Ocular Immunology and Inflammation最新文献

{"title":"Autoimmune Retinopathy Following COVID-19: A Case Report.","authors":"Sahba Fekri, Parisa Mahmoudimehr, Behrooz Oliya, Seyed-Hossein Abtahi, Hosein Nouri","doi":"10.1080/09273948.2024.2372666","DOIUrl":"https://doi.org/10.1080/09273948.2024.2372666","url":null,"abstract":"<p><strong>Purpose: </strong>To present a presumed case of non-paraneoplastic autoimmune retinopathy (nPAIR) following COVID-19 in a healthy woman.</p><p><strong>Methods: </strong>A single case was evaluated and followed for 32 months.</p><p><strong>Results: </strong>A healthy 32-year-old woman presented with photopsia and paracentral scotoma (OU) after a recent COVID-19 infection. Past medical history and family history were unremarkable. Her visual acuity was normal (OU). Retinal atrophy, mild disc pallor, and foveal reflex attenuation were observed (OU). Optical coherence tomography (OCT) scans showed outer nuclear layer thinning and ellipsoid zone disruption (OU). The visual field test showed blind spot enlargement and arcuate scotomas (OU). Uveitis workup and underlying malignancy investigations were negative. A diagnosis of nPAIR was presumed. At the time, she refused therapy, and 20 months later, her visual acuity was stable, but there were progressive retinal atrophic changes and visual field constriction. After initiation of glucocorticoids and immunosuppressive therapy, flashing lights completely disappeared, her visual field was stabilized without progression, and OCT scans showed partial recovery of ellipsoid zone.</p><p><strong>Conclusion: </strong>SARS-CoV-2 infection may be a trigger for nPAIR in susceptible individuals, but further research is needed to determine this association.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Acinetobacter baumannii</i> Endogenous Endophthalmitis Presenting with Iris Nodules.","authors":"Kalpana Babu, S Chandana, Aniruddha Tirumalai, Krishna R Murthy","doi":"10.1080/09273948.2024.2412215","DOIUrl":"https://doi.org/10.1080/09273948.2024.2412215","url":null,"abstract":"<p><strong>Aim: </strong>We report a unique finding of iris nodules in a woman with endogenous endophthalmitis due to <i>Acinetobacter baumannii</i> with no history of ocular surgery or trauma and good visual outcome.</p><p><strong>Materials & methods: </strong>Retrospective case report.</p><p><strong>Results: </strong>A 39-year-old woman with a history of type 2 diabetes mellitus presented with a decrease in vision in the right eye of 1-month duration. On examination, her BCVA was CF2m (OD) and 6/6 (OS). Right eye examination showed medium-to-large-sized keratic precipitates, iris nodules, and vitritis. PCR on the aqueous showed faint positivity for <i>Propionibacterium acne</i> and was negative to panfungal genome. Despite two intravitreal injections of vancomycin (1 mg/0.1 ml) and intravenous cefazolin 1 g bd for 5 days, there was progression to hypopyon. Vitrectomy with lensectomy was done. The vitreous culture grew <i>Acinetobacter baumannii</i>. She was given multiple intravitreal ceftazidime (2.25 mg/0.1 ml) with dexamethasone (0.4 mg/0.1 ml) injections. She was also put on tab bactrim DS twice a day for 3 months along with tab doxycycline 100 mg twice a day for 3 months by the infectious disease specialist. As the inflammation improved, the iris nodules were the last to resolve completely in 6 weeks. At 15-month follow-up, her eye was quiet, and vision was 6/9 (OD) with aphakic correction.</p><p><strong>Conclusion: </strong>We report a rare finding of iris nodules in a patient with culture proven <i>Acinetobacter baumannii</i> endogenous endophthalmitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Intermediate Uveitis.","authors":"Sonya Besagar, Alejandra de-la-Torre, Jennifer Thorne, Jyotirmay Biswas, Rupesh Agrawal, Eric B Suhler, John H Kempen, Sapna Gangaputra","doi":"10.1080/09273948.2024.2408411","DOIUrl":"https://doi.org/10.1080/09273948.2024.2408411","url":null,"abstract":"<p><p>Intermediate uveitis is defined as inflammation of the vitreous and pars planitis. Etiology can be infectious, associated with a systemic disease, neoplastic or idiopathic. Pars planitis is the term used for idiopathic intermediate uveitis that presents with snowballs and snowbanks. While relatively rare, intermediate uveitis is present globally and typically affects adult females. Awareness of the presentation and a dilated fundus examination in patients presenting with floaters is essential to the diagnosis. PCR testing has enhanced the ability to diagnose infectious and neoplastic conditions that masquerade as intermediate uveitis. A structured review of systems and focused imaging, and laboratory testing will assist with early diagnosis and initiation of treatment.