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1.
Vet Med Sci ; 10(2): e1374, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38403976

RESUMO

The objective of this article is to describe a case of suspected zonisamide-induced immune-mediated polyarthritis (IMPA) and anterior uveitis in a dog. A 7-year-old male neutered Siberian Husky with a history of refractory idiopathic epilepsy was presented for cluster seizures. Following the addition of zonisamide to the antiepileptic regime, the dog developed new IMPA and anterior uveitis. Within a few weeks of discontinuation of the zonisamide, the dog's IMPA and anterior uveitis resolved. These immune-mediated conditions were thus presumed to be an idiosyncratic reaction to zonisamide. To our knowledge, this is the first report of IMPA and anterior uveitis in dogs associated with zonisamide administration at its recommended dose.


Assuntos
Artrite , Doenças do Cão , Epilepsia Resistente a Medicamentos , Compostos Organofosforados , Uveíte Anterior , Masculino , Cães , Animais , Zonisamida/efeitos adversos , Epilepsia Resistente a Medicamentos/veterinária , Isoxazóis/efeitos adversos , Artrite/induzido quimicamente , Artrite/tratamento farmacológico , Artrite/veterinária , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/veterinária , Doenças do Cão/induzido quimicamente , Doenças do Cão/tratamento farmacológico
4.
Cornea ; 42(5): 648-650, 2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-36747320

RESUMO

PURPOSE: To report a case of fibrinous acute anterior uveitis associated with topical interferon-α2b (IFN-α2b) treatment for ocular surface squamous neoplasia in a patient with HLA-B27 uveitis predisposition. METHODS: Case report. RESULTS: We present the case of a 57-year-old man who received topical IFN-α2b as adjuvant therapy for a previously surgically removed ocular surface squamous neoplasia with affected surgical margins. Two weeks after topical IFN-α2b initiation, the patient was diagnosed with fibrinous acute anterior uveitis. Complementary tests to rule out other causes of uveitis resulted to be negative, except for HLA-B27, which tested positive. Response to treatment with topical corticosteroids and cyclopentolate was favorable. As IFN-α2b is considered an immune enhancer and has been widely associated with autoimmune side effects, topical therapy with IFN-α2b was temporally ceased until intraocular inflammation resolved. Topical IFN-α2b was resumed, and during follow-up, no signs of uveitis were detected. The main hypothesis is that IFN-α2b acts as a trigger for intraocular inflammation in individuals with uveitis predisposition. CONCLUSIONS: Topical IFN-α2b could trigger intraocular inflammation in patients with uveitis susceptibility. It may be reasonable to use IFN-α2b cautiously in patients with a known history of uveitis or uveitis predisposition.


Assuntos
Carcinoma de Células Escamosas , Neoplasias da Túnica Conjuntiva , Uveíte Anterior , Masculino , Humanos , Pessoa de Meia-Idade , Antígeno HLA-B27/uso terapêutico , Interferon-alfa/efeitos adversos , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Inflamação/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico
6.
Transpl Infect Dis ; 24(6): e13974, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36306187

RESUMO

Anterior uveitis is a reported complication of intravenous cidofovir, almost exclusively described in human immunodeficiency virus (HIV) infected patients treated for cytomegalovirus retinitis. In this study, we report the case of an allogeneic stem cell transplant recipient with significant visual impairment and hypotony following administration of high-dose intravenous cidofovir for hemorrhagic cystitis due to BK virus.


Assuntos
Vírus BK , Cistite , Transplante de Células-Tronco Hematopoéticas , Organofosfonatos , Infecções por Polyomavirus , Uveíte Anterior , Humanos , Cidofovir/efeitos adversos , Antivirais/efeitos adversos , Organofosfonatos/efeitos adversos , Citosina/efeitos adversos , Estudos Retrospectivos , Uveíte Anterior/tratamento farmacológico , Uveíte Anterior/induzido quimicamente , Transplante de Células-Tronco Hematopoéticas/efeitos adversos
7.
BMJ Case Rep ; 15(5)2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35606040

