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Since ecosystems are becoming inherently polluted, long-term contaminant removal methods are required. Electrodeionization, in particular, has recently been demonstrated as an effective approach for eliminating ionic compounds from contaminated water sources. Being a more environmentally friendly technology is most likely the main reason for its eminence. It uses electricity to replace toxic contaminants that are conventionally used to regenerate and hence reducing the toxins associated with resin regeneration. In wastewater treatment, continuous electrodeionization system overcomes several limitations of ion exchange resins, notably ion dumping. This prospective assessment delves into the mechanism, principle, and theory of electrodeionization system. It also focused on the design and applications, particularly in the removal of toxic compounds, as well as current advances in the electrodeionization system. Recent breakthroughs in electrodeionization were comprehensively discussed. Further developments in electrodeionization systems are also projected, with improved efficiency at the time of functioning at lower costs because of reduced energy use, proving them desirable for commercial usage with a broad array of applications across the globe.
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Poluentes Ambientais , Poluentes Químicos da Água , Purificação da Água , Ecossistema , Estudos Prospectivos , Íons , ÁguaRESUMO
PURPOSE: To describe the clinical profile of HLA B-27-associated uveitis in Indian population. METHOD: We conducted a retrospective review of medical records of 431 eyes of 255 consecutive patients with HLA B-27-associated uveitis, presented to our institute between 2012 and 2017. RESULT: The study observed a male preponderance (75.7%) and the mean age of patients was 35.6 ± 13.3 years. A total of 412 (95.3%) eyes had anterior uveitis, 17(3.9%) eyes had anterior and intermediate uveitis and 3 eyes (0.7%) had intermediate uveitis. Retinal vasculitis was detected in four eyes (0.9%). A total of 176 patients (69%) in the study had evidence of systemic disease and 85% patients developed recurrences. In addition to the treatment with topical and oral steroid, immunosuppressive was required in 39.6% patients and 4% patients received biological therapy. The majority of the eyes (78.4%) had a good visual outcome, while 61 (14.2%) eyes had moderate visual impairment and 32 (7.4%) eyes had severe visual impairment at the time of final follow-up. CONCLUSION: HLA-B27-associated uveitis can be associated with higher number of posterior segment involvement than it is estimated and aggressive therapy in moderate-to-severe uveitis can prevent severe visual impairment in these patients.
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Uveíte Anterior , Uveíte , Adulto , Antígeno HLA-B27 , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Uveíte/diagnóstico , Uveíte/epidemiologia , Uveíte Anterior/diagnóstico , Uveíte Anterior/epidemiologia , Adulto JovemRESUMO
PURPOSE: To describe clinical manifestations, management and visual outcome in postsurgical sympathetic ophthalmia (SO). METHODS: Retrospective study. RESULTS: Mean age of the patients was 41.1 years, and males were affected 1.8 times than the female. Vitrectomy and scleral buckling were the most common inciting surgeries followed by cataract surgery. Among 10 eyes with anterior uveitis, mutton-fat keratic precipitate was seen in only two eyes. Mean follow-up duration was 1556.50 ± 1470.75 days. Vision significantly improved in 11 patients (78.6%; p = 0.005). CONCLUSION: Postsurgical SO is a rare entity, but it is a bilateral blinding disease and SO following surgical intervention can have variable presentations. Rapid, effective management of postsurgical sympathetic ophthalmia can give improved visual outcomes.
