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Results for “Panuveitis”

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At least 19 recordsLinked to original sources
PubMed1991

Epstein-Barr virus antibodies in multifocal choroiditis and panuveitis.

Although it has been reported that patients with multifocal choroiditis and panuveitis have serologic evidence of a chronic or persistent Epstein-Barr virus infection, our patients did not seem to have other stigmata of Epstein-Barr virus infection. To reappraise the serologic evidence of chronic Epstein-Barr virus infection, the Epstein-Barr antibody levels in 11 patients with multifocal choroiditis and panuveitis and 11 sex- and age-matched control patients were measured. Neither the antiviral capsid antigen IgG (P = .15) nor the antinuclear antigen (P = .2) antibody titers of the patients with multifocal choroiditis and panuveitis were significantly different than those of the control patients. Neither the patients with multifocal choroiditis and panuveitis nor the control patients had increased antiviral capsid antigen IgM titers. One patient with multifocal choroiditis and panuveitis and three control patients had positive anti-early antigen antibody titers (P = .59). The results of this study do not support the hypothesis that patients with multifocal choroiditis and panuveitis have serologic evidence of chronic or persistent Epstein-Barr virus infection as a characteristic finding.

Adult↗
PubMedDate not supplied

Retinal tears associated with panuveitis and Behçet's disease.

To report retinal tears formation in 3 eyes of 2 patients with active panuveitis and Behçet's disease. We describe 2 patients that were diagnosed and treated for Behçet's disease with active panuveitis. Retinal tears developed while the inflammation was active. The patients were treated with topical, oral steroids, and cyclosporine therapy for bilateral panuveitis. One patient presented with a retinal tear located at the periphery of the active retinal lesion. The other had multiple tears associated with active retinal lesions in both eyes. Argon laser photocoagulation was performed in both patients as soon as the tears were detected. Ocular inflammation was controlled with this therapy, and only a few mild flare-ups occurred. The patients have been followed up for 8 and 16 months, respectively. During this period no new retinal tears have developed. Although retinal tear formation is rarely associated with Behçet's panuveitis, the clinician should be aware of this as a possible complication. When structural changes are present in the vitreous, detailed ophthalmoscopy is indicated to assess for retinal tears. If a tear is detected in a patient with panuveitis and Behçet's disease, laser photocoagulation therapy should be performed immediately to prevent retinal detachment.

Adult↗
PubMed1989

[Specificity of the humoral immune response to Candida albicans in patients with panuveitis].

Sera from 54 patients with panuveitis and 99 healthy blood donors were tested with an immunoblot assay for antibodies to 11 cytoplasmatic antigens of Candida albicans. In patients with panuveitis, IgG and IgM antibodies to a greater variety of Candida antigens were detected than in blood donors (t test, p = 0.005). Additionally, IgG antibodies to a 160-kDa protein and a 43-kDa protein, as well as IgM antibodies to the 160-kDa protein and a 67-kDa protein, were recognized more frequently in the sera of patients with panuveitis than in the sera of blood donors (U test, p = 0.05). These results suggest that in comparison to blood donors, patients with panuveitis have an altered immune response to Candida albicans.

Antibodies, Fungal↗
PubMed1999

Methotrexate treatment for sarcoid-associated panuveitis.

OBJECTIVE: To determine the safety and efficacy of low-dose methotrexate (MTX) for sarcoid-associated panuveitis. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Twenty eyes from 11 patients were analyzed. Eight patients had sarcoidosis. Three patients were clinically suspected of sarcoidosis despite negative laboratory testing. All charts of patients with sarcoidosis and idiopathic uveitis seen by the Duke Uveitis Service from 1989 to 1997 were retrospectively reviewed. Those with sarcoid-associated or sarcoid-suspected panuveitis treated with MTX with a minimum of 6 months of follow-up were studied. INTERVENTION: Low-dose MTX was administered to patients weekly and patients were followed with serial ophthalmologic and medical examinations. MAIN OUTCOME MEASURES: Visual acuity, oral and topical corticosteroid requirements, anterior chamber inflammation, and ability to undergo successful cataract extraction were used to measure the efficacy of MTX therapy. RESULTS: After MTX treatment was initiated, 90% of eyes had preserved or improved visual acuity. Mean initial Snellen visual acuity was 20/62 and mean final acuity was 20/40 (P = 0.044). Of those patients initially requiring oral corticosteroids, the dosage was decreased in 100%, and they were completely discontinued in 86%. The mean initial oral corticosteroid dose was 26.6 mg and the mean final dose was 1.5 mg (P = 0.012). Topical corticosteroids were decreased in 63% of eyes. The mean initial use was once every 1.6 hours, and the mean final use was once every 3.9 hours (P = 0.001). Ninety-five percent of eyes had stabilized or decreased inflammation. The mean initial inflammation score was 1.2, and the mean final score was 0.5 (P = 0.007). Five of six eyes previously unable to have cataract extraction because of uncontrolled inflammation became quiet on MTX and underwent surgery. One hundred percent of these eyes had improved vision after surgery. Side effects were mild and transient or reversible. CONCLUSION: Low-dose MTX is an effective and safe adjunct to treat chronic sarcoid-associated panuveitis.

