Quality of life in non-infectious uveitis patients on immunosuppressive therapy

To assess visual function and vision related quality of life in patients with non-infectious posterior or panuveitis treated with immunosuppressives. Forty-three patients with non-inflammatory posterior or panuveitis were enrolled in this prospective study. All subjects underwent a detailed interview, complete ophthalmic examination, quality of life assessment using National Eye Institute Visual Function Questionnaire [VFQ-25], visual function evaluation [visual acuity and visual field] at baseline and at a sixth month follow up visit. The mean NEI-VFQ 25 composite score of the subjects with posterior or panuveitis was 58.0 [ +/- 24.1]. There was a statistically significant improvement [P = 0.004] in the composite score following treatment from 58.0 [ +/- 24.1] to 74.3 [ +/- 22.0] with effect size of 1.03. The psychological well-being and general health subscales showed significant improvement in the mean score following immunosuppressive therapy. While considering the visual function tests, there was a three-line improvement in the visual acuity score and changeover in the visual field severity from moderate to early defect with corresponding improvement in the visual field pattern. Though most of the patients complained of side effects such as tiredness, gastrointestinal upset and weight gain, there was improvement in the general health subscale. The significant improvement in the general health subscale despite side-effects shows that the benefit of immunosuppressive outweighs the risks of the therapy and this may also reflect the relatively low impact of these side-effects on the quality of life. This study shows that the use of immunosuppressives improves the quality of life of the individual

Panuveitis as a manifestation of ocular syphilis leading to HIV diagnosis

Syphilis is a rare cause of panuveitis. We present the case of a 33-year-old man who presented with diminution of vision of three months duration in his left eye [OS], without any other systemic illness. Ophthalmic examination showed features of pauveitis with dense vitreous exudates, disc pallor and sheathing of vessels on fundoscopy. A diagnosis of probable endogenous endophthalmitis was made and vitreous tap performed. Vitreous biopsy showed no growth of fungus or bacteria. Rapid plasma reagin [RPR] and Treponema pallidum hemagglutination [TPHA] test were positive. Enzyme-Linked lmmuno Sorbent Assay [ELISA] and Western Blot test were then performed, which revealed concurrent HTV infection. The patient improved dramatically with intravenous penicillin therapy HIV positive patients may present with panuveitis secondary to ocular syphilis, as the only presenting feature in HIV positive patient in absence of any other systemic features