RESUMO

Intravesical Bacillus Calmette-Guérin (BCG) administration was used to treat bladder carcinoma in a woman in her 60s. Severe bilateral non-granulomatous anterior uveitis and gross papillitis developed subsequently. The severe BCG-induced bilateral uveitis and papillitis were treated with high dose oral corticosteroids, with topical steroids and cycloplegics. Resolution of her ocular symptoms and signs eventuated. On lumbar puncture, no evidence of systemic spread of the BCG was found. Visual acuity returned to 6/9 in each eye with subsequent resolution of papillitis. Repeat cystoscopy demonstrated no evidence of recurrent bladder tumour.Hypersensitivity reactions are well recognised with Tubercle bacilli While both hypersensitivity reactions and dissemination of BCG throughout the body have been previously documented, the literature demonstrates that this case is the first example in which papillitis and bilateral uveitis were the prominent ophthalmological features.


Assuntos
Vacina BCG , Imunoterapia , Papiledema , Neoplasias da Bexiga Urinária , Uveíte Anterior , Administração Intravesical , Vacina BCG/efeitos adversos , Feminino , Humanos , Imunoterapia/efeitos adversos , Mycobacterium bovis , Papiledema/induzido quimicamente , Papiledema/tratamento farmacológico , Neoplasias da Bexiga Urinária/terapia , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/tratamento farmacológico
8.
Ocul Immunol Inflamm ; 30(5): 1260-1264, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35404741

RESUMO

PURPOSE: To describe a case of herpes simplex virus 1 (HSV 1) infection following coronavirus disease 2019 (COVID-19) vaccination in an Asian Indian female. METHODS: Retrospective case report. RESULT: A 40-year-old female presented with decreased vision, pain, and photophobia of 2 weeks duration. She reported receiving the second dose of COVISHIELDTM (ChAdOx1-S [recombinant]) 1 week prior to the onset of ocular symptoms. Left eye examination revealed granulomatous anterior uveitis. Aqueous sample from the left eye tested positive for HSV1 by polymerase chain reaction(PCR) method. She was managed with oral antiviral therapy, topical steroids, and cycloplegic agent and showed significant improvement of inflammation within 1 week and resolved within 3 weeks. CONCLUSION: This report demonstrates a potential association of HSV 1 anterior uveitis with COVID-19 vaccination. A high index of suspicion of viral etiology is warranted when uveitis presents with reduced corneal sensations and pigmented keratic precipitates, following a recent history of COVID-19 vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Infecções Oculares Virais , Herpes Simples , Herpesvirus Humano 1 , Uveíte Anterior , Adulto , Feminino , Humanos , Antivirais/uso terapêutico , ChAdOx1 nCoV-19 , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , DNA Viral/análise , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1/genética , Midriáticos/uso terapêutico , Estudos Retrospectivos , Uveíte/tratamento farmacológico , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Vacinação/efeitos adversos
9.
Ocul Immunol Inflamm ; 30(5): 1244-1246, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35226563

RESUMO

PURPOSE: COVID-19 vaccines are currently undergoing long-term safety monitoring, including for ocular side effects. Uveitis following vaccination has been described previously with other vaccines and warrants evaluation for COVID-19 vaccines, especially given their widespread use. CASE REPORTS: We present two cases of patients who developed anterior uveitis following the Moderna COVID-19 vaccine, as reported to the National Registry for Drug-Induced Ocular Side Effects. We also summarize reports of anterior uveitis following COVID-19 vaccination as reported to the World Health Organization global database of individual case safety reports. CONCLUSIONS: Based on the temporal pattern of ocular inflammation following vaccine delivery in these cases, an association may be present between uveitis and COVID-19 vaccination. Further investigation to explore this association is warranted to guide patient care.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Uveíte Anterior , Uveíte , Vacinas , Humanos , Vacina de mRNA-1273 contra 2019-nCoV , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Uveíte/etiologia , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/etiologia , Vacinação/efeitos adversos , Vacinas/efeitos adversos
11.
Ocul Immunol Inflamm ; 30(1): 244-245, 2022 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-32946301

RESUMO

Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber, and sphincter paralysis. BAIT has been easily confused with other types of anterior uveitis because of pigment dispersion in the anterior chamber and some symptoms including pain, photophobia, and red eye, which is similar to those in the other types of anterior uveitis. However, inflammatory findings in these patients are not as marked as in those with other types of anterior uveitis. Therefore, systemic corticosteroid is generally not required for the treatment of pure BAIT patients because of limited intraocular inflammation. BAIT can also cause severe intraocular pressure (IOP) rise, which sometimes necessitates glaucoma surgery. Systemic corticosteroids can also increase the existing intraocular pressure rise in patients with BAIT. Therefore, it should not be used in these patients.