Administration, Oral↗
PubMed1990

Lack of the HLA-DR2 specificity in multifocal choroiditis and panuveitis.

The prevalence of the HLA-B7 and HLA-DR2 specificities in 17 unrelated patients with multifocal choroiditis and panuveitis, 11 with and six without subretinal neovascularisation, was evaluated and compared with those of two different groups. The first group was 17 patients with subretinal neovascularisation associated with presumed ocular histoplasmosis syndrome, and the second was a group of 105 eye patients with no retinal disease. HLA-DR2 was not found in any patient with multifocal choroiditis and panuveitis, but it was found in 13 patients with presumed ocular histoplasmosis syndrome (p = 6.72 x 10(-5), comparison of the groups with subretinal neovascularisation). The lack of HLA-DR2 was also significant in comparison with the control group of eye patients (p = 0.041). This study suggests that patients with multifocal choroiditis and panuveitis and presumed ocular histoplasmosis syndrome have differing genetic predispositions, though the fundus pictures in these entities have many similarities.

Adult↗
PubMed1994

Non-caseating conjunctival granulomas in patients with multifocal choroiditis and panuveitis.

PURPOSE: This study describes a group of patients with clinical findings of peripheral punched-out lesions and panuveitis who had non-caseating granulomas found by non-directed conjunctival biopsy. METHODS: A series of 10 patients seen at The University of Iowa Hospitals and Clinics between August 1989 and August 1990 with ocular findings similar to those of multifocal choroiditis with panuveitis, including peripheral punched-out chorioretinal lesions, vitritis, and frequently, cystoid macular edema, was examined. All patients underwent ophthalmic examination, ancillary testing, and non-directed conjunctival biopsy. RESULTS: Of the ten patients, nine were women. Results of FTA-ABS were negative for all patients. A non-directed conjunctival biopsy disclosed non-caseating granulomata in seven of the patients. Acid-fast bacilli were not detected in any specimens. Four of the seven patients with positive biopsy results had either elevated serum angiotensin-converting enzyme levels or chest x-rays consistent with sarcoid. Six of these seven patients were 58 years of age or older. CONCLUSION: It is recommended that non-directed conjunctival biopsy specimens be examined to exclude the presence of non-caseating granulomata in uveitis patients with small, inferior, peripheral, punched-out chorioretinal scars, especially in women older than 55 years of age.

Aged↗
PubMed1992

[A case of juvenile rheumatoid arthritis with panuveitis].

An association of bilateral panuveitis and juvenile rheumatoid arthritis (JRA) was recognized in a case which had an acute onset of systemic JRA without ocular manifestations 3 years previously. On the present occasion she had no active systemic inflammation at the onset of panuveitis. Fluorescein angiography demonstrated bilateral hypo-fluorescent patches at the posterior pole in the early stage and corresponding window defects in the late stage. Topical corticosteroid treatment and oral non-steroid therapy resulted in clinical improvement of the uveitis. It is concluded that ophthalmologic examinations, including fundus ophthalmoscopy, are important in patients with JRA, since there is a possibility of ocular symptoms, even in the systemic type in which ocular complications are rare, as well as in cases with a long interval since the onset of arthritis.

Adolescent↗
PubMed1994

[A case of multiple sclerosis associated with granulomatous panuveitis].

A case of multiple sclerosis (MS) associated with granulomatous panuveitis was reported. A 45-year-old woman developed diplopia in 1972, at age 24, optic neuritis in 1974 and acute transverse myelopathy in 1981. Subsequently, while being under our care with the clinical diagnosis of MS, right abducens palsy in 1989, deterioration of paraparesis with remission in 1991, and weakness of left arm in 1992 occurred. CSF study revealed high IgG index and brain MRI showed multiple abnormal intensity areas in the deep white matter and periventricular areas bilaterally. On the beginning in March, 1993, she noticed left hazy vision and the ophthalmological examinations revealed marked mutton-fat like keratic precipitates, posterior synechiae, cells and flare in anterior chamber, retinal phlebitis and snow ball vitreous opacity. Granulomatous panuveitis was diagnosed and treated by topical steroid with improvement within two months. During this episode, no neurological deterioration was seen. Granulomatous uveitis in MS was rarely documented in the literatures, but this seems to be more common in women, mildly symptomatic or asymptomatic and responds well to topical steroid treatment.

