Laura Pelegrín

Hospital Clínic de Barcelona · Servicio de Oftalmología

Background: Undifferentiated autoinflammatory diseases are characterized by recurrent or persistent fever, usually combined with other inflammatory manifestations, and negative or inconclusive genetic studies for monogenic autoinflammatory disorders. Aims: To define and characterize disease phenotypes in adult patients diagnosed in an adult refere...

Introduction Non-infectious inflammatory ocular diseases pose significant challenges in diagnosis and management, often requiring systemic immunosuppressive therapy. Since Janus kinase (JAK) inhibitors may represent a novel therapeutic option for these disorders, the present study aimed to expand current knowledge about their efficacy and safety in...

Purpose Hydroxychloroquine is currently recommended for the treatment of systemic lupus erythematosus (SLE), but it can cause irreversible retinal toxicity. This study aimed to identify factors associated with early hydroxychloroquine-induced retinal toxicity in patients with SLE from a single centre for 20 years. Methods SLE patients diagnosed be...

Objective To compare multimodal structural and functional diagnostic methods in patients with systemic lupus erythematosus (SLE) treated with hydroxychloroquine, to identify the best complementary approach for detecting subclinical retinal toxicity. Methods A cross-sectional, unicentric study was conducted on patients with SLE treated with hydroxy...

Background Microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are the two major antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitis (AAV). Objectives To characterize a homogenous AAV cohort and to assess the impact of clinicopathological profiles and ANCA serotypes on clinical presentation and prognosis. Clinica...

Background: Microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are the two major antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Objectives: To characterize a homogenous AAV cohort and to assess the impact of clinicopathological profiles and ANCA serotypes on clinical presentation and prognosis. Clini...

Autoinflammatory diseases include disorders with a genetic cause and also complex syndromes associated to polygenic or multifactorial factors. Eye involvement is present in many of them, with different extent and severity. The present review covers ophthalmological lesions in the most prevalent monogenic autoinflammatory diseases, including FMF (fa...

Since many biological drug patents have expired, biosimilar agents (BIOs) have been developed; however, there are still some reservations in their use, especially in childhood. The aim of the current study is to evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibitors BIOs as treatment for pediatric non-infectious uveitis (NIU). D...

Objectives: Ophthalmologic involvement in monogenic autoinflammatory diseases has been explored mainly in paediatric patients. The aim of this study is to characterise ophthalmologic manifestations, therapeutic management and visual outcomes in a Spanish (UVESAI) cohort of adult/paediatric patients with monogenic autoinflammatory diseases. Method...

Purpose This study assessed the effectiveness of the 0.19-mg fluocinolone acetonide (FAc) implant by multimodal measurements in patients with non-infectious uveitis (NIU) in a real-world setting in Spain. Methods A prospective study of patients who had NIU including uveitic macular oedema (UME) with ≥ 12 months follow-up was done. Exclusion criter...

Purpose This assessed the effectiveness of the 0.19 mg fluocinolone acetonide (FAc) implant by multimodal measurements in patients with non-infectious uveitis (NIU) in a real-world setting in Spain. Methods A prospective study of patients who had NIU including uveitic macular oedema (UME) with ≥ 12 months follow-up was done. Exclusion criteria incl...

Objectives: The aim of the present study was to detect preclinical changes in SLE patients in retinal microvascularization or retinal and optical nerve structure by optical coherence tomography. Methods: This cross-sectional, single-center study aimed to describe structural changes (macular and retinal nerve fiber layer [RNFL] thickness) by stru...

Background Because of the efficacy and good safety profile of antimalarials in systemic lupus erythematosus (SLE), hydroxychloroquine (HCQ) is currently recommended in all SLE patients. However, patients’ compliance was reported as suboptimal. This study aims to elucidate the reasons for discontinuing antimalarials in a large series of SLE patients...

