Luca Mautone, Laura Ponti, Pierre Sanchis, Vasyl Druchkiv, Christos Skevas, Johannes Birtel, Martin S Spitzer
{"title":"Anterior Segment Optical Coherence Tomography in Endophthalmitis.","authors":"Luca Mautone, Laura Ponti, Pierre Sanchis, Vasyl Druchkiv, Christos Skevas, Johannes Birtel, Martin S Spitzer","doi":"10.1080/09273948.2025.2555615","DOIUrl":"https://doi.org/10.1080/09273948.2025.2555615","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior Segment Optical Coherence Tomography (AS-OCT) can assess anterior chamber's (AC) changes. This study aims to describe AC changes in eyes with endophthalmitis using AS-OCT.</p><p><strong>Methods: </strong>Electronic patient records, slit lamp photography and anterior segment infrared imaging were reviewed in this retrospective single-center cohort study and correlated to swept-source AS-OCT scans of eyes with endophthalmitis.</p><p><strong>Results: </strong>Fourteen eyes of 14 patients with postoperative (<i>n</i> = 6 after cataract surgery; <i>n</i> = 6 after anti-VGEF-injection) and endogenous (<i>n</i> = 2) endophthalmitis were included. The visual acuity was light perception (<i>n</i> = 3), hand movement (<i>n</i> = 7) and ≥1.30 LogMar (<i>n</i> = 4). On slit lamp examination, hypopyon (<i>n</i> = 13) and fibrin (<i>n</i> = 5) were seen. AS-OCT detected hypopyon (<i>n</i> = 13) and fibrin formations (<i>n</i> = 10); hypopyon appeared as a hyperreflective level at the bottom of the AC and showed a hyperreflective lamellar prolongation on the corneal endothelium. Fibrin had the shape of hyperreflective filaments and presented in four patterns: single-stranded, stork-nest-like, cloth-like, or with a mixed phenotype.</p><p><strong>Conclusion: </strong>AS-OCT imaging may visualize inflammatory activity of the AC in endophthalmitis and enable a morphological characterization of fibrin formation. Characteristic findings are also seen in cases with reduced corneal transparency.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200172","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}
Zijun Zhou, Mirthe S Lourens, Kornvalee Meesilpavikkai, Tom Missotten, Mirjam van Velthoven, Kasiphak Kaikaew, Suphattra Phakham, Peter J van der Spek, Sigrid M A Swagemakers, Narissara Suratannon, Nattiya Hirankarn, Hanna IJspeert, Willem A Dik, P Martin van Hagen
{"title":"Gain-of-Function Variant in <i>STAT3</i> and Retinal Macular Edema: Insights into the IL-6 R/JAK/<i>STAT3</i> Pathway in Retinal Pigment Epithelium.","authors":"Zijun Zhou, Mirthe S Lourens, Kornvalee Meesilpavikkai, Tom Missotten, Mirjam van Velthoven, Kasiphak Kaikaew, Suphattra Phakham, Peter J van der Spek, Sigrid M A Swagemakers, Narissara Suratannon, Nattiya Hirankarn, Hanna IJspeert, Willem A Dik, P Martin van Hagen","doi":"10.1080/09273948.2025.2551803","DOIUrl":"10.1080/09273948.2025.2551803","url":null,"abstract":"<p><strong>Purpose: </strong>The IL-6 R/JAK/STAT3 signaling pathway is implicated in non-infectious uveitis-associated macular edema, and its inhibition using monoclonal anti-IL-6 receptor therapy has been associated with clinical improvement. However, the underlying pathogenic mechanisms remain unclear. In this study, we investigated the pathological effects of a STAT3 gain-of-function (GOF) variant p.L387R identified in a family with immune dysregulation syndrome and severe retinal vasculitis and macular edema.</p><p><strong>Methods: </strong>Primary retinal pigment epithelial (RPE) cells were transduced with STAT3 wildtype (WT), the retinal disease-associated familial STAT3 GOF variant p.L387R, or another pathogenic STAT3 GOF variant (p.Y360C) linked to immune dysregulation without retinal involvement. Cells were subsequently stimulated with IL-6 and IFN-α. RNA sequencing was performed to analyze gene expression differences, particularly related to cytokines, chemokines, and factors associated with RPE barrier permeability. Additionally, the expression of tight junction proteins involved in the blood-retinal barrier integrity was assessed. The efficacy of JAK inhibitors to modulate hyperactivation of the IL-6 R/JAK/STAT3 pathway was also evaluated.