Ocular Immunology and Inflammation最新文献

{"title":"Successful Use of Adalimumab Monotherapy in Managing Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome.","authors":"Shima Dehghani, Ramsey Yusuf, Janet L Davis","doi":"10.1080/09273948.2026.2696520","DOIUrl":"https://doi.org/10.1080/09273948.2026.2696520","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of successful control of IRVAN syndrome with adalimumab monotherapy and to describe relapse of aneurysms after dose tapering.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 46-year-old male presented with missing areas in his vision in both eyes and was diagnosed with IRVAN syndrome after comprehensive examination and imaging. The patient was initially treated with a three-month tapering course of high-dose oral prednisone, followed by azathioprine for four months. Due to worsening nonperfusion and vasculitis, cyclosporine was added; however, after five additional months without adequate disease control, both agents were discontinued and biweekly adalimumab monotherapy was initiated. The patient was monitored over five years, including an attempted tapering of the medication. The patient showed marked clinical improvement with adalimumab, including significant reduction in peripheral vascular leakage and aneurysmal dilatations. However, tapering the adalimumab dose from biweekly to monthly led to disease relapse, characterized by increased size and number of retinal aneurysms. Resuming the bi-weekly dose of adalimumab resulted in the regression of aneurysms and improvement in retinal hemorrhage.</p><p><strong>Conclusion: </strong>In this single case report, adalimumab monotherapy was associated with control of IRVAN syndrome, including improvement in vascular leakage and aneurysmal dilatations. The recurrence of aneurysms upon dose tapering and improvement after resuming biweekly dosing suggest a possible therapeutic effect on aneurysm control and the potential need for sustained treatment. Further studies are needed to determine the generalizability of these findings.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039972","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 Vitamin D in Noninfectious Uveitis: A Scoping Review with Transcriptomic and Bioinformatic Insights.","authors":"María Alejandra Fonseca-Mora, Laura Zarate-Pinzón, Diana Amador-Muñoz, Carlos Cifuentes-González, César Payán-Gómez, William Rojas-Carabali, Alejandra de-la-Torre","doi":"10.1080/09273948.2026.2725798","DOIUrl":"https://doi.org/10.1080/09273948.2026.2725798","url":null,"abstract":"<p><strong>Purpose: </strong>Vitamin D deficiency has been linked to immune dysregulation and increased risk of autoimmune diseases, including noninfectious uveitis (NIU). This study synthesized evidence linking vitamin D metabolism-related genes and immune mechanisms to NIU and explored transcriptomic pathways potentially modulated by vitamin D signaling.</p><p><strong>Methods: </strong>A scoping review of clinical, genetic, and experimental studies evaluating vitamin D status, vitamin D-related polymorphisms, and immunological mechanisms in NIU was conducted following PRISMA-ScR guidelines. In parallel, transcriptomic data from the Gene Expression Omnibus were analyzed using Gene Set Enrichment Analysis to identify immune and inflammatory pathways enriched in NIU subtypes versus healthy controls, focusing on vitamin D signaling and innate immune activation.</p><p><strong>Results: </strong>The review identified consistent associations between hypovitaminosis D and increased risk or severity of NIU across subtypes, including Behçet disease-associated uveitis and HLA-A29-positive birdshot chorioretinopathy. Genetic studies associated NIU susceptibility with polymorphisms in vitamin D metabolism and signaling genes, including DHCR7, GC/VDBP, CYP27B1, and VDR. Transcriptomic analysis revealed enrichment of innate immune and inflammatory pathways, including Toll-like receptor and MyD88-dependent signaling, tumor necrosis factor-related pathways, oxidative stress responses, and dysregulation of immunoregulatory mediators such as interleukin-10, particularly in immune-mediated NIU phenotypes.</p><p><strong>Conclusion: </strong>Integrating scoping review findings with transcriptomic analyses supports a multifactorial relationship between vitamin D status, genetic susceptibility, and immune pathway dysregulation in NIU. Although causality cannot be established, vitamin D deficiency may represent a potentially modifiable factor influencing innate and adaptive immune responses. Prospective and interventional studies are warranted to determine whether vitamin D supplementation can modify disease activity or clinical outcomes.