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At least 73 records · Page 4Linked to original sources

Neovascular glaucoma as a complication of retinal vasculitis in Crohn disease.

PURPOSE: To report a case of neovascular glaucoma as a complication of retinal vasculitis in Crohn disease. METHODS: Case report with fluorescein angiogram. RESULTS: A 62-year-old man with biopsy-proven Crohn disease presented with bilateral uveitis, bilateral iris new vessels, and neovascular glaucoma in the left eye. Fluorescein angiography revealed signs of retinal vasculitis and capillary nonperfusion in both eyes. CONCLUSION: Crohn disease may be associated with retinal vasculitis and, thus, neovascular glaucoma. A satisfactory result can be achieved by using corticosteroids to control the retinal vascular inflammation, by applying panretinal photocoagulation and by controlling the increased intraocular pressure surgically.

Administration, Topical↗

Retinal vasculitis and cystoid macular edema after body tattooing: a case report.

BACKGROUND: To report a case of retinal vasculitis occurring after the placement of permanent tattoos. HISTORY AND SIGNS: A 21-year-old male was referred to our department with impairment of visual acuity. Permanent tattoos covered the head, body, arms and legs. The patient was examined with ophthalmoscopy, fluorescein angiography, indocyanine green angiography and optical coherence tomography. Systemic medical and laboratory work-up were performed in order to exclude an infectious agent or an inflammatory disease. He had no history of intravenous drug abuse. THERAPY AND OUTCOME: Our patient presented severe posterior uveitis associated with retinal vasculitis and cystoid macular edema. Laboratory tests ruled out all diseases causing vasculitis. HIV and B, C hepatitis tests were negative. Cystoid macular edema and vasculitis were resolved after immunosuppressive therapy. CONCLUSIONS: This is the first description of a retinal vasculitis associated with cystoid macular edema in a completely healthy individual after the placement of permanent tattoos. A phagocytosis of tattoo pigments leading to their lysis is described in the literature as a mechanism causing vasculitis.

Adult↗

Haematological changes in retinal vasculitis.

Two selected cases of retinal vasculitis, apparently of unknown aetiology, are reported; one case without any systemic or laboratory manifestation and the second case with a clinical picture similar to VKH syndrome and immunodepression. Both cases showed abnormal haematological parameters related to blood viscosity in the early and acute phases which could be manipulated by therapy. Reduction or near normalisation of these haemorrheological parameters coincided with clinical and angiographic improvement. The second case with severe immunodepression was found to be retrovirus HIV-2 positive.

Adult↗

[Severe occlusive bilateral retinal vasculitis within the scope of seronegative systemic lupus erythematosus].

Retinal vascular manifestation is the most common form of ophthalmic involvement in patients with systemic lupus erythematosus (SLE). Most frequently these consist of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report on a 37-year-old white female with a 13-year follow-up of chronic discoid lupus erythematosus, which suffered massive bilateral visual loss coincident with the systemic exacerbation of her disease (proteinuria, pneumonia, serositis, leucopenia). The diagnosis of SLE was established with reference to the revised ARA-criteria (American Rheumatism Association). Ophthalmoscopy and fluorescein angiography revealed the typical aspect of a SLE-associated vaso-occlusive retinopathy on both eyes with marked ischemia of the macula. Immediate maximal immuno-suppressive therapy, early performed panretinal photocoagulation and subsequent cryoretinopexy did not stop the progression of the disease. Six months after the initial event vascularisations of the disc and rubeosis iridis occurred, but no secondary glaucoma up to date. In this patient, the almost complete absence of characteristic autoantibodies and immunological markers was striking. The correlation with other lupus manifestations, different therapeutic concepts and prognostic factors in SLE-associated retinal vasculitis are discussed.

Adult↗

Rifabutin-associated panuveitis with retinal vasculitis in pulmonary tuberculosis.

INTRODUCTION: Rifabutin-associated uveitis has been reported frequently in AIDS patients and more rarely in immunocompetent patients. It is characterized clinically by anterior acute uveitis. Only a few poorly documented cases of rifabutin-induced panuveitis with retinal vasculitis have been reported. Here, we report four cases of rifabutin-associated panuveitis with retinal vasculitis. CASE REPORTS: We describe four patients with active tuberculosis, treated with a multidrug regimen including rifabutin for at least 1.5 months before presentation. The first patient was immunocompetent, the three others had AIDS and were undergoing triple anti-HIV therapy. Three patients were women with a low body weight. All four patients presented with panuveitis and retinal vasculitis. Interruption of the drug rapidly reduced the ocular inflammation in all cases. CONCLUSION: Four cases of rifabutin-associated panuveitis with retinal vasculitis are reported in patients with active pulmonary tuberculosis. Immunogenicity of Mycobacterium tuberculosis as well as the very low weight of the patients might be implicated in the development of this unusual form of rifabutin-associated uveitis.