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Oftalmia Simpática , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Complicações Pós-Operatórias , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Imunossupressores/uso terapêutico , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Oftalmia Simpática/patologia , Oftalmia Simpática/fisiopatologia , Oftalmia Simpática/terapia , Procedimentos Cirúrgicos Oftalmológicos/estatística & dados numéricos , Estudos Retrospectivos , Esteroides/uso terapêutico , Acuidade Visual/fisiologia , Adulto JovemRESUMO
PURPOSE: To evaluate the reliability of clinical grading of vitreous haze using a new 9-step ordinal scale versus the existing 6-step ordinal scale. DESIGN: Evaluation of diagnostic test (interobserver agreement study). PARTICIPANTS: A total of 119 consecutive patients (204 uveitic eyes) presenting for uveitis subspecialty care on the study day at 1 of 3 large uveitis centers. METHODS: Five pairs of uveitis specialists clinically graded vitreous haze in the same eyes, one after the other using the same equipment, using the 6- and 9-step scales. MAIN OUTCOME MEASURES: Agreement in vitreous haze grade between each pair of specialists was evaluated by the κ statistic (exact agreement and agreement within 1 or 2 grades). RESULTS: The scales correlated well (Spearman's ρ = 0.84). Exact agreement was modest using both the 6-step and 9-step scales: average κ = 0.46 (range, 0.28-0.81) and κ = 0.40 (range, 0.15-0.63), respectively. Within 1-grade agreement was slightly more favorable for the scale with fewer steps, but values were excellent for both scales: κ = 0.75 (range, 0.66-0.96) and κ = 0.62 (range, 0.38-0.87), respectively. Within 2-grade agreement for the 9-step scale also was excellent (κ = 0.85; range, 0.79-0.92). Two-fold more cases were potentially clinical trial eligible on the basis of the 9-step than the 6-step scale (P<0.001). CONCLUSIONS: Both scales are sufficiently reproducible using clinical grading for clinical and research use with the appropriate threshold (≥ 2- and ≥ 3-step differences for the 6- and 9-step scales, respectively). The results suggest that more eyes are likely to meet eligibility criteria for trials using the 9-step scale. The 9-step scale appears to have higher reproducibility with Reading Center grading than clinical grading, suggesting that Reading Center grading may be preferable for clinical trials.
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Técnicas de Diagnóstico Oftalmológico , Oftalmopatias/classificação , Uveíte/classificação , Corpo Vítreo/patologia , Estudos Transversais , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Perfil de Impacto da DoençaRESUMO
PURPOSE: To report the clinical pattern of surgically induced necrotizing scleritis (SINS) in a tertiary eye care center in Southern India. METHODS: Retrospective analysis of all SINS cases visiting the uveitis clinic of a tertiary eye institute between January 2009 and April 2019. RESULTS: In total, 15 patients with a median age of 65 (IQR: 52-70) years were included in the study. Male (53%) predominance was noted, and SINS was unilateral (100%) in all cases. Most (87%) of the patients developed SINS after a single surgical procedure, with a median onset period of 251 (IQR: 127-1095) days. None of these patients had any evidence of systemic association. Ocular hypertension (n = 3, 20%), and cataract (n = 5, 33%) were the most common complications. When compared with a cohort of patients with idiopathic necrotizing scleritis, the index study did not find any statistically significant difference between SINS and idiopathic scleritis. CONCLUSION: SINS is idiopathic necrotizing scleritis rather than an independent entity of scleritis.
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Esclerite , Humanos , Esclerite/diagnóstico , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Feminino , Idoso , Índia/epidemiologia , Esclera , Procedimentos Cirúrgicos Oftalmológicos/métodos , Seguimentos , Complicações Pós-Operatórias , Incidência , Acuidade VisualRESUMO
PURPOSE: To evaluate the spectrum of uveitis occurring after 60 years of age in elderly patients who presented to a tertiary care eye center in India. METHODS: Retrospective study of patients who visited a tertiary eye care institute between January 2010 and July 2020. RESULT: Eighty-seven patients developed uveitis after 60 years, with only 44.8% having sufficient follow-up documentation and were included in the final analysis. The median age of these patients was 64 (IQR: 62-70) years, and 69% of them were male. Among the identifiable causes of uveitis, infectious uveitis (36%) was the most common and noninfectious uveitis was noted in 23% of patients. The most common subtype of uveitis was anterior uveitis (52%), followed by intermediate uveitis (32%), panuveitis (11%), and posterior uveitis (7%). Tuberculosis (28%) was the most common cause in our cohort, followed by HLA B27 (10%), sarcoid (8%), and Vogt-Koyanagi-Harada disease (5%). In 41% of patients, a definitive diagnosis of uveitis could not be achieved, and the anterior uveitis group had the highest number of undifferentiated uveitis cases. There were no undifferentiated cases of uveitis in the posterior and panuveitis category. The median follow-up period of these patients was 52 (15-91) months and 66% of eyes had recurrence. A statistically significant improvement in vision was seen in anterior uveitis and panuveitis groups, whereas the median visual acuity of the intermediate uveitis group remained stable throughout the follow-up period. CONCLUSION: Uveitis in the elderly can have a higher recurrence rate; however, the lack of follow-up in these groups of patients is a major challenge.
