ABSTRACT
Eales' disease is a retinal vasculitis characterized by retinal inflammation, ischemia, and neovascularization. Exact pathogenesis of this disease is yet to be found out. We present a 29-year-old male, diagnosed with Eales' disease in both eyes with persistent intraocular inflammation. Enucleation of the pthisical right eye was subjected for histopathological examination immunohistochemistry and molecular biologic study for mycobacterial tuberculosis DNA. Our study showed that Eales disease is probably a T cell mediated disease which is triggered by mycobacterial TB DNA. Further studies are needed to confirm our findings.
ABSTRACT
Purpose: Cytopathology of vitreous is most commonly done to diagnose vitreoretinal lymphoma in eyes with nonspecific inflammation. Vitreous cytopathology features of tuberculous intermediate uveitis have not been described in literature.Case report: We report a case of a healthy 35-year-old female who showed granulomatous inflammatory changes on vitreous cytopathology with polymerase chain reaction confirming a diagnosis of intraocular tuberculosis.Conclusion: This case highlights the role of cytopathology in determining the etiology and pathogenesis behind the elusive diagnosis of intermediate uveitis. Polymerase chain reaction can further help in confirming the diagnosis and allowing commencement of appropriate therapy.
Subject(s)
Granuloma/microbiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Ocular/microbiology , Uveitis, Intermediate/microbiology , Vitreous Body/microbiology , Adult , Antigens, Bacterial/metabolism , Bacterial Proteins/metabolism , Female , Genome, Bacterial/genetics , Granuloma/physiopathology , Humans , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/metabolism , Polymerase Chain Reaction , Tuberculosis, Ocular/physiopathology , Uveitis, Intermediate/physiopathology , Visual Acuity/physiology , Vitreous Body/pathologyABSTRACT
Purpose: To describe a case of presumed ocular toxoplasmosis.Method: A retrospective chart review.Result: This case report describes a 35-year-old male who presented hypopyon anterior uveitis in his left eye. Fundus examination revealed severe vitritis which precluded the view of retina. His serum anti-toxoplasma immunoglobulin (Ig)G was significantly raised, with a normal anti-toxoplasma IgM level and PCR from nested primers targeting B1 gene of Toxoplasma gondii was positive. He was started on empirical anti-toxoplasma therapy. Undiluted vitreous specimen collected during lensectomy and diagnostic vitrectomy in left eye was also positive for nested primers targeting B1 gene of T. gondii.Conclusion: Ocular toxoplasmosis without retinochoroiditis, though extremely rare, can occur.
Subject(s)
Disease Management , Endophthalmitis/diagnosis , Eye Infections, Parasitic/diagnosis , Toxoplasmosis, Ocular/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , DNA, Protozoan/analysis , Endophthalmitis/parasitology , Endophthalmitis/therapy , Eye Infections, Parasitic/parasitology , Eye Infections, Parasitic/therapy , Humans , Male , Retrospective Studies , Toxoplasma/genetics , Toxoplasmosis, Ocular/parasitology , Toxoplasmosis, Ocular/therapy , Vitrectomy , Vitreous Body/parasitology , Vitreous Body/pathology , Vitreous Body/surgeryABSTRACT
Purpose: The aim of this study was to evaluate the efficacy of adalimumab (ADL) and golimumab (GLM) in patients with HLA-B-27-associated uveitis.Method: We conducted a retrospective analysis of patients with HLA-B-27-associated uveitis who had received subcutaneous GLM and ADL between 2014 and 2018.Results: The study included 14 patients, 12 of whom received subcutaneous ADL and two patients were treated with subcutaneous GLM. Median age of the patients was 31.5 years (range 17-53 years). The most common associated systemic disease in these patients was ankylosing spondylitis (92.8%). Majority of the patients had anterior uveitis (71.4%) followed by anterior uveitis and intermediate uveitis (28.6%).Conclusion: ADL/GLM is a useful therapeutic option in refractory cases of HLA-B-27-associated uveitis, especially in patients with associated systemic manifestations.