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Helicobacter pylori</i> and Its Treatment Impact on Immune-Mediated Ocular Diseases.","authors":"Yi-Chun Chi, Hui-Min Hsieh, Wei-Shan Chang, Ming-Sheng Lee, Chih-Hao Lin, Kun-Der Lin, Fu-Chen Kuo, Deng-Chyang Wu, Shwu-Jiuan Sheu","doi":"10.1080/09273948.2024.2411299","DOIUrl":"https://doi.org/10.1080/09273948.2024.2411299","url":null,"abstract":"<p><strong>Purpose: </strong><i>Helicobacter pylori</i> (HP), which colonizes exclusively in the gastrointestinal tract, has been reported to dysregulate the immune response and gives rise to several extra-gastrointestinal autoimmune disorders. However, the relationship between HP and immune-mediated ocular diseases remains ambiguous. This study aims to clarify the association between immune-mediated ocular diseases and HP infection, as well as the impact of HP treatment on the incidence of immune-mediated ocular diseases.</p><p><strong>Methods: </strong>This is a retrospective population-based study using National Health Insurance Research Database in Taiwan. Patients with newly diagnosed peptic ulcer disease or HP infection between 2009 and 2015 were identified as HP group and compared to the non-HP group with one-to-one exact matching. Moreover, the incident risk of immune-mediated ocular diseases and its two subgroups (ocular surface and orbital inflammation group, intraocular inflammation group) were compared in HP patients with or without treatment.</p><p><strong>Results: </strong>A total of 1,030,119 subjects in the non-HP group and 1,030,119 patients in the HP group were enrolled. The incidence rate of immune-mediated ocular diseases was significantly higher in the HP group (95% confidence interval (CI): 2.534-2.547). The incident rate ratio was significantly higher in HP with treatment than without treatment (HR: 1.654, 95% CI: 1.641-1.668). The Cox proportional hazards regression model demonstrated a significantly increased HR of immune-mediated ocular diseases in HP treated group (HR: 2.265, 95% CI: 2.024-2.534) and less increased HR in HP non-treated group (HR: 1.427, 95% CI: 1.273-1.598) when comparing to non-HP group. Subgroup analysis demonstrated a significantly higher incidence rate of ocular surface and orbital inflammation as well as intraocular inflammation in the HP group.</p><p><strong>Conclusion: </strong>This study illustrated a higher incidence of immune-mediated ocular diseases in HP infection, and a heightened risk following HP eradication.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptospiral Uveitis: Case Series and Review of Literature.","authors":"Abhilasha Baharani, Raja Rami Reddy P","doi":"10.1080/09273948.2023.2296037","DOIUrl":"10.1080/09273948.2023.2296037","url":null,"abstract":"<p><strong>Aim: </strong>To present the clinical features and review of literature of leptospiral uveitis.</p><p><strong>Methods: </strong>We present clinical features of patients with leptospiral uveitis with positive Leptospira IgM antibodies.</p><p><strong>Results: </strong>Twenty-six eyes of 24 patients, 11 males (45.8%), were included. The mean age was 37.5 ± 15.6 years. 91.7% had unilateral uveitis, 88.5% panuveitis, 11.5% anterior uveitis, 15.4% had hypopyon, 8% had cataract and 3.8% eyes had cystoid macular edema. Vitritis with characteristic vitreous membranes was an important feature. Retinal and choroidal vasculature were preserved on swept-source optical coherence tomography angiography. Mean presenting BCVA was logMAR0.49 ± 0.41, while final BCVA was logMAR0.04 ± 0.13. The mean duration for complete resolution of uveitis was 39.1 ± 15.5 days. 84.6% eyes achieved BCVA 6/6.</p><p><strong>Conclusion: </strong>Leptospiral uveitis is an under-reported entity. It may present as anterior uveitis or panuveitis. It must be included in the differential diagnosis of non-granulomatous uveitis. The visual prognosis is usually favorable even in severe cases.