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Rosenberg CR, Pasadhika S. A Vascularized Iris Mass in Ocular Syphilis: A Case Report and Review of Literature. Ocul Immunol Inflamm 2023:1-7. [PMID: 37934906 DOI: 10.1080/09273948.2023.2276298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/21/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE To describe features of a syphilitic vascularized iris mass on multimodal imaging and its resolution after penicillin treatment. METHODS Observational case report and literature review of syphilitic iris masses. RESULTS A 43-year-old woman presented with a unilateral vascularized tan iris mass in the setting of bilateral panuveitis that occurred along with bilateral papillitis, cystoid macular edema and retinal vasculitis. Laboratory work-up confirmed a diagnosis of syphilis. Ultrasound biomicroscopy (UBM) of the iris mass showed parapupillary hyperechoic full-thickness iris stromal thickening with small intrinsic circular lumens without cyst or ciliary body extension, while the anterior segment optical coherence tomography (AS-OCT) demonstrated a hyperreflective mass with deep iris extension and partial hyporeflective rim. Following treatment, the mass fully resolved without residual sequela. A review of literature identified 11 additional cases of syphilitic iris masses in the English literature from 1915 to present. Their presentations and clinical courses were reviewed herein. CONCLUSIONS This report characterizes a syphilitic iris mass on slit-lamp photography, iris fluorescein angiography, UBM and AS-OCT; depicts key characteristics of syphilitic iris masses; and highlights the need for close inspection of the iris mass as an uncommon sign of ocular syphilis.
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Yang P, Zhang W, Chen Z, Zhang H, Su G, Cao Q, Zhu Y, Zhong Z, Zhou C, Wang Y, Kijlstra A. Development of revised diagnostic criteria for Fuchs' uveitis syndrome in a Chinese population. Br J Ophthalmol 2021; 106:1678-1683. [PMID: 34108225 DOI: 10.1136/bjophthalmol-2021-319343] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/23/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS Fuchs' uveitis syndrome (FUS) is one of the frequently misdiagnosed uveitis entities, which is partly due to the absence of internationally recognised diagnostic criteria. This study was performed to develop and evaluate a set of revised diagnostic criteria for FUS. METHODS The clinical data of Chinese patients with FUS and patients with non-FUS were collected and analysed from a tertiary referral centre between April 2008 and December 2020. A total of 593 patients with FUS and 625 patients with non-FUS from northern China were enrolled for the development of diagnostic criteria for FUS. Three hundred and seventy-seven patients with FUS and 503 patients with non-FUS from southern China were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients with FUS and patients with non-FUS. Multivariate two-step cluster analysis, logistic regression and decision tree algorithms in combination with the clinical judgement of uveitis experts were used to revise diagnostic criteria for FUS. RESULTS Three essential findings including diffuse iris depigmentation, absence of posterior synechiae, mild inflammation in the anterior chamber at presentation and five associated findings including mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms and characteristic iris nodules were used in the development of FUS diagnostic criteria. All essential findings were required for the diagnosis of FUS, and the diagnosis was further strengthened by the presence of associated findings. CONCLUSION Revised diagnostic criteria for FUS were developed and validated by analysing data from Chinese patients and showed a high sensitivity (96.55%) and specificity (97.42%).
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Affiliation(s)
- Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Wanyun Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Zhijun Chen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Han Zhang
- Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Qingfeng Cao
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Ying Zhu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Zhenyu Zhong
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Chunjiang Zhou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Yao Wang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht, The Netherlands
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Budmann GA, Parisi FB, Ortiz GB, Cirillo MP, Catalano C, Lávaque EB. Anterior uveal fungal abscess in an HIV positive patient. ARCHIVOS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGÍA 2021; 96:388-391. [PMID: 34217478 DOI: 10.1016/j.oftale.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/10/2020] [Indexed: 10/21/2022]
Abstract
Endogenous endophthalmitis (EE) accounts for approximately 2% to 8% of all cases of endophthalmitis. Candida albicans abscesses in the iris and ciliary body are a rare form of presentation, with only 3 cases reported up until now. The case is presented of a 27-year-old patient with an elevated lesion in the iris at the temporal zone of the left eye, with hypopyon, pupil membrane, and 4+ cells in the anterior chamber. Tests for syphilis and HIV were positive, and were associated with extraocular manifestations of secondary syphilis. Treatment with intravenous penicillin and HAART therapy were started, but the clinical course worsened after 7 days. Pars plana vitrectomy and an abscess aspiration were performed, and the intraocular fluids and the purulent content were sent for microbiological examination. Cultures were positive for Candida albicans. The case is presented of an anterior uveal abscess by Candida albicans in an HIV-positive patient not previously reported in the literature.