Subject(s)
Adalimumab/therapeutic use , Antibodies, Monoclonal/therapeutic use , Disease Management , HLA-B27 Antigen/immunology , Uveitis/drug therapy , Adolescent , Adult , Anti-Inflammatory Agents/therapeutic use , Female , Fluorescein Angiography/methods , Fundus Oculi , Humans , Male , Middle Aged , Retrospective Studies , Tumor Necrosis Factor Inhibitors/therapeutic use , Uveitis/epidemiology , Uveitis/immunology , Young AdultABSTRACT
PURPOSE: Serpiginous choroiditis (SC) is primarily an inflammation of choriocapillaris leading to nonperfusion. A quantitative assessment of choriocapillaris perfusion can be done by measuring the flow-density by OCT-Angiography (OCTA). This study measures a change in the flow-density of choriocapillaris with the resolution of inflammation. METHODS: The OCTA images of a choriocapillaris slab of 30 eyes with active SC were subjected to binarization and vessel density was measured at baseline and final visits and compared. RESULTS: Upon comparing the vessel density of the affected areas by OCTA of choriocapillaris-slab at baseline and final visits, there was statistically significant (P < 0.0001) improvement after the resolution of inflammation. The vessel density of a demarcated normal area was significantly higher when compared to that of lesions at baseline (P < 0.0001) and final visit (P < 0.0001). CONCLUSION: OCTA is a useful tool to assess reduction in the inflammatory activity on treatment in SC. This study shows that with treatment the perfusion of choriocapillaris improves; however, it remains lower than normal.
Subject(s)
Choroiditis , White Dot Syndromes , Choroid , Choroiditis/diagnosis , Fluorescein Angiography , Humans , Microvascular Density , Tomography, Optical CoherenceSubject(s)
Fluorescein Angiography/methods , Macula Lutea/pathology , Multimodal Imaging , Myopia, Degenerative/complications , Retinal Diseases/diagnosis , Scleral Diseases/diagnosis , Tomography, Optical Coherence/methods , Aged , Choroid/pathology , Female , Fundus Oculi , Humans , Imaging, Three-Dimensional , Male , Middle Aged , Myopia, Degenerative/diagnosis , Retinal Diseases/complications , Scleral Diseases/complications , Visual AcuityABSTRACT
Paracentral acute middle maculopathy (PAMM) refers to retinal lesions with changes in the inner nuclear layer on spectral domain optical coherence tomography (OCT). PAMM is associated with retinal vascular pathology involving the deep capillary plexus. We report two cases of PAMM in Indian subjects using multimodal imaging highlighting the OCT angiography (OCTA) findings. The first case is of a middle-aged female with a paracentral scotoma with SS-OCT (swept-source optical coherence tomography) and OCTA findings suggestive of "chronic" PAMM. The second case presented with sudden decreased vision, and multiple creamy white lesions suggestive of "acute" PAMM, imaging features depicting a possible venular obstruction. These cases demonstrate the importance of considering PAMM as a differential diagnosis in patient presenting with nonspecific visual complains and apparently normal ophthalmic examination. The recognition of PAMM should prompt an appropriate evaluation and investigation.
Subject(s)
Fluorescein Angiography/methods , Optic Disk/pathology , Retinal Diseases/diagnosis , Retinal Vessels/pathology , Scotoma/diagnosis , Tomography, Optical Coherence/methods , Visual Acuity , Acute Disease , Adult , Capillaries , Female , Fundus Oculi , Humans , MaleABSTRACT
Measles virus is a rare but important cause for acute retinitis as it can eventually lead to the fulminant complication of SSPE. We report a case of a young Indian male with acute viral retinitis who subsequently developed SSPE. It is of paramount importance to consider measles virus and SSPE as a cause in an immunocompetent young adult with necrotizing viral retinitis.