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039949","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":"More Than Meets the Eye: Topiramate-Induced Bilateral Secondary Angle Closure Unmasking Secondary Antiphospholipid Syndrome.","authors":"Aastha Bansal, Reni Philip, Jayaprakash Vadivelu, Arshee S Ahmed","doi":"10.1080/09273948.2026.2738067","DOIUrl":"https://doi.org/10.1080/09273948.2026.2738067","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a diagnostic challenge in a case of bilateral topiramate-induced secondary angle closure which led to unmasking of systemic lupus erythematosus (SLE) and secondary antiphospholipid syndrome (APS) highlighting the importance of recognizing posterior segment findings that are disproportionate to the expected manifestations of drug-induced angle closure.</p><p><strong>Methods: </strong>A 21-year-old female presenting with acute diminution of vision in both eyes, following initiation of oral topiramate for migraine was evaluated.</p><p><strong>Results: </strong>Anterior segment examination, gonioscopy, and ultrasound biomicroscopy were performed to assess angle status. Findings were consistent with bilateral topiramate-induced secondary angle closure. Following intraocular pressure reduction, posterior segment evaluation revealed findings suggestive of retinal vascular occlusive disease and vasculitis in RE and choroidal ischemia in LE. Progressive ischemic changes were noted on serial examinations over the course of the next few days. Systemic workup for autoimmune and hypercoagulable states was added based on fundus findings which were atypical for a case of drug-induced angle closure. The patient tested positive for antinuclear antibody, anti- double stranded DNA antibody, persistent triple-positive antiphospholipid antibodies, leading to a diagnosis of SLE with secondary APS. Despite aggressive immunosuppressive and anticoagulant therapy, RE had poor visual recovery, whereas timely intervention led to visual improvement in LE.</p><p><strong>Conclusion: </strong>The case illustrates that posterior segment findings that are disproportionate to the expected manifestations of topiramate-induced angle closure should prompt urgent evaluation for an underlying systemic autoimmune or hypercoagulable disorder. Careful posterior segment evaluation following normalization of intraocular pressure may reveal vision-threatening pathology and facilitate early multidisciplinary management.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040028","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":"Familial ROSAH Syndrome Associated with the <i>ALPK1</i> p.Thr237Ala Variant: Divergent Ocular Phenotypes and Partial Response to IL-6 Blockade.","authors":"Víctor Llorenç, Ángeles Herrador-Montiel, Juan I Árostegui, Elena Brotons, Teresa Jordà, Socorro Alforja","doi":"10.1080/09273948.2026.2734572","DOIUrl":"https://doi.org/10.1080/09273948.2026.2734572","url":null,"abstract":"<p><strong>Purpose: </strong>To report phenotypic variability and treatment response in familial ROSAH syndrome associated with the ALPK1 p.Thr237Ala variant.</p><p><strong>Methods: </strong>Longitudinal observational familial case series of a mother-daughter pair with ALPK1-associated ROSAH syndrome. The daughter carried a heterozygous ALPK1 p.Thr237Ala variant, whereas her mother showed an apparent homozygous genotype. Both underwent multimodal ophthalmic imaging, visual field testing, systemic assessment, genetic analysis, and 24 months of follow-up, including 17 months after starting tocilizumab.</p><p><strong>Results: </strong>The daughter presented with bilateral optic disc edema, peripheral retinal vascular leakage, cytopenias, splenomegaly, anhidrosis, headache, and short dental roots, with preserved visual acuity. Her mother showed advanced inflammatory-degenerative retinopathy with profound visual loss and fewer systemic manifestations. In the daughter, tocilizumab was associated with resolution of systemic inflammation, reduced optic nerve head edema, and preserved visual acuity. In the mother, inflammatory markers normalized and macrocystic intraretinal fluid resolved, but retinal atrophy and severe visual impairment remained unchanged.