); and the need for medical (RR 3.04, 95% CI 2.36 to 3.91; 2 trials, 544 eyes; moderate-certainty evidence); or surgical interventions (RR 5.43, 95% CI 3.12 to 9.45; 2 trials, 599 eyes; moderate-certainty evidence). In either comparison, these implants did not increase the risk for endophthalmitis, retinal tear, or retinal detachment (moderate-certainty evidence).  AUTHORS' CONCLUSIONS: Our confidence is limited that local corticosteroid implants are superior to sham therapy or standard-of-care therapy in reducing the risk of uveitis recurrence. We demonstrated different effectiveness on BCVA relative to comparators in people with non-infectious uveitis. Nevertheless, the evidence suggests that these implants may increase the risk of cataract progression and IOP elevation, which will require interventions over time.  To better understand the efficacy and safety profiles of corticosteroid implants, we need future trials that examine implants of different doses, used for different durations. The trials should measure core standard outcomes that are universally defined, and measured at comparable follow-up time points.


Assuntos
Catarata , Glaucoma , Pan-Uveíte , Uveíte Intermediária , Uveíte , Humanos , Corticosteroides/efeitos adversos , Qualidade de Vida , Esteroides , Uveíte/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Clin Immunol ; 246: 109210, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36528252

RESUMO

Uveitis with complex pathogenesis is a kind of eye emergency involving refractory and blinding inflammation. Dysregulation of TANK binding kinase 1 (TBK1), which plays an important role in innate immunity, often leads to inflammatory diseases in various organs. However, the role of TBK1 in uveitis remains elusive. In this study, we identified that the mRNA expression level of TBK1 and its phosphorylation level were significantly increased in peripheral blood mononuclear cells (PBMCs) of patients with uveitis. Consistent with this, the expression of Tbk1 was elevated in the ocular tissues of uveitis rats and primary peritoneal macrophages while its phosphorylation levels, which present activation forms, were upregulated as well, accompanied by an increase in the level of nuclear factor-κB (NF-κB) and proinflammatory cytokines. In addition, inhibition of TBK1 may effectively reduce the inflammatory response of uveitis rats by blocking NF-κB entry into the nucleus and impeding the initiation of NLRP3 inflammasome- and caspase-1-mediated pyroptosis pathways.


Assuntos
NF-kappa B , Uveíte , Animais , Ratos , Inflamassomos/metabolismo , Inflamação/metabolismo , Leucócitos Mononucleares/metabolismo , NF-kappa B/metabolismo , Transdução de Sinais , Uveíte/genética
13.
Semin Arthritis Rheum ; 58: 152153, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36549244

RESUMO

OBJECTIVE: To compare the efficacy of TNF inhibitors (adalimumab (ADA) and infliximab (IFX)) vs tocilizumab (TCZ) in patients with refractory cystoid macular edema (CME) due to Behçet's disease (BD). METHODS: Multicenter study of patients with BD-associated CME refractory to conventional and/or biological immunosuppressive drugs. From a cohort of 177 patients treated with anti-TNF and 14 patients treated with TCZ, we selected those with CME at baseline. We analyzed the evolution of macular thickness (main outcome), best-corrected visual acuity (BCVA) and intraocular inflammation (Tyndall and vitritis) from baseline up to 4 years in the 3 groups mentioned. RESULTS: 49 patients and 72 eyes with CME were included. ADA was used in 25 patients (40 eyes), IFX in 15 (21 eyes) and TCZ in 9 (11 eyes). No statistically significant baseline differences were observed between the 3 groups except for a lower basal BCVA in TCZ group and a higher basal degree of intraocular inflammation in ADA group. Most patients from all groups had received several conventional immunosuppressive drugs. In addition, most patients in the group of TCZ had also received anti-TNF agents. Biological therapy was used in monotherapy (n=8) or combined with conventional immunosuppressive drugs (n=41). Macular thickness progressively decreased in the 3 groups, with no signs of CME after 1 year of treatment. Similarly, BCVA improvement and inflammatory intraocular remission was achieved in all groups. CONCLUSION: Refractory CME associated with BD uveitis can be effectively treated either with ADA, IFX or TCZ. Furthermore, TCZ is effective in patients resistant to anti-TNF therapy.


