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De Man V, Bataillie S, Cassiman C, Sels L, Schauwvlieghe PP. Ophthalmological and Neurological Findings in Patients with Idiopathic Uveitis Associated with Retinal Vasculitis and the Relation with the HLA DR15 Allele. Ocul Immunol Inflamm 2024:1-7. [PMID: 38648262 DOI: 10.1080/09273948.2024.2316759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 02/05/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE In 15 patients with idiopathic uveitis associated with retinal vasculitis, HLA DRB1 gene testing was performed to detect a possible association. 11 patients tested positive and 4 negative for the HLA DRB1 × 15 allele. The presence of the HLA DRB1 × 15 haplotype might be associated with a higher susceptibility to develop Multiple Sclerosis (MS). METHODS In this case series, we describe the ophthalmological and neurological findings in 10 HLA DR15-positive patients and 4 HLA DR15-negative patients that had neurological workup, including Magnetic Resonance Imaging (MRI) of the brain. RESULTS All patients had granulomatous ocular inflammation with either panuveitis or intermediate uveitis. MRI of the brain showed white matter lesions in 13 patients (9/10 and 4/4 respectively) of which 4 patients were eventually diagnosed with MS (3/10 and 1/4 respectively). CONCLUSION Although the majority of tested patients was carrying at least one HLA DRB1-15 allele, there was no difference in ophthalmological and neurological findings in both groups.
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Affiliation(s)
- Vincent De Man
- Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Lise Sels
- Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands
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Schauwvlieghe PP, Van Calster J, Herbort CP, Kestelyn PA, de Vlam K. Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial. Br J Ophthalmol 2024; 108:244-252. [PMID: 36585127 PMCID: PMC10850705 DOI: 10.1136/bjo-2022-321585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Birdshot uveitis (BU) is a chronic autoimmune posterior uveitis, mostly affecting middle-aged Caucasians. There is a strong association with HLA-A29 and T-cell activation. Safety and efficacy of abatacept, an inhibitor of T-cell costimulation, is tested in active BU. METHODS Fifteen patients with active BU were treated with monotherapy of weekly subcutaneous injections of abatacept 125 mg/mL. Time-to-treatment failure was evaluated as a primary outcome. The secondary objective was to evaluate the utility of different outcome measures to monitor disease activity. Safety was evaluated by adverse event reporting and serial blood analyses. RESULTS At the year-1 endpoint, there was significant improvement in vitreous haze grade (p=0.0014), central choroidal thickness (CCT) (p=0.0011), Fluorescein Angiography (FA) Score (p=0.0014), Indocyanine Green Angiography (ICGA) Score (p<0.001) and total dual FA-ICGA Score (p<0.001). Best corrected visual acuity (BCVA) (p=0.8354) and central retinal thickness (CRT) (p=0.3549) did not change significantly. There were no serious adverse events reported. In total, 4 out of 15 patients left the trial during year 1 of whom 2 experienced treatment failure. CONCLUSIONS Abatacept is very efficacious to treat both retinal vasculitis and choroiditis in patients with BU and is well tolerated. BCVA and CRT are inadequate to monitor disease activity. On the other hand, CCT is a promising non-invasive tool to detect treatment response in early active BU and dual FA-ICGA Score is very helpful to evaluate retinal vasculitis and choroiditis quantitatively. TRIAL REGISTRATION NUMBER NCT03871361.
