Utility of Ultra-Widefield Retinal Imaging in the Follow-up and Management of Patients with Cytomegalovirus Retinitis.

Cytomegalovirus (CMV) retinitis is an opportunistic infection classically described in patients with acquired immune deficiency syndrome and other immune-compromising situations. As the diagnosis is based on clinical findings, classic retinal imaging montages have been a useful tool, being able to detect up to 140º of the retina. Since ultra-widefield (UWF) imaging systems have been available we can now detect more area of peripheral lesions in the diagnosis and follow-up of patients' response to antiviral treatment. We present a series of cases in which UWF was used as the main tool for diagnosis, monitoring, and management in patients with CMV retinitis.In all the cases presented, UWF imaging with fundus autofluorescence was able to capture peripheral CMV retinitis areas and discern active from inactive lesions. This, added to the comfort of use, seem to make UWF imaging a useful tool to detect changes in the follow-up of patients with CMV retinitis.

Caracterización de las uveítis diagnosticadas en un centro de referencia del área de Barcelona / Uveitis diagnosis characterization at a referral centre in the area of Barcelona, Spain

Fundamento y objetivo: Conocer el patrón uveítico de nuestra área geográfica. Los recientes cambios demográficos, ecológicos y científicos pueden determinar cambios epidemiológicos en las uveítis, que nos hemos propuesto investigar. Pacientes y método: Corte transversal desde el 1-01-2009 al 30-06-2010. Se incluyeron todos los pacientes atendidos por uveítis en nuestro centro. Se analizaron el tipo anatómico (IUSG & SUN), la etiología (tests «a medida»), la edad, el sexo, la procedencia y la lateralidad. Los resultados entre las «primeras visitas» y los controles fueron comparados estadísticamente mediante los tests de ANOVA y ji al cuadrado. Resultados: De 416 pacientes incluídos, 150 (36%) fueron uveítis anteriores, 128 (31%) posteriores, 101 (24%) panuveítis y 37 (9%) uveítis intermedias (UI). Un 56% (236) fueron bilaterales, la edad media fue de 46 años (extremos 6-87) y un 58% fueron mujeres. El 14% (58) fueron pacientes extranjeros. Por etiología, un 20% fueron inclasificables, un 31% infecciosas, un 26% asociadas a enfermedades sistémicas y un 23% oculares específicas. Entre las causas conocidas, la herpética (11%), Toxoplasma (8%), Behçet (8%) y tuberculosis (6%) fueron las más frecuentes. Las UI afectaron significativamente por primera vez a más extranjeros (p=0,018), afectaron a pacientes más jóvenes (p=0,008) y fueron más frecuentemente crónicas (p=0,003) e inclasificables (p=0,024). Conclusión: En nuestro medio, un 80% de las uveítis pueden ser correctamente clasificadas. Las UI han incrementado su frecuencia en población extranjera, suelen ser inclasificables y crónicas. La tuberculosis (6%) y la enfermedad de Birdshot (4%) deben ser tenidas en cuenta como causa de uveítis (AU)

Background and objective: To describe the uveitis pattern in our geographic area. Recent demographic, environmental and scientific changes can determine uveitis pattern changes, which we aim to investigate. Patients and methods: A cross-sectional study between 1st January 2009 and 30th June 2010 was done. All uveitis patients visited at our institution were included. Anatomical (IUSG & SUN) and aetiological patterns (by "tailored" tests), age, sex, origin and laterality were analyzed. Results from first visits and controls were compared statistically, by chi-square and ANOVA tests. Results:From 416 patients included, 150 (36%) were anterior uveitis, 128 (31%) posterior, 101 (24%) panuveitis and 37 (9%) intermediate uveitis (IU). Fifty-six percent (236) were bilateral, mean age was 46 years (6-87) and 58% were women. Fourteen percent (58) were from non-Spanish origin. By aetiology, 20% were unclassifiable, 31% infectious, 26% associated with systemic immune diseases and 23% were ocular specific syndromes. Among classified causes, herpes virus (11%), Toxoplasma (8%), Behçet (8%) and tuberculosis (6%) were the most common. IU were diagnosed more frequently at first time in foreign patients (P=.018); they affected younger patients (P=.008), were more chronic (P=.003) and unclassifiable (P=.024). Conclusion: In our area, 80% of uveitis can be correctly classified. IU have an increased frequency among foreigners, and they use to be unclassifiable and chronic. Tuberculosis (6%) and Birdshot chorio-retinopathy (4%) must be kept in mind as uveitis causes (AU)

[Uveitis diagnosis characterization at a referral centre in the area of Barcelona, Spain]. / Caracterización de las uveítis diagnosticadas en un centro de referencia del área de Barcelona.

BACKGROUND AND OBJECTIVE: To describe the uveitis pattern in our geographic area. Recent demographic, environmental and scientific changes can determine uveitis pattern changes, which we aim to investigate. PATIENTS AND METHODS: A cross-sectional study between 1(st) January 2009 and 30(th) June 2010 was done. All uveitis patients visited at our institution were included. Anatomical (IUSG & SUN) and aetiological patterns (by "tailored" tests), age, sex, origin and laterality were analyzed. Results from first visits and controls were compared statistically, by chi-square and ANOVA tests. RESULTS: From 416 patients included, 150 (36%) were anterior uveitis, 128 (31%) posterior, 101 (24%) panuveitis and 37 (9%) intermediate uveitis (IU). Fifty-six percent (236) were bilateral, mean age was 46 years (6-87) and 58% were women. Fourteen percent (58) were from non-Spanish origin. By aetiology, 20% were unclassifiable, 31% infectious, 26% associated with systemic immune diseases and 23% were ocular specific syndromes. Among classified causes, herpes virus (11%), Toxoplasma (8%), Behçet (8%) and tuberculosis (6%) were the most common. IU were diagnosed more frequently at first time in foreign patients (P=.018); they affected younger patients (P=.008), were more chronic (P=.003) and unclassifiable (P=.024). CONCLUSION: In our area, 80% of uveitis can be correctly classified. IU have an increased frequency among foreigners, and they use to be unclassifiable and chronic. Tuberculosis (6%) and Birdshot chorio-retinopathy (4%) must be kept in mind as uveitis causes.