Search

PurposeTo describe and analyse a method of detailed formal health review for patients with sight-threatening uveitis using oral immunosuppression.MethodsProspective clinical study of 37 patients.ResultsTreatment side effects were absent or tolerable in 31 patients (84%) but 34 significant treatment side effects or other significant clinical findings were newly identified. Ten patients underwent a treatment change including three who transferred to a different immunosuppressive.ConclusionsFormal health review has proved useful in identifying treatment side effects previously not volunteered by patients. A modified form is to be embedded within our clinic management system. We recommend such reviews to enhance drug safety in patients with sight-threatening chronic uveitis using oral immunosuppressives.Eye (2009) 23, 1400–1403; doi:10.1038/eye.2008.270; published online 26 September 2008 [ABSTRACT FROM AUTHOR]

AimsTo evaluate the efficacy and safety of low-dose (2 mg in 0.05 ml) intraocular triamcinolone injection for patients with uveitis-related cystoid macular oedema and/or intractable intraocular inflammation.Patients and methodsRetrospective clinical case series.ResultsCystoid macular oedema was eliminated in 24/30 eyes (80%). Intractable intraocular inflammation was eliminated in 4/8 eyes (50%). Snellen visual acuity was improved by two lines or more after 14/36 injections (38.9%). Intraocular pressure rose to above 21 mmHg after 8/36 injections (22%). There were no major complications.ConclusionsLow-dose (2 mg in 0.05 ml) intraocular triamcinolone acetonide injection is safe and effective for the management of refractory uveitic macular oedema. Its usefulness in controlling inflammation alone is questionable.Eye (2006) 20, 934–937. doi:10.1038/sj.eye.6702063; published online 12 August 2005 [ABSTRACT FROM AUTHOR]

OBJECTIVE:To investigate the long-term visual results after cataract extraction in patients with uveitis, and to demonstrate the long-term viability of intraocular lenses. DESIGN:In all, 61 patients (72 eyes), with update clinical examination, were retrospectively evaluated. Comparison of preoperative, postoperative, and latest visual function including best-corrected Snellen visual acuity, progression of uveitis and its complications, need for postoperative medical or surgical interventions. RESULTS:After a minimum follow-up of 5 years (mean 7 years 7 months), 82%of eyes maintained a visual improvement of two Snellen lines, 74%maintained 6/9 or better, and 14%had 6/18 or worse. The mode acuity was better than 6/6. The prevalence of macular oedema or scarring was 24%, of posterior capsule opacification 96%, and of glaucoma drainage, 15%. CONCLUSIONS:We report the long-term follow-up of cataract extraction and intraocular lens (IOL) implantation performed by a single surgeon on patients with uveitis attending a regional tertiary referral uveitis clinic. Using stringent perioperative and postoperative control of inflammation, patients with uveitis usually maintain high visual acuity over long-term follow-up. The incidence of sight-threatening postoperative complications is low and no ongoing complication has been attributed to IOL implantation.Eye (2005) 19, 191-197. doi:10.1038/sj.eye.6701450 Published online 2 July 2004 [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on disseminated nocardia infection with subretinal abscess.

Aim: To present the clinical presentation, diagnosis, and management of syphilitic uveitis in the context of an epidemic of syphilis in the UK. Method: Retrospective clinical case series. Results: Six new cases of syphilitic uveitis presented to the Manchester Uveitis Clinic in 2004, after a 15-fold increase in the incidence of syphilis in the UK, including 615 cases in Greater Manchester in the 5 years to 2004. Four cases had secondary syphilis, two had latent disease, two had no rash, and two were HIV positive. Ocular involvement included anterior or panuveitis, retinitis, retinal vasculitis, and papillitis. All resolved on treatment including intramuscular procaine penicillin G with oral probenecid. Conclusions: Syphilis is much more common recently and syphilitic uveitis should be considered in all patients with rash and/or headache, where there is retinitis and/or retinal vasculitis, or in any uveitis of uncertain origin. Treatment is that of neurosyphilis. [ABSTRACT FROM AUTHOR]

PurposeTo assess the effectiveness of anti-tuberculous treatment in patients with chronic uveitis and either active systemic or latent tuberculosis (TB) in a non-endemic community.MethodsRetrospective study of patients with chronic uveitis, non-ocular evidence of latent or active TB and no other identified cause of uveitis who underwent a 6-month course of standard anti-tuberculous chemotherapy. Response to treatment was assessed at 6 and 12 months after initiation of treatment.ResultsA total of 27 patients were included of whom 59% were female. In all, 19 were Asian, 4 Caucasian, and 4 Black. More than half of patients had a history of contact with another person treated for TB. Inflammation resolved after chemotherapy in 70.3% of patients, 18.5% had a change in the nature of their inflammation and 11.1% had no benefit.ConclusionsThere were no uveitis features characteristic of TB uveitis and a wide range of manifestations was seen ranging from non-granulomatous anterior uveitis to occlusive retinal vasculitis. TB is not endemic in the United Kingdom, therefore consideration of ethnicity, immigration, and history of TB contact remain important to direct investigations. In a patient with uveitis and latent TB, a full 6-month course of anti-tuberculous chemotherapy is recommended although it may not be curative of the uveitis. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in about "Sympathetic ophthalmia following severe fungal keratitis" by A. J. Buller and colleagues in vol. 20 of the 2006 January issue.

PurposeTo investigate the observed high prevalence of spontaneous sub-conjunctival haemorrhage (SCH) in patients using long-term topical steroid treatment.Patients and methodsA cross sectional survey of the occurrence of SCH was carried out in 248 patients using steroid eye drops and in a comparison group of 113 patients using topical glaucoma medication.ResultsTwenty-four patients with uveitis (10% of total) experienced single or recurrent SCH. Of these 71% used prednisolone acetate 1% (compared with 75% for those unaffected). None of 113 glaucoma patients were affected.ConclusionsThe long-term use of topical steroid for chronic uveitis substantially increases the prevalence of spontaneous or minimal-trauma SCH. Steroid-induced vascular fragility is the likely cause. [ABSTRACT FROM AUTHOR]

A response by K. Mercieda, C. Sanghvi, and N. P. Jones to a letter to the editor about their article "Spontaneous Sub-conjuctival Haemorrhage in Patients Using Long-term Topical Corticosteroids" in 2010 issue is presented.

Presents a letter to the editor in response to the article on the immunomodulatory effects of oestrogen and progesterone on acute uveitis, published in the previous issue of the "Eye."

Presents letters to the editor in response to articles previously published in the issue of the "Eye."