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To report demographic and clinical profiles of children with uveitis in theTurkishpopulation. The data of the pediatric uveitis cases in the nation wide uveitis database were analyzed. The study included 697 eyes of 442 patients with a meanage of 10.8 ± 3.8 years. There were 333 patients (75.3%) with non-infectious uveitis and 69 patients (15.6%) with infectious uveitis. Pars planitis (20.1%) was leading clinical form followed by idiopathic cases with uveitis other than pars planitis (18.8%), juvenile idiopathic arthritis(JIA) related uveitis (12.4%), Behçet uveitis (9.3%) and toxoplasma retinochoroiditis (7.9%). Ocular involvement was unilateral in 187 patients (42.3%) and bilateral in 255 patients (57.7%). The most common anatomiclocation of uveitis was anterior uveitis (39.1%), followed by intermediate uveitis (29.4%), panuveitis (16.1%) and posterior uveitis (15.4%). The most common systemic association was JIA in the younger children and Behçet disease in the older children. [ABSTRACT FROM AUTHOR]

Purpose: To describe Turkish patients with Fuchs uveitis syndrome (FUS). Design: Retrospective observational case series. Methods: We reviewed the records of 172 patients with FUS seen at Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, between January 1995 and July 2007. The main outcome measures were demographic features, clinical findings at presentation, laser flare photometry values, risk of new complications, and rate of decreased vision. Results: The mean age was 29.5 + 8.4 years. Male-to-female ratio was 1:1.3. Nine patients (5.2%) had bilateral involvement. The diagnosis of FUS had been made in only 10 of 115 (8.7%) referrals. Clinical findings at presentation included diffuse keratic precipitates (medium-sized round in 74.6%, fine-stellate in 22.1%), anterior chamber cells (74%), diffuse iris atrophy without hypochromia (48.6%), heterochromia (39.8%), iris nodules (32%), cataract/pseudophakia (69.1%), vitreous cells (71.8%), elevated intraocular pressure (12.7%), and chorioretinal scars (7.7%). The mean flare was 8.4 + 3.1 photons/ms in eyes with FUS and 3.7 + 0.8 photons/ms in the fellow eyes (P < .001). Hyperfluorescence of the optic disc was the only fluorescein angiographic finding, detected in 7 of 32 eyes (22%). Kaplan-Meier analysis estimated risks of cataract formation and intraocular pressure elevation as 42% and 17%, respectively, at 4 years. The rate of decreased visual acuity by 2 lines or more was 0.06/eye-year. Conclusions: The referral patterns suggest that FUS is frequently misdiagnosed in Turkish patients. Diffuse medium-sized round keratic precipitates, low flare readings, iris stromal atrophy without hypochromia, and vitreous opacities in the absence of macular edema are more often helpful clues to the diagnosis than heterochromia. [Copyright &y& Elsevier]

Purpose: To report new cases of bilateral acute depigmentation of the iris (BADI), a recently described clinical entity, and to report the 4-year follow-up of 2 patients that was published previously. Design: A retrospective case series. Participants: Twenty-six Turkish patients who were diagnosed with BADI between 2006 and 2008 and 2 patients who were reported previously. Methods: We reviewed the patients'' charts and clinical photographs. Observation procedures included clinical examination, anterior segment color photography, laser flare photometry, and pupillometry. We performed an anterior chamber tap in 2 patients for polymerase chain reaction (PCR) to demonstrate the DNA of herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV) in the aqueous samples. Main Outcome Measures: Demographic features, presenting symptoms, laboratory findings, changes in iris stromal pigment and architecture, and time to resolution of pigment dispersion in the anterior chamber. Results: Nineteen patients were female, and 7 patients were male. Mean age was 32.3±8.6 years. All had bilateral involvement. Twenty patients (76.9%) presented with photophobia and red eyes, and 4 patients (15.4%) presented with a recent change in eye color. Ten patients (38.5%) had flu-like symptoms preceding the onset of ocular symptoms. Diagnostic laboratory workup, viral serology, and PCR analysis of the aqueous humor were unrewarding. Diffuse depigmentation of the iris stroma from the collarette to the iris root was seen in 16 patients, and geographic areas of depigmentation were seen in 10 patients. There was heavy pigment deposition in the trabecular meshwork in all patients. Anterior chamber flare was elevated in eyes with circulating pigment. The pupil was not affected. Twenty patients received topical corticosteroids. Pigment dispersion resolved in 1 to 16 weeks (median, 9 weeks). The intraocular pressure was elevated in 8 steroid-treated eyes but was controlled with antiglaucomatous medications. In 2 patients reported previously, the depigmented iris stroma became repigmented after 4 years. Conclusions: Patients with BADI present with bilateral, symmetrical, nontransilluminating depigmentation of the iris stroma and pigment discharge into the anterior chamber. Young female persons are more commonly affected. The cause remains unknown. After 4 years, the ocular findings in 2 patients normalized. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]

