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[PMID]:28715846
[Au] Autor:Stansky E; Biancotto A; Dagur PK; Gangaputra S; Chaigne-Delalande B; Nussenblatt RB; Sen HN; McCoy JP
[Ad] Endereço:Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States.
[Ti] Título:B Cell Anomalies in Autoimmune Retinopathy (AIR).
[So] Source:Invest Ophthalmol Vis Sci;58(9):3600-3607, 2017 Jul 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: Autoimmune retinopathy (AIR) is a retinopathy associated with unexplained vision loss presumably linked to circulating antiretinal antibodies; currently, however, there are no standardized criteria regarding the diagnosis, treatment strategy, or pathogenesis of this disease. The importance of B-lymphocyte immunophenotyping in the classification of AIR is unknown. Methods: We utilized 15-color multiparametric flow cytometry to identify aberrations in B cell subsets that may contribute to the pathophysiology of AIR. Luminex cytokine analysis was also performed on plasma samples from AIR patients. Results: Significant differences in AIR patients compared to individuals with other inflammatory conditions or healthy donors were found in the B cell memory compartment, including an increase in naïve B cells and a decrease in switched and unswitched memory B cells, which correlated with alterations in immunoglobulin secretion. Conclusions: These findings suggest that the maturation process of B cells may be impaired and that B cell immunophenotyping may help in understanding disease process in AIR.
[Mh] Termos MeSH primário: Doenças Autoimunes/imunologia
Subpopulações de Linfócitos B/imunologia
Doenças Retinianas/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Autoanticorpos/sangue
Autoantígenos/imunologia
Doenças Autoimunes/patologia
Subpopulações de Linfócitos B/patologia
Citocinas/sangue
Eletrorretinografia
Feminino
Citometria de Fluxo
Voluntários Saudáveis
Seres Humanos
Imunofenotipagem
Masculino
Meia-Idade
Pan-Uveíte/sangue
Retina/imunologia
Doenças Retinianas/patologia
Uveíte Posterior/sangue
Transtornos da Visão/diagnóstico
Campos Visuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Autoantigens); 0 (Cytokines)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170718
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21704


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[PMID]:28624167
[Au] Autor:Sugar EA; Venugopal V; Thorne JE; Frick KD; Holland GN; Wang RC; Almanzor R; Jabs DA; Holbrook JT; Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group
[Ad] Endereço:Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Center for Clinical Trials, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Mar
[Ti] Título:Longitudinal Vision-Related Quality of Life for Patients with Noninfectious Uveitis Treated with Fluocinolone Acetonide Implant or Systemic Corticosteroid Therapy.
[So] Source:Ophthalmology;124(11):1662-1669, 2017 Nov.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate longitudinal vision-related quality of life (VRQoL) in patients with noninfectious uveitis. DESIGN: Cohort study using randomized controlled trial data. PARTICIPANTS: Patients with active or recently active intermediate uveitis, posterior uveitis, or panuveitis enrolled in the Multicenter Steroid Treatment Trial and Follow-up Study. METHODS: Data from the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) for the first 3 years after randomization were evaluated semiannually. Analyses were stratified by assigned treatment (129 implants vs. 126 systemic therapies) because of substantial differences in the trajectories of VRQoL. The impact of baseline measurements of visual function (visual acuity and visual field), demographics, and disease characteristics was assessed using generalized estimating equations. MAIN OUTCOME MEASURES: Primary outcome was the NEI-VFQ-25 composite score over 3 years after randomization. RESULTS: Individuals in both treatment groups showed similar improvement in NEI-VFQ-25 scores after 3 years of follow-up (implant: 11.9 points; 95% confidence interval [CI], 8.6-15.2; P < 0.001; systemic: 9.0 points; 95% CI, 5.6-12.3; P < 0.001; P = 0.21 for interaction). Individuals in the implant group showed a substantial improvement during the first 6 months followed by stable scores, whereas individuals in the systemic group showed a steady improvement over the course of follow-up. Worse initial visual acuity and visual fields were associated with lower initial NEI-VFQ-25 scores for both treatment groups. In the systemic group, these differences were maintained throughout follow-up. In the implant group, individuals with initial visual acuity worse than 20/40 showed additional improvement in NEI-VFQ-25 score to come within -7 points (95% CI, -15.0 to 0.9) of those with visual acuity 20/40 or better initially, a clinically meaningful but not statistically significant difference (P = 0.081). Results based on sensitivity analyses showed similar patterns. CONCLUSIONS: Both treatment groups demonstrated significant improvements in NEI-VFQ-25 scores; however, the improvement was immediate for the implant group as opposed to gradual for the systemic group. Poorer visual function was associated significantly with initial differences in NEI-VFQ-25 scores. However, only individuals in the implant group with poor visual acuity were able to overcome their initial deficits by the end of 3 years.