</p><p><strong>Conclusion: </strong>Familial ALPK1 p.Thr237Ala-associated ROSAH syndrome may show marked intrafamilial variability. The different clinical courses observed in these two related patients raise the possibility that inflammatory and degenerative mechanisms may progress, at least in part, independently. Interleukin-6 inhibition may improve inflammatory activity but appears limited once advanced retinal degeneration is established.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025498","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":"Beyond Neuroretinitis: A Multi-Centre Study of Bartonella-Associated Uveitis.","authors":"Priya D Samalia, Krish Sethi, Lyndell Lim, Shaikha Aljneibi, Stephen Guest, Elisa E Cornish, Peter McCluskey, Helen Zhang, Joanne Sims, Rachael L Niederer","doi":"10.1080/09273948.2026.2735417","DOIUrl":"https://doi.org/10.1080/09273948.2026.2735417","url":null,"abstract":"<p><strong>Purpose: </strong>To characterise the spectrum of clinical presentations of <i>Bartonella</i>-associated uveitis across multiple tertiary uveitis centres and assess the frequency of non-neuroretinitis phenotypes.</p><p><strong>Methods: </strong>Multi-centre retrospective case series of patients with serologically confirmed <i>Bartonella</i> infection and associated intraocular inflammation. Clinical phenotypes were classified as classical (isolated neuroretinitis) or non-neuroretinitis based on anatomic and multimodal imaging findings, and their relative frequencies were analysed.</p><p><strong>Results: </strong>Seventy eyes of 53 patients were included. Median presenting best-corrected visual acuity was 20/50 (IQR 20/20 to 20/400). Posterior uveitis (57.1%) and panuveitis (30.0%) were the most frequent anatomical classifications. Neuroretinitis was present in 35 (50.0%) eyes. Non-classical manifestations were common and included optic neuritis (34.3%), multifocal retinitis (30.0%), isolated papillitis (24.3%), retinal vascular occlusion (18.6%), and multifocal choroiditis (11.4%).</p><p><strong>Conclusion: </strong>Non-neuroretinitis manifestations of <i>Bartonella</i>-associated uveitis comprise a substantial proportion of presentations in tertiary uveitis practice. Although these phenotypes have been individually described previously, our findings emphasise that <i>Bartonella</i> infection should remain an important differential diagnosis across a broad spectrum of posterior segment inflammatory presentations rather than being considered predominantly a cause of neuroretinitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025559","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 of Iris Roseola/Papulosa: An Unusual Manifestation of Syphilitic Uveitis.","authors":"Bernardo Bahia Finotti, Ana Luiza Grossi Silva, Danuza de Oliveira Machado Azevedo, Daniel V Vasconcelos-Santos","doi":"10.1080/09273948.2026.2734576","DOIUrl":"https://doi.org/10.1080/09273948.2026.2734576","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize on multimodal imaging a case of iris roseola/papulosa, a unique manifestation syphilitic uveitis.</p><p><strong>Methods: </strong>Retrospective review of clinical data, laboratorial results and multimodal imaging (MI).</p><p><strong>Results: </strong>A 52-year-old white woman presented with decreased vision, redness and pain in the right eye (OD) for four days, preceded by a cutaneous rash two weeks before. Clinical evaluation revealed anterior uveitis in OD, associated with a vascularized deep nodule in the superotemporal aspect of the right iris, consistent with iris roseola and iris papulosa. MI disclosed progressive hyperautofluorescence of the iris deep stromal nodule, associated with detachment of iris pigment epithelium in OD, as well as unsuspected hyperfluorescence of the retinal veins and optic nerve head in the left eye (OS). Results of VDRL (1:128) and treponemal tests confirmed syphilis, with negative anti-HIV result. Treatment with aqueous crystalline penicillin G was initiated for 21 days, and supplemented with oral prednisone 24 h later, after development of a Jarisch-Herxheimer reaction. Prompt and complete resolution of the iris lesion and remission of intraocular inflammation were achieved after antibiotic therapy.</p><p><strong>Conclusion: </strong>Vascularized iris lesions are currently rare but possibly underestimated manifestations of secondary syphilis. Multimodal imaging may be of help for better characterization of their vascular component, as well as for delineating other subtle inflammatory changes that may go unnoticed. Antibiotic treatment supplemented with steroids is curative in the short term.