Ocular Immunology and Inflammation最新文献

{"title":"Medication Refill Adherence in Patients with Chronic Inflammatory Eye Disease.","authors":"Arthi D Bharadwaj, Avisek Datta, Pooja Bhat, Ann-Marie Lobo-Chan","doi":"10.1080/09273948.2024.2427257","DOIUrl":"https://doi.org/10.1080/09273948.2024.2427257","url":null,"abstract":"<p><strong>Purpose: </strong>To utilize pharmacy dispenses to investigate adherence rates to immunosuppressive therapy (IMT) for the treatment of noninfectious inflammatory eye disease (IED), impact of adherence on disease control, factors associated with nonadherence, and association between adherence in the medical record and pharmacy dispenses.</p><p><strong>Method: </strong>Retrospective medical chart review was conducted on patients followed for at least 2 years in the uveitis clinic. Appointment and lab attendance, and provider documentation, determined adherence through the medical record. Dispense history was obtained from pharmacies, and IMT infusion dates were noted. Disease control was determined by clinical exam findings.</p><p><strong>Results: </strong>Sixty-three patients qualified for the study. The mean age was 49 years (SD = 19.4), 76.2% were female, 36.5% were Black/African American, and 96.8% were taking 1 or 2 IMTs. Pharmacy refill data was collected from 58 patients to determine an adherence rate (AR) of 63.9%. Thirty-nine patients (67.2%) had an average AR < 85% by pharmacy refill data and were thus deemed nonadherent. The majority of patients (86.2%) achieved ocular inflammation control. Nonadherence was 4.72 times more likely in patients taking >1 medication compared to one medication alone (95% CI: 1.02-21.86, <i>p</i> = 0.047). Comparing adherence from information in the medical record to pharmacy refill data, 71.6% of IMT comparisons were congruent (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Patients taking IMT for >2 years demonstrated an AR < 65% based on pharmacy data. Most patients achieved ocular quiescence. Using pharmacy information as an objective measure of adherence correlates with assessing adherence through medical record information.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716555","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":"Vitamin D Supplementation and Remission from Chronic Anterior Uveitis.","authors":"Hueyjong Shih, Yineng Chen, Katie Huynh, Eric B Suhler, Jennifer E Thorne, Nirali P Bhatt, C Stephen Foster, Douglas A Jabs, Grace A Levy-Clarke, Robert B Nussenblatt, James T Rosenbaum, H Nida Sen, Sapna S Gangaputra, Abhishek R Payal, Hosne Begum, Naira Khachatryan, Sherri-Ann M Burnett-Bowie, Gui-Shuang Ying, John H Kempen, Lucia Sobrin","doi":"10.1080/09273948.2024.2427857","DOIUrl":"https://doi.org/10.1080/09273948.2024.2427857","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic anterior uveitis (CAU) often requires suppressive therapy, which has potential side effects including cataract, ocular hypertension, and increased risk of infection. No remittive therapy is currently available; however, several studies have demonstrated an association between low 25-hydroxy Vitamin D (25OHD) levels and either uveitis incidence or uveitis disease activity. This study investigates the potential of Vitamin D supplementation as a remittive treatment for CAU.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using data from the Systemic Immunosuppressive Therapy for Eye Disease (SITE) cohort study, which included patients with ocular inflammatory disease seen at U.S. tertiary centers between 1979 and 2010. Vitamin D supplementation data was analyzed for patients with CAU. Eyes were considered in remission if they remained quiet for at least 90 days off all anti-inflammatory treatment for eye disease.</p><p><strong>Results: </strong>Among 2688 patients who never used Vitamin D, the cumulative adjusted CAU remission incidence was 13.5% at the 16-month follow-up. In contrast, among 75 patients who used Vitamin D for a duration of ≤1 year, the cumulative adjusted CAU remission incidence was 28% at 16 months. The use of Vitamin D was associated with a crude hazard ratio for remission of 2.14 [95% confidence interval (CI) 1.23-3.71, <i>p</i> = 0.0071], and an adjusted hazard ratio for remission of 2.43 [95% CI: 1.36-4.33, <i>p</i> = 0.0027].</p><p><strong>Conclusion: </strong>In the SITE Cohort, Vitamin D supplementation is associated with a significantly increased incidence of remission. Vitamin D supplementation should be explored in a prospective trial as the next step of evaluation.