Female↗
PubMed1989

Panuveitis with positive serological tests for syphilis and Lyme disease.

The Treponema pallidum hemagglutination test and the fluorescent treponemal antigen absorption test are commonly considered highly specific serologic tests for syphilis. We describe a patient with panuveitis and a positive serologic result for syphilis; however, in the absence of clinical findings, additional tests for Lyme disease (borreliosis) were positive as well, although by Western blot test the diagnosis was tentative. The clinical appearance of the panuveitis was similar to that of syphilitic uveitis accompanied by pseudopigmentosa-like areas in the anterior retina. In the presence of uveitis with an otherwise unexplained positive serologic result for syphilis, the differential diagnosis of Lyme disease should be considered.

Diagnosis, Differential↗
PubMed1998

Peripheral multifocal chorioretinitis with panuveitis: clinical and immunogenetic characterization in older patients.

BACKGROUND: The etiology of peripheral multifocal chorioretinitis with panuveitis (MCP) is unclear. Characteristic signs of MCP are punched-out, white chorioretinal lesions of the lower fundus periphery, chronic smoldering chorioretinal inflammation, vitritis, and mild inflammation of the anterior chamber. In this retrospective study we investigated clinical and immunogenetic abnormalities in MCP in older patients. PATIENTS AND METHODS: 20 patients (18 women, 2 men), median age 70.5 years, were investigated clinically by ophthalmologists and were typed for HLA class I antigens using the standard microlymphocytotoxicity test. Typing for HLA-DR antigens was performed by polymerase chain reaction with sequence-specific primers (PCR-SSP). The HLA controls consisted of healthy people (108 for HLA class I, 114 for HLA class II). RESULTS: MCP was bilateral in 18 patients. Disease-related symptoms were present for 8 months (median) before diagnosis. The main presenting symptoms or findings were glaucoma (in 11 patients), visual loss (7), iritis (5), and vitritis (2). Anterior segment changes were frequently seen: keratitic precipitates (32 eyes), anterior chamber cells (25 eyes), aqueous flare (26 eyes), posterior synechiae (22 eyes), secondary glaucoma (15 eyes), and iris neovascularization (8 eyes). All patients had vitritis and typical chorioretinal fundus lesions. Fourteen patients developed cystoid macular edema (bilateral in seven cases). Subretinal neovascularization occurred in three patients. Although systemic medication was given to 17 patients and surgical treatment was performed in 25 eyes, improvement in vision was found in only 6 eyes, but 18 eyes deteriorated markedly (median 5 lines) during follow-up (median 24.5 months). Immunogenetically significant reduced frequencies of HLA-B7 and HLA-DR1 were found; also HLD-DR15(2) was reduced. However, several alleles were increased in MCP, although not significantly: HLA-A31; HLA-B57, HLA-B62; HLA-Cw3, HLA-Cw6; HLA-DR4, HLA-DR7, and HLA-DR8. CONCLUSIONS: MCP is clinically and immunogenetically open to speculation. The present diagnosis and treatment of MCP are insufficient. Further DNA typing methods should clarify, whether HLA-DQ antigens are associated with the disease.

Aged↗
PubMed1999

Iris angiographic changes in multifocal chorioretinitis with panuveitis.

BACKGROUND: Multifocal chorioretinitis with panuveitis (MCP) is a chronic inflammatory disease of the peripheral retina and choroid with typical clinical appearance. Although obvious involvement of the anterior segment is often mild, severe chronic inflammatory reactions can occur after cataract surgery. Explantation of an intraocular lens (IOL) or primary aphakia may be necessary. In this pilot study we therefore examined the iris of patients with MCP by means of fluorescein angiography (IAG) to investigate iris vessel involvement. MATERIALS AND METHODS: Twenty-one eyes of 13 patients with MCP (12 women, 1 man) were examined by IAG. The average age of the patients was 72.5+/-6.2 years, and the average duration of the disease prior to examination was 13 months. In 9 of 21 eyes a pars plana vitrectomy (PPV) was performed because of marked vitreous opacification. IAG was performed before and after surgery. RESULTS: Although clinically unremarkable the iris of 14/21 eyes showed avascular zones in IAG; 13/21 had irregular vessels such as vascular collaterals, and 10/21 exhibited neovascularization. All eyes showed leakage of dye at the pupillary margin, and in 15/21 there was leakage out of peripheral iris vessels. In 2 of 9 eyes angiographic changes such as avascular zones regressed after PPV. CONCLUSION: Irides in patients with MCP that are unremarkable on slit-lamp examination may show marked angiographic changes. Thus IAG in those cases with planned cataract extraction and IOL, if necessary combined with PPV for vitreous opacification, may be warranted in order to better assess the prognosis after surgery.