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Uveíte , Acuidade Visual , Humanos , Masculino , Índia/epidemiologia , Estudos Retrospectivos , Feminino , Idoso , Pessoa de Meia-Idade , Uveíte/diagnóstico , Uveíte/epidemiologia , Seguimentos , IncidênciaRESUMO
PURPOSE: To describe a cohort of patients with retinal vasoproliferative tumours (RVPT) seen in the uveitis clinic of a single tertiary eye care institute in India. METHODS: Retrospective Chart Review. RESULTS: In our study of 17 patients with 18 eyes affected by RVPTs, 94.1% showed unilateral involvement, one patient had bilateral RVPTs, and another had two RVPTs in the same eye. The mean age was 36.3 ± 15.1 years (range: 12-63 years), with a male majority (76.4%). The most common location was inferotemporal quadrant (44.4%). The most common associated uveitic condition was intermediate uveitis (50%). Patients were treated with oral corticosteroid (in 94.1%) and immunosuppressive (35.2%) in addition to transconjunctival cryotherapy (in 52.9%) or laser photocoagulation (in 41.1%). Regression of the RVPT was achieved in all cases except one. Visual acuity at time of detection of RVPT ranged from 6/6 to HM. No significant change was noted in the mean best corrected visual acuity pre and post treatment in the study group. CONCLUSION: RVPTs, rare peripheral retinal lesions often associated with intermediate uveitis, require early diagnosis with targeted therapy to prevent vision loss and achieve favorable long-term outcomes with rare recurrences.
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Purpose: This study aimed to describe visual outcomes in cases of pediatric uveitis in an Indian population and to analyze various factors affecting these outcomes. Methods: Single-center, retrospective chart review of 277 cases of uveitis in patients under the age of 18 years. Variables assessed included age and sex distribution, anatomical location of uveitis, systemic associations, complications, and various treatment strategies used, including long-term immunomodulation and surgical management of complications if required. The main outcome was the final visual acuity. Results: At the final visit, 51.5% of the eyes showed improvement in the final visual acuity, while vision remained stable in 28.7% and 19.7% of the eyes showed worsening of vision at the final follow-up. A total of 19.4% of patients were blind in at least one eye at the final visit, and 16 patients (5.77%) remained bilaterally blind at the final follow-up. The presence of cataract (p = 0), posterior uveitis (p = 0.005), and retinal detachment (p = 0.014) were the most significant risk factors for predicting worse visual outcomes. More than half (65.7%) of patients reported a complication at some point in their follow-up, and the most common complication was cataract. In total, 50.9% of patients required long-term immunomodulatory therapy. Conclusion: Pediatric uveitis remains a challenging condition to treat and follow-up, and the visual outcome remains guarded for most patients.