[Mh] Termos MeSH primário: Fluocinolona Acetonida/administração & dosagem
Glucocorticoides/administração & dosagem
Pan-Uveíte/tratamento farmacológico
Qualidade de Vida/psicologia
Uveíte Intermediária/tratamento farmacológico
Uveíte Posterior/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Coortes
Implantes de Medicamento
Feminino
Seguimentos
Nível de Saúde
Seres Humanos
Masculino
Meia-Idade
Pan-Uveíte/psicologia
Fatores de Risco
Perfil de Impacto da Doença
Inquéritos e Questionários
Uveíte Intermediária/psicologia
Uveíte Posterior/psicologia
Visão Ocular/fisiologia
Acuidade Visual/fisiologia
Campos Visuais/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drug Implants); 0 (Glucocorticoids); 0CD5FD6S2M (Fluocinolone Acetonide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE


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[PMID]:28574002
[Au] Autor:Priya D; Sudharshan S; Biswas J
[Ad] Endereço:Department of Uvea and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
[Ti] Título:Management of a rare presentation of Vogt-Koyanagi-Harada disease in human immunodeficiency virus/acquired immunodeficiency disease syndrome patient.
[So] Source:Indian J Ophthalmol;65(5):413-416, 2017 May.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Vogt-Koyanagi-Harada (VKH), a multisystem autoimmune bilateral panuveitis with systemic manifestations, is uncommon in immunocompromised patients such as human immunodeficiency virus (HIV)/acquired immunodeficiency disease syndrome (AIDS). We report a rare presentation of VKH in a 45-year-old HIV-positive female on highly active antiretroviral therapy (HAART) who presented with a history of recurrent panuveitis. A diagnosis of probable VKH was made based on ocular and systemic signs and symptoms. She was treated with topical and systemic steroids with close monitoring of CD4 counts and viral loads. After inflammation control, complicated cataract was managed surgically under perioperative steroid cover. VKH in HIV/AIDS has not been reported earlier. This case shows that significant inflammation can be seen even in HIV/AIDS patients on HAART with VKH in spite of moderate CD4 counts. Management is a challenge considering the systemic risks with long-term use of steroids.
[Mh] Termos MeSH primário: Síndrome de Imunodeficiência Adquirida/complicações
Glucocorticoides/uso terapêutico
HIV
Procedimentos Cirúrgicos Oftalmológicos/métodos
Pan-Uveíte/terapia
Síndrome Uveomeningoencefálica/terapia
[Mh] Termos MeSH secundário: Síndrome de Imunodeficiência Adquirida/diagnóstico
Feminino
Seres Humanos
Meia-Idade
Pan-Uveíte/diagnóstico
Pan-Uveíte/etiologia
Síndrome Uveomeningoencefálica/complicações
Síndrome Uveomeningoencefálica/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_544_16


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[PMID]:28477440
[Au] Autor:Kempen JH; Altaweel MM; Holbrook JT; Sugar EA; Thorne JE; Jabs DA; Writing Committee for the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Research Group
[Ad] Endereço:Department of Ophthalmology, Massachusetts Eye and Ear, Boston3The Discovery Eye Center, MyungSung Christian Medical Center and MyungSung Medical School, Addis Ababa, Ethiopia.
