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Results for “Uveitis, Intermediate”

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PubMed1994

[Bilateral intermediate uveitis and acute interstitial nephritis (TINU syndrome). Ultrasonographic documentation of a case].

Clinical features and natural course of acute interstitial nephritis and uveitis (TINU Syndrome) in a 9 years old boy are reported. The patient's ocular symptoms began seven month after the renal disease was diagnosed. Intermediate uveitis was present bilaterally with vitreous infiltration. Optic disc drusen were documented by echography. An immunological disorder causing the syndrome is most likely, as some laboratory data demonstrate. No systemic or infectious diseases were found in our case but an etiology to drugs considered likely.

Acute Disease↗
PubMed1995

[Progressive non-inflammatory lesions of the vitreous and intermediate uveitis].

A 77 year old man presented with a decreased vision, quite anterior segments, vitreous haze (++) (cells and flare) OD > OS, snow banks and snow balls at the inferior pars plana, suggesting an intermediate uveitis. Two subTenon injections of steroids were performed on the right eye, with improvement of his right visual acuity from 5 to 10/10. Cells and snow balls disappeared but the vitreous became more fluffy and more organized. Investigations did not demonstrate any systemic disease. The vitreous haze progressed bilaterally and failed to respond to systemic steroids. A year later, visual acuity was limited to hand movements (OD) and remained at 9/10 (OS). The vitreous haze + (OD) and ++ (OS) was extremely fluffy and moderately organized without inflammatory cells. Vitrectomy was performed in both eyes. Non inflammatory fibro-cellular membranes in a dense collagenous network with amorphous precipitates were observed in electron microscopy. One year later, he developed a systemic B-cell lymphoma. This unusual case illustrates the possible evolution of intermediate uveitis in a secondary PVR-like progressive non inflammatory vitreous haze with a particular increase of the amount of collagen fibrils and amorphous precipitates responsible for the fluffy aspect of the vitreous failing to respond to steroids.

Aged↗
PubMed2003

Acute allergy reaction after posterior sub-Tenon's triamcinolone injection in the treatment of intermediate uveitis in the asthmatic patient.

We report the case of a 21-year-old female patient afflicted with atopic asthma admitted to hospital in order to diagnose and treat bilateral uveitis. After diagnostic examination: serological tests for Candida and Aspergillus antigens, analysis of direct vitreous preparation and of culture searching for fungal and bacterial etiology, tests for antinuclear antibodies and for boreliosis, the diagnosis of idiopathic intermediate uveitis (pars planitis) were made. Routine treatment with Polcortolon in sub-Tenon's triamcinolone injection was applied. It resulted in acute allergic reaction characterized by blepharedema and chemosis. Hydrocortisone, Clemastin, Zyrtec, Calcium and locally Dexamethasone and Emadine in drops instilled to conjunctival sac were administered resulting in symptom disappearance.

Acute Disease↗
PubMed2006

Concurrent intermediate uveitis and an enhancing intracranial lesion as the initial manifestation of sarcoidosis.

INTRODUCTION: Posterior segment involvement has been described to be associated with central nervous system involvement in sarcoidosis as a result of direct sarcoid tissue infiltration or mass effect of a cerebral lesion. However, isolated intermediate uveitis occurring concurrently with central nervous system involvement prior to extensive systemic disease is rare. CLINICAL PICTURE: We describe a patient with neuro-ophthalmic manifestations of intermediate uveitis and an enhancing basal ganglia lesion at initial presentation, in the absence of extensive systemic disease. TREATMENT: He was treated with high-dose systemic steroids which was progressively tailed down over 6 months. OUTCOME: There was prompt resolution of vitritis with good preservation of visual acuity. CONCLUSION: The difficulties of the initial diagnosis of sarcoidosis and the indications for initiation of steroid therapy are illustrated. We use this case to emphasise the need for a high clinical suspicion of sarcoidosis in the presence of similar unusual and seemingly unrelated combinations of neurological manifestations so as to facilitate the prompt institution of appropriate treatment when indicated.

Adult↗
PubMed1996

Intermediate uveitis and retinal vasculitis as manifestations of cat scratch disease.

