Journal of Ophthalmic Inflammation and Infection最新文献

{"title":"Fluocinolone acetonide 0.18-mg implant for treatment of recurrent inflammation due to non-infectious uveitis: a case series of 15 patients","authors":"Robert A. Sisk, Daniel F. Kiernan, David Almeida, Anton M. Kolomeyer, David Eichenbaum, John W. Kitchens","doi":"10.1186/s12348-024-00427-9","DOIUrl":"https://doi.org/10.1186/s12348-024-00427-9","url":null,"abstract":"Uncontrolled non-infectious uveitis affecting the posterior segment (NIU-PS) can lead to vision loss due to repeated bouts of inflammation and consequent tissue damage. Patients with chronic NIU-PS who experience recurrent uveitis after being treated with systemic and short-acting local corticosteroids may benefit from the sustained-release 0.18-mg fluocinolone acetonide implant (FAi). In this case series, 18 eyes with chronic, recurrent NIU-PS and cystoid macular edema (CME) treated with the 0.18-mg FAi were analyzed retrospectively. Data on patient demographics, clinical history, previous and concomitant treatments for uveitis recurrence, time to and number of uveitis recurrences, intraocular pressure (IOP), central subfield thickness (CST), and visual acuity (VA) were collected and summarized. A majority of patients (14/15 [93%]) had a history of ocular surgery, largely cataract extraction, and all developed chronic and recurrent NIU-PS and CME. At baseline, patients had a mean age of 72 years (range: 46 to 93), were 53% male, and had a mean duration of NIU-PS of 3 years (range: 1 to 19). Patients were followed for an average of 16.5 months (range: 2 to 42.5 months) post FAi. Eleven of the 18 eyes (61%) had ≥ 5 recurrences of uveitis since diagnosis, with an average time to recurrence of approximately 12 weeks (range: 1 to 27). All eyes treated with the 0.18-mg FAi showed reduced NIU-PS recurrence and visual and anatomical improvement, as measured by VA and CST, respectively. Two eyes had an IOP elevation that was managed with topical therapy, and one eye was treated with topical prednisolone for additional inflammation management. Two eyes required adjunct therapy with short-acting intravitreal corticosteroids at 7 and 16 weeks for NIU-PS recurrence after 0.18-mg FAi insertion. After receiving the 0.18-mg FAi, eyes with uncontrolled NIU-PS had sustained resolution of CME and inflammation with limited need for supplementary steroid drops or injections and minimal steroid class-specific adverse effects; none required incisional IOP-lowering surgery.","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"2 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of in vivo confocal microscopy in suspected Acanthamoeba keratitis: a 12-year real-world data study at a Swedish regional referral center","authors":"Bogdana Toba, Neil Lagali","doi":"10.1186/s12348-024-00424-y","DOIUrl":"https://doi.org/10.1186/s12348-024-00424-y","url":null,"abstract":"To report real-world data (RWD) on the use of in vivo confocal microscopy (IVCM) in handling cases of suspected Acanthamoeba keratitis (AK) cases at a regional referral center during a 12-year period. Retrospective study of patients with suspected AK presenting at a regional referral center for IVCM in Sweden from 2010 to 2022. Demographics, symptoms, outcomes, and clinical management were analyzed, and IVCM images were interpreted. Of 74 included patients with suspected AK, 18 (24%) were IVCM-positive, 33 (44%) were IVCM-negative, 15 had inconclusive IVCM results (20.2%), and 8 (11%) were referred for a second opinion based on IVCM, 4 of which were IVCM-positive (5.5%), yielding an overall IVCM-positive rate of 29.5%. Cultures were taken in 38 cases (51%) with only 2 cases (2.7%) culture-positive for AK. Of IVCM-negative cases, cultures were taken in 22 (67%) of cases and 100% of these were AK-negative. IVCM-positive cases had more clinic visits (median 30, P = 0.018) and longer follow-up time (median 890 days, P = 0.009) than IVCM-negative patients, while visual acuity improvement did not differ (P > 0.05). Of IVCM-positive cases, 10 (56%) underwent surgery despite prior anti-amoebic treatment, and 14 (78%) had 3 or more IVCM examinations during follow-up, with cysts (100%), dendritic cells (89%) and inflammatory infiltrate (67%) as the most prevalent features. Longitudinal IVCM indicated improvement in cysts, dendritic cells and subbasal nerves with treatment, while clinical resolution was not always consistent with complete absence of cysts. In a real-world setting, IVCM has a