[Ti] Título:Association Between Long-Lasting Intravitreous Fluocinolone Acetonide Implant vs Systemic Anti-inflammatory Therapy and Visual Acuity at 7 Years Among Patients With Intermediate, Posterior, or Panuveitis.
[So] Source:JAMA;317(19):1993-2005, 2017 May 16.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: A randomized clinical trial comparing fluocinolone acetonide implant vs systemic corticosteroids and immunosuppression for treatment of severe noninfectious intermediate, posterior, and panuveitides did not result in a significant difference in visual acuity at 2 and 4.5 years; longer-term outcomes are not known. Objective: To compare the association between intravitreous fluocinolone acetonide implant vs systemic therapy and long-term visual and other outcomes in patients with uveitis. Design, Setting, and Participants: Nonprespecified 7-year observational follow-up of the Multicenter Uveitis Steroid Treatment (MUST) randomized clinical trial comparing the alternative treatments. Follow-up was conducted in tertiary uveitis subspecialty practices in the United States (21), the United Kingdom (1), and Australia (1). Of 255 patients 13 years or older with intermediate, posterior, or panuveitis (active within ≤60 days) enrolled in the MUST trial between December 6, 2005, and December 9, 2008, 215 consented to ongoing follow-up through at least 7 years postrandomization (last visit, February 10, 2016). Interventions: Participants had been randomized to receive a surgically placed intravitreous fluocinolone acetonide implant or systemic corticosteroids supplemented by immunosuppression. When both eyes required treatment, both eyes were treated. Main Outcomes and Measures: Primary outcome was change from baseline in best-corrected visual acuity in uveitic eyes (5 letters = 1 visual acuity chart line; potential range of change in letters read, -121 to +101; minimal clinically important difference, 7 letters), analyzed by treatment assignment accounting for nonindependence of eyes when patients had 2 uveitic eyes. Secondary outcomes included potential systemic toxicities of corticosteroid and immunosuppressive therapy and death. Results: Seven-year data were obtained for 161 uveitic eyes (70% of 90 patients assigned to implant) and 167 uveitic eyes (71% of 90 patients assigned to systemic therapy) (77% female; median age at enrollment, 48 [interquartile range, 36-56] years). Change in mean visual acuity from baseline (implant, 61.7; systemic therapy, 65.0) through 7 years (implant, 55.8; systemic therapy, 66.2) favored systemic therapy by 7.2 (95% CI, 2.1-12) letters. Among protocol-specified, prospectively collected systemic adverse outcomes, the cumulative 7-year incidence in the implant and systemic therapy groups, respectively, was less than 10%, with the exceptions of hyperlipidemia (6.1% vs 11.2%), hypertension (9.8% vs 18.4%), osteopenia (41.5% vs 43.1%), fractures (11.3% vs 18.6%), hospitalization (47.6% vs 42.3%), and antibiotic-treated infection (57.4% vs 72.3%). Conclusions and Relevance: In 7-year extended follow-up of a randomized trial of patients with severe intermediate, posterior, or panuveitis, those randomized to receive systemic therapy had better visual acuity than those randomized to receive intravitreous fluocinolone acetonide implants. Study interpretation is limited by loss to follow-up. Trial Registration: clinicaltrials.gov Identifier: NCT00132691.
[Mh] Termos MeSH primário: Anti-Inflamatórios/administração & dosagem
Fluocinolona Acetonida/administração & dosagem
Uveíte/tratamento farmacológico
Acuidade Visual/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Anti-Inflamatórios/efeitos adversos
Austrália
Implantes de Medicamento
Feminino
Fluocinolona Acetonida/efeitos adversos
Seguimentos
Seres Humanos
Imunossupressão/efeitos adversos
Injeções Intravítreas
Masculino
Meia-Idade
Pan-Uveíte/tratamento farmacológico
Qualidade de Vida
Fatores de Tempo
Resultado do Tratamento
Reino Unido
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Drug Implants); 0CD5FD6S2M (Fluocinolone Acetonide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170507
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.5103


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[PMID]:28426849
[Au] Autor:Sheppard J; Joshi A; Betts KA; Hudgens S; Tari S; Chen N; Skup M; Dick AD
[Ad] Endereço:Virginia Eye Consultants, Norfolk2Eastern Virginia Medical School, Norfolk.