Assuntos
Síndrome de Behçet , Produtos Biológicos , Edema Macular , Uveíte , Humanos , Síndrome de Behçet/complicações , Síndrome de Behçet/tratamento farmacológico , Síndrome de Behçet/diagnóstico , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Edema Macular/etiologia , Edema Macular/complicações , Resultado do Tratamento , Uveíte/complicações , Uveíte/tratamento farmacológico , Adalimumab/uso terapêutico , Imunossupressores/uso terapêutico , Infliximab/uso terapêutico , Inflamação/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Estudos Retrospectivos , Estudos Multicêntricos como Assunto
14.
Int Immunopharmacol ; 114: 109565, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36535124

RESUMO

Autoimmune uveitis is a non-infectious intraocular condition that affects the uveal tract of the eye and threatens vision if not treated properly. Increasing evidence suggests that activated CD4+ T cells are associated with progressive and permanent destruction of photoreceptors in ocular autoimmune diseases. As such, the purpose of this review is to offer an overview of the role of CD4+ T cells in autoimmune uveitis as well as a justification for the current development and assessment of innovative autoimmune uveitis medications targeting CD4+ T cells. With an emphasis on T helper (Th)17, Th1, and Th2 cells, follicular helper CD4+ T cells, and regulatory T cells, this review presents a summary of recent research related to the pathways and signaling that encourage CD4+ T cells to develop into specialized effector cells. We also describe immunotherapeutic approaches based on CD4+ T cell subsets and their potential as therapeutic agents for autoimmune disorders.


Assuntos
Doenças Autoimunes , Uveíte , Humanos , Uveíte/tratamento farmacológico , Olho , Linfócitos T Reguladores , Células Th2 , Linfócitos T CD4-Positivos , Células Th17
15.
Wiad Lek ; 75(10): 2541-2543, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36472295

RESUMO

Tubulointerstitial nephritis and uveitis syndrome (TINU) is a rare disease defined by a combination of different abnormalities, tubulointerstitial nephritis and uveitis. We describe an 11-year-old boy who got sick with the Covid-19 disease with positive outcome and after 2 weeks developed a complication - tubulointerstitial nephritis with pain in the abdominal cavity, loss of appetite, weakness and low-grade fever with further subsequent attachment of anterior uveitis. Laboratory indicators corresponded to renal insufficiency of tubular origin. Ophthalmological examination conducted against the background of redness of both eyes, photophobia, pain in the eyeball area and decreased vision confirmed bilateral uveitis. Analysis showed high levels of La/SS-B, anti-SARS-CoV-2 IgG with confirmed the suspicion of post-covid TINU syndrome. This case showed a good response to steroid therapy with long-term remission of nephritis and less clinical efficacy in the treatment of uveitis. Special attention should be paid to the occurrence of such a rare syndrome at an early stage after recovery from the Covid-19 disease.


Assuntos
COVID-19 , Nefrite Intersticial , Uveíte , Masculino , Humanos , Criança , COVID-19/complicações , Nefrite Intersticial/diagnóstico , Uveíte/complicações , Uveíte/tratamento farmacológico , Dor/complicações
16.
Indian J Ophthalmol ; 70(12): 4218-4225, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36453318

RESUMO

Purpose: To compare outcomes of surgical management of uveitic glaucoma (UG) and steroid-induced glaucoma (SIG) in children in terms of intraocular pressure (IOP) control, visual acuity, and associations for failure. Methods: This was a retrospective case-control study of consecutive UG (cases) and non-uveitic SIG (controls) in children <18 years of age who underwent surgery between January 2005 and December 2017. Results: Primary trabeculectomy with mitomycin C (MMC) was performed in 12 cases (mean age: 9.2 ± 4.3 years) and 40 controls (mean age: 10.4 ± 3.7 years) (P = 0.33). Primary phaco-trabeculectomy with MMC was performed in 11 cases (mean age: 11.4 ± 4.7 years) and 16 controls (mean age: 10.4 ± 3.4 years) (P = 0.57). IOP control (P = 0.26), visual acuity (P = 0.97), number of glaucoma medications (P = 0.06), and survival rates (49% cases vs. 68% controls at 5 years; P = 0.22) were similar between the two groups following trabeculectomy. Survival rates in the phaco-trabeculectomy group at 5 years were 68% cases vs. 69% controls (P = 0.71). IOP was higher (P = 0.008) and visual acuity was worse (P = 0.02) in cases at the last visit. Associations for failure (univariate analysis) were younger age (OR: 6.29, 95% CL: 1.43, 27.67; P = 0.03) and male gender (OR: 4.79, 95% CL: 1.09, 20.97; P = 0.04). On multivariate analysis, younger age (OR: 11.985, 95% CL: 1.071, 134.153; P = 0.04) remained significant. Preoperative number of uveitic attacks was protective on univariate (OR: 0.75, 95% CL: 0.48, 1.15; P = 0.1) and multivariate analyses (OR: 0.49, 95% CL: 0.24, 0.09; P = 0.04). Conclusion: Outcomes of trabeculectomy between cases and controls were similar in our series. However, phaco-trabeculectomy in pediatric uveitic eye group fared worse than eyes with SIG.


