High Efficacy of Methotrexate in Patients with Recurrent Idiopathic Acute Anterior Uveitis: a Prospective Study.

To evaluate prospectively the efficacy of methotrexate (MTX) in the treatment of recurrent idiopathic acute anterior uveitis (RIAAU). Nineteen out of 22 RIAAU patients completed the study (two patients withdrew their consent shortly after study initiation, one patient discontinued after 4 weeks because of the adverse effects). All patients were treated with MTX in a starting dose of 15 mg/week, increased to target dose of 25 mg/week after 4 weeks. In patients taking systemic corticosteroids (CS) the dose was gradually tapered (by 2.5 mg every week) until discontinuation. The mean follow-up period was 3.3 years (19-59 months). Sixteen patients (84 %) remained flare-free on MTX therapy. In the remaining three patients the mean interval between flares increased from 4.8 to 18.3 months. Systemic CS were tapered off in all patients. The number of acute anterior uveitis flares in the whole cohort decreased from 2.12 to 0.11/patient-year (p < 0.0001). All flares observed on MTX therapy occurred in HLA-B27-positive patients. MTX dosed at 25 mg/week is highly effective in the treatment of RIAAU.

[Pharmacological treatment of recurrent idiopathic anterior uveitis]. / Leczenie farmakologiczne chorych na nawrotowe idiopatyczne zapalenie przedniego odcinka blony naczyniowej oka.

Recurrent anterior uveitis (AU) is an autoimmune disease that in 20% of patients leads to severe visual loss or blindness, thereby a severe disability and significant quality of life impairment. That is why, it is important to conduct a long term treatment after an acute phase of the disease, to keep the remission as long as possible. Up to 50% of patients with recurrent AU have no additional symptoms of systemic disease. This situation, classified as idiopathic AU (IAU), causes a lot of problems when a therapeutic strategy has to be chosen. Nevertheless, IAU is considered to be a first symptom of spondylarthropathy (SpA), even several dozen years prior to other typical manifestations of SpA. There have been published few papers concerning only small groups of patients with IAU, treated with disease modifying anti-rheumatic drugs. The authors present the recommendations for systemic treatment of IAU, based on their own clinical experience, and systematic review of the literature.

[Amaurosis fugax: case report]. / Amaurosis fugax? Opis przypadku.

We describe the case of 27-year-old woman with systemic lupus erythematosus (SLE) and the presence of anticardiolipin antibodies (aCL) IgG isotype in high titre in the plasma, who reported sudden loss of vision in both eyes. We established diagnosis of acute optic neuropathy probably associated with aCL and SLE flare. Treatment with anticoagulation, high dose steroids and intravenous cyclophosphamide was followed by improvement of the visual function.

[Systemic management of autoimmune anterior uveitis]. / Leczenie systemowe autoimmunologicznego zapalenia przedniego odcinka--blony naczyniowej oka.

Autoimmune uveitis is an acute, recurrent, sight-threatening disease that can lead to severe visual loss and blindness. It requires systemic immunosuppressive therapy and continuous monitoring by ophthalmologist and rheumatologist. There are no universally accepted referral patterns for the treatment of endogenous uveitis. Most specialists indicate corticosteroids, methotrexate and cyclosporine A as the first use drugs. Anti-cytokine drugs are a new opportunity for the patients unresponsive to the conventional anti-inflammatory and immunosuppressive therapy.

[The usefulness of thermography in the diagnostics of dry eye syndrome]. / Przydatnosc termografii w diagnostyce zespolu suchego oka.

PURPOSE: The aim of the study was to evaluate corneal temperature in patients with dry eye syndrome, and in normal subjects by measuring with infrared radiation thermography. MATERIAL AND METHODS: Each eye of 9 patients with dry eye syndrome and each eye of 13 normal subjects, were evaluated in this study. The corneal surface temperature was measured during 15 seconds after opening the eye. RESULTS: Mean corneal temperature was lower in the dry eye syndrome patients compared with the control group. Decrease in time of mean corneal temperature in patients with dry eye syndrome, was lesser than in the control group. CONCLUSIONS: The study shows the usefulness of thermography in the diagnosis of dry eye syndrome.