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Soon-phaik Chee - One of the best experts on this subject based on the ideXlab platform.

  • Viral Anterior Uveitis.
    Indian journal of ophthalmology, 2020
    Co-Authors: Kalpana Babu, Soon-phaik Chee, Vinaya Kumar Konana, Sudha K Ganesh, Gazal Patnaik, Nicole Shu-wen Chan, Bianka Sobolewska, Manfred Zierhut
    Abstract:

    Viral Anterior Uveitis (VAU) needs to be suspected in Anterior Uveitis (AU) associated with elevated intraocular pressure, corneal involvement, and iris atrophic changes. Common etiologies of VAU include herpes simplex, varicella-zoster, cytomegalovirus, and rubella virus. Clinical presentations can vary from granulomatous AU with corneal involvement, Posner-Schlossman syndrome, Fuchs Uveitis syndrome, and endothelitis. Due to overlapping clinical manifestations between the different viruses, diagnostic tests like polymerase chain reaction and Goldmann-Witmer coefficient analysis on the aqueous humor may help in identifying etiology to plan and monitor treatment.

  • Differential Diagnosis of Viral-Induced Anterior Uveitis
    Ocular immunology and inflammation, 2018
    Co-Authors: Lia Judice M. Relvas, Soon-phaik Chee, Manfred Zierhut, Laure Caspers, Francois Willermain
    Abstract:

    Diagnosis of Uveitis is often challenging, but can be easy in typical viral-induced Anterior Uveitis (VIAU). Associated symptoms and signs are an important source of information. Certain classical clinical features such as keratic precipitates (KPs) distribution, iris atrophy, elevated intraocular pressure (IOP), and unilaterality are commonly used to support the diagnosis of VIAU. However, many etiologies of Anterior Uveitis may to a certain extent mimic VIAU, especially the ones with unilateral granulomatous KPs and elevated IOP. This review begins with how the clinician can differentiate viral from nonviral Anterior Uveitis, and subsequently focuses on the key features which may aid in differentiating among the different viruses that cause VIAU.

  • Clinical Features of CMV-Associated Anterior Uveitis.
    Ocular immunology and inflammation, 2017
    Co-Authors: Nicole Shu-wen Chan, Soon-phaik Chee, Laure Caspers, Bahram Bodaghi
    Abstract:

    Cytomegalovirus (CMV) Anterior Uveitis is the most common ocular manifestation of CMV disease in immunocompetent individuals. It is thought to be due to a local reactivation of latent CMV and is usually unilateral. The acute form presents as Posner-Schlossman Syndrome, a recurrent hypertensive Anterior Uveitis with few granulomatous keratic precipitates. There are geographic differences in the chronic form of CMV Anterior Uveitis. Asian patients commonly present as Fuchs Uveitis Syndrome with diffuse stellate keratic precipitates, while the European patients present with a chronic hypertensive Anterior Uveitis with fewer keratic precipitates that are brown in color and located inferiorly. Characteristic features of CMV Anterior Uveitis include mild Anterior chamber inflammation, elevated intraocular pressure, stromal iris atrophy. Synechiae, macular edema and retinitis are typically absent. CMV disease may also be associated with the development of corneal endotheliitis with a reduced endothelial cell count. Long-term complications include glaucomatous optic neuropathy and cataract formation.

  • Cytomegalovirus Anterior Uveitis
    Emerging Infectious Uveitis, 2017
    Co-Authors: Soon-phaik Chee, Aliza Jap
    Abstract:

    The seroprevalence of Cytomegalovirus (CMV) ranges from 40 to 100 % being highest in less developed areas and is a significant cause of ocular disease both in immunocompromised and immunocompetent persons. CMV retinitis has long been recognized as a major cause of blindness in patients with human immunodeficiency virus infection and perinatally acquired infections. It is increasingly also being found as a potential cause of blindness in immunocompetent persons where it manifests mainly as a hypertensive Anterior Uveitis that has a good response to ganciclovir/valganciclovir but also a high relapse rate. The main reasons for visual loss in CMV Anterior Uveitis are glaucomatous optic neuropathy from refractory or repeated elevations in intraocular pressure and or corneal endothelial damage as the CMV infection also results in endothelial cell loss. Corticosteroids may aggravate the inflammation and should be avoided in hypertensive Uveitis unless a viral infection can be excluded via aqueous sampling for viral nucleic acid and/or evidence of intraocular antibody production.