</p><p><strong>Results: </strong>Compared with WT and STAT3 p.Y360C variant-expressing cells, those expressing STAT3 p.L387R variant produced significantly elevated levels of IL-6, CCL2, and VEGF-A, which are known contributors to vascular leakage in retinal endothelial cells. Treatment with JAK1/2 inhibitors effectively reduced SOCS3 overexpression in STAT3 GOF RPE cells.</p><p><strong>Conclusion: </strong>The pathogenic STAT3 p.L387R GOF variant enhances inflammatory cytokine production in human primary RPE cells, potentially exacerbating retinal vascular leakage and macular edema. These effects can be mitigated by JAK1/2 inhibition, highlighting a promising therapeutic strategy for retinal inflammation and associated edema.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200332","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}
L Borrego-Sanz, L Morales-Fernández, F Sáenz-Francés San Baldomero, R Mendez Fernández, E Pato Cour, D Díaz Valle, J M Martínez de la Casa, J García Feijóo, L Rodríguez Rodríguez
{"title":"Peripapillary Vascular Parameters Measured by Optical Coherence Tomography Angiography in Uveitic Glaucoma.","authors":"L Borrego-Sanz, L Morales-Fernández, F Sáenz-Francés San Baldomero, R Mendez Fernández, E Pato Cour, D Díaz Valle, J M Martínez de la Casa, J García Feijóo, L Rodríguez Rodríguez","doi":"10.1080/09273948.2025.2560633","DOIUrl":"https://doi.org/10.1080/09273948.2025.2560633","url":null,"abstract":"<p><strong>Purpose: </strong>To assess differences in peripapillary vascular parameters measured by optical coherence tomography angiography (OCT-A) between patients with uveitic glaucoma (UG), primary open-angle glaucoma (POAG) and healthy subjects. To determine the relationship among functional and structural parameters in UG.</p><p><strong>Methods: </strong>30 patients with UG, 30 patients with POAG and 30 healthy subjects were recruited. Peripapillary analysis was measured using Angioplex™ OCT-A (Cirrus HD-OCT 5000) with a 4.5 × 4.5 mm optic nerve head (ONH) scan. Global and quadrant data from peripapillary vascular parameters were compared between groups. Correlation between clinical and peripapillary properties was obtained, as well as among vascular and structural parameters.</p><p><strong>Results: </strong>All vascular perfusion and flow measurements (global and by quadrants) were significantly reduced in UG compared to healthy subjects (all <i>p</i> < 0.030 except for peripapillary perfusion density (pPD) temporal (<i>p</i> = 0.095)).Flow values (overall and by quadrants) and pPD in the inferior sector were lower in POAG (<i>p</i> < 0.023). Among UG, no significant differences were found in OCT-A results between subjects with systemic vs topical treatment, nor between active vs quiescent cases or between purely ophthalmological vs systemic uveitis (all <i>p</i> > 0.09). A positive correlation was obtained between structural and vascular parameters in UG (average retinal nerve fiber layer (RNFL) and flow index (FI) (<i>r</i> = 0.632; <i>p</i> < 0.001) and with pPD (<i>r</i> = 0.676; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>A reduction in peripapillary vascular parameters, measured by OCT-A in UG and POAG compared to healthy patients, was observed in this study. POAG cases showed greater reduction in perfusion and FI, especially in the lower sector, compared to UG.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150209","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":"Optic Disc and Retinal Structural Changes in Takayasu Arteritis: Implications for Normotensive Glaucoma.","authors":"Esra Bulut Kızılay, Fehim Esen, Muhammed Emin Kızılay, Haner Direskeneli, Fatma Alibaz-Oner","doi":"10.1080/09273948.2025.2563713","DOIUrl":"https://doi.org/10.1080/09273948.2025.2563713","url":null,"abstract":"<p><strong>Objectives: </strong>Takayasu arteritis is a chronic large-vessel vasculitis that may lead to ocular hypoperfusion due to the involvement of major arteries. The ischemic hypothesis suggests that chronic reduction in ocular blood flow may predispose the optic nerve to structural damage, even when intraocular pressure is within normal limits. This study investigates whether Takayasu arteritis is associated with optic nerve head changes resembling early features of normotensive glaucoma.