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Colour fundus photograph. This shows an area of RPE rip nasal to the optic disc (shown in black arrow).
Source publication
We are reporting a case of granulomatous panuveitis in the right eye following penetrating injury to the left eye.
A 34-year-old female was diagnosed to have sympathetic ophthalmia on treatment with systemic steroids. Vision did not improve in spite of aggressive systemic steroid therapy. On examination, patient had large retinal pigment epithelial...
Context in source publication
Context 1
... pressure was 15 mmHg in the right eye. Slit lamp biomicroscopic examination revealed pigments on the anterior lens capsule with vitri- tis ++, haze ++, internal limiting membrane folds in the right eye with retinal pigment epithelial changes and ser- ous elevation of the retina in the posterior pole with a large area of retinal pigment epithelial rip nasal to the disc (Figure 1). ...
Citations
... 27,28 A case of persistent subretinal fluid in SO secondary to a RPE tear has been recently described by the use of SD-OCT. 29 Although reported just in single cases, choroidal features in the acute phases of SO resemble the widely described alterations found in VKH, including folds, massive thickening and loss of the physiologic architecture of the choroidal layers ( Figure 9B). 30,31 During the chronic stage of the disease, atrophic changes have been reported in the choroidal structure, regardless the inflammatory status of the patient. ...
Purpose:
To show the current status of multimodal imaging and its role in supporting an early diagnosis of sympathetic ophthalmia.
Methods:
The diagnosis is mainly clinical supported with ancillary investigations; mainly fluorescein angiography and others, including indocyanine angiography optical coherence tomography (OCT), OCT enhanced depth imaging, autofluorescence imaging, and ultrasonography.
Results:
Various imaging modalities such as OCT, autofluorescence imaging and angiography are critical in the diagnosis and management of sympathetic ophthalmia. The clinician must make adequate use of such ancillary investigations in the management of the patients.
Conclusions:
Sympathetic ophthalmia is a rare, bilateral inflammation of the uveal tract following penetrating trauma or surgery in one eye. The intraocular inflammation requires a prompt diagnosis so that the treatment can be initiated as early as possible.
... Sympathetic ophthalmia is a rare disease in which surgery or injury to one eye incites an immune reaction that causes an inflammatory injury to the patient's contralateral or sympathetic eye 69,70 . Despite aggressive immune suppression, some cases of sympathetic ophthalmia can result in irreversible blindness 71 . ...
Immunologically-matched, induced pluripotent stem cell (iPSC)-derived photoreceptor precursor cells have the potential to restore vision to patients with retinal degenerative diseases like retinitis pigmentosa. The purpose of this study was to develop clinically-compatible methods for manufacturing photoreceptor precursor cells from adult skin in a non-profit cGMP environment. Biopsies were obtained from 35 adult patients with inherited retinal degeneration and fibroblast lines were established under ISO class 5 cGMP conditions. Patient-specific iPSCs were then generated, clonally expanded and validated. Post-mitotic photoreceptor precursor cells were generated using a stepwise cGMP-compliant 3D differentiation protocol. The recapitulation of the enhanced S-cone phenotype in retinal organoids generated from a patient with NR2E3 mutations demonstrated the fidelity of these protocols. Transplantation into immune compromised animals revealed no evidence of abnormal proliferation or tumor formation. These studies will enable clinical trials to test the safety and efficiency of patient-specific photoreceptor cell replacement in humans.
Purpose
To evaluate the factors related to sympathetic ophthalmia (SO) in a series of patients in our ophthalmology center and previously published cases.
Methods
A retrospective and noncomparative review was performed on 16 patients with SO attending our ophthalmology center from 2013 to 2019. A total of 87 previously published cases of SO were identified by searching the Medline database from 2009 to 2019.
Results
Sixteen patients were included in the analysis, and six cases were induced by transscleral cyclophotocoagulation (TCP). All patients had achieved controlled inflammation at their last follow-up visit. Thirteen patients (81.3%) had improved best-corrected visual acuity (BCVA). A review of the literature revealed 87 previously reported cases of SO. Shared clinical features and treatment outcomes were summarized.