[Ti] Título:Effect of Adalimumab on Visual Functioning in Patients With Noninfectious Intermediate Uveitis, Posterior Uveitis, and Panuveitis in the VISUAL-1 and VISUAL-2 Trials.
[So] Source:JAMA Ophthalmol;135(6):511-518, 2017 Jun 01.
[Is] ISSN:2168-6173
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Adalimumab was recently approved for the treatment of noninfectious intermediate uveitis, posterior uveitis, and panuveitis. Objective: To assess the effect of adalimumab on the visual functioning and quality of life in patients with corticosteroid-dependent noninfectious intermediate uveitis, posterior uveitis, and panuveitis. Design: A post hoc analysis of clinical trials of adults with active (VISUAL-1) and inactive (VISUAL-2) noninfectious intermediate uveitis, posterior uveitis, and panuveitis was conducted in the United States, Canada, Europe, Israel, Australia, Latin America, and Japan. A total of 217 patients (110 adalimumab, 107 placebo) in VISUAL-1 and 226 patients (115 adalimumab, 111 placebo) in VISUAL-2 were studied using intent-to-treat analyses. The clinical trials were conducted between August 10, 2010, and May 14, 2015. Interventions: In VISUAL-1 and VISUAL-2, patients were randomized to receive adalimumab, 80-mg, subcutaneous loading dose followed by 40 mg every other week or placebo for 80 weeks. All patients underwent prednisone tapering, with patients in VISUAL-1 receiving an initial prednisone burst. Main Outcomes and Measures: The 25-item National Eye Institute Vision Function Questionnaire (NEI VFQ-25) composite score questionnaire assessed the impact of visual impairment from the patient's perspective; scores on the questionnaire range from 0 to 100, with higher scores indicating better vision-related quality of life. The change in NEI VFQ-25 from best state achieved prior to week 6 (VISUAL-1) and from baseline state (VISUAL-2) to the final or early termination visit was determined in each group and statistically compared using analysis of variance. The temporal effects of adalimumab and placebo on NEI VFQ-25 were investigated using a longitudinal model. Results: Of the 217 patients in VISUAL-1, 124 (57.1%) were women; the mean (SD) age was 42.7 (14.9) years. Of the 226 patients in VISUAL-2, 138 (61.1%) were women; the mean (SD) age was 42.5 (13.4). In VISUAL-1, the change from final score to best score in NEI VFQ-25 was -1.30 for adalimumab and -5.50 for placebo-a difference of 4.20 (95% CI, 1.04 to 7.36; P = .01) associated with adalimumab compared with placebo. In VISUAL-2, the change from baseline NEI VFQ-25 was 3.36 for adalimumab and 1.24 for placebo-a difference of 2.12 (95% CI, -0.81 to 5.04; P = .16). In both trials, the longitudinal models showed a significant difference in NEI VFQ-25 between adalimumab and placebo of 3.07 (95% CI, 2.09 to 4.06; P < .001) and 4.66 (95% CI, 0.05 to 9.26; P = .048) in the VISUAL-1 (74.15 vs 71.08) and VISUAL-2 (82.39 vs 77.73) trials, respectively. Conclusions and Relevance: This post hoc analysis suggests that adalimumab is associated with statistically significant and clinically meaningful improvements in patient-reported visual functioning for patients with noninfectious intermediate uveitis, posterior uveitis, and panuveitis. Trial Registration: clinicaltrials.gov Identifiers: NCT01138657 (VISUAL-1) and NCT01124838 (VISUAL-2).