</p><p><strong>Methods: </strong>The study included 62 patients with Takayasu arteritis (55 females, 7 males, mean age: 45.31 ± 13.42 years) and 51 healthy controls (48 females, 3 males, mean age: 45.53 ± 10.13 years). All participants underwent a comprehensive ophthalmological examination, including retinal nerve fiber layer (RNFL) thickness, ganglion cell layer thickness, Bruch's membrane opening-minimum rim width (BMO-MRW), subfoveal-peripapillary choroidal thickness, lamina cribrosa thickness, prelaminar tissue thickness, retinal vessel calibers, and 24-2 visual field testing.</p><p><strong>Results: </strong>The most frequent ocular complication in patients was hypertensive retinopathy (73.4%), while Takayasu retinopathy was observed in 6.5% of patients. Lamina cribrosa thickness was significantly thinner in patients compared to controls (<i>p</i> < 0.001). Additionally, mean deviation values were lower (<i>p</i> = 0.03) and pattern standard deviation values were higher in patients (<i>p</i> = 0.01). A tendency for thinner average BMO-MRW thickness was noted in patients (<i>p</i> = 0.051). No significant differences were found in ganglion cell layer thickness, prelaminar tissue thickness, or RNFL analysis.</p><p><strong>Conclusion: </strong>Optic nerve changes were observed in Takayasu arteritis patients under normotensive IOP conditions, particularly a significant reduction in lamina cribrosa thickness. However, no significant thinning was observed in RNFL or ganglion cell layer thickness, suggesting that these findings may reflect early or subclinical structural alterations rather than definitive glaucomatous damage. The lamina cribrosa thinning may serve as a potential biomarker of neurodegenerative effects in Takayasu arteritis, warranting long-term follow-up.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138389","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":"Pars Plana Vitrectomy Combined with Endolaser in Refractory Active Ocular Toxoplasmosis: A Retrospective Case Series.","authors":"Emilio M Dodds, Sebastián Inchauspe, Stefani Olivera Plata, Agustina Palacio, Graciela Arriazu","doi":"10.1080/09273948.2025.2566319","DOIUrl":"10.1080/09273948.2025.2566319","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the effectiveness of pars plana vitrectomy (PPV) combined with endolaser treatment for patients with active ocular toxoplasmosis who have not responded to conventional therapies.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of 18 consecutive patients with active ocular toxoplasmosis who failed to respond to ≥3 months of systemic therapy, experienced worsening retinitis during treatment, or developed vitreoretinal complications (retinal detachment or vitreous hemorrhage). All patients underwent 23-gauge PPV with direct 532 nm endolaser application to and around the active retinitis area.</p><p><strong>Results: </strong>Complete lesion resolution was achieved in 17 patients (95%; 95% CI: 74.2-99.0%). Four patients (22%; 95% CI: 9.0-45.2%) developed reactivation between 1.3 and 9 months after surgery; three responded promptly to oral therapy. Visual acuity improved in 44.5% of eyes, remained stable in 11%, and worsened in 44.5%. Postoperative complications occurred in 16 patients (89%), most frequently retinal detachment (39%) and cataract (33%). Mean follow-up was 33.3 months.</p><p><strong>Conclusion: </strong>Pars plana vitrectomy combined with endolaser appears to be an effective option for patients with active ocular toxoplasmosis who do not respond to standard therapies.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138316","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}
