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Biomedical subjects

A Rothova

Publications and source records attributed to A Rothova.

97 records · Page 6Linked to original sources

The use of HLA-B27 as a diagnostic and prognostic aid in acute anterior uveitis (AAU) in The Netherlands.

Acute anterior uveitis (AAU) may be considered to be one manifestation of the seronegative spondylarthropathies of which ankylosing spondylitis (AS) is the prototype, especially when the patient is HLA-B27 positive. However, it is not yet clear under which circumstances a patient with AAU should be referred to the rheumatologist. In a retrospective study we evaluated the management of 68 consecutive HLA-B27+ AAU patients from a rheumatologic point of view. Although the majority (73%) showed rheumatic problems, only half (52%) of the patients was referred to a rheumatologist, due to problems in evaluation of clinical history and of x-ray reading of the sacroiliac (SI) joints. Because HLA-B27 typing will determine whether the AAU patients "at risk" have AS or a related arthropathy, we suggest using HLA-B27 typing in AAU patients as a diagnostic and prognostic aid. When the AAU patient is found to be HLA-B27 positive, the rheumatologist will be able to "split" these patients into those with AS and those without. Early diagnosis of AS in AAU patients is important as an early start of drug therapy and physiotherapy may prevent deformities and improve final rheumatologic outcome.

Back Pain↗

Serology in ocular toxoplasmosis.

The diagnostic value of toxoplasma serology in ocular disease was evaluated in the following groups of patients: (I) uveitis cases of various causes (n = 291); (II) consecutive posterior and panuveitis patients (n = 60); (III) patients with definite congenital and ocular toxoplasmosis (n = 8); (IV) cases of clinical ocular toxoplasmosis (n = 25); and control patients with uveitis of non-toxoplasma origin (n = 12). No relation was observed between the level of the dye test titres and the diagnosis of ocular toxoplasmosis (groups I and II). During the active stages of the disease no typical change of the titres occurred in several longitudinally studied patients with toxoplasmosis. In group III one case was discovered to be negative by the dye test despite active ocular disease; however, IgG antibodies against toxoplasma were detected by the ELISA technique. In group IV, which was investigated by the ELISA technique, 100% of the toxoplasmosis patients were positive for IgG versus 58% of the control patients. Circulating immune complexes containing IgG and toxoplasma antigen were detected in seven of 25 toxoplasmosis patients (28%) and in two of 12 control patients (16%). Our study shows that the definite diagnosis of ocular toxoplasmosis or its exclusion by serological means only is not yet feasible. The possible superiority of the ELISA test to the dye test warrants further investigation.

Adolescent↗

Acute anterior uveitis (AAU) and HLA-B27.

A group of 30 consecutive HLA-B27 positive acute anterior uveitis (AAU) patients was compared to 30 consecutive HLA-B27 negative AAU patients. The B27 positive group was characterized by male preponderance, earlier age of onset, unilateral uveitis and favourable outcome with therapy. It is concluded that HLA-B27 typing is a useful diagnostic discriminant in AAU.

Acute Disease↗

Computer registration of uveitis patients.

An analysis was made of 1309 patients with uveitis seen at University Hospitals participating in the Uveitis Centre of the Netherlands Ophthalmic Research Institute. In this series B27-associated anterior uveitis was the most frequent entity (18%) followed by Toxoplasma chorioretinitis (7%). Sarcoid uveitis, pars planitis and Fuchs' heterochromic cyclitis each accounted for approximately 4-5% of cases. In 44% of the patients no specific diagnosis could be made. Central diagnosis registration is of great importance when conducting clinical uveitis research.

Computers↗

A retrospective analysis of heparin-surface-modified intraocular lenses versus regular polymethylmethacrylate intraocular lenses in patients with uveitis.

BACKGROUND: Several studies described the benefits of the heparin-surface-modified intraocular tens (HSM IOL) with regard to the reduced inflammation in routine extracapsular cataract extractions. However, limited information is available about the advantages of the HSM IOL in patients with an intraocular inflammation. AIM: To assess the eventual benefits of the HSM IOL compared to the regular polymethylmethacrylate intraocular lens (PMMA IOL) in patients with uveitis. METHODS: A retrospective study of 43 patients with uveitis of various origins who underwent an extracapsular cataract extraction (24 with HSM, 19 with PMMA IOL). The activity of intraocular inflammation, visual acuity, eventual complications, and medications were examined. Standardized follow-up dates were used (before surgery, one and fourteen days, five and eleven months after surgery.) RESULTS: No difference in the inflammatory, activity was noted between HSM and PMMA groups; neither at short term clinical evaluation, nor at five months after surgery. Despite a slightly better visual acuity in the HSM group before surgery, no long term differences were observed. After surgery the increase in visual acuity was similar for both groups, as well as the frequency of cystoid macular oedema (CMO) and synechiae. Fewer patients in HSM group required Nd:YAG posterior capsulotomy, but the difference was not significant. CONCLUSION: No clinical advantage was found when the HSM IOL was compared with the regular PMMA IOL in 43 patients with uveitis.

Adolescent↗