[Mh] Termos MeSH primário: Adalimumab/administração & dosagem
Nível de Saúde
Pan-Uveíte/tratamento farmacológico
Uveíte Intermediária/tratamento farmacológico
Uveíte Posterior/tratamento farmacológico
Acuidade Visual/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Anti-Inflamatórios/administração & dosagem
Relação Dose-Resposta a Droga
Método Duplo-Cego
Feminino
Seguimentos
Seres Humanos
Injeções Subcutâneas
Masculino
Meia-Idade
Pan-Uveíte/fisiopatologia
Estudos Retrospectivos
Resultado do Tratamento
Uveíte Intermediária/fisiopatologia
Uveíte Posterior/fisiopatologia
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); FYS6T7F842 (Adalimumab)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1001/jamaophthalmol.2017.0603


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[PMID]:28414043
[Au] Autor:Niemeyer KM; Gonzales JA; Rathinam SR; Babu M; Thundikandy R; Kanakath A; Porco TC; Browne EN; Rao MM; Acharya NR
[Ad] Endereço:F. I. Proctor Foundation, University of California, San Francisco, San Francisco, California.
[Ti] Título:Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis.
[So] Source:Am J Ophthalmol;179:10-17, 2017 Jul.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the changes in quality of life in noninfectious uveitis patients treated with 2 of the most commonly prescribed antimetabolite treatments. DESIGN: Secondary analysis of a multicenter, block-randomized clinical trial. METHODS: Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, Indian Vision Function Questionnaire (IND-VFQ), and Medical Outcomes Study 36-item Short Form Survey (SF-36) were obtained at enrollment and at 6 months (or prior, in the event of early treatment failure). RESULTS: IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% confidence interval [CI]: 4.9, 13.5, P = .0001). Although the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: -4.4, -0.1, P = .04) and the vitality subscale decreased by 3.5 points (95% CI: -5.6, -1.4, P = .001). Quality-of-life scores did not differ between treatment arms. Linear regression modeling showed a 3.2-point improvement in IND-VFQ score for every 5-letter improvement in visual acuity (95% CI: 1.9, 4.3; P < .001). CONCLUSIONS: Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.
[Mh] Termos MeSH primário: Antimetabólitos/administração & dosagem
Nível de Saúde
Pan-Uveíte/tratamento farmacológico
Qualidade de Vida
Inquéritos e Questionários
Uveíte Posterior/tratamento farmacológico
Acuidade Visual
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Relação Dose-Resposta a Droga
Feminino
Seguimentos
Seres Humanos
Masculino
Pan-Uveíte/psicologia
Resultado do Tratamento
Uveíte Posterior/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antimetabolites)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE


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[PMID]:28253223
[Au] Autor:Brydak-Godowska J; Golebiewska J; Turczynska M; Moneta-Wielgos J; Samsel A; Borkowski PK; Ciszek M; Plonecka-Rodzoch A; Kuznik-Borkowska A; Ciszewska J; Makomaska-Szaroszyk E; Brydak LB; Kecik D
[Ad] Endereço:Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.
[Ti] Título:Observation and Clinical Pattern in Patients with White Dot Syndromes: The Role of Color Photography in Monitoring Ocular Changes in Long-Term Observation.
[So] Source:Med Sci Monit;23:1106-1115, 2017 Mar 02.