PURPOSE: To study the ocular manifestations of systemic Rochalimaea infection. METHODS: We examined a healthy 21-year old woman who had floaters in both eyes. A bilateral mild vitreitis and multiple foci of retinal vasculitis were found; during the ensuing two weeks, exudates appeared over the inferior pars plana. The patient owned five kittens but had no history of cat bites or scratches. Serum levels of antibodies to Rochalimaea were elevated. RESULT: The retinal vasculitis and vitreitis resolved after three weeks of therapy with ciprofloxacin hydrochloride without concomitant anti-inflammatory therapy. CONCLUSION: Rochalimaea infection should be considered in the differential diagnosis of intermediate uveitis and retinal vasculitis.

Adult↗
PubMed1996

Tear deficiency in Fuchs' intermediate uveitis.

OBJECTIVE: To assess quantitatively and qualitatively tear secretion in Fuchs' intermediate (heterochromic) uveitis to detect any possible anomaly linked to Fuchs' uveitis. DESIGN: Prospective study. SETTING: University eye clinic, Chieti, Italy. PATIENTS: Thirty consecutive white patients aged 32 to 65 years with unilateral Fuchs' heterochromic uveitis. OUTCOME MEASURES: Results of Schirmer's test I, tear film breakup time, conjunctival mucus ferning. RESULTS: Schirmer's test I showed a tear deficiency in 15 patients; the tear film breakup time and ferning were abnormal in these patients. There was a significant difference in the test results between the affected eyes and the fellow, unaffected eyes (p < 0.001). There was no relation between tear deficiency and age. CONCLUSIONS: The presence of tear anomalies only in the affected eye of patients with Fuchs' heterochromic uveitis suggests a link between Fuchs' uveitis and tear deficiency.

Adult↗
PubMed1986

[Cyclosporin treatment in uveitis].

With Cyclosporin, a recently developed immunosuppressant drug, the authors treated eight patients with noninfectious chronic uveitis: intermediate uveitis (4), Behcet's disease (2), chorioiditis (1), and anterior uveitis (1). Therapy had to be discontinued in six patients who responded poorly or manifested severe side effects. In four cases the Cyclosporin concentration in the aqueous humor was determined. In spite of a concentration of about 900 ng/ml there was a deterioration in two cases with intermediate uveitis and Behcet's disease. Only one of the eight patients with intermediate uveitis responded well without any recurrence.

Adolescent↗
PubMed1987

Uveitis: a strategy for diagnosis.

Uveitis may be the first presentation of a wide variety of underlying ocular and systemic diseases. It is important for the ophthalmologist to make a specific diagnosis in order to instigate specific therapy and give an accurate prognosis. The ability to recognise the clinical patterns of uveitis and to initiate appropriate investigations should form the basis of the ophthalmologist's management of the condition. To this end, we have considered uveitis under four major patterns of presentation--anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis--with subclasses within each of these four groups. We have outlined both the investigations which facilitate diagnosis of the possible underlying causes of inflammation and the interpretation of the results of such investigations.

Capillaries↗
PubMedDate not supplied

An eye on inflammatory eye disease.

The purpose of this article is to outline the interaction between ophthalmologists and internists in the management of uveitis. Two issues will be addressed: 1) which strategies should the internist follow when asked to investigate a case of uveitis; and 2) in which systemic diseases should the internist order an ocular examination to rule out intraocular inflammation. The modern approach to the diagnosis of uveitis is based on the naming-meshing system popularized by Smith and Nozik. After a short history (ocular complaints, general health) an ophthalmic examination is carried out to determine the anatomic structures involved. Based on the results a uveitis is classified as anterior uveitis, intermediate uveitis, posterior uveitis, or panuveitis. Associated factors (eg, unilateral versus bilateral, acute versus chronic, granulomatous versus nongranulomatous, etc.) are also assessed. Based on this information the type of uveitis will be named (eg, acute, nongranulomatous, unilateral, anterior uveitis) and matched (meshing) to a potential list of etiologies (eg, viral iritis, HLA-B 27 associated iritis). Targeted questioning and selected medical and laboratory investigations based on the shortlist will then identify a possible cause for a particular patient's uveitis. In other words the ophthalmologist should never ask the internist to run the full battery of tests in a patient with uveitis. He rather should indicate which type of uveitis is present and what are the most likely diagnoses to be excluded. Many systemic diseases cause diffuse inflammation and are associated with uveitis. These include tuberculosis, spirochaetal diseases such as Lyme disease and syphilis, sarcoidosis, Behçet syndrome, juvenile idiopathic arthritis, and HIV infection amongst many others. Routine ophthalmic examination in patients with systemic disease may be indicated for diverse reasons: to prevent profound damage due to asymptomatic uveitis in JIA; to detect diagnostic clues in patients with febris e causa ignota; or to rule out opportunistic infections in HIV positive patients. It is clear that the information gained from routine examination in systemic disease will be greatly dependent on the prevalence of ocular involvement in a particular disease.