Cystoid macular edema (CME) is the most common cause of decreased visual acuity after both vitrectomy and cataract surgery. Various strategies have been used for its treatment, such as intravitreal corticosteroids. The intravitreal fluocinolone acetonide implant (Iluvien ® ) is approved for the treatment of persisting diabetic macular edema and for...

Purpose: To describe clinical and ophthalmological features, and outcomes of COVID-19 patients with retinal vascular occlusions. Methods: Retrospective multicenter case series and PubMed review of cases reported from March 2020 until September 2021. Outcome measures: type of occlusion, treatments, best corrected visual acuity (BCVA) and central...

Aim: To describe and evaluate the efficacy of Ahmed glaucoma valve implantation (AGV) combined with pars plana vitrectomy (PPV) in a single surgical act for the treatment of advanced neovascular glaucoma (NVG). Methods: Retrospective observational case series included 51 eyes from 50 patients with severe NVG treated with PPV, AGV, and panretinal...

Background: This study aims at describing the therapeutic outcome of patients carrying the R92Q variant in the TNFRSF1A gene treated with anakinra (ANA) or canakinumab (CAN) and identifying any factors predictive of complete response to IL-1 inhibition. Methods: Clinical data of patients treated with ANA or CAN for recurrent inflammatory attacks...

Antimalarials are first-line therapies in the management of systemic lupus erythematosus (SLE). Their immunomodulatory effects have been proven and are generally safe. Hydroxychloroquine (HCQ) has the best safety profile of these therapies. However, antimalarial retinopathy can lead to irreversible loss of vision. It is associated more frequently w...

Objectives: To evaluate the efficacy of tumour necrosis factor (TNF)-α inhibitors in refractory non-infectious scleritis. Methods: We carried out a retrospective study assessing the efficacy of TNF-α inhibitors in the treatment of scleritis, scleritis relapses, glucocorticoid (GC)-sparing effect, impact on best-corrected visual acuity (BCVA) and...

Objective: To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, a...

Ocular alterations induced by altitude include retinopathy, papilledema, and increased corneal thickness. Alterations in the permeability of blood-brain-retinal barriers have a crucial role in the pathophysiology of the eye at high-altitude hypoxia. Eleven trekkers (9♂, 2♀) aged 22-58 years were studied using optical coherence tomography (OCT; swep...

Purpose: To study the risk factors for visual loss in presumed tuberculosis-related uveitis (TRU). Methods: Retrospective observational cohort study of patients with TRU, either treated or not for tuberculosis, from January 2005 to January 2017. Clinical and demographic variables were recorded. Main outcome measure was a loss of visual acuity (VA)...

Background Background Peripheral ulcerative keratitis (PUK) is a corneal crescent-shaped inflammatory damage with/without concomitant scleritis. PUK can occur isolated or as part of an underlying systemic disease (SD). Objectives Objective To characterise a cohort of PUK patients with a long-term follow-up and to evaluate clinical (ocular and sy...

Isolated retinal vasculitis (IRV) is a primary sight-threatening condition involving the retinal vessels, mostly veins. It affects more frequently women in the third to fourth decades, with predominance of bilateral ocular involvement. Visual prognosis relies on the presence of ischemic lesions, macular edema and the involvement of central retinal...

A 37-year-old female presented with severe apraxia of lid opening (ALO) affecting the right upper lid associated with Becker congenital myotonia (MC). The patient had a history of right upper lid ptosis for 25 years that was exacerbated over the previous month with severe incapacity to open her right eye. No other associated neurological or ophthal...

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of...

Introduction: Isolated retinal vasculitis (IRV) is an inflammatory condition of unknown etiology confined to the retinal vessels. In contrast to secondary retinal vasculitis (RV), IRV has not been well characterized. Objective: To describe and characterize isolated forms of RV. Methods: We performed a retrospective review (2006-2016) of IRV pa...

