Methotrexate: an option for preventing the recurrence of acute anterior uveitis.

AIMS: To evaluate the efficacy of methotrexate (MTX) in preventing the recurrence of acute anterior uveitis (AAU). METHODS: This prospective, open, longitudinal study included patients from June 2002 to March 2005 who had either three or more episodes of AAU in the previous year, or a recurrence of AAU within 3 months before starting the trial. We excluded uveitis of infectious origin, masquerade syndromes, and patients with contraindications to MTX. The response criteria were defined as an absence of symptoms and the presence of a normal ophthalmologic examination. The study outcome compared the number of flare-ups of uveitis over an MTX-treated for 1 year to the number of flare-ups of the same group during the previous year without MTX. RESULTS: A total of 571 patients with uveitis were evaluated during the period of the study, and 10 fulfilled the inclusion criteria. One patient refused the treatment, and nine completed the study. The mean number of recurrences in the pre-MTX year was 3.4 (SD: 0.52), which was significantly reduced to 0.89 (SD: 1.17) in the year of treatment (P=0.011). CONCLUSION: MTX treatment seems to reduce the number of flare-ups in patients with recurrent AAU.

[Fuchs' heterochromic cyclitis without heterochromia: a diagnostic approach]. / Aproximación diagnóstica a la ciclitis heterocrómica de Fuchs en ausencia de heterocromía.

OBJECTIVE: To obtain diagnostic guidelines of Fuchs' heterochromic cyclitis (FHC) in the absence of heterochromia using Bayesian methods. METHODS: The pre-test and post-test likelihood that a certain patient without heterochromia (but with other characteristic symptoms of the disease such as iris nodules, cataracts, glaucoma or vitritis) has FCH, was assessed by the Bayes' theorem for conditioned likelihood. The prevalence values of FCH and the presentation rate of symptoms in FCH and in other forms of anterior uveitis were obtained from published literature data. RESULTS: In the absence of heterochromia, the combination of iris nodules together with cataracts, vitritis or glaucoma, and the association of the last three symptoms in the absence of nodules, resulted in an accumulated likelihood of more than 50% of subjects having the disease. CONCLUSIONS: The coincidence in one patient of several indicative symptoms, even in the absence of heterochromia, may make FCH a likely diagnostic option.

Aproximación diagnóstica a la ciclitis heterocrómica de Fuchs en ausencia de heterocromía / Fuchs´heterochronic cyclits without heterochromia: a diagnostic approach

Objetivo: Obtener pautas de diagnóstico de la ciclitis heterocrómica de Fuchs (CHF) en ausencia de heterocromía utilizando metodología bayesiana. Métodos: Se obtienen las probabilidades pre-test y post-test de que un determinado paciente sin heterocromía pero con otros síntomas característicos de la enfermedad, tales como nódulos iridianos, cataratas, glaucoma o vitritis anterior, tenga CHF. Para ello se utiliza el teorema de Bayes para la probabilidad condicionada. Los valores de la prevalencia de la CHF y de la frecuencia de presentación de los síntomas en la CHF y en el total de las uveitis anteriores se obtienen de los datos de la literatura publicada. Resultados: En ausencia de heterocromía, la combinación de nódulos iridianos junto con cataratas, vitritis o glaucoma, así como la asociación de estos tres últimos síntomas aún sin nódulos supone una probabilidad acumulada de más del 50% de tener la enfermedad. Conclusiones: La coincidencia en un paciente de varios síntomas indicativos aún en ausencia de heterocromía puede hacer que la CHF sea una opción diagnóstica probable