Purpose: To analyze the referral patterns and clinical features of uveitis in tertiary eye care centers in Turkey. Methods: Uveitis services of eight university clinics collected data on uveitis patients who presented during 2004. Data were collected on a form including a questionnaire on socio-demographic and clinical features which were documented at presentation. Results: A total of 761 patients (1187 eyes) with a mean age of 35.5 years were included in the study. Male to female ratio was 1.04:1. The majority of patients (89.6%) were from an urban population, 53% were referrals and 43% had had uveitis for more than one year. The most common type of uveitis was anterior uveitis (52.5%) followed by panuveitis (28.1%), posterior uveitis (12.7%) and intermediate uveitis (6.7%). In 56.8% of patients an etiological classification was established. The most common etiology was Behcet's disease (32.1%), followed by Fuchs' heterochromic iridocyclitis (5.1%) and ocular toxoplasmosis (4.7%). Among 48 pediatric patients uveitis associated with juvenile idiopathic arthritis and ocular toxoplasmosis both having equal frequencies (12.5%) were the most common diagnosis. These were followed by Behcet's disease with juvenile-onset (10.4%). At the time of presentation, 6.25% of the patients were legally blind (having visual acuity less than 0.1 in the better seeing eye). Conclusion: Compared to the uveitis series reported from other countries, Behcet uveitis was the leading cause of uveitis in this series. Uveitis associated with juvenile idiopathic arthritis and ocular toxoplasmosis were the most common cause of uveitis in childhood. On the other hand, entities like acquired immunodeficiency syndrome-related uveitis, presumed ocular histoplasmosis and Birdshot retinochoroidopathy were rare. [ABSTRACT FROM AUTHOR]

Purpose: To describe the demographic and clinical profiles of uveitis patients seen at secondary and tertiary care centers in Turkey.Methods: A nationwide web-based registry of patients with uveitis was initiated in November 2008. We analyzed data from a single baseline registry-enrollment visit.Results: In 33 centers, 6967 eyes of 4863 consecutive patients were registered. The mean age at presentation was 36.6 ± 15.7 (1-92) years; 51.3% were male. Behçet disease was the leading diagnosis (24.9%), followed by ankylosing spondylitis and/or HLA-B27-associated anterior uveitis (9.7%), toxoplasmosis (7.1%), Fuchs uveitis (6.3%), and presumed herpetic anterior uveitis (6.0%). Visual acuity was 0.1 or worse in 22% of eyes. The most common ocular complications were posterior synechiae (16.2%) and cataract formation (16.2%).Conclusions: Behçet disease is still the most common non-infectious etiology in Turkish uveitis patients, while ocular toxoplasmosis and herpetic anterior uveitis are the most common infectious uveitic entities. [ABSTRACT FROM AUTHOR]

Behçet's disease is a genetically complex disease of unknown etiology characterized by recurrent inflammatory attacks affecting the orogenital mucosa, eyes and skin. We performed a genome-wide association study with 311,459 SNPs in 1,215 individuals with Behçet's disease (cases) and 1,278 healthy controls from Turkey. We confirmed the known association of Behçet's disease with HLA-B*51 and identified a second, independent association within the MHC Class I region. We also identified an association at IL10 (rs1518111, P = 1.88 × 10−8). Using a meta-analysis with an additional five cohorts from Turkey, the Middle East, Europe and Asia, comprising a total of 2,430 cases and 2,660 controls, we identified associations at IL10 (rs1518111, P = 3.54 × 10−18, odds ratio = 1.45, 95% CI 1.34–1.58) and the IL23R-IL12RB2 locus (rs924080, P = 6.69 × 10−9, OR = 1.28, 95% CI 1.18–1.39). The disease-associated IL10 variant (the rs1518111 A allele) was associated with diminished mRNA expression and low protein production. [ABSTRACT FROM AUTHOR]