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Purpose: To conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief. Methods: A RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan-uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts’ estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial’s primary outcome. Results: A total of 11 of the 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03–45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1–1.2) and 0.7 (95% CrI 0.2–1.7) from the Bayesian analysis. Conclusions: A Bayesian analysis combining expert belief with the trial’s result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT. [ABSTRACT FROM PUBLISHER]

An introduction to the journal is presented in which the editors discuss studies on intraocular tuberculosis (IOTB).

An introduction to articles published within the issue is presented, including two articles on the pathogenesis, clinical presentation, diagnosis and management of Vogt-Koyanagi-Harada (VKH) disease, another on a study which examined the serum interleukin (IL)-25 levels in patients in the acute uveitic phase and those with chronic/recurrent inflammation, and a case of a woman diagnosed with Holmes-Adie syndrome.

Purpose: To analyze the demographics and clinical characteristics in patients with intraocular cysticercosis. Methods: Retrospective case series and comprehensive literature review. Results: Intraocular cysticercosis was diagnosed in 21 of 21,079 patients (0.10%) seen by the uveitis service at Aravind Eye Hospital. At presentation, visual acuity was 20/200 or worse in 14 eyes (63.6%). Inflammation was unilateral in all but one patient (95.2%). The cyst was located in the vitreous cavity in 36.4% of eyes and in the subretinal space in 63.6% of eyes. In the literature review, most patients were affected unilaterally (98.5%); visual acuity at presentation was 20/200 or worse in 82.3% of eyes; and the cyst was located in the vitreous cavity in 59.5% of eyes. Conclusions: Intraocular cysticercosis usually affects young patients unilaterally. The cyst may be in either the vitreous cavity or the subretinal space, and visual acuity at presentation is often poor. [ABSTRACT FROM AUTHOR]

Purpose Method Results Conclusions Chikungunya is a re-emerging viral infection across the globe. The purpose of this article is to review the systemic and ophthalmic manifestations associated with chikungunya fever.A review of literature was conducted using online databases.In this report, we have reviewed the presently available literature on uveitis caused by chikungunya and highlighted the current knowledge of its clinical manifestations, imaging features, laboratory diagnostics, and the available therapeutic modalities from the systemic and ophthalmic standpoint.Ocular involvement in chikungunya infection may occur at the time of systemic manifestations or it may occur as a delayed presentation many weeks after the fever. Treatment relies on a supportive therapy for systemic illness. Treatment of ocular manifestation depends on the type of manifestations and usually includes a combination of topical and oral steroids. [ABSTRACT FROM AUTHOR]

A response by Jon D. Wender and colleagues to a letter to the editor regarding their article on intraocular cysticercosis in the 2012 issue is presented.

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings. Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion. Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis. Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies. [ABSTRACT FROM AUTHOR]

The article discusses the diagnoses, characteristics, treatment and outcomes of uveitis or eye inflammation, following a mosquito-borne viral infection. Topics include ocular infection by Zika virus, cases of Purtscher-like retinopathy after dengue fever and association of chikungunya virus infection with blurred vision.