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-4"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716667","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":"Candidate Tear-Based Uveitis Biomarkers in Children with JIA Based on Arthritis Activity and Topical Corticosteroid Use.","authors":"Ilaria Maccora, Mekibib Altaye, Kenneth D Greis, Hermine I Brunner, Alexandra Duell, Wendy D Haffey, Tiffany Nguyen, Megan Quinlan-Waters, Grant S Schulert, Alyssa Sproles, Virginia Miraldi Utz, Sherry Thornton, Sheila T Angeles-Han","doi":"10.1080/09273948.2024.2428846","DOIUrl":"https://doi.org/10.1080/09273948.2024.2428846","url":null,"abstract":"<p><strong>Background: </strong>Uveitis is an inflammatory ocular disease secondary to disruption of the retinal pigmented epithelium (RPE) and blood retinal barrier (BRB). Known clinical factors do not accurately predict uveitis risk in Juvenile Idiopathic Arthritis (JIA). Tear fluid is easily obtained for biomarker study. We aim to identify tear-based markers associated with the presence of uveitis in children with JIA.</p><p><strong>Methods: </strong>In a cross-sectional comparative cohort study, tears were collected by Schirmer strips from children with oligoarticular JIA-associated uveitis (JIA-U) and JIA without uveitis (JIA-no-U). A tandem isotope tagging (iTRAQ and TMT) strategy was used for relative quantitation via nanoLC-MS/MS to quantify proteins in the affected eye. Log transformed relative protein abundance of protein levels was compared between groups using Wilcoxon exact test. We explored the influence of arthritis activity and topical corticosteroids (CS) use on protein levels. STRING analysis was performed.</p><p><strong>Results: </strong>Tear samples of 14 JIA-U and 14 JIA-no-U patients were analyzed. Thirteen proteins were differentially expressed between both groups. Stratified analysis based on arthritis activity (inactive arthritis) and topical CS (off CS) showed that alpha-2-macroglobulin (<i>p</i> = 0.012), apolipoprotein A1 (<i>p</i> = 0.036), S100A9 (<i>p</i> = 0.05), haptoglobin (<i>p</i> = 0.066), and transthyretin (<i>p</i> = 0.066) consistently differentiated between both groups. On STRING analysis, these proteins were associated with the RPE, BRB, and inflammation.</p><p><strong>Conclusion: </strong>Importantly, we identified proteins involved in the RPE, BRB, and immune response that were differentially abundant in the tears of children with JIA-U compared to JIA-no-U, regardless of arthritis activity or topical CS. Candidate tear-based biomarkers may represent a non-invasive means to detect uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716605","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":"Prevalence and Incidence of Uveitis in Korean Patients with Sarcoidosis: A Population-Based Study.","authors":"Daehwan Shin, Seongho Kim, Mingui Kong, Bo Hee Kim, Su Jeong Song","doi":"10.1080/09273948.2024.2430708","DOIUrl":"https://doi.org/10.1080/09273948.2024.2430708","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcoidosis is a systemic granulomatous inflammatory disease with varying clinical presentations, including sarcoid uveitis, which is the most prevalent ocular manifestation of sarcoidosis and differs by region and ethnicity. This study aims to determine the incidence and prevalence of sarcoidosis-related uveitis in South Korea, providing essential epidemiological data.</p><p><strong>Methods: </strong>This nationwide, population-based retrospective study used the Korean Health Insurance Review and Assessment database from 2010 to 2019. It included all individuals diagnosed with sarcoidosis (ICD-10 code D86) and focused on those with newly developed uveitis. We assessed annual incidence, prevalence, gender-specific trends, age at diagnosis, treatment patterns, and recurrence. Cases were categorized as single episode or recurrent/chronic based on treatment duration and interval before recurrence.</p><p><strong>Results: </strong>Among 9,485 patients with sarcoidosis, 2,730 (28.8%) had sarcoidosis-related uveitis, with 2,413 (88.4%) being recurrent/chronic. Anterior uveitis was the most common presentation (78.0%), with posterior segment involvement in 22.0% of cases. The peak age of onset was 50-59 years for both genders. The incidence rate was 0.33 and 0.64 per 100,000 for men and women, respectively. The prevalence was 0.18 and 0.35 per 100,000 for men and women, respectively. Among sarcoidosis patients, 32.9% with uveitis used three or more combinations of systemic steroids and immunosuppressants, compared to 11.1% without uveitis.