ABSTRACT
Rituximab may be effective in the treatment of ocular inflammatory disease. Dosing is less frequent than many medications currently available. Four cases are reported, each of which appeared to have responded well to treatment with rituximab, although patient 2 was able to remain on a low dose of prednisone for only 2 months. The ongoing pilot study will hopefully provide additional insight into the benefit of rituximab for treatment of scleritis and idiopathic orbital inflammatory disease.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Immunologic Factors/therapeutic use , Orbital Diseases/drug therapy , Scleritis/drug therapy , Adult , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Murine-Derived , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Immunologic Factors/adverse effects , Male , Middle Aged , Prednisone/administration & dosage , Prednisone/therapeutic use , Rituximab , Treatment OutcomeABSTRACT
PURPOSE: To characterize the nature and duration of contact lens training in ophthalmology residency training programs and to ascertain the comfort level of residents in fitting various types of contact lenses and in dealing with common contact lens-related complications. METHODS: Surveys were mailed to 126 ophthalmology residency program directors/coordinators and requested to be distributed to 1,381 ophthalmology residents. The questionnaire addressed issues related to contact lens training, hours of clinical and didactic training, comfort with fitting a variety of different types of contact lenses and dealing with common contact lens-related complications, and plans for incorporation of contact lens dispensing into future practice. RESULTS: Two hundred and forty-nine residents (18%) responded from 84 programs (67%). Most programs (87%) have some form of supervised contact lens training, frequently conducted by an optometrist (61% of programs), that consists of 20 hours or less of clinical experience and 20 hours or less of didactic training. A majority of the responding graduating residents (66%) feel comfortable fitting spherical soft contact lenses, while less than half of all residents feel comfortable fitting any other type of contact lens. In addition, most residents (65%) feel comfortable diagnosing and treating common contact lens-related complications. CONCLUSIONS: Most ophthalmology residency programs offer some form of supervised contact lens training which allows a majority of residents to feel comfortable fitting only spherical soft contact lenses, while also dealing comfortably with most contact lens-related problems. A comparison with previous data suggests increasing comfort with fitting most types of contact lenses over the last decade.
Subject(s)
Contact Lenses , Internship and Residency/standards , Ophthalmology/education , Surveys and Questionnaires , Humans , Internship and Residency/trends , Prosthesis Fitting , Retrospective Studies , United StatesABSTRACT
OBJECTIVE: To determine the prevalence of Bartonella henselae seropositivity in patients with a clinical diagnosis of neuroretinitis. DESIGN: Retrospective, clinic-based, cross-sectional study. PARTICIPANTS: Eighteen consecutive patients seeking treatment at the Casey Eye Institute from November 1993 through November 1998 who had neuroretinitis. METHODS: The billing and photographic records of the Casey Eye Institute were searched for patients with a primary or secondary diagnosis of neuroretinitis or Leber's idiopathic stellate neuroretinitis. Charts were then reviewed to determine the results of B. henselae antibody titers and other pertinent clinical information. MAIN OUTCOME MEASURES: Results of B. henselae serologic testing. RESULTS: Fourteen of 18 patients with neuroretinitis had serologic studies. Nine of the 14 tested patients (64.3%) were found to have elevated IgM or IgG for B. henselae, suggesting current or past infection. Patients with positive serologic analysis results tended to have worse vision at presentation. There were no other obvious differences between seropositive and seronegative groups in this study, including duration or quality of recovery. CONCLUSIONS: At our tertiary care ophthalmology institution, most tested patients with neuroretinitis had evidence of past or present cat-scratch disease based on positive serologic analysis for B. henselae, a much greater prevalence than is expected to be found in the general population or in patients with idiopathic uveitis. Further study is indicated to clarify the prevalence of cat-scratch disease in neuroretinitis and the role and efficacy of antibiotics in treatment.