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Affiliation(s)
- P P Schauwvlieghe
- Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Ophthalmology, Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
| | | | - Carl Peter Herbort
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Montchoisi Teaching Centre, Lausanne, Switzerland
| | | | - Kurt de Vlam
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
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3
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Demeuleneere A, Lambert J, Demeestere J, Lemmens R, Fourneau I, Houthoofd S, Schauwvlieghe PP, Jacob J, Cassiman C. A rare presentation of a common carotid artery occlusion. GMS Ophthalmol Cases 2023; 13:Doc20. [PMID: 38111470 PMCID: PMC10726582 DOI: 10.3205/oc000228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Background A common carotid artery occlusion (CCAO) is very rare and the clinical features of CCAO have rarely been described. Since the blood supply of the eye and orbit is derived from the internal carotid artery, a CCAO may present with various ophthalmological symptoms, ranging from incidental findings to complete visual loss but also other neuro-ophthalmological abnormalities. Case report A 61-year-old woman presented with acute monocular vision loss and an elevation deficit of the right eye. Fluorescein angiography showed delayed filling of both the retinal and choroidal vasculature, without occlusion/embolisms of the retinal arteries. Vascular imaging showed a right CCAO. Conclusion CCAO has a variable presentation. In patients with acute unilateral visual loss a CCAO should be considered, especially when ocular motility deficits are present. Fluorescein angiography examination can aid in the localization and diagnosis of the vascular insult. Urgent referral for a systemic work-up is essential.
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Affiliation(s)
| | - Julie Lambert
- Radiology Department, University Hospitals Leuven, Belgium
| | | | - Robin Lemmens
- Neurology Department, University Hospitals Leuven, Belgium
| | - Inge Fourneau
- Vascular Surgery Department, University Hospitals Leuven, Belgium
| | | | | | - Julie Jacob
- Ophthalmology Department, University Hospitals Leuven, Belgium
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Leysen L, Delbeke H, Desmet S, Schauwvlieghe PP, Maes P, Blanckaert G, Matthys E, Joossens M, Casteels I. Corrigendum to "In search of viable SARS-CoV-2 in the tear film: a prospective clinical study in hospitalized symptomatic patients" [Clin Microbiol Infect 28(8) (2022 Aug) 1172-1173]. Clin Microbiol Infect 2023; 29:1217. [PMID: 37169082 PMCID: PMC10167777 DOI: 10.1016/j.cmi.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Laura Leysen
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Heleen Delbeke
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium.
| | - Stefanie Desmet
- Department of Clinical Biology, University Hospitals Leuven, Leuven, Belgium
| | | | - Piet Maes
- Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
| | | | - Emiel Matthys
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Marie Joossens
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Ingele Casteels
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium
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Madoe A, Schauwvlieghe PP, Jacob J. VOGT-KOYANAGI-HARADA DISEASE-LIKE UVEITIS IN A PATIENT WITH ADVANCED MELANOMA TREATED BY SEQUENTIAL ADMINISTRATION OF NIVOLUMAB AND DABRAFENIB/TRAMETINIB THERAPY. Retin Cases Brief Rep 2023; 17:611-615. [PMID: 37643052 DOI: 10.1097/icb.0000000000001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE To describe a case of bilateral Vogt-Koyanagi-Harada (VKH)-like uveitis during treatment with dabrafenib and trametinib and three months after discontinuation of nivolumab for malignant melanoma, and discuss the possible (synergistic) role(s) of mitogen-activated protein kinase (MAPK) inhibitors and immune checkpoint inhibitors in its pathophysiology. METHODS Retrospective case report with fluorescein angiography and optical coherence tomography. RESULTS A 55-year old patient with metastatic melanoma presented with a complaint of gradually worsening blurry vision in the right eye during treatment with dabrafenib and trametinib, three months after discontinuation of nivolumab. Based on the clinical examination, optical coherence tomography and fluorescein angiography findings, and a thorough laboratory work-up, he was diagnosed with a bilateral VKH-like uveitis without extraocular manifestations. The uveitis responded well to oral corticosteroids. CONCLUSION Vogt-Koyanagi-Harada-like uveitis is a rare adverse effect of MAPK inhibitors and immune checkpoint inhibitors. Similar pathogenetic mechanisms including a drug-induced autoimmunity targeted against benign and malignant melanocytes may underlie MAPK inhibitor-induced and immune checkpoint inhibitors-induced VKH-like uveitis. In our report, the patient developed a VKH-like uveitis during MAPK inhibition therapy, four months after discontinuation of nivolumab. It is difficult to delineate whether MAPK inhibition alone was responsible for this adverse effect, or whether, on the contrary, potentiation occurred as a result of immune modulation by previous treatment with an immune checkpoint inhibitor. Further cases are needed to further clarify this latter hypothesis.
