ABSTRACT
Purpose: To evaluate the B-scan ultrasound findings in unilateral posterior scleritis. Methods: This was a retrospective observational case series at a tertiary uveitis clinic. The study population included patients who had been diagnosed with milder forms of unilateral posterior scleritis since 2010 and had B-scan ultrasonography of that eye. The healthy eye of each patient was considered the control eye for that patient. Results: The average age of patients was 50.2 ± 17.8 (range, 18-67). Posterior scleritis was idiopathic in 6 (66.7%) patients and associated with rheumatoid arthritis in two and HLA-B27 ankylosing spondylitis in one patient. The thickness of the thickest area in the diseased eye was 2.08 ± 0.49 (range, 1.35-3.2) and the control eye was 1.53 ± 0.38 (range, 1.03-2.3). The difference between the symptomatic and control eye was statistically significantly different (P = 0.02). 1.7 mm was the cut-off-point on the receiver operating characteristics curve with the highest combined sensitivity and specificity of 87.5% and 88.9%, respectively. Comparing the thickness of the thickest section of the symptomatic eye of one patient with the same section in the other eye of the same patient, there was a difference of 20% or more in sclero-choroidal complex. Conclusions: In this study, the sclero-choroidal complex thickness higher than 1.7 mm has the highest combined sensitivity and specificity. Comparing the thickest section of the symptomatic eye of one patient with the same section in the other eye can be diagnostic.
ABSTRACT
Purpose: To study whether rituximab and bortezomib combination therapy is more effective than rituximab monotherapy in the treatment of non-paraneoplastic autoimmune retinopathy (npAIR). Methods: Retrospective case series involving six patients with npAIR, taking either rituximab and bortezomib combination therapy (three cases) or rituximab monotherapy (one case and two historical patients). Results: Patients on both treatment regimens showed stability in most of the visual function parameters during the one year of follow-up. Combination therapy resulted in improvement of scotopic combined rod and cone a-wave and b-wave amplitudes in all eyes where they were available (four eyes); however, rituximab monotherapy resulted in only two eyes with stable scotopic combined rod and cone a-wave and b-wave amplitudes, while four eyes showed a decrease in both a- and b-wave amplitudes. The average improvement in b-wave amplitude (50.7% ± 29.4% [range, 25-90%]) was higher than the average improvement in a-wave amplitude (35.7% ± 9.74 [range, 25-63%]). No severe adverse effects were reported. Conclusion: Rituximab and bortezomib combination therapy may not be more effective than rituximab monotherapy in npAIR patients for most of the visual function parameters; however, this combination therapy may be more effective in improving scotopic combined rod and cone a- and b-wave amplitudes. This may indicate the higher efficacy of combination therapy when there is involvement of the inner retina.