high reliability in classifying AK-negative cases, while IVCM detects AK-positive cases more frequently than the gold-standard culture method, leading to its preferential use over the culture method where time or resources are limited. Despite this, a subset of cases are IVCM-inconclusive, the clinical course of referred patients is long requiring many hospital visits, and visual acuity in most cases does not improve with medical treatment alone. Information sharing across centers and standardization of referral and diagnostic routines is needed to exploit the full potential of IVCM in AK patient management.","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"57 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between in vitro susceptibility and clinical outcomes in fungal keratitis.","authors":"Louisa Lu, N Venkatesh Prajna, Prajna Lalitha, Revathi Rajaraman, Muthiah Srinivasan, Benjamin F Arnold, Nisha Acharya, Thomas Lietman, Jennifer Rose-Nussbaumer","doi":"10.1186/s12348-024-00418-w","DOIUrl":"10.1186/s12348-024-00418-w","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the association between antifungal susceptibility as measured by minimum inhibitory concentration (MIC) and clinical outcomes in fungal keratitis.</p><p><strong>Methods: </strong>This pre-specified secondary analysis of the Mycotic Ulcer Treatment Trial II (MUTT II) involved patients with filamentous fungal keratitis presenting to Aravind Eye Hospitals in South India. Antifungal susceptibility testing for natamycin and voriconazole was performed on all samples with positive fungal culture results according to Clinical and Laboratory Standards Institute Guidelines. The relationship between MIC and clinical outcomes of best-corrected visual acuity, infiltrate or scar size, corneal perforation, need for therapeutic penetrating keratoplasty, and time to re-epithelialization were assessed.</p><p><strong>Results: </strong>We obtained MIC values from 141 patients with fungal keratitis. The most commonly cultured organisms were Aspergillus (46.81%, n = 66) and Fusarium (44.68%, n = 63) species. Overall, there was no association between antifungal MICs and clinical outcomes. Subgroup analysis revealed that among Fusarium-positive cases, higher voriconazole MIC was correlated with worse three-month best-corrected visual acuity (p = 0.03), increased need for therapeutic penetrating keratoplasty (p = 0.04), and time to re-epithelialization (p = 0.03). No significant correlations were found among Aspergillus-positive cases. There were no significant correlations found between natamycin MIC and clinical outcomes among organism subgroups.</p><p><strong>Conclusions: </strong>Decreased susceptibility to voriconazole was associated with increased odds of requiring a therapeutic penetrating keratoplasty in Fusarium-positive cases. Susceptibility to natamycin was not associated with any of the measured outcomes.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"42"},"PeriodicalIF":2.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of adnexal cutaneous leishmaniasis in Washington DC.","authors":"Sinan Akosman, Heeyah Song, Paul Sheils, Tamer Mansour, Keith J Wroblewski, Lamise Rajjoub","doi":"10.1186/s12348-024-00423-z","DOIUrl":"10.1186/s12348-024-00423-z","url":null,"abstract":"<p><strong>Purpose: </strong>To report a rare non-endemic case of Leishmania aethiopica in Washington DC.</p><p><strong>Case report: </strong>A 68-year-old female presented for a routine examination with a complaint of right upper eyelid lesions for the past 5 months. On examination, a cluster of elevated and erythematous lesions extending from the medial canthus to the brow area of the right eye were seen. Initial treatment with Valtrex based on a suspected viral etiology failed. Although a biopsy was recommended at this time, the patient declined, and subsequent workup included nasolacrimal duct irrigation, blood work to rule out autoimmune etiology, a course of doxycycline, and an MRI, which yielded no improvement. Upon progression of the lesions into persistent plaques on the eyelids, a punch biopsy was performed, confirming leishmaniasis. The patient was then started on a 28-day course of oral miltefosine which led to complete resolution of her symptoms.</p><p><strong>Conclusion: </strong>This case underlines the importance of a broad differential including non-endemic diseases, particularly in urban areas with frequent patient travel. Furthermore, the delayed punch biopsy in this case highlights the importance of patient counseling to ensure prompt diagnosis and treatment.