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Artrite Juvenil , Catarata , Uveíte , Criança , Humanos , Adolescente , Estudos Retrospectivos , Seguimentos , Artrite Juvenil/complicações , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/epidemiologia , Catarata/complicaçõesRESUMO
The tuberculin skin test, used to detect latent systemic tuberculosis (TB), has its limitations. The utility of interferon-gamma assays, found useful in the diagnosis of latent TB, is still unestablished in tubercular uveitis. We present the results of QuantiFERON(®)-TB Gold (QFT-G) test and its relevance in the diagnosis and management of suspected tubercular uveitis in India. All suspected tubercular uveitis patients seen at our uveitis clinic between October 2006 and June 2008 who underwent relevant blood investigations, chest X-rays, Mantoux tests and QFT-G tests were included. Clinical profile, systemic correlation and outcome with treatment were analysed. Fifty suspected tubercular uveitis patients underwent QFT-G testing. The age range of the patients was 6-55 years (mean 32.66 years). Seven patients presented with active and three with a past history of systemic TB. The QFT-G test was positive in 29 patients. Radiological findings of TB were seen in four patients with a positive QFT-G and one patient with a negative QFT-G test. In 11 patients both QFT-G and Mantoux tests were positive. Eighteen Mantoux-negative patients were QFT-G-positive. Significantly, no patient with a positive Mantoux had a negative QFT-G test. Of the 32 patients with posterior uveitis, 17 patients had serpiginous choroiditis, four patients had a choroidal granuloma, six patients had multifocal choroiditis, four patients had retinal vasculitis, and one patient had a subretinal abscess. All QFT-G-positive patients were treated with anti-tuberculosis therapy as well as systemic steroids with a favorable clinical outcome. Our study shows that the QFT-G test is very useful in the diagnosis and management of suspected ocular TB. It was found to be very sensitive in identifying latent TB patients who, upon treatment, had a significantly reduced frequency of recurrences. It was more sensitive than the Mantoux test and is not significantly affected by previous treatment with systemic steroids or immunosuppressives. A negative QFT-G test can also be used as an adjunct before initiation of systemic steroids or immunosuppressives in uveitic patients particularly in an endemic setting like India.
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Técnicas de Diagnóstico Oftalmológico , Interferon gama/sangue , Tuberculose Ocular/diagnóstico , Uveíte/diagnóstico , Adolescente , Adulto , Antituberculosos/uso terapêutico , Criança , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Teste Tuberculínico , Tuberculose Ocular/sangue , Tuberculose Ocular/tratamento farmacológico , Tuberculose Pulmonar/diagnóstico por imagem , Uveíte/sangue , Uveíte/tratamento farmacológico , Adulto JovemRESUMO
The aim of this series is to report challenges faced in diagnosis of three cases of recurrent or atypical uveitis not responding to conventional treatment. A high index of suspicion, aided by newer techniques, such as cytology, immunohistochemistry, flow cytometry of ocular fluids, and contrast-enhanced magnetic resonance imaging, may be necessary for a prompt diagnosis of uveitis masquerade syndromes.
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Purpose: To evaluate the role of swept-source optical coherence tomography (SS-OCT) in the management of acute Vogt-Koyanagi-Harada's (VKH) disease. Methods: Retrospective analysis of SS-OCT images of acute VKH patients between January 2015 and February 2020 in a tertiary eye care hospital. Results: We studied 34 eyes of 17 patients with acute probable VKH disease. The mean age was 31.6 ± 10.4 years. Twelve patients were women. The mean follow-up was 17.1 ± 9.3 months. The mean visual acuity was 0.86 logMAR (Snellen equivalent: 6/45) at presentation and 0.18 logMAR (Snellen equivalent: 6/9) at the last follow-up. The mean subfoveal choroidal thickness (SFCT) was 784.97 microns at presentation, 431.40 microns at the first month of therapy, 453.94 microns at six months of therapy, and 405.83 microns at the last follow-up. Qualitative features noted on SS-OCT on presentation was subretinal fluid (SRF) in 29 (85%) eyes, subretinal hyperreflective dots in 34 (100%) eyes, subretinal septa in 33 (97%) eyes, RPE undulations in 21 (61.7%) eyes, posterior vitreous cells in 34 (100%) eyes, SRF around disc in 9 (26%) eyes, and disc swelling in 34 (100%) eyes. At the end of 1 year of follow-up, RPE undulations were absent in 30 eyes (88%) and disc swelling was notably absent in all 34 eyes (100%), though SRF around disc was noted in 4 eyes (11.7%) of 2 patients who had recurrences. Conclusion: SFCT, SRF around disc, RPE undulation, and disc swelling may be important indicators on SS-OCT to guide therapy and prognosticate recurrences in acute VKH.
