Syphilitic uveitis revealed by bilateral retinal occlusive vasculitis.
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5 adult patients (7 eyes) with acute severe uveitis with retinal vasculitis and retinal detachment of unknown etiology were studied. Yellowish exudations which appeared in the peripheral fundus rapidly extended posteriorly, and there was a patchy perivasculitis, white sheathing and obliteration of the retinal vessels. The absorption of these yellowish exudations was followed by atrophy of the retina and the choroid. Secondary detachment of the retina then developed, and the visual acuity remained poor in most cases.
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To describe a case of uveitis with widespread vitreoretinal traction simulating retinal vasculitis angiographically.Interventional case report.A 62-year-old woman was examined for low vision in her left eye that persisted for ∼1 year. She had been treated for polymyalgia rheumatica for 1 year. Visual acuity was 20/20 in the right eye and 20/100 in the left eye. There were a few aged vitreous cells in both eyes. On fundus examination, there was mild epiretinal membrane in the left eye. Fluorescein angiography revealed diffuse fluorescein leakage in the late phase of angiography in the macular peripapillary and superior retinal hemisphere in the left eye, which appeared similar to retinal vasculitis. With optical coherence tomography, there was vitreomacular traction on the macular, peripapillary, and major branches of vessels in the left eye. Fundus examination was normal in the right eye. Pars plana vitrectomy was performed in the left eye uneventfully. Visual acuity was 40/100 at the postoperative 1-year follow-up.Vitreoretinal traction can be widespread and can cause diffuse fluorescein leakage resembling vasculitis or other types of uveitis.
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Purpose To investigate the frequency, clinical findings and outcomes of occlusive retinal vasculitis in patients with multiple sclerosis (MS).Methods A retrospective case series.Results During the period between January 2000 and December 2021, we identified 24 patients who were diagnosed to have uveitis associated with MS. Among them, four (16.6%) patients presented with bilateral occlusive retinal vasculitis who were diagnosed to have MS prior to presentation. All patients were treated successfully with a combination of systemic corticosteroids combined with mycophenolate mofetil. In addition, scatter laser photocoagulation was applied to the ischemic retina in all eyes.Conclusions Early recognition and prompt treatment with systemic immunosuppressive agents and scatter laser photocoagulation prevent complications and improve outcomes in MS patients with occlusive retinal vasculitis.
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Particular types of retinal vasculitis are described and discussed: primary (idiopathic) and secondary to bacterial, viral, fungal, parasite infections and retinal vasculitis coexisting with systemic disease. Symptoms depend on the size and location of the vessels involved. Retinal vasculitis is often accompanied by uveitis.
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Purpose To describe predominant retinal vasculitis in children carrying human T-cell lymphotropic virus type 1 (HTLV-1). Methods The authors examined clinical records of patients with HTLV-1–associated uveitis between 1987 and 2001 in Kagoshima University Hospital and reviewed cases of extensive, smoldering retinal vasculitis. Results Three previously healthy teenagers noted mild visual symptoms and presented with extensive sheathing of retinal vessels, complicated by mild anterior segment inflammation. The retinal vascular disease responded poorly to systemic corticosteroids, had a smoldering course with persistent sheathing of retinal vessels, and eventually resulted in diffuse chorioretinal degeneration. Results of laboratory studies were unremarkable except for the presence of serum antibodies to HTLV-1. One patient developed HTLV-1–associated myelopathy 11 years after the onset of ocular disease. Conclusions The retinal vasculitis differed from the retinal vascular changes commonly seen in HTLV-1–associated uveitis. The authors suggest a clinical disease HTLV-1–associated retinal vasculitis that affects young HTLV-1 carriers, characterized by smoldering retinal vasculitis with ultimate retinal degeneration.
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<i>Purpose:</i> We aimed to describe the clinical and angiographic changes in an experimental model of autoimmune uveoretinitis and vasculitis in primates. <i>Methods:</i> Six cynomolgus monkeys received a single subcutaneous immunization with 100 µg of human S antigen with complete Freund’s adjuvant. <i>Results:</i> All the animals had a bilateral long-term disease occurring usually in 1 eye approximately 4 weeks after immunization, the second eye being involved 1–5 weeks later. A cyclic course of the disease could be demonstrated by repeated fundus fluorescein angiograms. The initial and principal manifestation consisted in retinal vascular sheathing affecting veins and venules. The more severe forms showed areas of posterior uveoretinitis, dense vitritis and anterior uveitis. <i>Conclusion:</i> A single systemic injection of pure human retinal S antigen could induce a chronic and recurrent ocular disease similar to human retinal vasculitis.
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AbstractPurpose. Eales' disease (ED) is an idiopathic retinal vasculitis condition, which affects the retina of young adult males. Retinal changes include perivasculitis, non-perfusion and neovascularization. Disruption of blood-retinal barrier (BRB) is the common feature in intra-ocular inflammatory diseases. Disruption of BRB results in vascular hyper permeability and infiltration of circulating leukocytes into the retinal parenchyma. Monocyte (MC) activation results in oxidant thrust and subsequent tissue damage. This has been reported in various intra-ocular inflammatory diseases such as uveitis and Behcet's disease. However, there are no such reports available in ED. Hence in the present study we have investigated the role of MC activation and hydroxyl radicals (•OH) production and its possible involvement in promoting the development of retinal vasculitis in patients with ED. Methods. Twelve patients with ED and twelve healthy volunteers were recruited for the study. MC was separated from their peripheral blood. MC from patients with ED and control subjects was stimulated with phorbol-12-myristate - acetate (PMA) and •OH generated was analyzed using an electron spin resonance spectrometer (ESR). Superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS), and iron content was determined in MC to assess the oxidant thrust and antioxidant defense. Results.•OH generation was elevated in MC from patients with ED, which coincided with diminished SOD activity and elevated levels of iron and TBARS, when compared with healthy control subjects. •OH generation was abrogated when MC from ED were co-incubated with PMA and iron chelators such as diethylenetriaminepentacetic acid (DTPA) and desferrioxamine. Iron chelation also inhibited TBARS accumulation restored SOD activity in MC of patients with ED. Conclusions. For the first time we have demonstrated the production of •OH generation in MC of patients with ED using ESR. Further we have shown the beneficial effect of iron chelation in mitigating free radical mediated changes in cellular metabolism. Based on our findings, we provide further evidence for the role of oxidant thrust in promoting retinal tissue damage in patients with ED.KeywordsEales' DiseaseRetinal VasculitisMonocytesHydroxyl RadicalElectron Spin Resonance SpectroscopyIron Chelators
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