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"41"},"PeriodicalIF":2.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis in Alexandria-Egypt.","authors":"Suzan Ibrahim Sakr, Amira Ahmed Nayel, Ahmed Lotfi Khattab, Waad Mahmoud Elhamamsy, Islam Abdelmonaem Abozaid, Ramy Awad, Hager AbdelKhalek Elkazaz, Christeena Saeed Habeel, Raymond Samaha, Alaa Atef Ghaith","doi":"10.1186/s12348-024-00421-1","DOIUrl":"10.1186/s12348-024-00421-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed at measuring the effect of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis and identifying the specific risk factors to both microbial and non-microbial keratitis independently.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Alexandria Ophthalmology Hospital from May to October 2023. All contact lens wearers attending the outpatient clinic had undergone face-to-face interviews using a standardized validated questionnaire which included demographic data and contact lenses (CLs) hygiene risk factors. Participants were classified into two groups; normal group and keratitis group. Keratitis group was further subdivided into non-microbial and microbial group.</p><p><strong>Results: </strong>The study included 245 contact lens wearers; 149 normal cases, 50 (20.4%) contact lens-related non-microbial keratitis (CLNK) cases, and 46 (18.8%) contact lens-related microbial keratitis (CLMK) cases. Sharing contact lenses and eye trauma were significant risk factors for both CLNK (p=0.036), (p=0.001) and CLMK (p=0.003), (p=0.017). CLs wear duration for more than 12 hours was associated with an increased risk of CLNK by about 4 times (p=0.030) and overnight wear of contact lenses increased the risk of CLNK by 2.6 times (p=0.030). Showering or swimming in lenses was identified as a significant risk factor for CLMK (p=0.012), moreover washing lenses with tap water increased the risk of CLMK (p=0.030).</p><p><strong>Conclusions: </strong>Poor compliance with contact lenses hygiene rules results in a high prevalence of contact lens-related keratitis. Eye trauma and sharing contact lenses were significant hygiene risk factors for both contact lens-related non-microbial keratitis and contact lens-related microbial keratitis.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"40"},"PeriodicalIF":2.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous endophthalmitis secondary to Lemierre's Syndrome originating from pharyngotonsillitis.","authors":"Nerea Gangoitia Gorrotxategi, Iñigo Salmeron Garmendia, Henar Heras-Mulero, Santiago López Arbués, Esther Compains Silva","doi":"10.1186/s12348-024-00420-2","DOIUrl":"10.1186/s12348-024-00420-2","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this article is to report a case of Lemierre's Syndrome producing unilateral endogenous endophthalmitis in a healthy, young woman with a history of tonsillitis.</p><p><strong>Case report/observations: </strong>A 17-year-old healthy woman developed fever after a few days of sore throat. She later developed pneumonia with septic signs, leading to admission to the Intensive Care Unit. Lemierre Syndrome was diagnosed due to multiple septic pulmonary emboli and signs of sepsis following a recent episode of tonsillitis. During hospitalization, the patient complained of decreased visual acuity and floaters in her left eye. Ophthalmological examination revealed papillary edema, vitritis, foci of chorioretinitis in the macula and Roth's spots, confirming the diagnosis of endogenous endophthalmitis. Subsequently, she underwent appropriate treatment, progressing satisfactorily.</p><p><strong>Conclusion and importance: </strong>Although ophthalmological manifestations are rare, due to the pathophysiological characteristics of Lemierre's Syndrome, all patients should underwent standard ophthalmologic assessment, even in the absence of ophthalmic symptoms or visible findings, as part of a multidisciplinary management approach.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"39"},"PeriodicalIF":2.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of paranasal abnormalities and systemic inflammation on primary acquired nasolacrimal duct obstruction.","authors":"Neslihan Sevimli, Sevda Aydın Kurna, Muhammet Çakır, Sezen Akkaya","doi":"10.1186/s12348-024-00416-y","DOIUrl":"10.1186/s12348-024-00416-y","url":null,"abstract":"<p><strong>Background: </strong>To determine the paranasal changes and inflammatory markers that may cause primary acquired nasolacrimal duct obstruction (PANDO) and to determine their relationship with success rates on different types of surgeries.