Secondary glaucoma induced by bilateral acute depigmentation of the iris / Glaucoma secundário à despigmentação bilateral aguda da íris

Abstract We report a case of a middle-aged woman who developed acute, bilateral, symmetrical, slightly transilluminating depigmentation of the iris and pigment discharge into the anterior chamber following the use of oral moxifloxacin for bacterial sinusitis. She had been misdiagnosed as having autoimmune uveitis, treated with steroids and tropicamide, and underwent severe ocular hypertension and glaucoma despite posterior correct diagnosis.

Resumo Relato de um caso de uma paciente do sexo feminino de meia idade que desenvolveu despigmentação bilateral simultânea aguda com dispersão de pigmentos na câmara anterior e discreta transiluminação após o uso de moxifloxacino oral para tratamento de sinusite bacteriana. Ela Havia sido diagnosticada com uveite autoimune e tratada com corticosteroide tópico e tropicamida e evoluiu com hipertensão ocular grave e glaucoma apesar de ,posteriormente, o diagnóstico ter sido correto.

Chikungunya virus iridocyclitis in Fuchs’ heterochromic iridocyclitis.

We are reporting a case of bilateral Fuchs’ heterochromic iridocyclitis with chikungunya virus infection in the left eye. A 20-year-old female was presented with a past history of fever suggestive of chikungunya with bilateral Fuchs’ heterochromic iridocyclitis and complicated cataract. She had a tripod dendritic pattern of keratic precipitates by confocal microscopy in the left eye with a stippled pattern of keratic precipitates in both eyes. The real-time polymerase chain reaction (RT-PCR) assay in the aqueous humor detected 98 copies/ml of chikungunya virus RNA. The patient underwent clear corneal phacoemulsification with in-the-bag intraocular lens implantation in the left eye with a good visual outcome. This is the first report where the presence of chikungunya virus RNA has been associated with a case of bilateral Fuchs’ heterochromic iridocyclitis.

Ocular toxicity by latex of Calotropis procera (Sodom apple).

We report the spectrum of ocular toxicity following accidental inoculation of latex of Calotropis procera (Sodom apple) in 29 eyes between January 2003 and December 2006. All patients presented with sudden painless dimness of vision with photophobia. Twenty-five (86%) patients had initial visual acuity of less than 20/60. All eyes had conjunctival congestion and mild to severe corneal edema with Descemet's folds. Three (10%) eyes had an epithelial defect, nine (31%) had iridocyclitis, and seven (24%) had associated secondary glaucoma. After treatment with topical corticosteroids, antiglaucoma agents, cycloplegics, hypertonic saline and tears supplements, 27 (93%) eyes recovered completely within 3-14 days. After three months, 17 (74%) out of 23 eyes showed a significant low endothelial cell count compared to the normal fellow eye ( P 0.001). The latex of Calotropis procera causes significant ocular morbidity which may be preventable by simple health education. The long-term effect on corneal endothelium has to be studied further.

Ocular manifestations of Behcet's disease in Indian patients.

PURPOSE: To study the prevalence, manifestations and severity of ocular involvement in Indian patients with Behcet's disease. METHOD: Prospective analysis of all patients of suspected Behcet's disease between 1997 and 2001. RESULTS: A total of 19 patients were diagnosed to have Behcet's disease. Ocular manifestations were seen in 36% patients. The commonest manifestation was conjunctival ulcer (26.3%), followed by iridocyclitis (10.5%). None of the patients had posterior segment involvement or visual loss. Response to topical corticosteroids was good. CONCLUSION: The prevalence and severity of ocular lesions in Behcet's disease is relatively low in Indian patients. Conjunctival ulcers was a common finding, which is rarely reported in the world literature.

Manifestaciones oculares en artritis reumatoide juvenil / Juvenile rheumatoid arthritis and ocular manifestations

La artritis reumatoide juvenile (ARJ) es considerada como la enfermedad del tejido conectivo más frecuente en la infancia. La incidencia de manifestaciones oculares, es variable y ha sido reportado entre 5 y 24 por ciento. La iridociclitis que se desarrolla en los pacientes con ARJ, es la alteración más grave y puede llevar a los niños a la pérdida total de la visión. El objetivo de este estudio fue conocer la frecuencia y tipo de manifestaciones oculares en pacientes con ARJ en nuestro medio. Se realizó un estudio descriptivo y trasversal. Se analizaron 30 pacientes con diagnóstico de ARJ con edad promedio de inicio de 10.2 años (2-5 años), evaluación promedio de la enfermedad de 4.6 años (3 meses-35 años). En este estudio la frecuencia de alteraciones oculares fue de 40 por ciento (12 pacientes). Sin embargo, no todas las alteraciones encontradas se asociarion a la presencia de ARJ. La queratoconjuntivitis sieca se presentó en el 23 por ciento (7 pacientes) y en ningún caso se detectó iridociclitis aguda o crónica. La presencia de daño ocular en estos pacientes pudiera depender de otros factores (genéticos, ambientales, etc.) aunque la evaluación periódica no detecte patología grave; se pueden encontrar alteraciones menos mediante vigilancia y seguimiento oportunos

Sulphasalazine therapy in chronic uveitis of children with chronic arthritis.

Four children with chronic arthritis (3 juvenile rheumatoid arthritis and 1 juvenile ankylosing spondylitis) and poorly controlled chronic uveitis, were given sulphasalazine (SASP) therapy for a mean period of 3.3 years. Three patients showed an excellent response, as evidenced by a reduction of inflammatory cells in the anterior chamber of the eyes and improvement of visual acuity. The response occurred after a mean of 7.7 weeks. These data suggested SASP therapy may have a role in the treatment of chronic anterior uveitis in children with chronic arthritis.

Pattern of juvenile rheumatoid arthritis in a teaching hospital in Kuwait

Reports on juvenile rheumatoid arthritis [JRA] from developing countries are scarce due to lack of comprehensive epidemiologic surveys. We report our experience with this disease in Kuwait. This study involves 47 children diagnosed with JRA over a period of 3 years. All 47 children satisfied the American College of Rheumatology criteria for the diagnosis of JRA. The results revealed a prevalence of 0.36 cases per 1,00 children at risk., a rate compatible with international figures. Pauciarticular onset, the predominant subtype, accounted for 49% while polyarticular and systemic onset type accounted for 25.5% each. Iridocyclitis was diagnosed in 3 children [6.4%] with positive antinuclear antibody. Although the prevalence of JRA and its subtypes in not different from figures reported for other regions, iridocyclitis appears to be infrequent in the population of Kuwait

Uveíte associada à artrite reumatóide juvenil / Uveitis associated with rheumatoid arthritis

Foram estudados 54 pacientes com Artrite Reumatóide Juvenil (ARJ). Manifestaçöes de Iridociclite crônica näo granulomatosa foram encontradas em 5 casos, sendo que 2 tiveram complicaçöes graves que levaram a atrofia do olho afetado. Quatro (80 por cento) destes casos, näo apresentavam queixas ou sinais oftalmológicos antes do diagnóstico clínico de ARJ, mas ao serem encaminhadas ao setor de uveítes, encontramos sinais de comprometimento ocular da doença. Salientamos a importância do diagnóstico precoce das alteraçöes oculares que podem passar desapercebidas e serem responsáveis por complicaçöes graves e irreversíveis

Ciclite heterocrômica de Fuchs: a propósito de oito casos / Fuchs' heterochronics cyclitis: eigt cases

Os autores apresentam 8 casos de ciclite heterocrômica de Fuchs enfocando os aspectos terapêuticos