Conclusion
Ocular therapies, including both penetrating ocular therapy and non-penetrating ocular intervention, have become increasingly prevalent risk factors for SO, and the latent period has increased compared to past reports. Visual prognosis with appropriate medical management is relatively good.
Sympathetic ophthalmia (SO) is often diagnosed when an inflammatory process appears to be advanced. Herein, the authors present the prospective optical coherence tomography (OCT) study of the onset of SO in the sympathizing eye. Prior to any signs of uveitis, we noted the mild disintegration of the retinal pigment epithelium (RPE) layer, the interdigitation zone (IZ), and the ellipsoid zone (EZ). The complete disruption of IZ and EZ was seen 12 weeks later. After 14 weeks, the uveal inflammation was present, and OCT imaging disclosed the formation of nodule-like lesions between the Bruch's membrane and the RPE layer. The histopathological evaluation of the enucleated exciting eye confirmed the diagnosis of SO.
Introduction: Bilateral multifocal retinal pigment epithelium (RPE) detachment is a very rare and serious ocular condition associated with age-related macular degeneration, central serous chorioretinopathy and systemic corticosteroid therapy. RPE detachment has not been yet reported in patients with ankylosing spondylitis (AS), which is a chronic systemic inflammatory disease commonly associated with acute anterior uveitis. In this report, we present an unusual case of bilateral multifocal RPE detachment as the only ocular manifestation in a patient with AS.
Case description: A 34-year-old male patient with human leukocyte antigen-B27 positive AS was evaluated for possible ocular involvement. On posterior segment evaluation, there were several well-circumscribed light yellow, whitish lesions scattered throughout the posterior pole of both fundi. Fluorescein angiography demonstrated multiple well-defined areas of hyperfluorescence at the macula, corresponding to the localised collections of sub-RPE fluid. These findings were confirmed by spectral domain optical coherence tomography as bilateral multifocal RPE detachment. The patient is currently on follow-up for 8 months without any change in number or extent of RPE detachments.
Discussion: This is the first case of AS associated with bilateral multifocal RPE detachment without any anterior segment involvement. This association could be a random coexistence, thus, further clinical studies are needed to reveal the casual relationship between AS and RPE.
Dengue and Chikungunya are viral infections that are a major public health hazard in recent times. Both these infections are caused by RNA viruses termed arboviruses owing to their requirement of an arthropod vector to get transmitted to vertebrate hosts. Apart from sharing a common vector, namely Aedes mosquitoes, these infections are also characterized by overlapping clinical presentations and are known to exist as co-infections. The present review traces the history and evolution of co-infections across the globe and provides specific compilation of the scenario in India. Furthermore, clinical manifestations during co-infections are discussed. Lastly, up-to-date information with respect to vector behaviour during co-infections both under laboratory conditions and in natural Aedes populations is reviewed.
The purpose of this study was to describe the EDI-OCT findings in an acute phase of sympathetic ophthalmia (SO). A 24-year-old gentleman was referred to clinic complaining of progressive blurry vision of his right eye within last 3 days. He had a history of repaired corneoscleral laceration in his left eye followed by lensectomy and anterior vitrectomy approximately 1 month before his recent right eye discomfort. Physical examination revealed a granulomatous uveitis with an exudative RD of the right eye consistent with SO. EDI-OCT was done at initial exam and repeated 1 and 15 months after therapy. EDI-OCT 1 month following therapy showed significant improvement in choroidal thickening and outer retinal cell layers. The choroidal thickness in the right sympathizing eye decreased from 617 to 568 μm and in the left exciting eye from 539 to 521 μm. After 15 month follow-up, choroidal thickness that is reported in EDI-OCT is 436 μm in the right and 382 μm in the left eye. SO should be added to the list of choroidopathies that cause an increase in choroidal thickness in acute phase of disorder with subsequent decrease after therapy, so help us in assessing and estimation of response to treatment.