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Affiliation(s)
- Aline Madoe
- Department of Ophthalmology, University Hospital of Leuven, Leuven, Belgium
| | - Pieter-Paul Schauwvlieghe
- Department of Ophthalmology, University Hospital of Leuven/Middelheim Hospital in Antwerp, Leuven, Belgium; and
| | - Julie Jacob
- Department of Ophthalmology, University Hospital of Leuven, Leuven, Belgium
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Casselman P, Jacob J, Schauwvlieghe PP. Relation between ocular paraneoplastic syndromes and Immune Checkpoint Inhibitors (ICI): review of literature. J Ophthalmic Inflamm Infect 2023; 13:16. [PMID: 37022562 PMCID: PMC10079794 DOI: 10.1186/s12348-023-00338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/11/2023] [Indexed: 04/07/2023] Open
Abstract
PURPOSE To describe different ocular paraneoplastic syndromes in patients treated with Immune Checkpoint Inhibitors (ICI), its relation with different types of ICI and different types of tumors, and its implications for treatment. METHODS A comprehensive review of the literature was performed. RESULTS Patients treated with ICI can present with different ocular paraneoplastic syndromes, such as Carcinoma Associated Retinopathy (CAR), Melanoma Associated Retinopathy (MAR) and paraneoplastic Acute Exudative Polymorphous Vitelliform Maculopathy (pAEPVM). In literature, the different types of paraneoplastic retinopathy are mostly related to different types of primary tumors, with MAR and pAEPVM seen in melanoma, and CAR in carcinoma. Visual prognosis is limited in MAR and CAR. CONCLUSION Paraneoplastic disorders result from an antitumor immune response against a shared autoantigen between the tumor and ocular tissue. ICI enhance the antitumor immune response, which can lead to increased cross-reaction against ocular structures and unmasking of a predisposed paraneoplastic syndrome. Different types of primary tumors are related to different cross-reactive antibodies. Therefore, the different types of paraneoplastic syndromes are related to different types of primary tumors and are probably unrelated to the type of ICI. ICI-related paraneoplastic syndromes often lead to an ethical dilemma. Continuation of ICI treatment can lead to irreversible visual loss in MAR and CAR. In these cases overall survival must be weighed against quality of life. In pAEPVM however, the vitelliform lesions can disappear with tumor control, which may involve continuation of ICI.
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Affiliation(s)
- Pauline Casselman
- Department of Ophthalmology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Julie Jacob
- Department of Ophthalmology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
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Alsaddi MA, Hondeghem K, Schauwvlieghe PP. Relapse of Birdshot Uveitis after Stopping Immunosuppressive Treatment and Starting Immune Checkpoint Inhibitors for Lung Cancer. Case Rep Ophthalmol 2022; 13:910-915. [DOI: 10.1159/000526636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
A 56-year-old Caucasian woman with birdshot uveitis had to stop immunosuppressive treatment with adalimumab due to metastatic squamous lung carcinoma. She was subsequently treated with chemotherapy and pembrolizumab, an immune checkpoint inhibitor (ICI). After stopping adalimumab and starting pembrolizumab, the patient had an inflammatory relapse of birdshot uveitis with macular oedema. Birdshot uveitis is triggered by an unknown antigen presented on the HLA-A29 molecule which activates cytotoxic T-cells. Although immunosuppressive therapy effectively stabilizes birdshot uveitis, it might induce a higher risk of developing cancer. Treatment with ICIs, on the other hand, might exacerbate birdshot uveitis by increasing anti-tumoural immune reaction and inducing off-target autoimmunity.