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Affiliation(s)
- G A Budmann
- Hospital Oftalmológico Dr. Pedro Lagleyze, Sección Uveítis, Buenos Aires, Argentina.
| | - F B Parisi
- Hospital Oftalmológico Dr. Pedro Lagleyze, Sección Uveítis, Buenos Aires, Argentina
| | - G B Ortiz
- Hospital Oftalmológico Dr. Pedro Lagleyze, Sección Uveítis, Buenos Aires, Argentina
| | - M P Cirillo
- Hospital Oftalmológico Dr. Pedro Lagleyze, Sección Uveítis, Buenos Aires, Argentina
| | - C Catalano
- Hospital Oftalmológico Dr. Pedro Lagleyze, Sección Uveítis, Buenos Aires, Argentina
| | - E B Lávaque
- Hospital Oftalmológico Santa Lucía, Servicio de Retina, Buenos Aires, Argentina
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Shi T, Wu L, Cai J, Chen H. An Iris Tumor Secondary to Talaromyces Marneffei Infection in a Patient with AIDS and Syphilis. Ocul Immunol Inflamm 2021; 30:1129-1132. [PMID: 33646066 DOI: 10.1080/09273948.2021.1878234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To report a case of iris tumor secondary to Talaromyces marneffei infection in a patient with AIDS and syphilis.Case report: A 25-year-old man presented with gradual vision decrease in the right eye for 2 months. Ocular examination revealed best-corrected visual acuity (BCVA) of 0.12 and a vascularized and solid tumor at inferotemporal iris base in the right eye. There were some papulonecrotic skin lesions. Both serum treponema pallidum particle agglutination and human immunodeficiency virus antibody were positive. Non-target metagenome next-generation sequencing detected Talaromyces marneffei in the skin lesion and aqueous humor. After 8 weeks of oral voriconazole and fluconazole eyedrop treatment, the iris tumor completely subsided, and the BCVA improved to 1.0.Conclusion: Talaromyces marneffei infection may present as an iris tumor. Metagenome next-generation sequencing is helpful in diagnosis. Oral and topical anti-fungus therapy was sufficient to regress the disease without intraocular injection.
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Affiliation(s)
- Tingkun Shi
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, Shantou, China
| | - Lingjie Wu
- Department of Infectious Diseases, Shantou Central Hospital, Shantou, China
| | - Jinnan Cai
- Department of Dermatology, Shantou Central Hospital, Shantou, China
| | - Haoyu Chen
- Joint Shantou International Eye Center, Shantou University & The Chinese University of Hong Kong, Shantou, China
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Mahesh M, Sudharshan S, Khetan V, Janani MK, Krishnakumar S. Polymerase chain reaction-proven tuberculous anterior segment mass mimicking juvenile xanthogranuloma in a child. Indian J Ophthalmol 2020; 68:2033-2035. [PMID: 32823470 PMCID: PMC7690467 DOI: 10.4103/ijo.ijo_852_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mass lesions arising from the anterior segment in children involving the iris and ciliary body can be of myogenic, neurogenic, or hematogenic/vascular origin. These include nevi, melanomas, adenoma, adenocarcinoma, cysts, metastatic tumours among others. Multiple iris mass lesions due to tuberculosis in children are rare. We present an uncommon atypical presentation of multiple anterior segment mass lesions referred to us as neoplasia. Although excision biopsy can be diagnostic, it was deferred and anterior chamber tap was done. Aqueous cytology was suspicious of juvenile xanthogranuloma (JXG) but polymerase chain reaction (PCR) confirmed tuberculous etiology. Treatment with antituberculous therapy (ATT) and steroids lead to complete resolution of the lesions.
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Affiliation(s)
- Meenakshi Mahesh
- Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - S Sudharshan
- Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Vikas Khetan
- Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - M K Janani
- Sankara Nethralaya Referral Laboratory, Chennai, Tamil Nadu, India
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Antunes-Foschini RMS, Costa RMS, Faria-E-Sousa SJ, Rocha EM. Are iris mammillations correlated with keratoconus? Am J Ophthalmol Case Rep 2019; 14:16-18. [PMID: 30793057 PMCID: PMC6370584 DOI: 10.1016/j.ajoc.2019.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/06/2018] [Accepted: 01/22/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To describe the presence of iris mammillations (IM) in keratoconus. Design Retrospective case series and literature review. Observations This is a retrospective case series of eight patients presenting with keratoconus and IM, who were examined between January 2016 and December 2017 in the ophthalmology outpatient clinic. They had a median age of 14 (11–30), and all had bilateral keratoconus and diffusely distributed IM. The IM had similar presentations and similar iris colors. None had relevant medical or family diseases associated with IM. Three eyes previously had penetrating keratoplasty. Four (31%) out of 13 eyes had mean keratometry (Km) > 55D, and 4 (31%) had the thinnest pachymetry between 300 and 400μm. Conclusions and importance To the best of our knowledge, this is the first time that IM was observed in association with keratoconus patients. The possibility that IM is an early finding in otherwise healthy patients may help to predict the future diagnosis of keratoconus. Future studies are needed to show the frequency and possible association between IM and a keratoconus prognosis. This may also demonstrate that there is a subgroup of patients with a distinct etiology of keratoconus.
