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Purpose: To retrospectively assess the frequency of ocular relapse and the possibility of long-term remission in patients treated with interferon (IFN) for severe uveitis associated with Behçet disease.Methods: All patients were treated with an initial dosage of 3 million IU IFN three times a week. The main outcome measure was the number of relapses per person per year before, during, and after IFN treatment.Results: Of 36 patients (67 eyes), 31 (86.1%) responded to IFN. The mean follow-up was 8.19 years. Twenty-one out of 36 patients discontinued IFN and 76% of these have not relapsed within 5.05 years after discontinuation. The mean relapse per person per year decreased significantly from 1.39 to 0.0496 (p = 1.82×10-10) during the treatment period and remained at 0.057 relapses per person per year after IFN discontinuation.Conclusion: IFN efficiently decreases the relapse rate and seems to permit long-term remission even after discontinuation. [ABSTRACT FROM AUTHOR]

Objective: To characterize the clinical features of ocular Whipple''s disease (WD) and determine the long-term prognosis after antibiotic treatment. Design: Retrospective case series. Participants: Medical records of patients referred between January 1993 and December 2010 were reviewed for chronic corticosteroid-resistant uveitis or neuro-ophthalmologic findings consistent with WD. Eleven patients (male/female = 9/2) were included in this study. Methods: Diagnosis was based on cytologic examination and molecular analysis of samples (cerebrospinal fluid, vitreous, duodenum, or any involved lymph node). It was based on cytology before the routine use of polymerase chain reaction (PCR) and on both cytology and molecular biology for more recent patients. Long-term antibiotic therapy included oral trimethoprim-sulfamethoxazole (TMP-SMX) and rifampin, TMP-SMX alone, rifampin alone, or tetracycline alone. Main Outcome Measures: (1) Demographic and clinical characteristics of patients with positive PCR for Tropheryma whipplei or periodic acid-Schiff–positive macrophages in the vitreous and (2) long-term prognosis after antibiotic treatment. Results: Mean age at diagnosis was 63 years (range, 51–73 years). Average time between the onset of the disease and diagnosis was 2 years (range, 1 month to 11 years). Mean follow-up was 7.2 years (range, 0.25–18 years). Ophthalmologic findings consisted of chronic uveitis (9 patients), isolated bilateral optic disc swelling (1 patient), and Parinaud syndrome (1 patient). All patients had PAS-positive macrophages, and 6 patients had a positive PCR for T. whipplei. Nine patients were treated with TMP-SMX and rifampin. One patient treated with only tetracycline relapsed and was successfully treated with TMP-SMX. No major side effects were reported. Intraocular inflammation and neurologic manifestations were controlled in all cases. At the end of follow-up, 2 patients were off treatment, 2 patients had a neurologic relapse after treatment interruption, and 5 patients were still taking TMP-SMX. One patient was taking only rifampin. Two patients were lost to follow-up. Conclusions: Ocular WD seems to be a neurologic manifestation of WD. Trimethoprim-SMX with rifampin is an efficient treatment, and prolonging treatment for at least 1 year is recommended. Long-term low-dose antibiotic therapy may reduce the rate of relapse, neurologic involvement, and death. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To explore the efficacy and safety of 2 concentrations (0.1% and 0.2%) of sodium naproxen ophthalmic solution in controlling ocular inflammation in patients having phacoemulsification and intraocular lens implantation.Setting: Service d’Ophtalmologie La Pitie` and Centre Ophtalmologique, Paris, and Clinique Sourdille, Nantes, France; Department of Ophthalmology, University of Lausanne, Switzerland.Methods: One hundred one patients were randomly treated with naproxen 0.1%, naproxen 0.2%, or diclofenac 0.1% 3 times a day for 30 days starting the day before surgery. Postsurgical ocular inflammation was measured after 1, 10, and 30 days using the Kowa FC-1000 laser flare-cell meter and a conventional slitlamp biomicroscope. Safety parameters were evaluated at the same visits.Results: Naproxen 0.2% ophthalmic solution and diclofenac 0.01% were comparable in controlling postsurgical inflammation. The naproxen was well tolerated. No serious adverse events occurred during the study.Conclusions: These preliminary results suggest that naproxen ophthalmic solution may be effectively and safely used to control inflammation after uneventful phacoemulsification. Because of the limited number of patients, larger studies are needed to confirm these results. [Copyright &y& Elsevier]