Topic

#Uvea and Intraocular Inflammation

22 articles
  1. Articles 30 May 2022 22 min read

    Ocular Toxoplasmosis

    Introduction: Toxoplasmosis is the most common cause of posterior uveitis in the world, accounting for over 80% of the cases in some regions[1-5]. For many years, ocular toxoplasmosis was considered to be the result of the recurrence of the congenital form of the disease [6]. However, it is recently believed that acquired infections might be a more important cause of ocular diseases than congenital ones[7-9]. Acquired infections occur secondary to ingestion of uncooked and infected meat, contaminated vegetables, or water. Epidemiology: The Toxoplasma Gondii infection is one of the most common zoonoses in the world. A large percentage of the population has chronic asymptomatic disease[10]. The prevalence varies extensively in different regions, depending on socioeconomic, geographic, and climatic factors. A high prevalence is found in tropical areas close to sea level, and a lower prevalence is found in arid regions, cold climates, and at high altitudes. In addition, the habit of eating

    Dr. Deepika MP · Dr. Nidhi Dubey · +1 other
  2. Articles 30 Nov 2021 24 min read

    Ocular Manifestations of HIV

    Human immunodeficiency virus (HIV) disease is a pandemic of global concern, not only due to serious health issues affecting all organs of the body but also due to its huge economic burden.(1) The diagnosis is often associated with social stigma that includes changing sexual practices, lack of availability of a vaccine and the chronicity of the disease requiring lifelong treatment.(2) The disease runs a severe course, involving multiple organs. Ocular lesions are varied and can affect any structure, usually in the late phase of HIV infection. Rarely, these lesions can be the presenting manifestations of the disease. While a variety of cell types may be infected by HIV, the immunologic hallmark is the selective loss of the CD4+ T cells. CD4 is a cell surface marker that identi?es the helper/inducer subset of T cells. During the initial phases of infection, a majority of patients remain asymptomatic. With a decrease in the CD4+ T cell count (< 500 cells/µL) the immune system shows evidenc

    Dr. Sharanya Abraham
  3. Articles 4 Sep 2021 6 min read

    Ten Points One Must Know on Toxic Anterior Segment Syndrome (TASS)

    TASS is an uncommon, non-infectious condition causing severe inflammation of the anterior segment structures without vitreous involvement [1],[2],[5]. The name TASS was coined by Monson and colleagues in 1992 [1],[3]. It is usually associated with phacoemulsification surgery but can also happen after procedures like penetrating keratoplasty, descemet stripping automated endothelial keratoplasty, deep anterior lamellar keratoplasty, vitrectomy and anterior and posterior segment phakic intraocular lenses. The alternative names of TASS include sterile post -operative endophthalmitis, toxic lens syndrome, toxic endothelial cell destruction syndrome and localized endophthalmitis [1],[3],[7]. 1. What is TASS? It is an acute sterile post-operative inflammatory condition affecting the anterior segment structures following intraocular surgery. It is usually seen within 12-48 hours of surgery and is due to the reaction of anterior segment structures to some toxic substance usually associated wit

    Dr. Priya Rasipuram Chandrasekaran
  4. Students Gallery 14 May 2021 12 min read

    i-File: Vogt-Koyanagi - Harada disease

    Brief Scenario of the case: A 25 year-old-female, resident of Rajasthan presented to us with the chief complaints of diminution of vision in the right eye for a period of 3 days and redness with mild pain in both eyes for one month. History of Present Illness: The patient was apparently well 3 days back when she started to develop diminution of vision in her right eye. She had mild pain and redness in both her eyes for the last one month. Past Ocular History: She was diagnosed as a case of right eye choroiditis elsewhere. Routine blood counts were normal. Erythrocyte sedimentation rate (ESR) was 22mm in the first hour. Veneral Disease Research Laboratory (VDRL) test was negative. Human Immunodeficiency Virus (HIV) test was negative. Past Medical History/ History of Medication: The patient was using topical steroids and cycloplegic eye drops. No history of tuberculosis or any systemic disease. Family History: There was no significant family history. Review of Systems/Systemic Examinatio

    Dr. Navneet Mehrotra · Dr. Nivesh Gupta
  5. Students Gallery 12 Apr 2021 6 min read

    i-File: Vitreous Haemorrhage

    Question A healthy 26-year-male presented with sudden onset diminution of vision in OS of 1-week duration. The loss of vision was not associated with any trauma, pain, redness. No history of flashes. No previous history of a similar episode. On examination BCVA OD: 6/9 N6; OS: HM. Anterior segment unremarkable OU. Fundus: OD: as depicted in the fundus and FFA, OS: had a dense vitreous hemorrhage What are the differentials for the case based on the fundus picture/ Fundus Fluorescein Angiogram? How do you manage it? Answer: Let’s go in a stepwise fashion to decipher this question. The relevant points from history and FFA are The patient is young with no previous such episodes The loss of visual acuity is 1 week Although not mentioned, we presume the patient to be non-diabetic, and is not hypertensive; however, the same needs to be investigated The better eye has a large frond of NVE( neovascularization elsewhere) in the temporal quadrant So differentials in a young with dense vitreous he