Aged↗
PubMed1991

Linear streaks in multifocal choroiditis and panuveitis.

The clinical differentiation between multifocal choroiditis and panuveitis (MCP) and the presumed ocular histoplasmosis syndrome (POHS) can be difficult. Each condition is associated with peripapillary atrophy, chorioretinal spots, and subretinal neovascularization. Peripheral chorioretinal streaks have been described as the "fourth sign" of POHS. A consecutive series of patients with MCP were examined to determine the prevalence of peripheral chorioretinal streaks. Examination of 47 involved eyes in 25 patients revealed three eyes with streaks near the equator. These findings suggest that the presence of peripheral linear streaks cannot be used to differentiate the POHS from MCP.

Choroiditis↗
PubMed1999

Bilateral granulomatous panuveitis as initial presentation of diffuse systemic T cell lymphoma.

A high-grade diffuse T cell lymphoma, initially simulating bilateral panuveitis, was diagnosed by analysis of a vitreous biopsy specimen and a breast tumor in a 57-year-old woman. It responded favorably to aggressive chemotherapy before it relapsed in leukemic transformation. This case emphasizes the misleading initial symptoms of primary intraocular lymphoma and the role of immunophenotyping in the diagnosis and classification of lymphoproliferative ocular disorders. The presentation and management of uveal lymphoid neoplasia are discussed.

Diagnosis, Differential↗
PubMed1999

[Etiologies of intermediate, posterior, and panuveitis: a review of 201 cases].

The authors conducted a retrospective analysis of 201 patients with intermediate, posterior or panuveitis to determine the most frequent etiologies and collect some epidemiological data. A specific diagnosis was made in 70% of the cases: 35% were of infectious origin, 23% were associated with a systemic disease and 24% had a specific ocular condition. The most common entities included toxoplasmosis (24%), sarcoidosis (7.5%) and Behçet disease (5.5%). Birdshot retinochoroidopathy was the most frequent specific ocular disease (3.5%). The findings of this study are compared with those previously published in the literature.

Behcet Syndrome↗
PubMed1989

[Eye manifestations in borreliosis--bilateral panuveitis with exudative retinal detachment].

Lyme disease, a tick-borne infection with the spirochete Borrelia burgdorferi, can lead to various different organ manifestations. Severe ocular effects however, have until now been rare. The case of a 20-year-old woman is reported, who developed systemic illness (headache, nausea, vomiting, fever, diarrhea) and severe bilateral panuveitis with exudative retinal detachment about 2-3 weeks after several insect bites. The case history, clinical course, and serological examinations suggest an infection with B. burgdorferi. Later on, the fluorescein angiography results and clinical picture were suggestive of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). The etiology of this disease is unknown so far, but it may be possible that infections with B. burgdorferi are of etiological significance.

Adult↗
PubMed1998

Darkfield microscopic (DFM) and serologic evidences for leptospiral infection in panuveitis cases.

186 out of 226 (82%) panuveitis cases showed the presence of leptospira in their blood samples by dark field microscopy. 75% cases were found positive for leptospira after low speed centrifugation and an additional 7% became positive after high speed centrifugation. Leptospirosis was four times more common in males than in females. The disease was more prevalent in the age group of 15 to 54 years. MAT was performed in 23 cases of which 9 were positive. ELISA was performed in 20 cases of which 9 were positive. DFM was positive in 19 out of these 23 cases. MAT, ELISA and DFM were positive in six cases. Highest antibody titre was found due to L. autumalis alone in two cases, L. autumnalis, and L. pomona in one case, L. bharathy in one case, L. lanka alone in one case and L. pomona one in one case. DFM was found to be more sensitive in a smal number of cases and hence DFM needs further evaluation by other workers in this field.

Adolescent↗
PubMed1990

The possible role of herpes viruses in multifocal choroiditis and panuveitis.

7 cases of multifocal choroiditis and panuveitis are reported here (6 females, 1 male). All clinical data were carefully considered. In all cases an aqueous sampling was made for the detection of anti-herpes virus antibodies in aqueous and serum. 3 specificities were tested: herpes simplex (HSV), herpes zoster (HVZ) and cytomegalovirus (CMV). An intraocular synthesis of specific antibodies was found against VZV in 2 cases and against HSV in 1 case. There was another presumptive case for HSV.

Adult↗