Eye Diseases↗
PubMed1998

[Serum soluble interleukin-2 receptor levels in uveitis].

PURPOSE: To investigate the relationship between serum SIL-2R levels and uveitis. METHODS: SIL-2R levels were measured in sera of 64 patients with active uveitis by ELISA assay, 61 healthy subjects as control. RESULTS: Serum SIL-2R levels in the patients with active uveitis were significantly higher than that in the controls, but there were no significant difference among anterior uveitis, intermediate uveitis, Behcet disease and Vogt-Koyanagi-Harada syndrome. After therapy the serum SIL-2R levels were obviously decreased. CONCLUSION: SIL-2R Levels in serum correlate with activity of uveitis.

Adolescent↗
PubMed1989

[The effect of long-term dialysable leukocyte extract therapy on the recurrence behavior of idiopathic uveitis].

26 patients with idiopathic uveitis (anterior uveitis 11, intermediate uveitis 8, posterior uveitis 7) were treated with Dialysable Leukocyte Extract (DLE) for a long period. In comparison with the period before DLE in anterior and posterior uveitis the numbers of relapses decrease, the inflammation-free intervals become longer. These prolongations are significant. In cases with intermediate uveitis such a significance is not available. But in all types of uveitis DLE therapy shortens the duration of inflammatory episodes. These effects lead to a highly significant decrease of the portion of the period during and after DLE therapy in which inflammatory signs occur in comparison with the period before DLE therapy. The latter result becomes evident for all types of uveitis.

Adolescent↗
PubMed2004

Ocular complications of pediatric uveitis.

PURPOSE: To determine the cumulative proportion and the visual significance of ocular complications of pediatric uveitis. DESIGN: Cohort study. PARTICIPANTS: Patients with onset of endogenous or infectious uveitis before or at age 16 years. METHODS: Retrospective review of existing records at a university-based uveitis clinic. MAIN OUTCOME MEASURES: Type and prevalence of complications related to uveitis, time to development of complications, and vision loss after initial diagnosis. RESULTS: There were 148 patients, 71 males and 77 females, with a mean age of 10.4+/-4.9 years (median, 10.3 years) for an estimated prevalence of pediatric uveitis of 13.8%. Noninfectious uveitis was present in 112 patients (75.7%); 105 (71%) patients had bilateral disease. Anterior uveitis accounted for 30.4%, intermediate uveitis for 27.7%, posterior uveitis for 23.7%, and panuveitis for 18.2% of patients. Patients were followed for a mean of 71.7 months (range, 0 months-44 years) after diagnosis. Approximately 34% of all patients had 1 or more complications at the time of first diagnosis of uveitis by an ophthalmologist, increasing to 61.6% by 3 months, 69.4% by 6 months, 75.2% by 1 year, and 86.3% by 3 years after diagnosis. There were a total of 617 complications of all types. Anterior and intermediate uveitis had a higher risk of band keratopathy (P = 0.005). Posterior and intermediate uveitis had a lower risk of cataract (P = 0.009) or posterior synechiae (P<0.001). Intermediate uveitis had a higher risk of cystoid macular edema compared with anterior or posterior uveitis (P = 0.002). The cumulative percentages (standard error) of patients with first loss to 20/200 or worse after diagnosis in the affected eyes of unilateral cases or in either eye of the bilateral cases were: 31.3% (3.9) at 1 month; 40.5% (4.1) at 6 months; 56.0% (4.3) at 24 months; and 69.6% (4.5) at 60 months. Fifty-four patients (48.2%) received systemic antiinflammatory or immunomodulatory therapy. Sixty-eight patients (45.9%) had ocular surgery, and 38 of these had ocular surgery in both eyes. CONCLUSIONS: Childhood uveitis is significant for numerous complications, many of which are vision threatening. Complications increase with duration of disease.

Adolescent↗