Assuntos
Glaucoma de Ângulo Aberto , Doenças da Íris , Uveíte Anterior , Humanos , Pressão Intraocular , Iris , Doenças da Íris/diagnóstico , Moxifloxacina , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico
12.
Eur J Ophthalmol ; 32(4): NP94-NP97, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33719653

RESUMO

INTRODUCTION: Ibrutinib is a small-molecule drug approved for the treatment of haematological disorders and is known to be associated with visual disturbances, but uveitis has not yet been reported as an adverse effect of this medication. We present two cases of ibrutinib-associated severe uveitis in patients with chronic lymphocytic leukaemia. CASE DESCRIPTION: Our first case is a 65-year-old woman who presented with acute onset of bilateral fibrinous anterior uveitis 1 day after starting ibrutinib. Her vision was hand movements in the right eye and 20/120 in the left with hyperaemic discs and subretinal fluid. Ibrutinib was stopped and she experienced a significant improvement under local and oral steroid treatment. The second case is a 64-year-old male with subacute onset of bilateral hypertensive anterior uveitis with pupillary seclusion and right eye hyphaema. He was on ibrutinib for the past 9 months. His vision at presentation was 20/80 and 20/60 for the right and left eye, respectively. He responded poorly to local steroid treatment until ibrutinib was stopped due to cardiac side-effects, after which his uveitis resolved and treatment was stopped. CONCLUSION: The temporal association between changes in ibrutinib treatment and our patients' ocular inflammation suggests a causative link. Ibrutinib increases Th1-based immune responses which is proposed as a mechanism for drug-induced uveitis. Its antiplatelet effect may explain the fibrinous nature of the inflammation and hyphaema.


Assuntos
Uveíte Anterior , Uveíte , Adenina/análogos & derivados , Idoso , Feminino , Humanos , Hifema , Inflamação , Masculino , Pessoa de Meia-Idade , Piperidinas , Uveíte/induzido quimicamente , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Transtornos da Visão
14.
Retina ; 41(12): 2462-2471, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34369440

RESUMO

PURPOSE: To describe uveitis cases after the BNT162b2 mRNA SARS-CoV-2 vaccination. METHODS: This is a multicenter, retrospective study. Vaccine-related uveitis diagnosis was supported by the classification of the World Health Organization Adverse Drug Terminology and the Naranjo criteria. RESULTS: Twenty-one patients (23 eyes) with a mean age of 51.3 years (23-78 years) were included. Eight of the 21 patients had a known history of uveitis. The median time from previous to current attack was 1 year (0.5-15 years). There were 21 anterior uveitis cases, two with bilateral inflammation. Eight cases occurred after the first vaccination and 13 after the second vaccination. All but three presented as mild to moderate disease. Two patients developed multiple evanescent white dot syndrome after the second vaccination. The mean time from vaccination to uveitis onset was 7.5 ± 7.3 days (1-30 days). At final follow-up, complete resolution was achieved in all but two eyes, which showed significant improvement. One case of severe anterior uveitis developed vitritis and macular edema after the second vaccination, which completely resolved after an intravitreal dexamethasone injection. CONCLUSION: Uveitis may develop after the administration of the BNT162b2 mRNA vaccine. The most common complication was mild to moderate anterior uveitis, while multiple evanescent white dot syndrome can also occur less frequently.