</p><p><strong>Conclusion: </strong>The high prevalence of sarcoid uveitis in sarcoidosis patients necessitates regular ophthalmic examinations. Our findings highlight the need for comprehensive eye care in managing sarcoidosis and suggest that uveitis may increase disease severity, warranting tailored treatment and enhanced monitoring protocols in Korea.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716574","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":"CMV-Related Hemorrhagic Retinal Vasculitis in a Multiple Myeloma Patient on Daratumumab Therapy: A Case Report.","authors":"Matthaeus Ware, Yasmin Motekalem, Kirill Zaslavsky, Miguel Cruz-Pimentel, Vishal Kukreti, Alexander J Kaplan, Peng Yan","doi":"10.1080/09273948.2024.2432554","DOIUrl":"https://doi.org/10.1080/09273948.2024.2432554","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of cytomegalovirus (CMV)-related hemorrhagic retinal vasculitis in a patient with multiple myeloma (MM) on daratumumab, a trial cereblon E3 ligase modulatory drug (CELMoD), dexamethasone, and acyclovir, and discuss clinical implications for CMV prophylaxis.</p><p><strong>Methods: </strong>Case report, narrative review of CMV reactivation risk in MM patients on daratumumab and antiviral agent efficacy for CMV prophylaxis.</p><p><strong>Results: </strong>A 63-year-old female presented with 3 days of progressive unilateral vision loss in the right eye to the level of counting fingers. She had a history of relapsed and refractory MM and autologous stem cell transplant (ASCT). At the time of presentation, she was receiving daratumumab, a trial CELMoD, dexamethasone, and acyclovir. Posterior segment exam demonstrated trace vitreous cells (0.5+ vitritis as per SUN criteria) and scattered hemorrhages with multifocal intraluminal vascular whitening, aligned with infectious posterior uveitis and suggestive of panretinal occlusive vasculitis. Optical coherence tomography showed inner macular edema and epiretinal membrane formation. CMV reactivation was confirmed with PCR of anterior chamber fluid and blood.</p><p><strong>Conclusion: </strong>Patients with MM on daratumumab are at increased risk of opportunistic reactivations including CMV, potentially due to daratumumab's immunomodulatory side effects. Our patient developed CMV-related hemorrhagic retinal vasculitis despite low-dose acyclovir, which provides limited protection against CMV reactivation in CMV seropositive individuals. This case report therefore offers casuistic support for ophthalmic screening for CMV reactivation or CMV prophylaxis with letermovir in this patient population.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-4"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716552","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":"Multimodal Imaging in Unilateral Acute Idiopathic Maculopathy with <i>Staphylococcus aureus</i> Infection.","authors":"Padmamalini Mahendradas, Aditya Patil, Rahul Patil, Raghav Narasimhan, Radhika Sriram, Sai Bhakti Mishra, Ankush Kawali, Poornachandra Gowda, Rohit Shetty, Abhijit Sinha Roy","doi":"10.1080/09273948.2024.2425976","DOIUrl":"https://doi.org/10.1080/09273948.2024.2425976","url":null,"abstract":"<p><strong>Purpose: </strong>To report the multimodal imaging findings in the case of unilateral acute idiopathic maculopathy (UAIM) associated with <i>Staphylococcus aureus</i> infection in a young girl with good clinical outcome.</p><p><strong>Methods: </strong>Rare case report with multimodal imaging including fundus photography, optical coherence tomography (OCT), autofluorescence, multicolor imaging, OCT angiography, fluorescein angiography (FA), and polarization sensitive OCT (PS-OCT).</p><p><strong>Results: </strong>A 13-year-old girl presented with blurring of vision in the left eye (OS). Fundus examination revealed yellowish subretinal deposits at the fovea in OS with findings resembling UAIM on ophthalmoscopy, OCT, and FA. We noted the OCT angiography and PS-OCT findings in this case. Blood culture revealed the growth of <i>Staphylococcus aureus</i>. Autoimmune work-up was negative. Patient was treated with appropriate systemic antibiotics. At 8 weeks follow-up, there was resolution of the lesion clinically and on OCT, with residual derangement of the retinal pigment epithelium.</p><p><strong>Conclusion: </strong>Our patient had UAIM presumed to have been triggered by systemic bacterial infection. The patient made an uneventful recovery following antimicrobial therapy. Multimodal imaging demonstrates the affection of the outer retinal layers and retinal pigment epithelium in this case.