Background Uveitis is defined as inflammation of the uvea. As standardized and validated outcome measures are lacking in uveitis management. Objectives To develop a disease activity score for patients with uveitis and determine its discriminating ability to classify patients based on the level of activity. Methods Multicenter cross-sectional obse...

PurposeTo compare dexamethasone (DEX) intravitreal implant effect in non-vitrectomized (non-PPV) vs vitrectomized (PPV) eyes with macular edema (ME) secondary to non-infectious uveitis.Methods Medical records of patients with uveitic ME treated with DEX-intravitreal implant were reviewed. Main outcome measures were changes in central retinal thickn...

PurposeTo quantify the proportion of regulatory T cells (Treg) and cytokine expression by peripheral blood mononuclear cells (PBMCs) in patients with active non-infectious uveitis, and to evaluate the effect of in vitro treatment with infliximab, dexamethasone, and cyclosporine A on Treg levels and cytokine production in PBMCs from uveitis patients...

Purpose To identify clinical outcomes and treatment patterns of intravitreal dexamethasone implant (Ozurdex®) in non-infectious uveitis in the clinical setting. Design Multicenter retrospective cohort study. Methods 82 eyes (63 patients) receiving 142 implant injections over 35 months were included. Treatment indication, uveitis diagnosis, visual...

A 72 year old man presented with signs on uveítis. Biopsy of an iris lesión established the diagnosis of uveal MALT lymphoma with presumed choroidal involvement.

Purpose: To evaluate the long-term visual prognosis and complications of patients who received intravitreal Ozurdex injections for the treatment of non-infectious uveitic macular edema (UME). Methods: A retrospective study of 32 patients with UME refractory to systemic and intraocular therapies were treated with intravitreal dexamethasone. Vitrecto...

Purpose: To describe the diverse patterns observed with the use of Ultra-wide-field images in patients with Birdshot chorioretinopathy (BSCR) Methods: A chart review of patients with BSCR seen at Clinic Hospital of Barcelona, who had ultra-wide-field images including retinography, autofluorescence fundus photography and angiography. The data obtain...

Purpose: To evaluate clinical features of patients with scleritis of unknown origin and positive QuantiFERON-TB Gold test (quantiferon) Methods: Retrospective review of clinical, laboratory, and therapeutic outcome data of 12 patients with scleritis and positive quantiferon. Quantiferon was ordered in patients with clinically suspected tuberculosis...

Clinic case Two patients with systemic lupus erythematosus presented with vision loss, and were diagnosed with retinal vasculopathy. Patient 1 had occlusive vasculitis with macular oedema and retinal ischaemia in the right eye. Corticosteroid therapy was increased and intravenous rituximab added. Intravitreal therapy and panretinal photocoagulation...

Background Over the past decade, the off-label use of biologic agents such as TNF-a antagonists has improved the treatment armamentarium for refractory immune-mediated uveitis, with particular success in Behçet’s disease associated uveitis. Objectives To assess the long-term efficacy and safety of TNF-a antagonists (infliximab, [IFX]; adalimumab, [...

To report the efficacy of rituximab (RTX) in the treatment of ocular or orbital inflammation accompanying autoimmune diseases refractory to previous standard immunosuppressive therapy. We reviewed medical records of 9 consecutive patients with noninfectious ocular or orbital inflammation treated with RTX. Over a mean followup of 42 months, 7 patien...

Purpose: Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and is associated with considerable morbidity. The aim of this study was to examine the risk factors associated with uveitis in oligoarticular JIA. Methods: We conducted a chart review of 86 patients with oligoarticular JIA to assess if antin...

This retrospective study investigated the efficacy of tocilizumab (TCZ), a fully humanized antibody that binds both to soluble and membrane bound IL-6 receptors, for the treatment of uveitis-related cystoid macular edema (CME) refractory to immunomodulatory therapy. Five refractory patients with uveitis-related CME who received TCZ between January...