Assuntos
Vacina BNT162/efeitos adversos , COVID-19/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , SARS-CoV-2 , Uveíte Anterior/induzido quimicamente , Vacinação/efeitos adversos , Adulto , Idoso , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Uveíte Anterior/diagnóstico , Adulto Jovem
16.
Int J Infect Dis ; 110: 95-97, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34289406

RESUMO

BACKGROUND: Uveitis is a vision-threatening inflammation and is considered an ophthalmic emergency. It generally arises as a result of autoimmune conditions, infections, or ocular trauma, but it may also occur as an isolated disorder. Over the past decades, several cases of vaccine-associated uveitis have been described, with the hepatitis B virus vaccine being the leading cause. CLINICAL CASE: A case of anterior uveitis in a 23-year-old male, with onset 14 days after the second dose of BNT162b2 COVID-19 vaccine, is reported here. Initial symptoms were pain, photophobia, and red eye. Ocular examination showed pericheratic and conjunctival hyperaemia, posterior synechiae, and anterior chamber cells ± keratic precipitates in the lower quadrants. The posterior segment did not show any alteration, and optical coherence tomography ruled out the presence of cystoid macular oedema. After a 10-day treatment course of topical steroids and cycloplegic eye drops, the ocular inflammatory signs disappeared and visual acuity was completely restored. Even if causality remains presumed, a warning should be given to physicians about the possibility of eye inflammation following SARS-CoV-2 vaccination.


Assuntos
COVID-19 , Uveíte Anterior , Uveíte , Adulto , Vacina BNT162 , Vacinas contra COVID-19 , Humanos , Masculino , SARS-CoV-2 , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Vacinação/efeitos adversos , Adulto Jovem
17.
Arch Osteoporos ; 16(1): 104, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-34180015

RESUMO

PURPOSE: This three-case report aims to highlight the ocular adverse effects induced by bisphosphonate therapy and to call clinicians' attention. METHODS: Three cases of acute anterior uveitis secondary to the initial dose of zoledronate infusion were reported with focus on their symptoms, treatment regimens, and outcomes. A review of published reports provided a basis for discussion. RESULTS: Three cases of acute anterior uveitis were either bilateral or unilateral. They demonstrated typical manifestations of bisphosphonate-induced acute anterior uveitis such as eye pain, blurred vision, conjunctival and ciliary hyperemia, keratic precipitates, and flare in the anterior chamber. After topical corticosteroid-containing comprehensive treatments, these symptoms resolved completely without any vision loss and long-term sequelae. CONCLUSIONS: Acute anterior uveitis may be part of the acute phase reaction induced by zoledronate. Patients should be informed of its symptoms in advance and be monitored closely during and after administration. Clinicians should have a good awareness of the zoledronate-associated acute anterior uveitis and to treat it in a prompt and appropriate manner.


Assuntos
Conservadores da Densidade Óssea , Uveíte Anterior , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Humanos , Imidazóis/efeitos adversos , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Ácido Zoledrônico/efeitos adversos
18.
Semin Ophthalmol ; 36(8): 794-799, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33780309

RESUMO

Aim: Nivolumab is an immune checkpoint inhibitor that has recently been widely used for metastatic malignant melanoma. We report a case who developed multiple different ocular immune-related side effects (iRAEs) related to nivolumab.Case Presentation: A 60-year-old man on nivolumab treatment for metastatic malignant melanoma developed a decrease in vision in both eyes several days after the third infusion. The initial best-corrected visual acuity (BCVA) was counting fingers in both eyes. Slit-lamp examination revealed no abnormal findings in the anterior segment of both eyes. Posterior segment evaluation showed serous retinal detachment, including the whole macula and inferior retina in both eyes, and optical coherence tomography (OCT) confirmed the diagnosis. On en face OCT analysis, hyperautoflorescent dots were noticed on the whole macular region but more intense at the inferior quadrant corresponding to serous retinal detachment. On Fluorescein Angiography (FA), no abnormality was observed. Oral corticosteroid treatment was administered. Subretinal fluid resolved one week after treatment in the right eye and two weeks after treatment in the left eye. BCVA was 20/20 in both eyes at first month of treatment. After that, oral corticosteroid treatment was tapered and stopped at the end of the second month. The patient was followed monthly. Two months after the treatment patient presented with an anterior uveitis episode with mild vision loss. Slit-lamp examination revealed 3+ cells in the anterior chamber and posterior synechia in both eyes. Posterior segment examination was normal. The patient was treated with topical corticosteroid and cycloplegic for two months. Hyperautoflorescent dots formed with serous detachment disappeared six months after the onset of serous detachment, and they did not occur during anterior uveitis episodes.Conclusions: This is the first clinical report of nivolumab-associated ocular iRAEs presenting with recurrent episodes presenting with serous retinal detachment and anterior uveitis. En face OCT imaging may help diagnose and show the activity of the posterior segment manifestation. When managed properly and observed closely following general and ocular conditions, it is possible to held iRAEs and overcome them by oral and/or topical corticosteroid therapy without interrupting the nivolumab.