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676298","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":"Bilateral Involvement in Childhood Presumed Trematode Induced Granulomatous Anterior Uveitis.","authors":"Amgad El Nokrashy, Ghada H Allam, Anas Adi, Waleed A Abou Samra, Engy Elemry, Nashaat Shawky, Aya M Hashish","doi":"10.1080/09273948.2024.2428422","DOIUrl":"https://doi.org/10.1080/09273948.2024.2428422","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to elucidate the clinical spectrum of trematode-induced uveitis (TIU), with a particular focus on its bilateral presentation and providing significant insights into its pathophysiology.</p><p><strong>Methods: </strong>A prospective cross-sectional observational study was conducted at the uveitis outpatient clinic of Mansoura University Ophthalmic Center. The study involved children diagnosed with presumed TIU. Comprehensive clinical evaluations were performed, including detailed history taking and thorough ophthalmological examinations of both the anterior and posterior segments, emphasizing the unaffected fellow eye.</p><p><strong>Results: </strong>The cohort consisted of 80 children, with a male predominance of 98.75%. The proportion of bilateral involvement was observed in 12 out of 80 (15%). The involvement of the fellow eye was observed as follows: conjunctival hyperemia (3/80), conjunctival phlycten-like lesions (3/80), ciliary injection (10/80), corneal immune infiltration (4/80), retro-corneal membrane (5/80), anterior chamber granuloma (5/80), peripheral anterior synechiae (3/80), complicated cataract (2/80), diffuse cyclitis and choroid thickening (12/80), and intermediate uveitis (11/80).</p><p><strong>Conclusion: </strong>This study demonstrates that TIU is not confined to the initially affected eye; the fellow eye may also be affected in a significant number of cases. Therefore, it is crucial to conduct thorough examinations of both eyes in patients diagnosed with TIU to ensure comprehensive clinical management.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676392","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":"MicroRNAs as Biomarkers for Uveitis in Juvenile Idiopathic Arthritis.","authors":"Yael Sharon, Gil Ben-David, Yael Nisgav, Gil Amarilyo, Guy Shapira, Ifat Israel-Elgali, Shani Pillar, Nir Pillar, Noam Shomron, Michal Kramer","doi":"10.1080/09273948.2024.2428417","DOIUrl":"https://doi.org/10.1080/09273948.2024.2428417","url":null,"abstract":"<p><strong>Purpose: </strong>Uveitis associated with juvenile idiopathic arthritis (JIA-U) is a clinically silent vision-impairing disease. Early detection and aggressive treatment are crucial for optimal visual outcome. Alterations in levels of microRNAs (miRNAs) are characteristic of autoimmune diseases. The present clinical study sought to explore the expression of miRNAs in JIA-U and their potential role as a predictive biomarker.</p><p><strong>Methods: </strong>MiRNA expression profiling was performed on peripheral blood mononuclear cells derived from pediatric patients with JIA, JIA-U, or other types of uveitis using the high-throughput small-RNA sequencing (on Next Generation Sequencing (NGS)). Patient- and disease-related data were retrieved from the medical files. Main outcome measure was the differential expression of miRNAs among the groups.</p><p><strong>Results: </strong>The cohort included 35 patients; 20 children with JIA-U (8 with active disease), 10 with JIA without ocular involvement, and 5 with other types of uveitis (4 with active disease). Mean age was 8.6 years; 83% were female. Nineteen patients (54%) received immunomodulatory treatment. The expression of miR-4485-3p was significantly increased in patients with JIA-U compared to patients with JIA alone (<i>p</i> < 0.05), with no difference between patients with active or inactive uveitis. The expression in patients with uveitis of other etiologies was similar to the expression in JIA-U patients.</p><p><strong>Conclusions: </strong>This study demonstrates a differential expression profile of a specific miRNA in JIA patients with and without uveitis. If verified in larger studies, the findings may assist to identify JIA patients at risk to develop uveitis and to improve early detection of disease activity.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676396","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":"Is it Time to Adopt a New Nomenclature and Classification for White Dot Syndromes Using Multimodal Imaging Techniques? Report 1 from Multimodal Imaging in Uveitis (MUV) Task Force.","authors":"Claudia Fabiani, Jessica Shantha, Sapna Gangaputra, Antonio Vitale, Jennifer E Thorne, Douglas A Jabs, Amani Fawzi, Justine R Smith, Massimo Accorinti, Marc D de Smet, Rupesh Agrawal, Marion R Munk, Aniruddha Agarwal, Francesco Pichi, Ester Carreño, Alessandro Invernizzi, Soon-Phaik Chee, Janet L Davis, David Sarraf, Vishali Gupta","doi":"10.1080/09273948.2024.2423870","DOIUrl":"https://doi.org/10.1080/09273948.2024.2423870","url":null,"abstract":"<p><strong>Purpose: </strong>The survey aims to explore the use of existing nomenclature and current clinical and multimodal imaging (MMI) approach in diagnosing white dot syndromes (WDS) among uveitis and retina specialists.