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Tomografia de Coerência Óptica , Síndrome Uveomeningoencefálica , Doença Aguda , Adulto , Corioide , Feminino , Humanos , Masculino , Estudos Retrospectivos , Líquido Sub-Retiniano , Tomografia de Coerência Óptica/métodos , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Adulto JovemRESUMO
PURPOSE: Chronic uveitis can lead to hypotony that may result in severe visual impairment. We highlight the use of ultrasound biomicroscopy (UBM) as an imaging tool to decide the modality of therapy and management of uveitic hypotony. METHODS: This was a retrospective hospital-based interventional case-series study that included a total of 36 eyes of 25 patients with uveitic hypotony seen between January 1997 and January 2020. RESULTS: Thirty-six eyes of 25 patients with uveitic ocular hypotony were included. Unilateral involvement was seen in 56%. The median age of presentation was 21 years with a median follow-up of 21.5 months. Anterior uveitis was noted in 13.88%, intermediate uveitis in 52.77%, and panuveitis in 33.33% eyes. UBM findings commonly noted were pars plana membranes, supraciliary effusion, blunted ciliary process, and ciliary body traction. Other findings included ciliochoroidal detachment and ciliary body edema. Moreover, 22.2% eyes were managed with medical therapy alone, whereas 77.8% eyes received both medical and surgical intervention based on UBM findings. Furthermore, 66.7% eyes showed improvement in intraocular pressure, 13.9% eyes maintained the same IOP, whereas 19.4% eyes had worsening of IOP at final follow-up. CONCLUSION: We found UBM as a useful imaging tool in evaluating and judiciously deciding the mode of management of uveitic hypotony.
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Hipotensão Ocular , Uveíte , Adulto , Humanos , Pressão Intraocular , Microscopia Acústica , Hipotensão Ocular/diagnóstico , Hipotensão Ocular/etiologia , Estudos Retrospectivos , Tonometria Ocular , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/cirurgia , Vitrectomia , Adulto JovemRESUMO
Purpose: To describe the clinical profile of patients presenting with uveitis following COVID-19 infection at a tertiary care eye hospital in South India. Methods: In this retrospective chart review, all consecutive cases presenting with an acute episode of intraocular inflammation and a history of COVID-19 infection diagnosed within the preceding 6 weeks, between March 2020 and September 2021, were included. Data retrieved and analyzed included age, sex, laterality of uveitis, and site of inflammation. The diagnosis was categorized based on the SUN working group classification criteria for uveitis. Details regarding clinical features, investigations, ophthalmic treatment given, response to treatment, ocular complications, and status at last visit were also accessed. Statistical analysis of demographical data was done using Microsoft Excel 2019. Results: Twenty-one eyes of 13 patients were included in this hospital-based retrospective observational study. The study included six male and seven female patients. The mean age was 38 ± 16.8 years. Eight patients had bilateral involvement. Seven patients were diagnosed with anterior uveitis, three with intermediate uveitis, one with posterior uveitis, and two with panuveitis. All patients responded well to treatment and were doing well at their last visit. Two patients had complications that necessitated surgical treatment, following which they recovered good visual outcomes. Conclusion: With prompt diagnosis and appropriate management, all the patients with uveitis post-COVID-19 infection recovered with good visual outcomes. Thus, ophthalmologists must be aware of the possible uveitic manifestations following even uneventful COVID-19 infection.