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Therssen S, Meers S, Jacob J, Schauwvlieghe PP. Brentuximab vedotin induced uveitis. Am J Ophthalmol Case Rep 2022; 26:101440. [PMID: 35243175 PMCID: PMC8885609 DOI: 10.1016/j.ajoc.2022.101440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a case of bilateral Vogt-Koyanagi-Harada (VKH)-like granulomatous pan uveitis secondary to brentuximab vedotin (BV) administration to treat for classical Hodgkin lymphoma (CHL). Observations A case of bilateral pan uveitis is described, following administration of BV, with features of VKH-like uveitis: presence of inflammatory cells in the anterior and posterior segment, multiple small serous detachments around the optic disc and retinal pigment epithelium (RPE) folds confirmed by optical coherence tomography (OCT) as well as hypocyanesent dark dots, disc hyperfluorescence and fuzzy vascular patterns seen on indocyanine green and fluorescein angiography. There were no systemic features of VKH disease. Further etiological investigation showed no clear infectious or inflammatory cause. The uveitis responded well to treatment with corticosteroids and cessation of BV. A relapse occurred a few months later when BV treatment was reinitiated, suggesting a probable adverse event to this drug, according to the Naranjo algorithm. Conclusions We hypothesize that administration of BV can induce a VKH-like uveitis, caused by loss of function of protective CD30+ cells present in the uveal tract, possibly aggravated by collateral damage to surrounding CD30−cells and melanocytes, leading to a uveal immune reaction. It is therefore important for the clinicians using BV to be aware of this adverse event. Growing experience with immunotherapy will provide more clinical insights in these complex immune mechanisms in the future.
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Willekens E, De Groot V, Beel K, De Muynck K, Schauwvlieghe PP. Iris pigment epithelial (IPE) cysts secondary to Hodgkin's lymphoma: A case report. Am J Ophthalmol Case Rep 2022; 27:101597. [PMID: 35813584 PMCID: PMC9263858 DOI: 10.1016/j.ajoc.2022.101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 05/08/2022] [Accepted: 05/22/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose To describe a unique case of a white male who presented with reduced visual acuity, growing bilateral iris pigment epithelial (IPE) cysts and granulomatous panuveitis, probably related to Hodgkin's lymphoma. Observations The granulomatous panuveitis was reactive to corticosteroids, but the IPE cysts were not. After extensive work-up, the patient was diagnosed with Hodgkin's lymphoma (HL) mixed cellularity type with cervical and mediastinal lymph node involvement. After starting chemotherapy, the IPE cysts shrank. Conclusions and importance To our knowledge, IPE cysts have not been described in HL before. Therefore, this case can contribute to our knowledge of the relation between IPE cysts and hematological malignancy.
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Affiliation(s)
- Elien Willekens
- Department of Ophthalmology, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium
- Corresponding author. Lindendreef 1, 2020, Antwerp, 032803112, Belgium.