Administration, Topical↗

Retinal vasculitis caused by adult T-cell leukemia/lymphoma.

BACKGROUND: To report a case of lymphomatous infiltration and bilateral retinal vasculitis observed among 83 cases of adult T-cell leukemia (ATL) treated in the University Hospital Center in Fort-de-France (Martinique, French West Indies) between 1984 and 2003. CASE: A complete clinical ophthalmologic examination was performed in this patient along with fluorescein angiography. OBSERVATIONS: After being checked for diffuse adenopathies, myodesopsias, and phosphenes, the 35-year-old patient was diagnosed with ATL. The ocular impairment, present since the onset of ATL as peripheral subretinal infiltrates, spread progressively and afferently to the rest of the retina in the form of an essentially venous vasculitis. Impairment of the vitreous was noted only in the end stages of disease progression. As ocular lesions progressed, the general state of the patient degraded at the same time despite chemotherapeutic measures. CONCLUSION: Among the more than 300 seropositive for human T-cell lymphotropic virus type 1 (HTLV-1) or patients with HTLV-1-associated myelopathy/tropical spastic paraparesis treated at our hospital in the last 20 years, and among the 83 cases of ATL, only this single case of retinal vasculitis associated with HTLV-1 was observed (1/83, 1.2%) in Martinique, confirming the geographic variability of the clinical phenotype of HTLV-1 infection. The incidence of retinal vasculitis in ATL patients may signify an even worse prognosis than initially indicated.

Adult↗

Corticosteroid-sparing strategies in the treatment of retinal vasculitis in systemic lupus erythematosus.

BACKGROUND: Systemic corticosteroids have been traditionally used in the therapy of retinal vasculitis in patients with systemic lupus erythematosus. The high morbidity associated with long-term corticosteroid therapy has prompted the use of corticosteroid-sparing strategies with cytotoxic agents. METHODS: This retrospective study summarizes the authors' experience of the last 10 years including 9 systemic lupus erythematosus patients with retinal vasculitis who required treatment for longer than 6 months. RESULTS: Seven of these patients were treated with cytotoxic agents. Average follow-up was 39 months. Inflammation was controlled clinically and angiographically in all patients using the following therapeutic regimens: systemic corticosteroids and hydroxychloroquine (n = 1 patient); systemic corticosteroids and cytotoxic chemotherapy (n = 6); cytotoxic chemotherapy and hydroxychloroquine (n = 1); and hydroxychloroquine alone (n = 1). Visual acuity was preserved (> 20/30) or improved in all patients. All patients retained excellent control of their systemic disease during their follow-up. Side effects of cytotoxic drugs requiring discontinuation of all chemotherapy were not encountered in this group; Imuran therapy did result in substantial adverse effects necessitating its replacement with other drugs. CONCLUSION: These results suggest a valuable role for corticosteroid-sparing drugs in the therapy of retinal vasculitis associated with systemic lupus erythematosus.

Adolescent↗

Anti-endothelial cell antibodies in retinal vasculitis.

Auto-antibodies to endothelial cells are found in a variety of vasculitic disorders including two diseases associated with retinal vasculitis: Behcet's disease and multiple sclerosis. In this study we have examined the prevalence of anti-endothelial cell antibodies [AECA] in 15 patients with retinal vasculitis [RV] associated with Behcet's disease, multiple sclerosis or sarcoidosis and 20 patients with idiopathic retinal vasculitis. 47% of patients with RV associated with systemic disease and 35% of patients with idiopathic RV had AECA, compared to 1% of 70 normal controls. The mean levels of AECA were similar in both groups of patients, and comparable to levels found in other systemic vasculitides.

Adult↗

The role of azathioprine in the management of retinal vasculitis.

