Presentation
To describe the clinical presentation and course of Whipple disease in an adult. A 34-year-old man with phthisis bulbi in the right eye secondary to uveitis-induced neovascular glaucoma presented with severe acute posterior uveitis in the left eye. [ncbi.nlm.nih.gov]
Entire Body System
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Cushingoid
Cushingoid stigmata worsened after administration of posterior subtenon injection of corticosteroids. The patient's truncal obesity worsened, and his linear growth stopped. [ncbi.nlm.nih.gov]
Skin
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Lanugo
After initial topical corticosteroid therapy, the patient developed a cushingoid habitus accompanied by increased lanugo hair, acanthosis nigricans, posterior subcapsular lens opacities, and increased intraocular pressure. [ncbi.nlm.nih.gov]
Eyes
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Eye Pain
It typically causes eye pain, eye redness and sensitivity to light (photophobia). The eye pain is often aching and the eyeball feels tender. Vision may be slightly blurred. [rnib.org.uk]
When to get medical advice Contact a GP as soon as possible if you have persistent eye pain or an unusual change in your vision, particularly if you've had previous episodes of uveitis. [nhs.uk]
While anterior uveitis often causes eye pain and redness, light sensitivity, and blurred vision, the symptoms of posterior uveitis are more subtle. Uveitis can lead to other complications, including glaucoma, cataracts, or retinal detachment. [rarediseases.org]
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Visual Acuity Decreased
However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects. [ncbi.nlm.nih.gov]
Immunosuppressors[5] If macular oedema recurs and visual acuity decreases, an additional drug is necessary to help control the inflammation. Ciclosporin is the drug of choice for most patients aged under 50 years. [patient.info]
Neurologic
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Dysautonomia
We report a 68-year-old woman who presented with posterior uveitis, cerebellar ataxia, dysautonomia, peripheral neuropathy and undifferentiated carcinoma. Autopsy showed slight brain inflammatory changes and severe Purkinje cell degeneration. [ncbi.nlm.nih.gov]
Workup
Workup ultimately revealed ocular syphilis, and neurosyphilis was additionally confirmed with cerebrospinal fluid studies. Treatment with intravenous penicillin was promptly initiated with complete visual recovery. [ncbi.nlm.nih.gov]
Designed for quick point-of-care reference, the book features numerous full-color photographs and bulleted how-to instructions for workup and treatment of each disorder. [books.google.com]
(eg, HIV, toxoplasmosis), depending on the presentation See Workup for more detail. [emedicine.medscape.com]
[…] of the choroid and/or retina Further workup of any suspected underlying systemic condition Complications Cataract Secondary glaucoma Posterior synechia Anterior synechia Visual field loss due to scarring Major loss of visual acuity, if macula is affected [amboss.com]
X-Ray
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Multiple Pulmonary Nodules
The chest roentgenogram showed multiple pulmonary nodules throughout both lung fields. No definitive diagnosis was established either by brushing cytology or biopsy through bronchoscopy or percutaneous needle biopsy. [ncbi.nlm.nih.gov]
Treatment
One patient developed ocular and systemic tuberculosis, which responded to antituberculous treatment. Infliximab is effective in the treatment of sight-threatening refractory posterior uveitis. [ncbi.nlm.nih.gov]
Prognosis
In addition, preliminary data indicate that fundus autofluorescence characteristics may serve as markers of disease activity, allow prediction of visual prognosis, and may help determine the adequacy of therapy. [ncbi.nlm.nih.gov]
A good prognosis can be expected for those who undergo appropriate treatment. The condition can lead to permanent blindness if left undiagnosed or untreated Complications, such as glaucoma and cataract, can worsen the prognosis. [dovemed.com]
The clinical characteristics and visual prognosis did not reveal statistically significant difference compared to the patients with anterior uveitis. [iovs.arvojournals.org]
Etiology
Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. [ncbi.nlm.nih.gov]
Introduction Uveitis represents a heterogeneous group of intraocular inflammatory diseases with a diverse set of infectious and noninfectious etiologies. [dovepress.com]
Posterior Uveitis: Advances in Imaging and Treatment focuses on the ocular imaging modalities used in the diagnosis of various uveitis and intraocular inflammation entities resulting from infectious and non-infectious etiologies. [amazon.com]
[…] discusses the adjunctive role of visual evoked potential (VEP), multifocal VEP, electroretinogram (ERG), and mul- focal ERG in the diagnosis of more challenging visual problems, es- cially in distinguishing them from macular disorders and psychogenic etiologies [books.google.com]
Uveitis includes a large number of intraocular inflammatory conditions of different etiologies. However, still, the etiological diagnosis remains a challenge in spite of better understanding and advanced diagnostic techniques. [jcor.in]
Epidemiology
Nakae K, Masaki F, Hashimoto T, et al (1992) A nation-wide epidemiological survey on Behçet’s disease, report 2: association of HLA-B51 with clinico-epidemiological features. Report of Behçet’s Disease Research Committee. [link.springer.com]
From the *Department of Ophthalmology and the †Department of Medicine, The Johns Hopkins University School of Medicine, and the ‡Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. [journals.lww.com]
Uveitis epidemiology varies widely with geographic location; however, it remains a significant cause of vision loss throughout the world. [dovepress.com]
Epidemiology: This clinical syndrome is encountered frequently. Pathogenesis: The pathogen,Toxoplasma gondii, is transmittedby ingestionof tissue cysts in raw or undercooked meat or by oocysts from cat feces. [brainkart.com]
The Northern California Epidemiology of Uveitis Study. Ophthalmology 2004;111:491-500. Rothova A, Suttorp-van Schulten MS, Frits Treffers W, et al: Causes and frequency of blindness in patients with intraocular inflammatory disease. [karger.com]
Pathophysiology
uveal melanoma) Pathophysiology Chronic ischemia of the retina ; release of vasoproliferative substances;, such as VEGF, which also affect the anterior segment of the eye neovascularization of the iris Clinical features: initially asymptomatic; symptoms [amboss.com]
Pathophysiology As there are different forms of scleritis, the pathophysiology is also varied. Scleritis associated with autoimmune disease is characterized by zonal necrosis of the sclera surrounded by granulomatous inflammation and vasculitis. [eyewiki.aao.org]
Non-neoplastic: retinitis pigmentosa intraocular foreign body juvenile xanthogranuloma retinal detachment Neoplastic: retinoblastoma lymphoma malignant melanoma leukemia reticulum cell sarcoma Pathophysiology[edit] Immunologic factors[edit] Onset of uveitis [en.wikipedia.org]
Clinical trial data on these and other potential therapies will enhance understanding of the pathophysiology of NIU of the posterior segment, and one or more of these agents may in the future provide additional therapeutic options for patients. n 1. de [retinatoday.com]
Pathophysiology Autoimmune reaction (similar to Episcleritis and Scleritis ) Uveitis may occur in isolation or as part of a systemic inflammatory condition (see causes below) Diagnosis is as a result of spillover inflammation into the aqueous and vitreous [fpnotebook.com]
Prevention
There are no current guidelines to prevent posterior uveitis. [lahey.org]
Treatment Goals Symptom Relief – Pain, photophobia, blurred vision Prevent Visual Loss Prevent Complications 14. Treatment 1. [pt.slideshare.net]