Toxoplasma gondii infection is an important cause of ocular disease. Although parasite-mediated host cell lysis is probably the principal cause of tissue destruction in immunodeficiency states, hypersensitivity and inflammatory responses may underlie severe disease in otherwise immunocompetent individuals. The purpose of the current investigation w...

Purpose To assess the long-term efficacy and safety of tumour necrosis factor alpha (TNF-a) antagonists (infliximab, [IFX]; adalimumab, [ADA]; and golimumab [GLM]) for the treatment of patients with Behçet's disease (BD) and uveitis who failed to respond or did not tolerate conventional immunosuppressive (IS) treatment. Methods Retrospective study...

Purpose: To describe the inflammatory ocular manifestations of patients with systemic lupus erythematosus (SLE) at a multidisciplinary uveitis unit Methods: Retrospective chart review of patients with SLE in a tertiary referral center between 2007 and 2012 was performed. All patients have undergone complete rheumatologic and ophthalmic examination...

Purpose To evaluate the effects of intravitreal dexamethasone (DEX) implant (Ozurdex®; Allergan, Inc., Irvine, CA) for the treatment of persistent uveitic macular edema (ME) Methods Medical records of 37 patients with persistent uveitic ME treated with intravitreal DEX implant were reviewed. Patients had an inadequate control of ME despite differen...

Purpose: To evaluate circulating regulatory T-cell (Treg) levels and cytokine production by peripheral blood mononuclear cells (PBMC) in patients with active non-infectious uveitis and to evaluate the effect of in vitro treatment with infliximab, dexamethasone, and cyclosporine on Treg levels and cytokine production in PBMC from uveitis and healthy...

Purpose: To report spectral-domain optical coherence tomographic (OCT) findings during the natural history of a sub-internal limiting membrane (sub-ILM) hemorrhage. Methods: Observational case report of a 20-year-old man with myeloid acute leukemia who presented a spontaneous resolution of a premacular hemorrhage, which was demonstrated by OCT....

Background Systemic lupus erythematosus (SLE) can affect all structures of the eye and ocular adnexa. The most common ocular findings include dry eye and retinal vascular changes. Objectives To describe the inflammatory ocular manifestations of patients with systemic lupus erythematosus (SLE) at a multidisciplinary uveitis unit. Methods Retrospecti...

Purpose To describe the adulthood uveitis pattern in our geographic area. Recent demographic, environmental and scientific changes could determine uveitis pattern changes that we aim to investigate. Methods A cross-sectional study between 1st January 2009 and 30th June 2012 was done. All uveitis patients visited at our institution were included. Ex...

Background/Aims: To analyze the clinical pattern of ocular toxoplasmosis in a referral center in Spain. Methods: The medical records of consecutive patients with ocular toxoplasmosis admitted from a single referral center for uveitis in Barcelona (Spain) were retrospectively analyzed between January 2005 and January 2011. Results: One hundred and t...

Purpose: To evaluate the safety and efficacy of Ozurdex (dexamethasone intravitreal implant) 0.7 mg in the treatment of uveitic macular edema in vitrectomized eyes. Methods: Data from 13 patients (17 eyes) with persistent uveitic cystoid macular edema and a history of pars plana vitrectomy in the study eyes that were treated with intravitreal in...

Abstract Over the past decade, the off-label use of biologic agents such as TNF-α antagonists, including infliximab and adalimumab, has improved the treatment armamentarium for refractory immune-mediated uveitis, with particular success in Behçet disease-associated uveitis. Golimumab is a novel fully human anti-TNF-α monoclonal antibody that has be...

Purpose: To evaluate clinical and paraclinical parameters for the indirect diagnosis of tuberculosis-related uveitis (TRU). Methods: Prospective 2-year study in a tertiary referral centre. Patients with clinically suspected TRU were recruited. Demographical and clinical data were recorded. QuantiFERON®-TB Gold (QFT), tuberculosis skin test (TST) an...