PURPOSE: Azathioprine is commonly used as a second-line immunosuppressive agent in the management of patients with retinal vasculitis. The aim of this study was to determine the efficacy of azathioprine by evaluating its effect on relapse rate, clinical outcome and maintenance steroid dose. METHODS: A retrospective analysis was performed of 34 patients presenting over 15 years to the Medical Eye Unit at St Thomas Hospital. Relapse rate, steroid dosage, inflammatory score and visual acuity were assessed before and during treatment with azathioprine. RESULTS: Thirty-four patients (23 male) aged 17-70 years (median 41.4, median 38) were enrolled. Fifteen had idiopathic retinal vasculitis, 12 had Behçet's disease, 2 sarcoidosis, 2 sympathetic ophthalmia, 1 birdshot retinochoriodopathy, 1 Still's disease and 1 Harada's disease. The principal indications for azathioprine treatment were uncontrolled disease despite appropriate steroid therapy in 28 patients (82%) or to permit a decrease in steroid dosage in 6 patients (18%). Frequency of relapse was assessed in 10 patients whose pre-treatment and treatment periods with azathioprine were of 1 year or greater. All were found to have a decreased relapse rate. In 60%, reduction of steroid dosage was achieved. Ocular inflammatory score decreased in 56% of eyes and visual acuity was improved or maintained in 64%. In 8 patients treatment had to be stopped due to side effects. CONCLUSION: Within the limitations of a retrospective study, we found azathioprine when used in combination with systemic steroids to be most effective at reducing the relapse rate of retinal vasculitis, but only partially effective in allowing a reduction in steroid dosage.

Adolescent↗

[Interferon-alpha for the treatment of retinal vasculitis associated with human T-lymphotropic virus type I myelopathy (HAM)].

Interferon-alpha was effective for the treatment of retinal vasculitis and vitreous opacity in a patient with human T-lymphotropic virus type I associated myelopathy (HAM). The patient was a 40-year-old male with retinal vasculitis, vitreous opacity and Koeppe's iris nodules. Systemic administration of corticosteroid hormone was not fully effective for the treatment of ocular involvements except for iris nodules. After Interferon-alpha treatment, given 3 million IU/day as the intramuscular injection for 4 weeks, the retinal vasculitis subsided and vitreous opacity disappeared.

Adult↗

Retinal vasculitis in ocular toxoplasmosis in nonhuman primates.

Six monkeys had prior systemic immunization followed by intraretinal challenge to each eye with Toxoplasma antigens. All eyes developed iridocyclitis, vitritis, and retinal edema, but no necrotizing retinochoroiditis. One-half of the eyes were then challenged with living organisms and the other one-half with Toxoplasma antigens. All eyes developed iridocyclitis, vitritis, and retinal edema, but no necrotizing retinochoroiditis. Four months later, the right eye of each monkey was challenged with living Toxoplasma organisms injected intraretinally. Each injected eye developed iridocyclitis, vitritis, and retinal edema 24 hours after injection, and all developed a retinal vasculitis 6 days after injection. One injected eye developed a papillitis. A subcutaneous booster of living Toxoplasma organisms in four of the monkeys failed to produce a reactivation of the iridocyclitis, vitritis, and vasculitis. These findings suggest that hyperimmunization provides protection against the development of a necrotizing toxoplasmic retinochoroiditis in nonhuman primates and that it may lead to retinal vasculitis and iridocyclitis. This study also serves as an animal model of retinal vasculitis in ocular toxoplasmosis.

Animals↗

Thrombophilic factors in ischaemic and non-ischaemic idiopathic retinal vasculitis.

Two common causes of visual loss in idiopathic retinal vasculitis (RV) are retinal ischaemia and cystoid macular oedema. This study investigated whether thrombophilic factors are more prevalent in patients with ischaemic RV than non-ischaemic RV. Twenty patients with RV (10 ischaemic, 10 non-ischaemic) were prospectively recruited before starting systemic immunosuppression. Twenty-one different haemostatic parameters were tested. Seventeen patients had at least one haemostatic abnormality. Three patients had low Protein S, one had low Protein C. Three patients had positive anticardiolipin antibody titres, 1 had poor fibrinolytic activity, 3 had raised fibrinogen levels. Ten patients had raised lipoprotein (a) levels. Fibrinogen levels were higher in the smokers (p = 0.02). Although all von Willebrand's factor levels were within the normal range, they were higher in the ischaemic group (p = 0.008), in which smoking was more prevalent. This study has shown a high prevalence of thrombophilic abnormalities in RV patients, and implicates smoking in the aetiology of ischaemic RV.

Adult↗

Retinal vasculitis and posterior pole "hypopyons" as early signs of acute bacterial endophthalmitis.