Objective: To obtain diagnostic guidelines of Fuchs’ heterochromic cyclitis (FHC) in the absence of heterochromia using Bayesian methods. Methods: The pre-test and post-test likelihood that a certain patient without heterochromia (but with other characteristic symptoms of the disease such as iris nodules, cataracts, glaucoma or vitritis) has FCH, was assessed by the Bayes’ theorem for conditioned likelihood. The prevalence values of FCH and the presentation rate of symptoms in FCH and in other forms of anterior uveitis were obtained from published literature data. Results: In the absence of heterochromia, the combination of iris nodules together with cataracts, vitritis or glaucoma, and the association of the last three symptoms in the absence of nodules, resulted in an accumulated likelihood of more than 50% of subjects having the disease. Conclusions: The coincidence in one patient of several indicative symptoms, even in the absence of heterochromia, may make FCH a likely diagnostic option

[Measurement of lens density with a Scheimpflug camera in diabetic patients]. / Medida de la densidad del cristalino con cámara de Scheimpflug en pacientes diabéticos tipo II.

OBJECTIVE: To assess if diabetes, in patients without cataracts or diabetic retinopathy, alters the densitometric values of the lens and to what degree this occurs. METHODS: A total of 93 patients, divided into two groups, were studied: the diabetic patients had a visual acuity equal to or greater than 0.8 and normal eye funduscopy, and the control group consisted of healthy patients of a similar age. Measurements in all patients were made with the Scheimpflug camera and the lens density of the anterior capsule, anterior cortex and nucleus was defined. The values obtained in the two groups were compared by analysis of variance (ANOVA). RESULTS: All densitometric values were greater in the diabetic patients than in the normal controls. The greatest difference was seen in the values of the anterior capsule, followed by the nucleus and cortex. The differences approached statistical significance (P=0.07) only in the case of the anterior capsule. CONCLUSIONS: Diabetes increases densitometric values of the anterior capsule and to a lesser degree of the anterior cortex. However, further studies are necessary to verify if this alteration is of significance.

Medida de la densidad del cristalino con cámara de Scheimpflug en pacientes diabéticos tipo II / Measurement of lents density with a scheimpflug camera in diabetic patients

Objetivo: Averiguar si la diabetes en pacientes sin catarata ni retinopatía diabética altera los valores densitométricos del cristalino y en qué medida esto se produce. Métodos: Se estudian 93 ojos pertenecientes a 47 pacientes, divididos en dos grupos: 53 ojos de 27 pacientes diabéticos tipo II con agudeza visual igual o superior a 0,8 y fondo de ojo normal y un grupo control de 40 ojos de 20 pacientes sanos con una media de edad semejante. A todos se les realiza una medida con cámara de Scheimpflug y se consignan la densidad cristaliniana de la cápsula anterior, el cortex anterior y el núcleo. Los valores obtenidos en los dos grupos se comparan mediante análisis de la varianza (ANOVA). Resultados: Todos los valores densitométricos fueron mayores en los pacientes diabéticos con respecto a los normales. La mayor diferencia se produce en los valores de la cápsula anterior, seguidos del núcleo y el cortex. Solo en el caso de la cápsula anterior los valores se acercan a la significación estadística (P=0,07). Conclusiones: La diabetes incrementa los valores densitométricos de la cápsula anterior y en menor medida del cortex anterior. No obstante son necesarios nuevos estudios para verificar si esta alteración se produce de forma significativa (AU)

Objective: To assess if diabetes, in patients without cataracts or diabetic retinopathy, alters the densitometric values of the lens and to what degree this occurs. Methods: A total of 93 patients, divided into two groups, were studied: the diabetic patients had a visual acuity equal to or greater than 0.8 and normal eye funduscopy, and the control group consisted of healthy patients of a similar age. Measurements in all patients were made with the Scheimpflug camera and the lens density of the anterior capsule, anterior cortex and nucleus was defined. The values obtained in the two groups were compared by analysis of variance (ANOVA). Results: All densitometric values were greater in the diabetic patients than in the normal controls. The greatest difference was seen in the values of the anterior capsule, followed by the nucleus and cortex. The differences approached statistical significance (P=0.07) only in the case of the anterior capsule. Conclusions: Diabetes increases densitometric values of the anterior capsule and to a lesser degree of the anterior cortex. However, further studies are necessary to verify if this alteration is of significance (AU)