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Posterior Uveitis


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]
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]
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]
Eye Pain
  • 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]
Visual Acuity Decreased
  • However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects.[ncbi.nlm.nih.gov]
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]
  • Laboratory testing and appropriate workup may reveal that some cases have no known systemic disease association, either infectious or autoimmune.[retinatoday.com]
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]
  • Abstract Vitrectomy, sadly, is either not listed in the armamentarium for the treatment of this disease or only at such a late stage that the prognosis is poor (which seems to reinforce the initial reluctance to consider it).[link.springer.com]

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]
  • […] 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]
  • In developed countries, the etiology of uveitis is noninfectious in approximately 80% to 90% of cases.[retinatoday.com]

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]
  • 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]
  • EPIDEMIOLOGIC IMPACT Figure 2. Age distribution of uveitis onset in a study of 2619 uveitis patients.[retinatoday.com]
  • The Wisconsin Epidemiologic Study of Diabetic Retinopathy found that over a 10-year period approximately 19% of people with diabetes included in the study were diagnosed with DME.[globenewswire.com]
Sex distribution
Age distribution

Pathophysiology

  • 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 Steven[retinatoday.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]
  • 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]
  • 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[en.wikipedia.org]

Prevention

  • There are no current guidelines to prevent posterior uveitis.[winchesterhospital.org]
  • CONCLUSIONS: Infliximab is rapidly effective and safe in a high proportion BD patients with refractory posterior uveitis, and may be helpful to prevent recurrences.[ncbi.nlm.nih.gov]
  • Treatment is important and can prevent serious complications. Make sure you report any new symptom to your doctor, and go to your follow-up visits as your doctor says.[webmd.com]

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