| | - Veva De Groot
- Department of Ophthalmology, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium
| | - Karolien Beel
- Department of Haematology, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium
| | - Kim De Muynck
- Department of Pneumology, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium
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De Sutter C, Schauwvlieghe PP, Ruys J, Cosemans I, Depla J, Van Laere S, Veckeneer M. Occurrence of macular neovascularization after RPE-choroid translocation surgery to treat complicated AMD: incidence, management and outcome. Ophthalmologica 2021; 245:69-79. [PMID: 34530427 DOI: 10.1159/000519519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Charlotte De Sutter
- Department of Ophthalmology, University Hospital Brussels, Free University Brussels, Brussels, Belgium
| | | | - Joke Ruys
- Department of Ophthalmology, ZNA Middelheim, Antwerp, Belgium
| | - Ine Cosemans
- Department of Ophthalmology, ZNA Middelheim, Antwerp, Belgium
| | - Jozef Depla
- Department of Ophthalmology, ZNA Middelheim, Antwerp, Belgium
| | - Sven Van Laere
- Interfaculty Center Data Processing & Statistics, Free University Brussels, Brussels, Belgium
| | - Marc Veckeneer
- Department of Ophthalmology, ZNA Middelheim, Antwerp, Belgium
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Ramaekers A, Aspeslagh S, De Brucker N, Van Mierlo C, Ten Tusscher M, Schauwvlieghe PP, Termote K. Bilateral Corneal Perforation in a Patient Under Anti-PD1 Therapy. Cornea 2021; 40:245-247. [PMID: 33395118 DOI: 10.1097/ico.0000000000002490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/30/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT Immune checkpoint inhibition has improved the clinical outcomes for numerous patients with cancer. However, the downside is a whole new spectrum of immune-related adverse events. We report a 68-year-old man with a history of nonsmall cell lung cancer presenting with a spontaneous corneal perforation in the right eye after 22 cycles of pembrolizumab. In addition, a chronic central nonhealing epithelial defect developed after performing a penetrating keratoplasty. Treatment with autologous serum drops resulted in complete healing of the corneal ulcer, where other conventional therapies had no effect. One month after reinitiating pembrolizumab therapy, our patient presented again with a corneal perforation in the fellow eye. This case describes relapsing sterile ulcerations associated with pembrolizumab use and presents an unexpected cure.
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Affiliation(s)
| | | | | | | | | | | | - Karolien Termote
- Departments of Ophthalmology; and
- Medical Oncology, UZ Brussel - VUB, Brussels, Belgium
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Van Camp S, Vande Walle S, Casteels I, Jacob J, Cassiman C, Wouters C, Schauwvlieghe PP. Acute bilateral serous retinal detachments with spontaneous resolution in a 6-year-old boy. GMS Ophthalmol Cases 2020; 10:Doc37. [PMID: 32884891 PMCID: PMC7452953 DOI: 10.3205/oc000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A healthy 6-year-old boy presented with acute bilateral vision loss, multiple serous retinal detachments between the vascular arcades and a thickened choroid. Spontaneous resolution occurred over several weeks. We hypothesize that the clinical constellation in our patient is suggestive of acute exudative polymorphous vitelliform maculopathy (AEPVM) or might be an atypical presentation of Vogt-Koyanagi-Harada (VKH) disease. We propose that it was caused by an autoimmune-mediated activation of inflammatory cells at the level of the choroid, induced by an unknown trigger.
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Affiliation(s)
- Sophie Van Camp
- Department of Ophthalmology, University Hospitals Leuven, Belgium
| | | | - Ingele Casteels
- Department of Ophthalmology, University Hospitals Leuven, Belgium
| | - Julie Jacob
- Department of Ophthalmology, University Hospitals Leuven, Belgium
| | | | - Carine Wouters
- Department of Pediatrics, University Hospitals Leuven, Belgium
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Sillen H, Ruys J, Schauwvlieghe PP, Veckeneer M. Autologous full-thickness RPE-choroid graft to treat high-risk drusenoid pigment epithelial detachment without CNV. GMS Ophthalmol Cases 2020; 10:Doc24. [PMID: 32676269 PMCID: PMC7332716 DOI: 10.3205/oc000151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: To report on the survival of a retinal pigment epithelium (RPE)-choroid graft translocated to treat a patient with drusenoid pigment epithelial detachment (DPED). Methods: We describe a patient with bilateral high-risk DPED where one eye was treated with RPE-choroid translocation surgery and followed up for more than two years. Results: The RPE-choroid graft surgery was straightforward and the fully perfused graft was able to support stable vision of 0.5 Snellen acuity for more than two years despite the development of a choroidal neovessel at the edge of the graft. The vision in the fellow eye dropped from 0.5 to 0.2 Snellen in the same period. Conclusion: RPE-choroid translocation may slow the progression of DPED to atrophy but it can also transform dry age-related macular degeneration (AMD) into neovascular AMD.