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Vasculitis in a Patient with Rhupus.","authors":"Harshali Kamat, Ashad Sivaraman, Mithun C B, Parthopratim Dutta Majumder","doi":"10.1080/09273948.2023.2295533","DOIUrl":"10.1080/09273948.2023.2295533","url":null,"abstract":"<p><p>This case report describes a case of retinal vasculitis in a patient with Rhupus, which has not been reported earlier in the literature. A 39-year-old female patient with a history of Rhupus presented with sudden vision loss in her left eye. The patient was treated earlier, for her polyarthritis, with oral corticosteroids, hydroxychloroquine, and oral methotrexate, which were discontinued after 1 year of treatment. At presentation, fundus examination of the left eye revealed mild vitritis, perivenous sheathing, and hemorrhagic periphlebitis. The patient was administered three doses of pulse corticosteroid, resulting in a reduction in retinal vasculitis and macular edema. The patient was continued on oral corticosteroids and started on oral methotrexate and hydroxychloroquine. At 6-week follow-up, the patient's vision had improved to 6/9, and fundus examination revealed resolving phlebitis and retinal hemorrhages. This case also highlights the importance of prompt diagnosis and treatment of retinal vasculitis in patients with Rhupus.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Anterior Uveitis: A Practical and Comprehensive Review of Diagnosis and Treatment.","authors":"Yun Feng, Ruby Garcia, William Rojas-Carabali, Carlos Cifuentes-González, Ikhwanuliman Putera, Jingyi Li, Rina La Distia Nora, Padmamalini Mahendradas, Vishali Gupta, Alejandra de-la-Torre, Rupesh Agrawal","doi":"10.1080/09273948.2023.2271077","DOIUrl":"10.1080/09273948.2023.2271077","url":null,"abstract":"<p><p>Anterior uveitis is the most common type of uveitis worldwide. The etiologies of anterior uveitis can be divided into infectious and non-infectious (idiopathic, autoimmune, autoinflammatory, trauma, and others). The viral pathogens most commonly associated with infectious anterior uveitis include Herpes Simplex Virus, Varicella-Zoster Virus, Cytomegalovirus, and Rubella Virus. Other emerging causes of viral anterior uveitis are West Nile Virus, Human-Immunodeficiency Virus, Epstein-Barr Virus, Parechovirus, Dengue Virus, Chikungunya Virus, and Human Herpesvirus type 6,7, and 8. Early recognition allows prompt management and mitigates its potential ocular complications. This article provides an updated literature review of the epidemiology, clinical manifestations, diagnostic tools, and treatment options for viral anterior uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49680393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular Whipple Disease: Cases Diagnosed Over Four Decades.","authors":"Ali R Salman, Diva R Salomao, Lauren A Dalvin, Timothy W Olsen, Wendy M Smith","doi":"10.1080/09273948.2023.2271995","DOIUrl":"10.1080/09273948.2023.2271995","url":null,"abstract":"<p><strong>Purpose: </strong>To describe ocular involvement in subjects with Whipple's disease (WD).</p><p><strong>Methods: </strong>Retrospective review of documented WD cases seen at Mayo Clinic between 1980 and 2021 with ocular involvement.</p><p><strong>Results: </strong>Of 217 patients with WD, 30 had eye exams and four (two female, median age 58.5 years) had ocular involvement. Findings included anterior/intermediate uveitis (<i>n</i> = 2), intermediate uveitis and phlebitis (<i>n</i> = 1), and chorioretinitis with vitritis (<i>n</i> = 1). The diagnosis was confirmed by vitreous biopsy in three of four cases. In two cases, WD diagnosis was unconfirmed prior to the ocular diagnosis. Systemic manifestations included gastrointestinal symptoms in all patients, synovitis (<i>n</i> = 3), weight loss (<i>n</i> = 2), and pericarditis (<i>n</i> = 1). Mean time from onset of ocular symptoms to ocular diagnosis was 11 months (range 2-28 months). Prior systemic symptoms were present as long as 3 years.</p><p><strong>Conclusions: </strong>WD is uncommon and ocular involvement is even more rare. However, WD should be considered in the differential for all patients with chronic recalcitrant uveitis, especially in the setting of polyarthralgias and/or gastrointestinal symptoms. Vitreous biopsy is a reliable method to diagnose ocular WD.