Jennifer L Patnaik, Alan G Palestine, Anne M Lynch, Nicolas Neumeister, Flora Lum, Karen L Christopher
{"title":"Utilizing the IRIS® Registry (Intelligent Research in Sight) to Characterize Cases of <i>Acanthamoeba</i> Keratitis in the United States.","authors":"Jennifer L Patnaik, Alan G Palestine, Anne M Lynch, Nicolas Neumeister, Flora Lum, Karen L Christopher","doi":"10.1080/09273948.2025.2565462","DOIUrl":"https://doi.org/10.1080/09273948.2025.2565462","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to utilize data from a large national registry to characterize patients diagnosed with acanthamoeba keratitis (AK) and compare with cases at our institution.</p><p><strong>Methods: </strong>Cases of AK were identified in the IRIS® Registry (Intelligent Research in Sight) from October 2015 through December 2019 and at University of Colorado Hospital (UCH) from October 2015 through June 2024. Outcomes were corneal transplant and visual acuity within 3-24 months after diagnosis.</p><p><strong>Results: </strong>A total of 356 eyes with AK from 292 patients were identified in the IRIS Registry and 31 eyes from 27 patients at UCH. Corneal transplant following AK diagnosis was performed in 39 (11.2%) eyes in the IRIS Registry and 10 (32.3%) of UCH eyes. Patient eyes undergoing corneal transplant were on average older, mean of 52 years in the IRIS Registry (standard deviation (SD): 18) compared to 42 (SD: 20) for those not undergoing this procedure (<i>p</i> = 0.002). Having a final follow-up visual acuity of worse than 20/200 occurred in 28.2% of eyes in the IRIS Registry and 31.3% at UCH. Older age was associated with poor follow-up visual acuity in the IRIS Registry (<i>p</i> < 0.0001) and in the UCH cohort (<i>p</i> = 0.114), but was not significant in the UCH cohort likely due to small sample size.</p><p><strong>Conclusions: </strong>This large cohort of AK cases shows that Big Data such as the IRIS Registry is useful for research, but some details will differ from institutional chart review due to limitations in coding precision and verification.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138344","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}
Richard Adamovich-Zeitlin, Meera S Ramakrishnan, Daniel Zhu, David Ritterband, Gaetano Barile, William Schiff, John Seedor, Isha Cheela, Andrew Tirsi, Elmira Baghdasaryan, Talia R Kaden
{"title":"Clinical Outcomes of Boston Type 1 Keratoprosthesis with and without Endophthalmitis During the Covid-19 Pandemic.","authors":"Richard Adamovich-Zeitlin, Meera S Ramakrishnan, Daniel Zhu, David Ritterband, Gaetano Barile, William Schiff, John Seedor, Isha Cheela, Andrew Tirsi, Elmira Baghdasaryan, Talia R Kaden","doi":"10.1080/09273948.2025.2562357","DOIUrl":"https://doi.org/10.1080/09273948.2025.2562357","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the risk factors and outcomes of developing endophthalmitis in patients with Boston Type 1 keratoprosthesis (KPro) during the COVID-19 pandemic.</p><p><strong>Design: </strong>Retrospective single-center cohort study.</p><p><strong>Methods: </strong>Retrospective chart review of all patients with KPro-1 who presented for follow-up at a tertiary eyecare center between January 2003 and May 2023 was performed.</p><p><strong>Main outcome measures: </strong>The incidence and risk factors of endophthalmitis in eyes with KPro-1 implantation. Visual outcome at the last follow-up prior to study conclusion after keratoprosthesis implantation.</p><p><strong>Results: </strong>Of 79 Kpro-1 implanted eyes in 67 patients, with median 29 months follow-up, 15 eyes (18%) developed endophthalmitis. Ten of these cases (67%) presented to clinic during the COVID-19 pandemic between March 2020 and May 2023. Black patients had a significantly higher risk of developing endophthalmitis as compared to White patients (<i>p</i> = 0.024). Eyes with bandage contact lens (BCL) usage had a significantly lower risk of developing endophthalmitis (<i>p</i> = 0.032), yet having a prior PPV or consistent use of postoperative antibiotics did not significantly affect endophthalmitis rates (<i>p</i> > 0.1). At the last follow-up, visual outcomes were similar in both endophthalmitis and non-endophthalmitis groups.