  • Cytomegalovirus Anterior Uveitis Following Topical Cyclosporine A.
    Ocular immunology and inflammation, 2017
    Co-Authors: Jay Siak, Soon-phaik Chee
    Abstract:

    Cytomegalovirus (CMV) Anterior Uveitis and endotheliitis occurs among immunocompetent individuals and may manifest as Posner-Schlossman syndrome or Fuchs Uveitis syndrome. The condition may first present following ophthalmic surgery, the use of a fluocinolone-sustained steroid drug delivery implant, or the use of topical prostaglandin analogues for the treatment of glaucoma. We report the first case of a non-human immunodeficiency virus-infected individual who presented with CMV Anterior Uveitis after the use of topical cyclosporine A 0.05% ophthalmic emulsion for the treatment of symptomatic dry eyes.

Theresa M Cooney - One of the best experts on this subject based on the ideXlab platform.

  • topical cyclosporine a 0 05 for recurrent Anterior Uveitis
    British Journal of Ophthalmology, 2016
    Co-Authors: Shreya S. Prabhu, Roni M. Shtein, Monica Michelotti, Theresa M Cooney
    Abstract:

    Aim To evaluate the effectiveness of treatment with cyclosporine A 0.05% eye drops in reducing frequency and severity of recurrences in patients with recurrent Anterior Uveitis. Methods A retrospective case-crossover study was conducted by reviewing medical charts of patients treated for recurrent Anterior Uveitis between 2002 and 2011 at the Kellogg Eye Center by one cornea specialist. We identified patients who had been treated with topical cyclosporine A 0.05% and recorded data regarding demographics, episodes of Anterior Uveitis, severity of episodes and treatment modalities before and after initiation of cyclosporine A 0.05%. Results Eight patients were identified as having been treated with topical cyclosporine 0.05% in addition to standard treatment with an average follow-up of 54.9±33.9 months (range: 28–143 months). The patients had statistically significant fewer episodes of Anterior Uveitis, shorter duration of episodes and fewer total days of inflammation per year while on topical cyclosporine 0.05%. Conclusions This study showed improvement of recurrent Anterior Uveitis in patients while on conventional treatment with cyclosporine A 0.05% compared with conventional treatment alone.

  • Topical cyclosporine A 0.05% for recurrent Anterior Uveitis
    The British journal of ophthalmology, 2015
    Co-Authors: Shreya S. Prabhu, Roni M. Shtein, Monica Michelotti, Theresa M Cooney
    Abstract:

    Aim To evaluate the effectiveness of treatment with cyclosporine A 0.05% eye drops in reducing frequency and severity of recurrences in patients with recurrent Anterior Uveitis. Methods A retrospective case-crossover study was conducted by reviewing medical charts of patients treated for recurrent Anterior Uveitis between 2002 and 2011 at the Kellogg Eye Center by one cornea specialist. We identified patients who had been treated with topical cyclosporine A 0.05% and recorded data regarding demographics, episodes of Anterior Uveitis, severity of episodes and treatment modalities before and after initiation of cyclosporine A 0.05%. Results Eight patients were identified as having been treated with topical cyclosporine 0.05% in addition to standard treatment with an average follow-up of 54.9±33.9 months (range: 28–143 months). The patients had statistically significant fewer episodes of Anterior Uveitis, shorter duration of episodes and fewer total days of inflammation per year while on topical cyclosporine 0.05%. Conclusions This study showed improvement of recurrent Anterior Uveitis in patients while on conventional treatment with cyclosporine A 0.05% compared with conventional treatment alone.

James T. Rosenbaum - One of the best experts on this subject based on the ideXlab platform.

  • Evolving "Diagnostic" Criteria for Axial Spondyloarthritis in the Context of Anterior Uveitis.
    Ocular immunology and inflammation, 2016
    Co-Authors: James T. Rosenbaum
    Abstract:

    Anterior Uveitis is far more common than intermediate, posterior or panUveitis. About 50% of patients with acute Anterior Uveitis are HLA B27+. Those who are HLA B27+ are highly likely to have associated back, joint, or tendon disease. The majority of patients with acute Anterior Uveitis and inflammatory low back pain are suffering from axial spondyloarthritis and radiographic evidence for abnormal sacroiliac joints is not required to make this diagnosis. Received 12 October 2015; revised 31 January 2016; accepted 16 February 2016; published online 12 April 2016.