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COVID-19 , Pan-Uveíte , Uveíte , Adulto , COVID-19/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2 , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia , Adulto JovemRESUMO
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.
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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 , EsteroidesRESUMO
AIM: To look at markers to differentiate ocular sarcoidosis from ocular tuberculosis in a high TB endemic population. MATERIALS & METHODS: Retrospective multicenter study involving seven tertiary eyecare centers in India between July 2016 to December 2016. Demographic, clinical and laboratory data were retrieved from respective hospital databases. Group A included biopsy-proven ocular sarcoidosis while group B included ocular tuberculosis. RESULTS: Data from 2726 consecutive patients with uveitis were retrieved from the databases. Group A had 61 cases while group B included 307 cases. The mean age in group A was 43 ± 16.55 years while in group B was 38 ± 13.13 years. Females were more common in group A. Uveitis with low Schirmer test (OR-30, CI-95%), candlewax retinal vasculitis (OR-8.69, CI-95%), hilar lymphadenopathy (OR-15.23, CI-95%), fissural nodules (OR-39.11, CI-95%) had higher odds of having ocular sarcoidosis. CONCLUSION: Presence of dry eye, candlewax retinal vasculitis, hilar lymphadenopathy, and fissural nodules if present in a patient with uveitis, could help differentiate ocular sarcoidosis from ocular tuberculosis in a high TB endemic population.
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Vasculite Retiniana , Sarcoidose , Tuberculose Ocular , Uveíte , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Vasculite Retiniana/diagnóstico , Vasculite Retiniana/epidemiologia , Estudos Retrospectivos , Sarcoidose/diagnóstico , Sarcoidose/epidemiologia , Tuberculose Ocular/diagnóstico , Tuberculose Ocular/epidemiologia , Uveíte/diagnóstico , Uveíte/epidemiologiaRESUMO
Purpose: To report the clinical profile of cataract and its surgical management in a scleritis cohort from India.Methods: We conducted a retrospective review of medical records of 39 eyes of 32 consecutive patients with scleritis who underwent cataract surgery in a tertiary eye care institute.Results: The mean age at presentation was 50.9 ± 11.1 years and 65.6% of the patients were female. Five patients (15.6%) were ≤ 40 years of age. Necrotizing scleritis (56.4%) was the most common subtype of scleritis in this cohort followed by diffuse anterior scleritis (28.2%), nodular scleritis (12.8%). The preferred incision for phacoemulsification was clear corneal in 30 eyes (77%). In the immediate post-operative period, four eyes (10.2%) developed severe corneal edema, one eye had descemet membrane detachment. Anterior chamber reaction was observed in 18 eyes (46.1%). Fifteen eyes (38.4%) developed raised intraocular pressure and two required surgical intervention after 3 months of cataract surgery. Early posterior capsular opacification was observed in 5 eyes (12.8%) and cystoid macular edema in 2 eyes (5.1%).Conclusion: In addition to providing a distinct pattern of cataract, index study showed that long-term control of scleral inflammation prior to the cataract surgery remains the primary requisite for the successful outcome.
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Implante de Lente Intraocular , Facoemulsificação , Esclerite/complicações , Adulto , Idoso , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Esclerite/diagnóstico , Esclerite/fisiopatologia , Microscopia com Lâmpada de Fenda , Tonometria Ocular , Acuidade Visual/fisiologiaRESUMO
BACKGROUND AND OBJECTIVE: To evaluate outcomes of phacoemulsification cataract surgery with intraocular lens (IOL) implantation in children and adults with juvenile idiopathic arthritis-associated uveitis. PATIENTS AND METHODS: Charts of 7 patients (10 eyes) with juvenile idiopathic arthritis-associated uveitis who had phacoemulsification cataract surgery between December 2002 and March 2005 were analyzed. RESULTS: Ten eyes of 7 patients had phacoemulsification with IOL implantation done by a single surgeon. A heparin surface modified IOL was used in 7 eyes and a foldable acrylic IOL was used in 3 eyes. At final follow-up, 70% of eyes had a visual acuity of 20/40 or better and 30% had improved visual acuity to 20/60. Posterior capsular opacification was found in 2 eyes and anterior capsular fibrosis in 1 eye. CONCLUSION: Keys to success following cataract surgery in juvenile idiopathic arthritis are the age of the child, the absence of amblyopia, and strict preoperative and postoperative control of inflammation.