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Affiliation(s)
| | | | - Sidney Júlio Faria-E-Sousa
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Melani Rocha
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Michaelov E, Iqbal MM, Hooper PL. Uveal Mass, Uveitis, and Diffuse Rash in a Woman in Her 50s. JAMA Ophthalmol 2018; 136:704-705. [DOI: 10.1001/jamaophthalmol.2017.5560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Evan Michaelov
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Munir M. Iqbal
- Department of Ophthalmology, Western University, London, Ontario, Canada
| | - Philip L. Hooper
- Department of Ophthalmology, Western University, London, Ontario, Canada
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Mili-Boussen I, Gharbi O, Letaief I, Dridi H, Touati S, Errais K, Ouertani A. Fluffy white iris precipitates in Fuchs uveitis: a new sign for an old disease. Int Ophthalmol 2013; 33:733-6. [PMID: 23359133 DOI: 10.1007/s10792-013-9721-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 01/09/2013] [Indexed: 11/27/2022]
Abstract
To describe particular iris precipitates in a series of five eyes from six patients with Fuchs uveitis (FU). Iris precipitates were noted by four independent examiners during routine physical examination of the angle by gonioscopy with Goldmann's three-mirror lens in patients with FU. The result was confirmed by examination, using the same method, of five other consecutive patients with FU and compared to 10 normal control eyes from five healthy individuals. Other causes of anterior uveitis were excluded. There were no iris precipitates in the healthy eyes. In eyes with FU, there were fluffy white iris precipitates, not visible by full-face examination or by classic slit-lamp examination. They were similar to keratic precipitates described in FU: starry, blurry and transparent with a tendency towards the white. Situated on the surface of the iris, they were visible only with the particular diffusion of the light from the gonioscopy's glass on the darkly pigmented iris of patients from North Africa. Fluffy white iris precipitates, seen in FU patients, appear to represent an additional clinical sign and may improve our diagnostic accuracy in this disease. Its visibility requires a specific technique during clinical examination. The validity of this new clinical sign based on this fact is yet to be determined.
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Affiliation(s)
- Ilhem Mili-Boussen
- Department of Ophthalmology, Charles Nicolle University Hospital, BP 318-Mahrajene, 1082, Tunis, Tunisia,
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Braich PS, Chang JS, Albini TA, Schefler AC. Irido-lenticular abscess as the initial sign of Candida albicans endogenous endophthalmitis. Ophthalmic Surg Lasers Imaging Retina 2011; 42 Online:e107-9. [PMID: 22150597 DOI: 10.3928/15428877-20111201-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 10/30/2011] [Indexed: 11/20/2022]
Abstract
A-33-year-old man presented with 9 days of conjunctival erythema, pain, and worsening vision in the left eye. Anterior segment examination was significant for a well-defined, cream-colored iridociliary mass. Ultrasound biomicroscopy demonstrated an iris lesion with ciliary body and lenticular involvement. The authors performed a pars plana vitrectomy and lensectomy with an iris biopsy. Culture of the vitreous cassette and iris mass yielded a diagnosis of Candida albicans endophthalmitis. Clinicians encountering an iris nodule with lenticular involvement, even in an immunocompetent adult, are urged to consider a diagnosis of an endogenous endophthalmitis secondary to C. albicans.
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Affiliation(s)
- Puneet S Braich
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA
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Agrawal RV, Murthy S, Sangwan V, Biswas J. Current approach in diagnosis and management of anterior uveitis. Indian J Ophthalmol 2010; 58:11-9. [PMID: 20029142 PMCID: PMC2841369 DOI: 10.4103/0301-4738.58468] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Accepted: 06/17/2009] [Indexed: 12/20/2022] Open
Abstract
Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis.