Assuntos
Descolamento Retiniano , Uveíte Anterior , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Receptor de Morte Celular Programada 1 , Descolamento Retiniano/induzido quimicamente , Tomografia de Coerência Óptica , Uveíte Anterior/induzido quimicamente , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico
19.
Ocul Immunol Inflamm ; 29(7-8): 1370-1374, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-32546073

RESUMO

Purpose: To report cases of uveitis induced by biological therapy given for cancer.Methods: Retrospective review of medical charts of patients.Results: Included were six patients aged 14-81 years. Three were treated with vemurafenib and one each with nivolumab, ipilimumab, and osimertinib. The oncological diagnoses were metastatic thyroid carcinoma, pleomorphic xanthoastrocytoma, metastatic melanoma, adenocarcinoma of the lung, and metastatic breast cancer. Ocular manifestations appeared 4-82 weeks after the biological treatment was initiated. The most common ocular presentation was anterior uveitis. Onset was sudden in all cases. The median duration of uveitis was 70 weeks. Treatment included topical or systemic corticosteroids; one patient received a single intravitreal steroid injection in one eye.Conclusions: Uveitis may rarely be induced by treatment with biological agents for cancer. Both oncologists and ophthalmologists should be aware of this potential side effect. Early detection and management can prevent permanent complications and save the patient's vision.


Assuntos
Antineoplásicos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Inibidores de Checkpoint Imunológico/efeitos adversos , Neoplasias/tratamento farmacológico , Uveíte Anterior/induzido quimicamente , Acrilamidas/efeitos adversos , Adolescente , Adulto , Idoso de 80 Anos ou mais , Compostos de Anilina/efeitos adversos , Feminino , Glucocorticoides/uso terapêutico , Humanos , Ipilimumab/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nivolumabe/efeitos adversos , Estudos Retrospectivos , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Vemurafenib/efeitos adversos
20.
Ocul Immunol Inflamm ; 29(7-8): 1366-1369, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-32469689

RESUMO

Purpose: To report a case of a drug-induced anterior uveitis secondary to the use ofintracameral moxifloxacin.Case report: A 64-year-old Colombian male patient presented with severe ocular pain and photophobia in his left eye 15 days after cataract surgery. In the ophthalmology and glaucoma specialist evaluation, pigment dispersion in the anterior chamber and camerular angle, severe anterior segment inflammation, and elevated intraocular pressure were observed. Poor response to treatment for a suspected viral origin and exclusion of other possible etiologies, led to the conclusion of intracameral moxifloxacin induced anterior uveitis.Conclusion and importance: We present the second published case worldwide about anterior uveitis secondary to intracameral moxifloxacin, which may rarely cause hypertensive uveitis that may be confused with viral uveitis. This provides evidence on the importance of postoperative follow-up by the surgeon for an early referral and treatment of these cases.


Assuntos
Câmara Anterior/efeitos dos fármacos , Antibacterianos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Moxifloxacina/efeitos adversos , Uveíte Anterior/induzido quimicamente , Extração de Catarata , Diagnóstico Diferencial , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Endoftalmite/prevenção & controle , Síndrome de Exfoliação/induzido quimicamente , Síndrome de Exfoliação/diagnóstico , Dor Ocular/induzido quimicamente , Dor Ocular/diagnóstico , Gonioscopia , Humanos , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/induzido quimicamente , Hipertensão Ocular/diagnóstico , Fotofobia/induzido quimicamente , Fotofobia/diagnóstico , Uveíte Anterior/diagnóstico
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