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BackgroundSyphilitic uveitis is re-emerging alongside the systemic infection. In July 2017, an international group of uveitis-specialised ophthalmologists formed the International Ocular Syphilis Study Group to define current practice patterns.Methods103 Study Group members based in 35 countries completed a 25-item questionnaire focused on case load, clinical presentations, use and interpretation of investigations, treatment and clinical indicators of poor prognosis.ResultsMembers managed a mean of 6.1 patients with syphilitic uveitis in clinics that averaged 707 annual cases of uveitis (0.9%); 53.2% reported increasing numbers over the past decade. Patients presented to more members (40.2%) during secondary syphilis. Uveitis was usually posterior (60.8%) or pan (22.5%); complications included optic neuropathy, macular oedema and posterior synechiae. All members diagnosed syphilitic uveitis using serological tests (simultaneous or sequential testing algorithms), and 97.0% routinely checked for HIV co-infection. Cerebrospinal fluid (CSF) analysis was ordered by 90.2% of members, and 92.7% took uveitis plus Venereal Disease Research Laboratory test (VDRL) or fluorescent treponemal antibody absorption test (FTA-ABS) to indicate neurosyphilis. Patients were commonly co-managed with infectious disease physicians, and treated with penicillin for at least 10–14 days, plus corticosteroid. Features predicting poor outcome included optic neuropathy (86.3%) and initial misdiagnosis (63.7%). Reasons for delayed diagnosis were often practitioner-related. 82.5% of members tested every patient they managed with uveitis for syphilis.ConclusionThis comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.

The most frequent ocular manifestation of the SARS-CoV-2 is a conjunctivitis. It is found in 1-3% of patients and has unusually a benign course. In those patients but also in patients without ocular involvement, the virus can be detected by PCR in conjunctival swabs or in the tears. Whereas the presence of the virus in the conjunctiva is proven, its transmission through the conjunctiva is still discussed. Despite the poor level of evidence, the use of protective eyewear is recommended. Ocular thromboembolic events have been described in Covid-19. They can be found in the context of the Covid-related coagulopathy. A multidisciplinary approach should be provided in these cases. In the ICU, severe ocular complications might be indirectly related to Covid-19 in ventilated patients.

Uveitis is an inflammation of the eye, resulting from infection or inflammation and is sometimes related to rheumatic and other auto-immune diseases. The condition is classified according to the anatomical site of inflammation: anterior, intermediate, posterior or panuveitis. Uveitis may result in a significant loss of visual acuity, that may however be avoided by controlling the inflammation. Anterior uveitis is the only form that responds to topical therapies (prednisolone acetate and mydriatics). The other forms of inflammatory and non-infectious uveitis often require treatment with systemic corticosteroids, followed by immunosuppressive or biological therapies, which requires close collaboration between the different medical sub-specialties.

To describe the optical coherence tomography angiograhy (OCTA) of drusenoid pigment epithelial detachments (PEDs) in a woman affected by Complement 3 (C3) glomerulopathy, which represents a spectrum of glomerular diseases characterized on fluorescent microscopy by C3 accumulation with absent, or scanty, immunoglobulin deposits. It is due to acquired or genetically defective alternative pathway control and is generally associated with drusen-like deposits in Bruch's membrane, as well as choriocapillaris. These retinal lesions can be associated with choroidal neovascularization and central serous chorioretinopathy (CSCR). OCTA is useful to detect neovascularization without injecting a contrast product, particularly in these patients who may have renal insufficiency. A 28-year-old woman affected by C3 glomerulpathy was diagnosed with asymptomatic multiple bilateral PEDs during a routine ophthalmologic consultation. To better characterize the lesions, multimodal imaging was performed and included: optic coherence tomography (OCT), en-face OCT, OCTA, fluorescence and indocyanine angiography. The OCTA clearly identified vascular network rarefaction with decreased choriocapillary vascularization. It confirmed that PEDs associated with C3 glomerulonephritis are not vascularized, but rather of serous type. Patients affected by C3 glomerulopathy can develop neovascular membranes as retinal complications of pigment epithelial detachments. Optical coherence angiography may be indicated to identify this complication, without injecting any contrast product that could produce further kidney damage.

Hamartoma is a nodular malformation, with a single or multiple malformations, it is a recognized prenatal developmental abnormality. This benign tumor lesion has the same histological components of normal parenchyma, but these components are arranged haphazardly which disrupts normal function. Hamartomas usually remain connected with the tissue of origin; as is the case with pulmonary hamartoma or the splenic hamartoma. The exact incidence of retinal astrocytic hamartoma (RAH) is not well known, but it is estimated at one case per 100 000 births per year [1]. The astrocytic hamartoma is a neuroglial tissue and produces astrocytes within the optic nerve [2], and consequently it often appears within papillary region.