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Affiliation(s)
- Rupesh V Agrawal
- L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Somasheila Murthy
- L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Virender Sangwan
- L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
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Brooks DE, Taylor DP, Plummer CE, Quinn R, Kallberg ME, Sheppard B, Barrie KP, Blackwood SE, Nunnery CM, Ben-Shlomo G, Clark CJ, Woodworth AA. Iris abscesses with and without intralenticular fungal invasion in the horse. Vet Ophthalmol 2009; 12:306-12. [PMID: 19751491 DOI: 10.1111/j.1463-5224.2009.00718.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe clinical and histologic findings in horses with iris abscesses. Design Retrospective medical records study. ANIMALS STUDIED Medical records of horses that had iris abscesses at the University of Florida Veterinary Medical Center, Peterson & Smith Equine Hospital, and Veterinary Eye Specialists of London, Ontario, from 2005 to 2008 were reviewed. PROCEDURE Data collected from the medical records included signalment, clinical and histologic descriptions of ocular lesions, therapy, complications, and visual outcomes. RESULTS The medical records of two Quarterhorses, one pony, one warmblood, one Westphalian, and one Arab horse with unilateral iris abscesses were identified. Mild-to-severe clinical signs of iridocyclitis were present in all six eyes with iris abscesses. The eyes of two horses with iris abscesses were also associated with deep stromal abscesses and responded to medical therapy alone in one case, and medical therapy and corneal transplantation in the other. Iris abscesses in two horses were also associated with intralenticular invasion due to a Cladosporium and a Fusarium-type fungus respectively, and resulted in enucleations. Two horses with iris abscesses and no apparent lens involvement resolved with medical therapy in one case and surgical removal of the iris abscess and medical therapy in the other. CONCLUSIONS This is the first clinical report of iris abscesses in the horse, and the first histologic report of fungal invasion of the horse lens.
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Affiliation(s)
- Dennis E Brooks
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608, USA.
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Mistr S, Chavis PS. Treatment of neuro-ophthalmologic manifestations of tuberculosis. Curr Treat Options Neurol 2005; 8:53-67. [PMID: 16343361 DOI: 10.1007/s11940-996-0024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the absence of obvious pulmonary or disseminated tuberculosis, ocular and central nervous system (CNS) tuberculosis may represent a significant diagnostic challenge. Refinements in polymerase chain reaction techniques and neuroimaging have strengthened the battery of tests used to diagnose CNS and ocular tuberculosis, yet in many cases, the diagnosis remains one of exclusion; it may ultimately be determined through exacerbation by anti-inflammatory therapy with subsequent improvement by antitubercular medication treatment. Because of emerging drug resistance, at least a two-drug regimen is required for therapeutic testing and treatment of isolated ocular tuberculosis. If pulmonary or miliary disease coexists, a 6-month, four-drug regimen with isoniazid, rifampin, pyrazinamide, and ethambutol is required for treatment. Tubercular meningitis is treated with the same four-drug regimen for at least 9 to 12 months. Burden of therapeutic compliance rests on the treating physician and public health sector. Best compliance is realized with directly observed therapy.
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Affiliation(s)
- Susannah Mistr
- Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, 167 Ashley Avenue, Charleston, SC 29425, USA
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Javadi MA, Jafarinasab MR, Araghi AAS, Mohammadpour M, Yazdani S. Outcomes of phacoemulsification and in-the-bag intraocular lens implantation in Fuchs' heterochromic iridocyclitis. J Cataract Refract Surg 2005; 31:997-1001. [PMID: 15975468 DOI: 10.1016/j.jcrs.2004.08.050] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2004] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the visual outcomes and complications of phacoemulsification (PE) and posterior chamber intraocular lens implantation, (PC IOL) in patients with Fuchs heterochromic iridocyclitis (FHIC). SETTING Private clinic and an academic hospital. METHODS In this noncomparative interventional case series, existing data for 41 eyes of 40 consecutive patients clinically diagnosed with FHIC and cataract were studied retrospectively. Scleral tunnel PE and in-the-bag IOL implantation were performed in all cases. Preoperative and postoperative visual acuities and intraoperative and postoperative complications were evaluated. RESULTS Twenty-four male and 16 female patients aged 12 years to 70 (SD) (mean 35 +/- 12 years) were operated on and followed for 17.8 +/- 8.7 months. Preoperatively, best corrected visual acuity (BCVA) was less than 20/40 in all patients, which improved to 20/40 or better after surgery. Twenty-two eyes (53.6%) achieved BCVA of 20/20. The major cause of postoperative visual acuity less than 20/20 was vitreous haze. There were no major intraoperative complications. Postoperatively, mild anterior chamber fibrin reaction occurred in 4 patients (9.7%), IOL deposits occurred in 11 eyes (26.8%), and decentration was observed in 1 eye. During follow-up, 6 eyes (14.6%) developed posterior capsule opacification requiring a neodymium:YAG (Nd:YAG) laser capsulotomy. There was 1 case of clinical cystoid macular edema that resolved with medication. There were no cases of posterior synechias, postoperative glaucoma, or retinal detachment. CONCLUSION Phacoemulsification with PC IOL implantation is a safe procedure with good visual outcomes in patients with FHIC and cataract.
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Affiliation(s)
- Mohammad-Ali Javadi
- Ophthalmology Department and Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, 16666 Tehran, Iran.
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