<b>Abbreviations and Acronyms:</b> Whipple's disease (WD), intestinal lipodystrophy (IL), polymerase-chain reaction (PCR), periodic acid-Schiff (PAS), trimethoprim/sulfamethoxazole (TMP/SMX).</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71425488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of IL-6, IL-10, and TNF-α in Ocular GVHD Following Allogeneic Transplantation.","authors":"Yingjie Chen, Xinyu Zhuang, Lei Wang, Yue Xu, Zhengtai Sun, Yaru Ren, Feng Chen, Xiao Ma, Xiaowen Tang, Xiaofeng Zhang","doi":"10.1080/09273948.2024.2302445","DOIUrl":"10.1080/09273948.2024.2302445","url":null,"abstract":"<p><strong>Purpose: </strong>To figure out the roles of tear inflammatory cytokines in Ocular graft-versus-host disease (oGVHD) symptoms by analyzing tear cytokine levels and related factors.</p><p><strong>Methods: </strong>This prospective study involved 27 post-HSCT patients and 19 controls with dry eye disease. Analyses included tear cytokine (IL-6, IL-10, and TNF-α), ocular surface evaluation, and conjunctival impression cell examination. Tear cytokine levels were evaluated in three grades of corneal epithelial lesions. The study also analyzed the correlation between tear cytokine levels and ocular surface parameters. Tear cytokine levels were then used in a Receiver Operating Characteristic (ROC) curve and linear regression model to predict oGVHD related factors.</p><p><strong>Results: </strong>IL-6 has good diagnostic efficacy in oGVHD related dry eye. Elevated levels of tear IL-6 and TNF-α were observed in the group with severe corneal epithelial lesions. IL-6 levels were positively correlated with corneal fluorescein staining (CFS), eyelid margin hyperemia, conjunctival lesions, and meibum secretion. IL-6 showed excellent predictive ability with Area Under the Curve (AUC) values all greater than 0.70 (<i>p</i> < 0.05). IL-10 and TNF-α were negatively correlated with the meibomian gland proportion and conjunctival goblet cell (GC) density, while TNF-α was positively correlated with CFS and eyelid margin hyperemia.</p><p><strong>Conclusion: </strong>Dry eye symptoms related to ocular GVHD, can be partly diagnosed and assessed using various tear cytokine level detection methods.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Diagnostic Accuracy and Management Recommendations of ChatGPT in Uveitis.","authors":"William Rojas-Carabali, Carlos Cifuentes-González, Xin Wei, Ikhwanuliman Putera, Alok Sen, Zheng Xian Thng, Rajdeep Agrawal, Tobias Elze, Lucia Sobrin, John H Kempen, Bernett Lee, Jyotirmay Biswas, Quan Dong Nguyen, Vishali Gupta, Alejandra de-la-Torre, Rupesh Agrawal","doi":"10.1080/09273948.2023.2253471","DOIUrl":"10.1080/09273948.2023.2253471","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate diagnosis and timely management are vital for favorable uveitis outcomes. Artificial Intelligence (AI) holds promise in medical decision-making, particularly in ophthalmology. Yet, the diagnostic precision and management advice from AI-based uveitis chatbots lack assessment.</p><p><strong>Methods: </strong>We appraised diagnostic accuracy and management suggestions of an AI-based chatbot, ChatGPT, versus five uveitis-trained ophthalmologists, using 25 standard cases aligned with new Uveitis Nomenclature guidelines. Participants predicted likely diagnoses, two differentials, and next management steps. Comparative success rates were computed.</p><p><strong>Results: </strong>Ophthalmologists excelled (60-92%) in likely diagnosis, exceeding AI (60%). Considering fully and partially accurate diagnoses, ophthalmologists achieved 76-100% success; AI attained 72%. Despite an 8% AI improvement, its overall performance lagged. Ophthalmologists and AI agreed on diagnosis in 48% cases, with 91.6% exhibiting concurrence in management plans.</p><p><strong>Conclusions: </strong>The study underscores AI chatbots' potential in uveitis diagnosis and management, indicating their value in reducing diagnostic errors. Further research is essential to enhance AI chatbot precision in diagnosis and recommendations.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10313380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}