</p><p><strong>Main body: </strong>We retrospectively reviewed the blood sample and computed tomography (CT) results on 92 patients who underwent dacryocystorhinostomy (DCR) surgery for PANDO and 82 healthy controls. Age, gender, paranasal abnormalities, hemogram values, International Normalized Ratio (INR) values, type of surgery, and recurrence rate were recorded; systemic Immune-inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), monocytes-to- lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) were calculated in both groups. In the case group, total white blood cells, monocytes, and INR values were significantly lower (p < 0.05). Platelet, lymphocyte, neutrophil, PLR, MLR, NLR, and SII values did not differ significantly between the control and case groups (p > 0.05). There was no significant difference in the CT results between the groups (p > 0.05). No correlation was found between CT findings and inflammatory markers. Dacryocystitis (DC) was seen in 20% of patients and they were all in the case group. No correlation was found between recurrence rate and age, gender, type of surgery, CT findings, and blood results (p > 0.05). The recurrence rate was significantly higher in patients with bilateral PANDO and with DC (p < 0.05).</p><p><strong>Short conclusion: </strong>The incidence of PANDO may not be directly related to paranasal abnormalities and systemic inflammation. Low INR values may cause obstruction in the nasolacrimal duct. Age, gender, type of surgery, CT findings, and inflammation level do not affect the success of the surgery.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"38"},"PeriodicalIF":2.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11324618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of pan-bacterial and pan-fungal PCR in endophthalmitis: case report and review of the literature.","authors":"Carson W Ercanbrack, Dania A Rahal, Muhammad Z Chauhan, Sayena Jabbehdari, Sami H Uwaydat","doi":"10.1186/s12348-024-00419-9","DOIUrl":"10.1186/s12348-024-00419-9","url":null,"abstract":"<p><strong>Background: </strong>Endophthalmitis is a clinical diagnosis but identification of the disease-causing agent or agents allows for a more tailored treatment. This is routinely done through intraocular fluid cultures and staining. However, culture-negative endophthalmitis is a relatively common occurrence, and a causative organism cannot be identified. Thus, further diagnostic testing, such as pan-bacterial and pan-fungal polymerase chain reactions (PCRs), may be required. BODY: There are now newer, other testing modalities, specifically pan-bacterial and pan-fungal PCRs, that may allow ophthalmologists to isolate a causative agent when quantitative PCRs and cultures remain negative. We present a case report in which pan-fungal PCR was the only test, amongst quantitative PCRs, cultures, and biopsies, that was able to identify a pathogen in endophthalmitis. Pan-PCR has unique advantages over quantitative PCR in that it does not have a propensity for false-positive results due to contamination. Conversely, pan-PCR has drawbacks, including its inability to detect viruses and parasites and its increased turnaround time and cost. Based on two large retrospective studies, pan-PCR was determined not to be recommended in routine cases of systemic infection as it does not typically add value to the diagnostic workup and does not change the treatment course in most cases. However, in cases like the one presented, pan-bacterial and pan-fungal PCRs may be considered if empiric treatment fails or if the infective organism cannot be isolated. If pan-PCR remains negative or endophthalmitis continues to persist, an even newer form of testing, next-generation sequencing, may aid in the diagnostic workup of culture-negative endophthalmitis.</p><p><strong>Conclusion: </strong>Pan-bacterial and pan-fungal PCR testing is a relatively new diagnostic tool with unique advantages and drawbacks compared to traditional culturing and PCR methods. Similar to the tests' use in non-ophthalmic systemic infections, pan-bacterial and pan-fungal PCRs are unlikely to become the initial diagnosis test and completely replace culture methods. However, they can provide useful diagnostic information if an infectious agent is unable to be identified with traditional methods or if empiric treatment of endophthalmitis continues to fail.