PURPOSE: To report a case of acute postoperative bacterial endophthalmitis presenting with retinal vasculitis and posterior pole "hypopyons." DESIGN: Observational case report. METHODS: Observational case report. RESULTS: In a 73-year-old woman, acute postoperative endophthalmitis presented with retinal vasculitis, diffuse retinal hemorrhages, and several posterior pole "hypopyons" that were collections of yellow-white inflammatory debris. The inflammation was located primarily in the posterior one third of the vitreous, and except for severely impaired visual acuity, the classic signs of acute postoperative endophthalmitis were not present until the next day. An immediate pars plana vitrectomy with intravitreal injection of vancomycin, amikacin, and dexamethasone was performed. Vitreous and aqueous cultures grew coagulase-negative Staphylococcus species. After intravenous and topical therapy for endophthalmitis, the inflammation subsided. Eight weeks after the initial cataract surgery, the best corrected visual acuity of the patient was 20/25. CONCLUSION: Acute postoperative bacterial endophthalmitis may present with atypical clinical signs and inflammation located primarily in the retina and posterior vitreous.

Acute Disease↗

A CX3CR1 genotype associated with retinal vasculitis in patients in the United Kingdom.

PURPOSE: To investigate whether polymorphisms in the gene encoding the chemokine receptor CX3CR1, which has been linked to changes in functional ligand-binding activity, are associated with retinal vasculitis (RV) in a cohort of patients in the United Kingdom. METHODS: DNA was prepared from whole blood of 126 patients with RV and 95 healthy individuals by a standard salting-out procedure. Two polymorphisms, V249I and T280M, were analyzed by multiplex polymerase chain reaction-sequence-specific primers (PCR-SSPs). RESULTS: There was no significant difference between the prevalence of V249 or I249 variants in patients with RV or in control subjects. By contrast, the 280M variant was significantly raised in patients compared with control subjects (P=0.01), the IV/MT haplotype was also more prevalent in patients with RV than in control subjects (P=0.006), and the I249/M280 haplotype was associated with retinal vasculitis (P=0.01). The 280M variant was significantly associated with the nonischemic form of RV compared with healthy control subjects (P=0.009). CONCLUSIONS: Polymorphisms related to a functional decrease in ligand binding activity of CX3CR1 are associated with disease in U.K. patients with retinal vasculitis. CX3CR1 and its ligand CX3CL1 have been implicated in leukocyte adhesion and neuronal protection. Changes in the activity of this interaction may have a role in the pathogenesis of RV.

CX3C Chemokine Receptor 1↗

Retinal vasculitis in rheumatoid arthritis.

A woman with exacerbation of severe rheumatoid arthritis developed lesions compatible with retinal vasculitis. Laboratory studies confirmed the diagnosis, and the rapid clinical improvement that accompanied a fall in circulating immune complexes suggested that the vasculitis was a direct consequence of the rheumatoid disease. From these observations retinal vasculitis should probably be sought in any patient with rheumatoid disease and the vasculitis added to the list of ocular complications of rheumatoid arthritis.

Antigen-Antibody Complex↗

Intermediate uveitis and retinal vasculitis as manifestations of cat scratch disease.

PURPOSE: To study the ocular manifestations of systemic Rochalimaea infection. METHODS: We examined a healthy 21-year old woman who had floaters in both eyes. A bilateral mild vitreitis and multiple foci of retinal vasculitis were found; during the ensuing two weeks, exudates appeared over the inferior pars plana. The patient owned five kittens but had no history of cat bites or scratches. Serum levels of antibodies to Rochalimaea were elevated. RESULT: The retinal vasculitis and vitreitis resolved after three weeks of therapy with ciprofloxacin hydrochloride without concomitant anti-inflammatory therapy. CONCLUSION: Rochalimaea infection should be considered in the differential diagnosis of intermediate uveitis and retinal vasculitis.

Adult↗

Elevated anti-human T-cell lymphotropic virus type I antibody in serum of patients with retinal vasculitis and uveitis living in Izumo area.

Four patients with human T-lymphotropic virus type I associated myelopathy (HAM) were examined ophthalmologically, and serum titers to human T-lymphotropic virus type I (HTLV-I) in 11 patients with nonspecific retinal vasculitis or uveitis were determined. All of the patients lived in the Izumo area. All 4 patients with HAM (Cases 1 to 4) had vitreous opacities. Of the 11 patients with nonspecific retinal vasculitis or uveitis, 3 (Cases 5 to 7) had elevated titers to HTLV-I. We believe that HTLV-I infection may be involved in the causes of retinal vasculitis and uveitis in patients living not only in the endemic area but also outside the endemic area.

Adult↗