[Is] ISSN:1643-3750
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND The aim of this study was to assess the clinical course and distinctive features of different white dot syndromes (WDS) in patients attending the Ophthalmology Department, Medical University of Warsaw in the years 1995-2015. MATERIAL AND METHODS Sixty-two (62) patients (43 females and 19 males), aged 18 to 77 years, referred with a WDS were included in this prospective study, with observation period ranging from 5 months to 16 years. All patients underwent a complete ophthalmological examination and multimodal imaging studies. RESULTS In this cohort of 62 patients, the following WDS entities were identified: multifocal choroiditis with panuveitis (MFCPU), multifocal choroiditis (MFC), punctate inner choroidopathy (PIC), birdshot, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), subretinal fibrosis and uveitis, multiple evanescent white dot syndrome (MEWDS), serpiginous choroiditis, and single cases of acute annular outer retinopathy (AAOR). CONCLUSIONS The study was performed at a Polish referral center and may to some extent reflect the varied geographical distribution of white dot syndromes, as none of the subjects was found to suffer from acute zonal occult outer retinopathy (AZOOR), acute macular neuroretinopathy (AMN), or diffuse unilateral subacute neuroretinitis (DUSN). Long-term follow-up is warranted by the evolution of lesions in the eye fundus, while management depends on correct diagnosis of WDS. When the posterior pole is involved in some cases of the WDS an immunosuppressive treatment, the use of the PDT or anti-VEGF injections were necessary.
[Mh] Termos MeSH primário: Corioidite/patologia
Doenças Retinianas/diagnóstico
Acuidade Visual/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Corioidite/diagnóstico
Oftalmopatias/diagnóstico
Feminino
Fundo de Olho
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Pan-Uveíte/patologia
Fotografia/métodos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE


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[PMID]:28237149
[Au] Autor:Yesilirmak N; Lee WH; Gur Gungor S; Yaman Pinarci E; Akkoyun I; Yilmaz G
[Ad] Endereço:Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey; University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, Florida. Electronic address: nxy28@med.miami.edu.
[Ti] Título:Enhanced depth imaging optical coherence tomography in patients with different phases of Behcet's panuveitis.
[So] Source:Can J Ophthalmol;52(1):48-53, 2017 Feb.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the changes in choroidal thickness (CT) at 13 different points between "active," "remission," and "end-stage" phase of Behcet's panuveitis and compare this with the age, sex, and spherical equivalent matched healthy controls using enhanced depth imaging optical coherence tomography. DESIGN: Prospective study. PARTICIPANTS: Eighty-five eyes of 45 patients with Behcet's panuveitis (19 eyes with active phase, 48 eyes with remission phase, and 18 eyes with end-stage phase) and 84 eyes of 42 controls were enrolled in this study. METHODS: CT measurements were obtained beneath the fovea and at 500-µm intervals for 3 mm nasal and temporal to the centre of the fovea. Correlation analyses were calculated to assess the relationship of the CT with age and disease duration. RESULTS: At all 13 measurement points, CT was significantly thinnest in end-stage-phase eyes and thickest in active-phase eyes (p < 0.01). CT was thicker in remission-phase eyes compared with control eyes at foveal and perifoveal points, but the trend was not statistically significant. The mean CT at each of the 13 measured points showed a negative correlation with age and disease duration (p < 0.01). CONCLUSIONS: Submacular CT, as measured by enhanced depth imaging optical coherence tomography, was significantly reduced in eyes with Behcet's panuveitis in the end-stage phase and increased in those in the active phase.
[Mh] Termos MeSH primário: Síndrome de Behçet/diagnóstico
Corioide/anatomia & histologia
Fóvea Central/diagnóstico por imagem
Aumento da Imagem/métodos
Pan-Uveíte/diagnóstico
Tomografia de Coerência Óptica/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Tamanho do Órgão
Estudos Prospectivos
Reprodutibilidade dos Testes
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE


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[PMID]:27571426
[Au] Autor:Jung JJ; Chen MH; Rofagha S; Lee SS
[Ad] Endereço:*East Bay Retina Consultants Inc, Oakland, California; †Silicon Valley Eyecare, Santa Clara, California; and ‡Department of Ophthalmology, University of California San Francisco, San Francisco, California.
[Ti] Título:GRAFT-VERSUS-HOST DISEASE PANUVEITIS AND BILATERAL SEROUS DETACHMENTS: MULTIMODAL IMAGING ANALYSIS.
[So] Source:Retin Cases Brief Rep;11 Suppl 1:S54-S61, 2017 Winter.