</p><p><strong>Conclusions: </strong>This KPro cohort, with 67% of patients presenting during the COVID-19 pandemic, had a higher rate of endophthalmitis than previously reported in the literature. Black patients had a higher risk of getting endophthalmitis than White patients. BCL usage appeared to have a protective effect against endophthalmitis, while neither post-operative antibiotic use nor vitrectomy had a significant effect on rates of endophthalmitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125182","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}
R Khalil, A Patel, P Torpiano, Austen Worth, H Petrushkin
{"title":"Partial Response to Abatacept for Bilateral Asymmetrical Intermediate Uveitis in CTLA-4 Haploinsufficiency.","authors":"R Khalil, A Patel, P Torpiano, Austen Worth, H Petrushkin","doi":"10.1080/09273948.2025.2504576","DOIUrl":"https://doi.org/10.1080/09273948.2025.2504576","url":null,"abstract":"<p><strong>Purpose: </strong>We report a case of bilateral asymmetrical intermediate uveitis in CTLA-4 haploinsufficiency and its response to abatacept.</p><p><strong>Methods: </strong>Retrospective case report and literature review.</p><p><strong>Results: </strong>A 12-year-old male on sirolimus for control of autoimmune cytopenias in the context of CTLA-4 haploinsufficiency developed sudden onset reduced vision in his left eye after one year of treatment. He had bilateral anterior segment inflammation and disc oedema, with subretinal fibrosis in the left eye. Fluorescein angiography revealed the presence of non-occlusive retinal vasculitis with asymmetrical diffuse capillaritis in the left eye. Optical coherence tomography (OCT) showed cystoid macular oedema in the left eye. He was treated with topical and systemic corticosteroids, and commenced on abatacept infusions. After two years of treatment, there was complete remission of anterior segment inflammation, resolution of disc oedema and improvement of microvascular leakage on fluorescein angiography. To date, there have been two case reports identifying uveitis in patients with CTLA-4 haploinsufficiency, both of which responded well to abatacept.</p><p><strong>Conclusion: </strong>CTLA-4 haploinsufficiency may present with asymmetrical intermediate uveitis and abatacept has a potential role in its treatment. Our case demonstrates the response to treatment through sequential multimodal imaging, and has the longest reported follow-up to date.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131522","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}
Mina B Pantcheva, Sapna Gangaputra, Erin Sieck, Massimo Accorinti, Ron Neumann, Bryan Chin Hou Ang, Keith Barton, David S Chu, John Grigg, John H Kempen, Jeffrey M Liebmann, Francisco J Muñoz-Negrete, Quan Dong Nguyen, Alan G Palestine, Jennifer Thorne, Charlotte van Meerwijk, Peizeng Yang, Marc D de Smet
{"title":"Uveitic Glaucoma Interest Group Recommendations for Uveitis-Related Ocular Hypertension and Glaucoma Management.","authors":"Mina B Pantcheva, Sapna Gangaputra, Erin Sieck, Massimo Accorinti, Ron Neumann, Bryan Chin Hou Ang, Keith Barton, David S Chu, John Grigg, John H Kempen, Jeffrey M Liebmann, Francisco J Muñoz-Negrete, Quan Dong Nguyen, Alan G Palestine, Jennifer Thorne, Charlotte van Meerwijk, Peizeng Yang, Marc D de Smet","doi":"10.1080/09273948.2025.2542286","DOIUrl":"https://doi.org/10.1080/09273948.2025.2542286","url":null,"abstract":"<p><strong>Purpose: </strong>Uveitic glaucoma (UG) is a complex disease with nearly three times higher risk for severe visual loss than uveitis without glaucoma. Monitoring and management vary among ophthalmologists, making it difficult to identify optimal follow-up and treatment approaches. The Uveitic Glaucoma Interest Group (UGIG) proposes guidelines to reduce variation in practice through best practice management guidelines for uveitis-related ocular hypertension (UOHT) and UG.