</p><p><strong>Methods: </strong>The members of the International Uveitis Study Group (IUSG) task force MUV (Multimodal imaging in UVeitis) developed a survey. The questionnaire, created using Qualtrics, consisted of 22 questions. The responses were compared against regions, workplace setting, sub-specialty, and experience of the participants.</p><p><strong>Results: </strong>A total of 432 participants initiated the background section; 343 initiated the investigation section and 263/343 completed the survey (76.7%). The majority (43.7%) reported a specialty/practice focus mostly on uveitis, 32.2% on uveitis and retina, and 20.1% mostly on retina. Specifically, 55.7% were in practice > 10 years post-fellowship and 65.8% worked in academic settings. The term WDS was not universally used in clinical practice, with no significant differences by region, subspecialty, experience, workplace setting or number of WDS patients managed in the prior year (<i>p</i> > 0.01). Nearly 90% of participants reported using MMI to diagnose WDS. More than 70% advocated redefining the nomenclature and classification of WDS based on the primary anatomical location of disease using MMI without significant regional or professional differences (<i>p</i> > 0.01).</p><p><strong>Conclusion: </strong>These results underscore the widespread adoption of MMI among uveitis and retina specialists in the characterization of entities traditionally grouped under the term WDS. Respondents strongly agree that MMI provides a precise distinction between these posterior uveitis, advocating for the overcoming of the clinical term WDS in favor of a patho-anatomic redefinition.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625085","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":"Vogt-Koyanagi-Harada Disease Presenting as Papillitis vs. Classic Serous Retinal Detachment: A Comparative Analysis of Outcomes.","authors":"Raul E Ruiz-Lozano, Eugenia M Ramos-Dávila, Eduardo Camacho-Martinez, Carlos Alvarez-Guzman, Angelina Espino Barros Palau, Alejandro Rodriguez-Garcia","doi":"10.1080/09273948.2024.2424475","DOIUrl":"https://doi.org/10.1080/09273948.2024.2424475","url":null,"abstract":"<p><strong>Background: </strong>To compare the treatment outcome and visual prognosis of Vogt-Koyanagi-Harada (VKH) disease presenting as papillitis vs. serous retinal detachment (SRD).</p><p><strong>Methods: </strong>Retrospective comparative cohort study of 35 patients with previously unknown VKH diagnosis, followed-up for ≥6 months. Outcomes measured: (1) time to achieve inflammatory control; (2) VKH relapse; (3) ocular complications (glaucoma, sunset glow fundus, cataract, and vision loss ≥2 Snellen lines); and (4) chances for developing a chronic-recurrent disease.</p><p><strong>Results: </strong>Females predominated in both groups: 12/16 (75%) papillitis and 18/19 (94.7%) SRD. The mean age at presentation was 29 ± 12 years in the papillitis and 36 ± 14 years in the SRD group (<i>p</i> = 0.119), with an overall median follow-up of 26 months (6-180 months). The papillitis-onset VKH group's mean time elapsed between symptoms onset and initial treatment was shorter (2.9 ± 1.0 vs. 4.6 ± 2.8 weeks, <i>p</i> = 0.024). Anterior segment inflammation was lower (56% vs. 79%, <i>p</i> = 0.018), requiring a shorter corticosteroids treatment duration (12.8 ± 16.1 vs. 32.7 ± 34.1 months, <i>p</i> = 0.040), achieving an earlier inflammatory control (1.9 ± 0.6 vs. 4.1 ± 3.2 months, <i>p</i> <0.001) with fewer ocular complications (13% vs. 74%, <i>p</i> <0.001), including sunset glow fundus (SGF) (0% vs. 63%, <i>p</i> <0.001). Conversely, SRD-onset VKH was a risk factor for developing disease relapse (HR: 4.53; 95% CI: 1.31-15.69, <i>p</i> = 0.017), ocular complications (OR: 19.60, 95% CI: 3.24-118.50, <i>p</i> = 0.001), and chronic-recurrent disease (OR: 20.63; 95% CI: 2.24-189.84, <i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>Mexican-mestizo VKH patients with papillitis-onset VKH disease showed earlier inflammatory control, fewer recurrences, and better visual and ocular complication outcomes.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605414","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}