[Is] ISSN:1937-1578
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report the multimodal imaging findings and follow-up of a case of graft-versus-host disease-induced bilateral panuveitis and serous retinal detachments after allogenic bone marrow transplant for acute myeloid leukemia. METHODS: A 75-year-old black man presented with acute decreased vision in both eyes for 1 week. Clinical examination and multimodal imaging, including spectral domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and swept-source optical coherence tomography angiography (Investigational Device; Carl Zeiss Meditec Inc) were performed. RESULTS: Clinical examination of the patient revealed anterior and posterior inflammation and bilateral serous retinal detachments. Ultra-widefield fundus autofluorescence demonstrated hyperautofluorescence secondary to subretinal fluid; and fluorescein angiography revealed multiple areas of punctate hyperfluorescence, leakage, and staining of the optic discs. Spectral domain and enhanced depth imaging optical coherence tomography demonstrated subretinal fluid, a thickened, undulating retinal pigment epithelium layer, and a thickened choroid in both eyes. En-face swept-source optical coherence tomography angiography did not show any retinal vascular abnormalities but did demonstrate patchy areas of decreased choriocapillaris flow. An extensive systemic infectious and malignancy workup was negative and the patient was treated with high-dose oral prednisone immunosuppression. Subsequent 6-month follow-up demonstrated complete resolution of the inflammation and bilateral serous detachments after completion of the prednisone taper over a 3-month period. CONCLUSION: Graft-versus-host disease panuveitis and bilateral serous retinal detachments are rare complications of allogenic bone marrow transplant for acute myeloid leukemia and can be diagnosed with clinical and multimodal imaging analysis. This form of autoimmune inflammation may occur after the recovery of T-cell activity within the donor graft targeting the host. Infectious and recurrent malignancy must be ruled out before initiation of immunosuppression, which can affectively treat this form of graft-versus-host disease.
[Mh] Termos MeSH primário: Transplante de Medula Óssea/efeitos adversos
Coriorretinopatia Serosa Central/etiologia
Doença Enxerto-Hospedeiro/complicações
Pan-Uveíte/etiologia
Descolamento Retiniano/etiologia
[Mh] Termos MeSH secundário: Idoso
Coriorretinopatia Serosa Central/diagnóstico
Seres Humanos
Leucemia Mieloide Aguda/cirurgia
Masculino
Imagem Multimodal
Pan-Uveíte/diagnóstico
Descolamento Retiniano/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160830
[St] Status:MEDLINE
[do] DOI:10.1097/ICB.0000000000000404


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[PMID]:27541620
[Au] Autor:Diwo E; Gueudry J; Saadoun D; Weschler B; LeHoang P; Bodaghi B
[Ad] Endereço:a Ophthalmology Department , Pitié-Salpêtrière Hospital , Paris , France.
[Ti] Título:Long-term Efficacy of Interferon in Severe Uveitis Associated with Behçet Disease.
[So] Source:Ocul Immunol Inflamm;25(1):76-84, 2017 Feb.
[Is] ISSN:1744-5078
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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 ) 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.
[Mh] Termos MeSH primário: Síndrome de Behçet/tratamento farmacológico
Fatores Imunológicos/uso terapêutico
Interferon-alfa/uso terapêutico
Uveíte Posterior/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Síndrome de Behçet/diagnóstico
Síndrome de Behçet/fisiopatologia
Criança
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Pan-Uveíte/diagnóstico
Pan-Uveíte/tratamento farmacológico
Pan-Uveíte/fisiopatologia
Proteínas Recombinantes/uso terapêutico
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
Uveíte Posterior/diagnóstico
Uveíte Posterior/fisiopatologia
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunologic Factors); 0 (Interferon-alpha); 0 (Recombinant Proteins); 43K1W2T1M6 (interferon alfa-2b); 47RRR83SK7 (interferon alfa-2a)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170406
[Lr] Data última revisão:
170406
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160820
[St] Status:MEDLINE
[do] DOI:10.1080/09273948.2016.1206204



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