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031143","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":"Measles-Related Macular Necrotizing Retinitis in an Unvaccinated Adult: A Case Report.","authors":"Elena Bolletta, Rocco Bruno, Andrea Trinco, Giuliana Zoboli, Luca De Simone, Fabrizio Gozzi, Pietro Gentile, Chantal Adani, Alessandro Invernizzi, Luca Cimino","doi":"10.1080/09273948.2026.2735408","DOIUrl":"https://doi.org/10.1080/09273948.2026.2735408","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical features, multimodal imaging (MMI) findings, and therapeutic management in a case of asynchronous bilateral macular necrotizing measles-related retinitis in an unvaccinated adult.</p><p><strong>Methods: </strong>Observational case report.</p><p><strong>Results: </strong>A 36-year-old unvaccinated male presented with acute vision loss in the right eye. He had a past history of idiopathic encephalitis and prior necrotizing retinitis in the contralateral eye. MMI revealed full-thickness macular retinitis with the characteristic \"moth-eaten\" appearance accompanied by the \"ballooning\" of an intact internal limiting membrane (ILM) on optical coherence tomography (OCT). Both intraocular fluid and cerebrospinal fluid (CSF) PCR, and the CSF/serum measles-specific antibody index, were non-diagnostic contributory, a known limitation in late-onset, compartmentalized measles complications. Diagnosis was reached through integration of clinical history, systemic seropositivity, and hallmark MMI features. A combined treatment regimen of remdesivir, pegylated interferon alpha-2a, and intravenous immunoglobulin (IVIg) appeared to halt disease progression and preserved central vision.</p><p><strong>Conclusion: </strong>Late-onset measles retinitis poses a significant diagnostic challenge, as negative direct molecular testing may mislead clinicians and delay appropriate treatment. This case underscores the critical role of systemic serology, MMI, and structured clinical reasoning in reaching a timely diagnosis. In an era of declining vaccination coverage, clinicians should maintain a high index of suspicion for measles-related ocular complications.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031126","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 Deficiency in Children with Uveitis: A Comparison of Juvenile Idiopathic Arthritis-Associated and Idiopathic Uveitis - A Retrospective Study (2019-2025).","authors":"Blerta Lang, Betina Rogalski, Annekatrin Rickmann, Marc Andrej Macek, Peter Szurman, Karl Thomas Boden","doi":"10.1080/09273948.2026.2736176","DOIUrl":"https://doi.org/10.1080/09273948.2026.2736176","url":null,"abstract":"<p><strong>Purpose: </strong>To assess vitamin D deficiency in pediatric uveitis, compare 25-hydroxyvitamin D (25(OH)D) levels between juvenile idiopathic arthritis (JIA)-associated and idiopathic uveitis, and explore clinical associations.</p><p><strong>Methods: </strong>Retrospective study of children (0-18 years) with uveitis treated during 2019-2025 at a tertiary eye clinic and affiliated pediatric rheumatology unit. All had documented serum 25(OH)D; deficiency was < 20 ng/mL. Group comparisons, correlations, and exploratory complete-case regression were performed.</p><p><strong>Results: </strong>Forty-four children were included (21 JIA-associated, 23 idiopathic; 59% female; mean age 9.2 years). Mean 25(OH)D was 23.3 ± 11.5 ng/mL; 52.3% were deficient and 11.4% severely deficient. Idiopathic uveitis had lower unadjusted 25(OH)D than JIA-associated uveitis (median 16.0 vs 30.4 ng/mL; <i>p</i> = 0.002; Cohen's d = 1.0) and higher deficiency frequency (73.9% vs 28.6%; <i>p</i> = 0.006). 25(OH)D correlated inversely with age (ρ =  -0.61; <i>p</i> < 0.001). In complete-case regression (<i>n</i> = 30; R² = 0.47), age remained associated with lower 25(OH)D (β =  -1.5 ng/mL/year; <i>p</i> = 0.022), whereas the adjusted group effect was not statistically significant and imprecise (β = 0.1 ng/mL; 95% CI - 10.4 to 10.6; <i>p</i> = 0.98).Sufficiency was often supplementation-related (9/14, 64.3%). No associations were found with flares, treatment, season, or ocular complications.</p><p><strong>Conclusions: </strong>In this selected cohort, vitamin D deficiency was common, but prevalence cannot be compared with the general pediatric population. Lower unadjusted 25(OH)D in idiopathic uveitis appeared age-related, although the wide adjusted confidence interval leaves uncertainty. Future studies should systematically document 25(OH)D, age, season, supplementation, and relevant lifestyle factors.