La rétinopathie diabétique touche un nombre croissant de personnes, soit quatre millions en Europe, ce chiffre va probablement doubler d'ici 2030. Si l'on considère que 25-30% de ces patients sont atteints de rétinopathie diabétique, un dépistage et un traitement précoce permettent d'éviter les complications oculaires sévères telles que l'oedème maculaire cystoïde où la rétinopathie diabétique proliférative. Un résumé des dernières données de la littérature ophtalmologique est présenté en insistant sur le rôle de l'anti-VEGF (vascular endothelial growth factor) et des implants intravitréens de corticostéroïdes pour une pathologie oculaire récemment classée dans les pathologies inflammatoires. Diabetic retinopathy affects an increasing number of persons, about 4 millions in Europe, a number that will probably double until 2030. If we consider that 25-30% of patients are affected by diabetic retinopathy, an ophthalmologic screening and early therapy will allow a better visual prognosis and avoid severe ocular complications such as diabetic macular edema and proliferative diabetic retinopathy. A summary of current ophthalmologic literature was performed and was focused on the role of anti-VEGF (vascular endothelial growth factor) therapies and intraocular drug delivery of corticosteroids in a pathology that was recently classified in inflammatory pathologies.

Background Fluorescein (FA) and indocyanine-green angiography (ICGA) may offer valuable information concerning disease severity and prognosis in ocular syphilis. The aim of the present study is to describe angiographic patterns encountered in the context of ocular syphilis, and to explore the associations between specific angiographic manifestations and severity of disease presentation, as well as disease evolution after treatment. Methods We performed a retrospective institutional study with the inclusion of 23 patients with ocular syphilis presenting to the uveitis clinic of the Jules-Gonin Eye Hospital in a 10-year period. FA and ICGAwere performed following a standard protocol for posterior uveitis. Patterns of fluorescence were noted, and statistical associations between each angiographic pattern and any demographic, clinical, or laboratory parameter at baseline and after treatment were sought. Results The presence of any dark dots in ICGA was significantly associated with anterior uveitis (p=0.031). The presence of hot spots in ICGA was significantly associated with longer duration of symptoms prior to initial visit (p= 0.032) and with male gender (p=0.012). Weak nonsignificant trends were found associating vascular staining in FAwith anterior uveitis (p=0.066), vitritis (p=0.069), and younger age (p=0.061), as well as disc hyperfluorescence in FA with seropositivity for HIV (p=0.089) and macular edema in FA with longer disease duration (p=0.061). The presence of any dark dots in ICGA exhibited a weak trend of association with anterior uveitis and/or vitritis (p=0.079). Conclusions Out of the several associations identified implicating specific angiographic features, we underline the possible role of the presence of dark dots in ICGA for identifying active inflammation, and the role of hot spots in ICGA as markers of long-standing disease. Vascular staining in FA appears to be more common in patients with severe ocular inflammation with presence of anterior uveitis and/or vitritis. © 2011 Springer-Verlag.

Background: The aim of this study is to determine whether statistical associations can be demonstrated in ocular syphilis between baseline clinical and laboratory parameters with visual acuity at presentation and with any change in visual acuity after treatment. Methods: Charts of 26 patients (42 eyes) with ocular syphilis presenting to the Uveitis clinic of the Jules-Gonin Eye Hospital were reviewed. A baseline cross-sectional analysis was performed in order to identify any association between visual acuity at presentation and demographic, clinical or laboratory parameters. After treatment, any analogy between these parameters and a change in visual acuity was subsequently assessed in a series of univariate comparisons. Results: The following factors were associated with worse initial visual acuity: severity of visual field impairment at presentation (p=0.012), macular oedema (p=0.004) and optic neuropathy (p=0.031). There was a borderline association with the presence of vasculitis on fluroangiography (p=0.072). Improvement in best corrected visual acuity after treatment was significantly associated with the presence of vasculitis on fluroangiography (p=0.005), neurosyphilis, according to lumbar puncture findings (p=0.037) and marginally with anterior uveitis (p=0.070). Inflammation relapse was associated with the coexistence of pain as presenting sign (p

Purpose: To investigate six cases of annular cyclitis. Methods: All patients with impairment of visual acuity underwent complete ophthalmologic examination, color fundus photography, laboratory tests and fluorescein angiography. Indocyanine green (ICG) angiography and B-scan ultrasonography were also performed in three cases in order to diagnose the disease. Results: All patients presented a unilateral or bilateral granulomatous uveitis, associated with in. ammatory annular cyclitis. They had a shallow anterior chamber, a mildly elevated intraocular pressure (under 25 mm Hg) and an annular serous retinal detachment. A resolution was observed after specific therapy associated with systemic prednisolone therapy and antiglaucomatous drops. Conclusion: This is the first description of an observational study of six patients with inflammatory annular cyclitis. © 2009 Moschos et al, publisher and licensee Dove Medical Press Ltd.