    Dr. Bikramjit Pal
  6. Articles 2 Apr 2021 17 min read

    Primary Intraocular Lymphoma

    Introduction Intraocular lymphoma, a great non-infective masquerader occurs intraocularly in either the vitreoretinal( primary vitreoretinal lymphoma PVRL)) or in the uveal space( primary choroidal, iris lymphoma). By definition, PVRL denotes the presence of pathology limited to vitreoretinal space without its occurrence in the central nervous system. The term ‘primary’ is however controversial as almost 56-90% of PVRL patients will ultimately go on to involve the CNS over few months to years( 8-29 months) and is considered a subset of primary CNS lymphoma( PCNSL) [1]. Incidentally, 25% of patients with PCNSL will have concurrent ocular involvement at presentation [2]. Primary choroidal and iridial lymphomas are rarer, less aggressive as compared to their vitreoretinal counterpart and due to their rarity, the following section will deal primarily with PVRL. Pathophysiology of Primary Vitreoretinal Lymphoma The origin of lymphoma cells in the retina is a point of debate. Two etiologies

    Dr. Bikramjit Pal
  7. Articles 2 Apr 2021 49 min read

    Viral Uveitis

    Viral uveitis has myriad presentations. They may present as anterior uveitis, intermediate uveitis, acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN) and neuroretinitis. The causative viruses mainly include herpes group of viruses and human immunodeficiency virus (HIV). Other DNA viruses which cause uveitis are poxviruses, adenoviruses especially those that produce epidemic keratoconjunctivitis and pharyngoconjunctival fever. RNA viruses isolated are influenza virus, mumps virus, measles virus, rubella virus, rift valley fever virus and Newcastle virus. Here we have discussed all the different types of viral uveitis except opportunistic viral infections in HIV. ANTERIOR UVEITIS Viral anterior uveitis is caused mainly by herpes simplex virus (HSV) type 1 and 2, varicella zoster virus (VZV), cytomegalovirus virus (CMV), Epstein-Barr virus (EBV) and human herpes virus (HHV) type 6, 7 and 8 (1-3). Herpes literally means ‘to crawl’ from the Greek word ‘herpein’. Herpes

    Dr. Vinita Rao · Dr. Gunjan Deshpande
  8. Articles 2 Apr 2021 12 min read

    Eales Disease: Current Concepts in Etiopathogenesis and Management

    Introduction Eales’ disease is an idiopathic retinal periphlebitis that primarily affects the peripheral retina in young adults. Eales’ disease was first described by Henry Eales, a British ophthalmologist, in 1880 and 1882.1,2 He found it in seven young, male patients ranging in age from 14 to 29 years with recurrent vitreous hemorrhage. In addition, these patients had history of headache, variation in peripheral circulation, chronic constipation and epistaxis. In the next century, the disease was redefined by several investigators. 3-6 Elliot first recognized the inflammation of retinal vein and described it as periphlebitis retinae.4 Subsequently several investigators documented both venular and arteriolar inflammation.5,7 Eales’ disease most commonly affects healthy young adult males and is an important cause of preventable blindness in young adults. The predominant age of onset of symptoms is 20-30 years. The disease is more commonly seen in the Indian subcontinent. However, it ha

    Sandeep Saxena, M.S., MAMS
  9. Articles 2 Apr 2021 6 min read

    Malarial Retinopathy: A Diagnostic Clue

    Introduction Malaria is the most important of parasitic diseases of humans and remains today, as it has been for centuries a large burden on tropical communities. Cerebral malaria is the most important complication of falciparum malaria and also the leading cause of death in malaria 1. It is defined as an acute, symmetric encephalopathy associated with sequestration of parasite-infected erythrocytes in the cerebral vessels and capillaries in patients with falciparum malaria 2. WHO Criteria for Diagnosis The World Health Organization has laid down definite guidelines for diagnosis and management of cerebral malaria 3. This definition requires the presence of unarousable coma using the Glasgow Coma Scale (GCS), exclusion of other encephalitides, especially bacterial meningitis and if possible, locally prevalent encephalitis and the presence of asexual forms of P. falciparum in the blood film. Retinal Involvement in Cerebral Malaria Eye being an extension of the brain, retina provides a u

    Sandeep Saxena, M.S., MAMS · Shaili Misra, MBBS · +1 other
  10. Articles 2 Apr 2021 9 min read

    Seasonal Hyperacute Panuveitis (SHAPU)

    Introduction: Seasonal Hyperacute Panuveitis (SHAPU) is a mysterious eye disease with grave prognosis, reported only from Nepal. Though it was reported for the first time in 1975,1-3 no definite etiopathogenesis has been established to date. It occurs as an outbreak in certain regions of Nepal in a cyclical pattern during the autumn season and peaks during the winter season (August–December) only in odd years. Thus, after the first outbreak of 1975, the next outbreaks occurred in 1977,1979, 1981, and so on and the last outbreak was reported in 2019. SHAPU predominately occurs among children4 and the youngest reported case is a 38- day-male baby.5 No gender predilection has been identified in SHAPU.4 All cases are mainly immunocompetent with no prior history of systemic or ocular illness/trauma.4, 6 SHAPU is very devastating and generally leads to the loss of sight within a week, followed by cosmetic disfigurement due to phthisis bulbi, which can have a significant emotional impact on t

    Dr. Ranju Kharel (Sitaula)

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