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031083","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":"Spontaneous Regression of Vitreoretinal Lymphoma Lesions: Case Series and Literature Review.","authors":"Federico Rissotto, Stefano Lingardo, Gloria Oldoni, Francesco Bandello, Maria Vittoria Cicinelli, Elisabetta Miserocchi","doi":"10.1080/09273948.2026.2734578","DOIUrl":"https://doi.org/10.1080/09273948.2026.2734578","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case series of spontaneous regression of vitreoretinal lymphoma (VRL) lesions documented through multimodal imaging and to contextualize findings with a review of the literature.</p><p><strong>Methods: </strong>We report five Caucasian patients with biopsy-confirmed VRL. All patients underwent multimodal imaging, including spectral-domain optical coherence tomography (SD-OCT), ultra-widefield (UWF) pseudocolor, and autofluorescence (AF) imaging, and fluorescein angiography (FA). Clinical and imaging data were reviewed to assess the occurrence of spontaneous lesion regression.</p><p><strong>Results: </strong>Spontaneous regression of VRL lesions was observed both in treatment-naïve patients and in patients under surveillance following prior systemic or intravitreal therapy. In one case, bilateral regression of optic nerve infiltration was observed; in two cases, unilateral regression of subretinal or sub-RPE lesions occurred; and in two cases, retinitis-like lesions spontaneously regressed.</p><p><strong>Conclusions: </strong>Spontaneous regression of VRL is a rare but clinically relevant phenomenon that may follow diagnostic interventions such as vitrectomy, possibly via immune-mediated mechanisms. Multimodal imaging is essential for documenting regression and guiding clinical management. Awareness of this phenomenon may prevent misinterpretation of disease activity and inform the need for close follow-up, even when apparent lesion regression occurs.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017681","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":"Topographic Fundus Autofluorescence Patterns in MEWDS: Clues to Differentiate Primary Disease from Secondary MEWDS and Ocular Syphilis.","authors":"Luca De Simone, Elisa Stradiotto, Rocco Bruno, Fabrizio Gozzi, Elena Bolletta, Pietro Gentile, Chantal Adani, Rodolfo Mastropasqua, Mario R Romano, Luca Cimino","doi":"10.1080/09273948.2026.2734626","DOIUrl":"https://doi.org/10.1080/09273948.2026.2734626","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize topographic fundus autofluorescence (FAF) patterns in Primary Multiple Evanescent White Dot Syndrome (MEWDS) and assess their value as diagnostic clues for differentiating Primary MEWDS from Secondary MEWDS and ocular syphilis.</p><p><strong>Methods: </strong>In this retrospective observational single-centre study, patients diagnosed with MEWDS between July 2014 and April 2026 at a tertiary ocular immunology unit were reviewed. Demographic, clinical, and multimodal imaging data were collected. FAF was used for lesion distribution pattern classification. Secondary MEWDS cases from our cohort were analyzed together with previously reported cases identified through a targeted literature review.</p><p><strong>Results: </strong>Eighteen eyes of 17 patients were classified as Primary MEWDS. Four FAF distribution patterns were identified: diffuse, peripapillary, placoid-like, and peripheral sectorial. The diffuse pattern was the most frequent presentation. Localized patterns showed clinically relevant overlaps with Acute Idiopathic Blind Spot Enlargement/Acute Zonal Occult Outer Retinopathy-spectrum disease, Acute Syphilitic Posterior Placoid Chorioretinitis, and infectious Secondary MEWDS. Secondary MEWDS was identified in 17 eyes of 13 patients and occurred in association with infectious uveitis, non-infectious uveitis, and other retinal conditions. Syphilis-associated Secondary MEWDS cases consistently showed a peripheral sectorial distribution.</p><p><strong>Conclusion: </strong>Distinct FAF distribution patterns may provide practical diagnostic clues in MEWDS presentations. Diffuse FAF involvement appears most typical of Primary MEWDS, whereas placoid-like and peripheral sectorial patterns should prompt exclusion of infectious etiologies, particularly ocular syphilis. Recognition of these patterns may help guide targeted systemic investigation and improve diagnostic confidence in atypical MEWDS presentations.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025567","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}