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Artrite Juvenil/complicações , Catarata/complicações , Implante de Lente Intraocular/métodos , Facoemulsificação/métodos , Adolescente , Criança , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Adulto JovemRESUMO
Purpose: To report a case series of pediatric inflammatory choroidal neovascularization (CNV) seen at referral uveitis clinic.Methods: Records of pediatric patients with uveitis and inflammatory CNV between January 2000 and December 2012 were analyzed.Results: Ten eyes of seven patients were included. Mean age 12.6 years, mean follow-up 89.6 months. Three out of seven patients had bilateral CNV. Subfoveal CNV was noted in five eyes, extrafoveal CNV in three eyes and juxtafoveal and peripapillary CNV each in one eye. All patients received corticosteroids; immunosuppressives were used in three patients. Additional anti-VEGF injections were given, in six eyes, anti-VEGF and PDT in one eye and only PDT in three eyes.Conclusion: Pediatric inflammatory CNV though challenging, can be successfully managed with prompt therapy of the underlying uveitic disease, coupled with additional local therapy to selectively target the CNV.
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Neovascularização de Coroide/diagnóstico , Glucocorticoides/administração & dosagem , Centros de Atenção Terciária , Administração Oral , Adolescente , Criança , Neovascularização de Coroide/tratamento farmacológico , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodosRESUMO
Viral anterior uveitis (VAU) needs to be suspected in anterior uveitis (AU) associated with elevated intraocular pressure, corneal involvement, and iris atrophic changes. Common etiologies of VAU include herpes simplex, varicella-zoster, cytomegalovirus, and rubella virus. Clinical presentations can vary from granulomatous AU with corneal involvement, Posner-Schlossman syndrome, Fuchs uveitis syndrome, and endothelitis. Due to overlapping clinical manifestations between the different viruses, diagnostic tests like polymerase chain reaction and Goldmann-Witmer coefficient analysis on the aqueous humor may help in identifying etiology to plan and monitor treatment.
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Infecções Oculares Virais , Herpes Simples , Uveíte Anterior , Uveíte , Humor Aquoso , Citomegalovirus/genética , DNA Viral , Infecções Oculares Virais/diagnóstico , Humanos , Vírus da Rubéola/genética , Uveíte Anterior/diagnóstico , Uveíte Anterior/etiologiaRESUMO
PURPOSE: To report the clinical profile of a series of anterior nodular scleritis in Indian population. METHODS: We conducted a retrospective review of medical records of 140 eyes of 123 consecutive patients with nodular scleritis who presented to a tertiary eye care institute between 2007 and 2018. RESULTS: The mean age at presentation was 46.8 ± 13.1 years and 70.7% of the patients were female. Bilateral involvement was observed in 14% patients. The most common presenting symptom was redness (92.6%) and ocular pain (69.1%). Twenty-seven patients (22%) had some systemic association and rheumatoid arthritis (5%) was the most common autoimmune disease. Presumed ocular tuberculosis was diagnosed in 13% patients. Methotrexate was the most common immunosuppressive used in these patients and an additional immunosuppressive was required in 6.5% patients. Recurrence of inflammation was observed in 74.8% patients. Deterioration of vision noted in 2.8% eyes. CONCLUSION: Tuberculosis remains an important cause of nodular scleritis in India. Recurrence of scleritis is common in nodular scleritis and cases with non infectious nodular scleritis often require treatment with immune suppressives.