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Affiliation(s)
- Hedwig Sillen
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Joke Ruys
- Department of Ophthalmology, ZNA Middelheim Hospital, Antwerp, Belgium
| | | | - Marc Veckeneer
- Department of Ophthalmology, ZNA Middelheim Hospital, Antwerp, Belgium
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Zonnevylle K, Schauwvlieghe PP, Van Calster J, Lenaerts J, Peeters D. Co-occurrence of bilateral nodular anterior scleritis and large-vessel arteritis in a patient with TINU syndrome. GMS Ophthalmol Cases 2019; 9:Doc34. [PMID: 31728261 PMCID: PMC6839028 DOI: 10.3205/oc000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a case of tubulointerstitial nephritis and uveitis (TINU) with nodular anterior scleritis and large-vessel arteritis. A 67-year-old patient was admitted to the hospital with high fever, thoracic pain, and weakness. Bilateral anterior uveitis was seen at that time. Laboratory examination showed acute renal failure. A renal biopsy was performed and showed pathognomonic signs of tubulointerstitial nephritis (TIN). Six months later, she developed ocular inflammation suggestive of nodular scleritis. One year after hospital admission, she presented with large-vessel arteritis. We describe a case of TINU with co-occurrence of scleritis and large-vessel arteritis.
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Affiliation(s)
| | | | | | - Jan Lenaerts
- Department of Rheumatology, University Hospitals Leuven, KU Leuven, Belgium.,Reuma-Instituut Hasselt, Belgium
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Vandendriessche S, Rybarczyk J, Schauwvlieghe PP, Accou G, Van den Abeele AM, Vanrompay D. A Bird's-Eye View of Chronic Unilateral Conjunctivitis: Remember about Chlamydia psittaci. Microorganisms 2019; 7:microorganisms7050118. [PMID: 31052181 PMCID: PMC6560389 DOI: 10.3390/microorganisms7050118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/17/2019] [Accepted: 04/26/2019] [Indexed: 11/16/2022] Open
Abstract
Chlamydia psittaci causes psittacosis in humans, mainly in people in contact with birds in either the setting of occupational or companion bird exposure. Infection is associated with a range of clinical manifestations from asymptomatic infection to severe atypical pneumonia and systemic disease. C. psittaci has also been associated with ocular adnexal lymphoma in human patients. The current paper describes successful doxycycline treatment of a male patient suffering from C. psittaci chronic unilateral conjunctivitis, most probably linked to the visit of a South African wildlife reserve. Increased awareness among general and occupational physicians, ophthalmologists, clinicians, and the public on the potential of C. psittaci to cause ocular infection is needed.
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Affiliation(s)
- Stien Vandendriessche
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Lucas Ghent, 9000 Ghent, Belgium.
- Department of Laboratory Medicine, Medical Microbiology, Ghent University Hospital, 9000 Ghent, Belgium.
| | - Joanna Rybarczyk
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium.
| | | | - Geraldine Accou
- Department of Ophthalmology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium.
| | | | - Daisy Vanrompay
- Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium.
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Kreps EO, Hondeghem K, Augustinus A, Sys C, Van de Veire S, Leroy BP, Schauwvlieghe PP. Is oral moxifloxacin associated with bilateral acute iris transillumination? Acta Ophthalmol 2018; 96:e547-e548. [PMID: 29068528 DOI: 10.1111/aos.13558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Elke O. Kreps
- Department of Ophthalmology; Ghent University Hospitals; Ghent Belgium
| | - Kathy Hondeghem
- Department of Ophthalmology; Middelheim General Hospital; Antwerp Belgium
| | - Albert Augustinus
- Department of Ophthalmology; Middelheim General Hospital; Antwerp Belgium
| | - Celine Sys
- Department of Ophthalmology; Ghent University Hospitals; Ghent Belgium
| | - Sara Van de Veire
- Department of Ophthalmology; Saint Johns General Hospital; Bruges Belgium
| | - Bart P. Leroy
- Department of Ophthalmology; Ghent University Hospitals; Ghent Belgium
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