Two patients with systemic lupus erythematosus presented with vision loss, and were diagnosed with retinal vasculopathy. Patient 1 had occlusive vasculitis with macular oedema and retinal ischaemia in the right eye. Corticosteroid therapy was increased and intravenous rituximab added. Intravitreal therapy and panretinal photocoagulation were perfor...

Objective: To describe the epidemiology, clinical features and visual prognosis in uveitis associated with demyelinating disease (DD) of the CNS. Methods: A clinical, retrospective, and descriptive study was performed. Data regarding age at presentation, gender, time from onset was recorded, as well as, type of uveitis, complications, treatment...

Purpose. To evaluate the role of pars plana vitrectomy (PPV) for the treatment of vitreoretinal complications of ocular Behçet disease (BD). Methods. Retrospective review of the medical records of all patients who underwent PPV for vitreoretinal complications of Behçet uveitis in the Ophthalmology Department of the Hospital Clinic of Barcelona, Ba...

Purpose: Toxoplasma gondii infection is an important cause of ocular disease. Although parasite-mediated host cell lysis is probably the principal cause of tissue destruction in immunodeficiency states, hypersensitivity and inflammatory responses may underlie severe disease in otherwise immunocompetent individuals.

Purpose: To evaluate clinical and paraclinical parameters for the indirect diagnosis of tuberculosis-related uveitis (TRU). To investigate binary classification tests and concordance between tuberculosis skin test (TST) and QuantiFERON®-TB Gold (QF). Methods: Prospective 2-year study in a tertiary referral center in Spain. Patients with clinically...

Purpose: : To evaluate the role of pars plana vitrectomy (PPV) for the treatment of vitreoretinal complications of ocular Behçet's disease (BD). Methods: : Retrospective review of the medical records of all patients who underwent PPV for vitreo-retinal complications of ocular BD in the

To describe the uveitis pattern in our geographic area. Recent demographic, environmental and scientific changes can determine uveitis pattern changes, which we aim to investigate. A cross-sectional study between 1(st) January 2009 and 30(th) June 2010 was done. All uveitis patients visited at our institution were included. Anatomical (IUSG & SUN)...

Bilateral ocular ischemic syndrome and ischemic optic neuropathy have rarely been reported as initial manifestations of Takayasu arteritis (TA). Appearance of ocular symptoms in TA is related to the extent and severity of involvement of the aorta and its major branches. We report a case of bilateral ocular ischemic syndrome with unilateral ischemic...

To evaluate the anatomical and functional outcomes of pars plana vitrectomy (PPV) in the treatment of vitreoretinal complications of birdshot chorioretinopathy (BCR). The clinical records of 9 consecutive patients (16 eyes) with vitreo retinal complications in BCR refractory to medical therapy who underwent pars plana vitrectomy were reviewed. Indi...

We report the case of a 52-year-old woman with advanced colorectal cancer who was treated with oxaliplatin on a FOLFOX schedule. After 3 cycles of chemotherapy, she started to complain of visual loss, altered color vision and neurological symptoms. Due to the suspicion of ocular and neurological toxicity, antineoplastic treatment was stopped. Her v...

Objective: To evaluate the effect of pars plana vitrectomy in the management of patients with pars planitis. Methods: A retrospective analysis of the clinical course, post-operative complications and recurrent uveal inflamation following pars plana vitrectomy in patients with pars planitis. Results: The study included 22 eyes of 19 patients. The me...

To determine the efficacy of infliximab treatment in refractory posterior uveitis in Behçet's disease after withdrawal of infusions. Four patients with posterior uveitis secondary to Behçet's disease were treated with infliximab until complete remission and were followed after withdrawal of infusions. Intra-ocular inflammation was assessed using th...

To evaluate the effect of pars plana vitrectomy in the management of patients with pars planitis. A retrospective analysis of the clinical course, post-operative complications and recurrent uveal inflammation following pars plana vitrectomy in patients with pars planitis. The study included 22 eyes of 19 patients. The mean follow-up was 55.7 (± 39....