</p><p><strong>Methods: </strong>A group of ophthalmologists with expertise in uveitis and glaucoma conducted an extensive literature review of UOHT and UG. Following review and discussion generated recommendations to standardize best management practices.</p><p><strong>Results: </strong>The recommendations cover: 1) glaucoma-related testing and timing, 2) intraocular pressure (IOP) monitoring and goals, 3) follow-up after starting corticosteroids (CS) or IOP-lowering agents, 4) timing of referral to a glaucoma specialist, 5) management considerations and guidelines.</p><p><strong>Conclusions: </strong>Uveitic eyes have a heightened risk of developing ocular hypertension (OHT) and glaucoma. IOP is often very high and highly variable, associated with rapid progression rates from OHT to glaucoma, and with more rapid visual field loss. Glaucoma can also develop at lower IOP as compared to non-uveitic patients. The UGIG proposes recommendations to standardize the care of UG patients, facilitating more effective management and optimizing visual outcomes. A consensus is presented regarding IOP management based on a more stringent IOP threshold of 16 mmHg. When possible, a close collaboration between a glaucoma specialist and the uveitis expert is preferred. Appropriate referral to glaucoma specialist should be made early, ideally at the time IOP-lowering therapy is initiated.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091911","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":"Cytomegalovirus Corneal Endotheliitis Mimicking Graft Rejection After Corneal Transplantation.","authors":"Kaevalin Lekhanont, Papichaya Vongthongsri, Puttiya Kaewkorn, Weerapat Udomwong, Passara Jongkhajornpong","doi":"10.1080/09273948.2025.2562355","DOIUrl":"https://doi.org/10.1080/09273948.2025.2562355","url":null,"abstract":"<p><strong>Purpose: </strong>Cytomegalovirus (CMV) corneal endotheliitis is an underrecognized postoperative complication of corneal transplantation that closely resembles allograft rejection, often leading to delayed diagnosis and treatment. This study explored its clinical presentations, diagnostic challenges, treatment strategies, and long-term outcomes.</p><p><strong>Methods: </strong>A retrospective case series of nine patients (10 eyes) diagnosed with post-keratoplasty CMV endotheliitis at Ramathibodi Hospital, Bangkok, Thailand. Clinical features, diagnostic findings, treatment regimens, and outcomes were analyzed. A literature review was conducted to contextualize findings within previously reported cases.</p><p><strong>Results: </strong>The mean age at presentation was 65.4 ± 17.9 years, with a slight female predominance (55.6%). Seven out of 10 eyes were initially misdiagnosed with endothelial graft rejection. Common clinical findings were medium-to-large pigmented keratic precipitates (KPs) (80%) and mild anterior chamber inflammation (100%). The hallmark coin-shaped KPs were observed in only 20% of cases at initial presentation. CMV DNA was detected in all patients via aqueous humor polymerase chain reaction (PCR), with one case of possible Epstein-Barr virus co-infection. Treatment with systemic and/or topical ganciclovir led to clinical improvement; however, recurrence was common, with 85.7% of eyes on low-dose topical ganciclovir maintenance experiencing relapse. In contrast, higher-dose maintenance therapy was associated with a lower recurrence rate.</p><p><strong>Conclusions: </strong>Post-keratoplasty CMV endotheliitis can be misdiagnosed as graft rejection, delaying appropriate treatment. Early detection through heightened awareness and PCR testing is critical for timely intervention. Higher-dose topical ganciclovir maintenance therapy may be more effective in reducing recurrence, though long-term monitoring remains crucial for optimal outcomes.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075743","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}