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"37"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, predisposing factors, and management of moraxella keratitis in a tertiary eye hospital.","authors":"Mohammad Soleimani, Sadra Jalali Najafabadi, Alireza Razavi, Seyed Ali Tabatabaei, Saeed Mirmoosavi, Hassan Asadigandomani","doi":"10.1186/s12348-024-00417-x","DOIUrl":"10.1186/s12348-024-00417-x","url":null,"abstract":"<p><strong>Purpose: </strong>The Moraxella species is a very uncommon pathogen that leads to microbial keratitis (MK). This study aimed to evaluate the clinical features, predisposing factors, and outcomes of Moraxella keratitis in patients of a tertiary eye hospital.</p><p><strong>Methods: </strong>This retrospective study was conducted from 2015 to 2022, on patients who were admitted with the diagnosis of Moraxella keratitis confirmed by positive culture in a referral eye hospital. Demographics, predisposing factors, best-corrected visual acuity (BCVA), and prognosis were assessed.</p><p><strong>Results: </strong>A total of 106 individuals diagnosed with Moraxella keratitis, were analyzed. The mean age was 54.42 ± 19.43 years. The mean baseline BCVA of the patients was 2.28 ± 0.6 LogMAR, while this amount reached 1.49 ± 0.81 in the 6-month follow-up (P-value = 0.02). The mean BCVA in the six-month follow-up of the patients who needed surgical interventions was significantly lower than the patients who received only medical treatment (2.15 ± 0.65 vs. 1.29 ± 0.75 LogMAR, P-value = 0.02). Patients with diabetes and those without diabetes did not substantially vary in the prevalence of corneal perforation (P-value = 0.515). Three predisposing factors including corneal perforation (odds ratio = 19.27, P-value = 0.001), hypertension (HTN) (odds ratio = 3.62, P-value = 0.03), and older age (odds ratio = 1.03, P-value = 0.008) were significantly associated with more need for surgical interventions.</p><p><strong>Conclusion: </strong>In this cohort, poor prognosis necessitating surgical interventions in Moraxella keratitis was found to be associated with corneal perforation, HTN, and older age.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"36"},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Uveitis Patients on Anti-TNF Agents Who Develop Demyelinating Disease - A Case Series.","authors":"Abel Hamdan, Sumit Sharma, Kimberly Baynes, Rula A Hajj Ali, Careen Y Lowder, Sunil K Srivastava","doi":"10.1186/s12348-024-00403-3","DOIUrl":"10.1186/s12348-024-00403-3","url":null,"abstract":"<p><strong>Background/aims: </strong>Anti-tumor necrosis factor (Anti-TNF) agents have proven beneficial for the treatment of chronic non-infectious uveitis, yet rare neurological complications and demyelinating disease can occur with their use. Management of uveitis and neurological disease after developing these rare complications is not well understood. We sought to identify these specific cases and their outcomes through a retrospective observational case series.</p><p><strong>Methods: </strong>Electronic Medical Record (EMR) chart review of 394 non-infectious uveitis patients on anti-TNF therapy focused on identifying patients seen by uveitis specialists at a single institution who were on anti-TNF therapy and had developed neurological symptoms. Cases were reviewed for subsequent management and outcomes of both their neurologic and ocular inflammatory disease.</p><p><strong>Results: </strong>Five (5) patients were included following complaints of neurological symptoms while on anti-TNF therapy. Subsequent demyelinating diagnosis, acute treatment, and long-term course were described. All five patients continue to be inactive at around three years of anti-TNF discontinuation.</p><p><strong>Conclusion: </strong>Unidentified rare neurological symptoms and demyelinating disease associated with the use of anti-TNF agents can be detrimental to patient treatment outcomes. Emphasis is given on possible avoidance and early identification of exacerbating underlying disease through a detailed neurologic history and use of imaging when suspicion is high. Patients may have no evidence of higher neurological risk prior to starting an anti-TNF treatment. Discontinuation of an anti-TNF agent and subsequent control of disease is possible with alternative immunosuppressive treatments.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"14 1","pages":"35"},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}