Search

Will optical coherence tomography angiography (OCTA) replace invasive imaging techniques like fundus fluorescein angiography (FFA) and indocyanine green (ICG) angiography entirely? While OCTA is being increasingly applied in the field of medical retina, will we see this change in the subspeciality of uveitis? In this article, five uveitis specialists with renowned imaging expertise answer to 10 specific questions to address this issue. The final verdict based on the comments of the experts suggests that FFA and ICG cannot be replaced by OCTA in uveitis, at least for now. While OCTA can offer new insights into the pathogenesis of certain inflammatory conditions and help in the diagnosis of complications like inflammatory choroidal neovascularisation, multimodal imaging is still the preferred approach in the assessment of patients with uveitis. [ABSTRACT FROM AUTHOR]

Longer-term systemic immunosuppression has been employed successfully in eyes with frequent recurrences.[1],[2],[38],[39] Anti-microbial therapy should be added in eyes with CNV in the setting of active toxoplasmic or tuberculous retinochoroiditis. Thirteen eyes (32.5%) had CNV at first visit, whereas four eyes developed CNV during follow up, and eyes with CNV tended to have worse vision at both presentation and last visit. Focal choroidal excavation (FCE) was observed in five eyes with CNV (31.3%) verses 10 eyes without CNV (41.7%; I p i =.44). Subretinal fibrosis was noted in four eyes with CNV (25.0%) verses no eyes without CNV (0.0%; I p i =.02). [Extracted from the article]

Macular edema (ME) is a leading cause of vision loss in both children and adults with uveitis.1-7 Reported rates of uveitic ME (UME) from tertiary referral clinics have ranged from roughly 20% to 30%,8-13 with the vast majority of cases occurring in the setting of intermediate, posterior, or panuveitis--although ME occurs occasionally in eyes with anterior uveitis, especially when inflammation spills over to involve the vitreous. Corticosteroid-induced ocular complications were common and included cataract in eight of 17 phakic eyes (47.1%), intraocular pressure (IOP) elevation to or above 21mmHg in 20 eyes (45.4%) and IOP above 30 mmHg in three eyes (6.8%). Ratra et al.24 retrospectively assessed the tolerability and efficacy of the dexamethasone intravitreal implant (OZURDEX®) for the retreatment of refractory UME in 42 eyes of 34 patients seen at a uveitis referral clinic in Chennai, India, between April, 2011, and December, 2015. Multicenter uveitis steroid treatment trial research group. outcome of treatment of uveitic macular edema: the multicenter uveitis steroid treatment trial 2-year results. [Extracted from the article]

Purpose: To analyze the efficacy of tocilizumab in uveitic macular edema (ME) resistant to various immunomodulatory drugs.Methods: Patients received tocilizumab every 4 weeks intravenously. Central foveal thickness (CFT) was assessed by optical coherence tomography (OCT).Results: Five patients (8 eyes) who were ineffectively pretreated with systemic prednisolone, at least one immunosuppressive drug, and at least one biologic drug for uveitic macular edema were included in the study. At 3 months, a response of ME (≥25% reduction in CFT) was observed in 6 eyes (75.0%) of 5 patients. During follow-up, complete resolution of ME was achieved in 5 eyes (62.5%) of 4 patients. Improvement of BCVA was observed in 3 eyes of 3 patients, and stabilization in 3 eyes of 3 patients. Tocilizumab was well tolerated, and no severe side effects occurred.Conclusions: Treatment with tocilizumab can be considered in chronic uveitic macular edema even if previous immunomodulatory therapy has failed. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discuss various reports within the issue on topics including infectious uveitis, the use of optical coherence tomography angiography (OCT-A) to diagnose multifocal serpiginoid choroiditis (MSC) lesion, and the use azathioprine for uveitis treatment.

An introduction is presented in which editor discusses various articles within the issue on topics including features of patients diagnosed with posterior scleritis, use of enhanced depth anterior segment optical coherence tomography and use of oral flurbiprofen to treat patients of scleritis.

An introduction is presented in which the authors discuss various papers within the issue focusing on the use of high resolution optical coherence tomography (OCT) in patients with inflammatory diseases known to affect the eye including the findings of E. Ayhan Tuzu and M. Kola in patients with ankylosing spondylitis (AS) using spectral-domain OCT (SD-OCT), M.S. Zinkernagel and colleagues' use of a Heidelberg Spectralis SD-OCT, and M. Ecsedy and colleagues' use of a StratusOCT.

An editorial is presented on the neuroinflammatory condition called multiple sclerosis-associated uveitis which clinically defined as relapsing-remitting (RRMS) or primary progressive (PPMS). It also cites on the condition that is characterized by transient episodes of neurologic dysfunction periods and of relative to complete remission.

Juvenile idiopathic arthritis-associated uveitis (JIAU) accounts for a sizable proportion of uveitis cases in children and is an important cause of ocular morbidity in uveitis patients in this age group. The authors present the results of a survey conducted to obtain a better understanding of the current views and practices of ophthalmologists involved in the care of children with JIAU. A detailed questionnaire consisting of 54 questions addressing epidemiology, diagnosis, and therapy of JIAU was distributed to 67 uveitis specialists. The responses from 37 completed questionnaires were tabulated for this report. While the experts often agreed on aspects of the epidemiologic and clinical features of JIAU and its complications, considerable diversity of responses was noted-particularly with regard to practice patterns. Regarding diagnostics and disease monitoring, all experts favored ANA testing, whereas two-thirds also suggested HLA-B27 typing. Laser flare photometry was available to and routinely used by almost one-third of the experts. Optical coherence tomography (OCT) was used by more than half. The survey revealed an overall consensus on therapeutic strategies, including the use of both conventional immunosuppressive and biologic agents. Methotrexate was the initial choice for immunosuppression by most respondents. Most would add an anti-TNF-alpha agent following failure of traditional immunosuppressive therapy, and adalimumab was favored by almost half of the experts. Questions addressing the management of individual situations, such as the treatment of macular edema and perioperative management, revealed considerable differences in therapeutic approaches. The results of this survey support the development of international guidelines for the management of JIAU. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including role of choroidal neovascularization in eyes with inflammation, enhanced depth imaging optical coherence tomography (EDI-OCT) and complications in patients with uveitis.

An introduction is presented in which editor discusses various articles within the issue on topics including modalities in diagnosis and management of uveitis, high resolution optical coherence tomography (OCT) and the rise in the impact factor of the periodical.