Assuntos
Glaucoma , Uveíte , Masculino , Humanos , Criança , Pré-Escolar , Adolescente , Estudos de Casos e Controles , Estudos Retrospectivos , Glaucoma/induzido quimicamente , Glaucoma/diagnóstico , Glaucoma/cirurgia , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/cirurgia , Mitomicina/efeitos adversos , Resultado do Tratamento , Esteroides
17.
Indian J Ophthalmol ; 70(12): 4357-4361, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36453344

RESUMO

Purpose: To evaluate efficacy of topical interferon alfa-2b (IFN) in the treatment of uveitic macular edema (UME). Methods: This is a prospective, interventional case study of patients with UME. Injection IFN was reconstituted into eye drops and a four times/day (QID) application was prescribed. Central macular thickness (CMT) on optical coherence tomography (OCT) scan was evaluated. Improvement in CMT by ≥50 µm from the baseline was studied in eyes with presenting CMT ≥400 µm. Results: Twenty eyes of 20 patients with UME were studied: anterior uveitis (n = 3), anterior + intermediate uveitis (n = 5), posterior uveitis (n = 3), retinal vasculitis (n = 3), and panuveitis (n = 6). Mean CMT at the presentation was 423.3 µm (range: 270-604 µm), which improved at 1 month (n = 16), 2 months (n = 10), and ≥3 months (n = 11) follow-up, to 415.3 µm (range: 247-579 µm) (P = 0.411), 364.4 µm (range: 258-566 µm) (P = 0.099), 344 µm (range: 258-484 µm) (P = 0.001), respectively. Twelve eyes of 12 patients had presenting CMT ≥400 µm. In these cases, decrease in CMT by ≥50 µm was seen in 4/10, 4/5, and 5/6 eyes at 1 and 2 months and ≥3 months follow-up. Mean follow-up was 4 months (range: 1-17 months). Complete resolution of UME was seen only in three eyes. No ocular or systemic side effects were observed. Conclusion: Topical IFN therapy in QID doses is safe but may have limited role in UME. Long-term therapy may improve its efficacy. Larger studies with dose modification, combination with other drugs, and with homogeneous uveitis population are recommended.


Assuntos
Edema Macular , Uveíte Anterior , Uveíte , Humanos , Edema Macular/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Estudos Prospectivos , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Olho
19.
Vestn Oftalmol ; 138(6): 108-114, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36573954

RESUMO

This review is devoted to the potential application of genetically engineered biological drugs of different classes in the treatment of main forms of uveitis and other types of non-infectious ocular inflammation in immunoinflammatory rheumatic diseases. The article presents the results of studies demonstrating the influence of interleukin-17 inhibitor secukinumab on the course of uveitis in spondylarthritis, shows the possibilities of treating uveitis in juvenile idiopathic arthritis with inhibitors of interleukin-6, co-stimulation of T-lymphocytes. Inhibition of interleukin-1 is considered an effective method of influencing the ocular inflammation in monogenic autoinflammatory syndromes and Behcet's disease. Rituximab is considered as an option for immunosuppressive therapy of non-infectious uveitis and scleritis.


Assuntos
Doenças Reumáticas , Esclerite , Uveíte , Humanos , Inflamação/tratamento farmacológico , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia , Transtornos da Visão , Doenças Reumáticas/complicações , Doenças Reumáticas/tratamento farmacológico , Esclerite/diagnóstico , Esclerite/tratamento farmacológico , Esclerite/etiologia
20.
Cesk Slov Oftalmol ; 78(6): 315-318, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36543598

RESUMO

In this case report, we describe the case of a 50-year-old woman referred by her general practitioner to a pulmonologist in order to investigate persistent fever and elevation of C-reactive protein despite antibiotic treatment following a respiratory infection. The patient was examined extensively, during which rheumatology, gastroenterology, nephrology, ophthalmology, laboratory and imaging tests were performed. Due to a rapid progression of renal insufficiency with active urinary sediment, the patient was referred for a renal biopsy, which confirmed tubulointerstitial nephritis, followed by a diagnosis of bilateral anterior uveitis two months later - genetic testing was also conducted, which confirmed the diagnosis of tubulointerstitial nephritis with uveitis syndrome. Steroid treatment brought about a gradual reduction of proteinuria and a stabilisation of renal function.


Assuntos
Nefrite Intersticial , Uveíte , Feminino , Humanos , Pessoa de Meia-Idade , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Nefrite Intersticial/complicações , Nefrite Intersticial/diagnóstico , Nefrite Intersticial/tratamento farmacológico , Glucocorticoides , Síndrome
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...