  • Risk of Relapse in Primary Acute Anterior Uveitis
    Ophthalmology, 2011
    Co-Authors: Lili Grunwald, James T. Rosenbaum, Craig Newcomb, Ebenezer Daniel, R. Oktay Kaçmaz, Douglas A. Jabs, Grace A. Levy-clarke, Robert B. Nussenblatt, Eric B. Suhler, Jennifer E. Thorne
    Abstract:

    Purpose To evaluate the risk of and risk factors for a second episode (relapse) among patients with remitted primary Anterior Uveitis. Design Retrospective cohort study. Participants Patients with primary Anterior Uveitis presenting to 1 of 4 academic ocular inflammation subspecialty practices achieving remission of the primary episode within 90 days of initial Uveitis diagnosis. Methods Data were obtained by standardized chart review. Main Outcome Measures Time to relapse of Anterior Uveitis and risk factors for relapse. Results We included 102 patients with a first episode of Anterior Uveitis who were seen within 90 days of first-ever Uveitis onset and followed for 165 person-years after achieving remission of the initial episode. Most patients were female (60%) and white (78%). Forty patients had a recurrence of Anterior Uveitis. The incidence of relapse was 24% per person-year (95% confidence interval [CI], 17%–33%). At 1.5 years after remission, 61% (95% CI, 48%–71%) were still in remission. Younger adults had significantly higher relapse risk than middle-aged adults (hazard ratio [18- to 35-year-old persons vs. 35- to 55-year-old persons], 2.7; 95% CI, 1.3–6.0). Conclusions Our results suggest that many patients with remitted primary Anterior Uveitis presenting for tertiary Uveitis care will relapse. Age in the young adult range was associated with higher risk of relapse. Given the high relapse risk, management of patients with primary Anterior Uveitis should include an explicit plan for detecting and managing relapses. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

  • Anterior Uveitis: current concepts of pathogenesis and interactions with the spondyloarthropathies.
    Current Opinion in Rheumatology, 2002
    Co-Authors: Tammy M. Martin, Justine R. Smith, James T. Rosenbaum
    Abstract:

    Anterior Uveitis describes inflammation that involves the iris or ciliary body. Anterior Uveitis may be part of a systemic illness such as a spondyloarthropathy. It may also arise from an infection such as herpes simplex; be part of an ocular syndrome, such as Fuchs' heterochromic iridocyclitis; be part of trauma, as in cataract surgery; or result from an idiopathic eye disease with a presumed immune pathogenesis. During 2001, progress has been made understanding Uveitis in general, as well as specifically, in association with spondyloarthropathy. Here, we review recent insights into Anterior Uveitis with regard to clinical presentation, immune mechanisms, genetics, and anti-tumor necrosis factor therapy.

  • Acute Anterior Uveitis and spondyloarthropathies.
    Rheumatic diseases clinics of North America, 1992
    Co-Authors: James T. Rosenbaum
    Abstract:

    An acute onset, unilateral Anterior Uveitis occurs during the course of either Reiter's syndrome or ankylosing spondylitis. Conversely, many patients who suffer from an acute Anterior Uveitis are HLA-B27-positive and have associated joint disease. The consistent presentation of the Uveitis can aid in the process of differential diagnosis. This article includes a discussion of the recognition of the characteristic presentation, the complications, the role of B27 testing, the relevance of animal models, the pathogenesis, and treatment.

M Zierhut - One of the best experts on this subject based on the ideXlab platform.

  • The Project of “Virus-induced Anterior Uveitis”
    Acta Ophthalmologica, 2011
    Co-Authors: M Zierhut
    Abstract:

    Purpose To summarize the clinical signs of virus-induced Anterior Uveitis and to compare our understanding with the results of a Symposium recently hold in Berlin, comparing proven to unproven cases of herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (clinically like Posner-Schlosman Syndrome), and rubella virus (clinically the picture of Fuchs heterochromic Uveitis). Methods Presentation of typical signs and symptoms of Anterior Uveitis which may be viral induced. This will include secondary glaucoma, keratitis, iris color changes, synechiae, complications like cataract and macular edema. Results Typically viral induced Anterior Uveitis only sometimes leads to posterior synechiae (HSV, VZV), mostly to a mild Anterior chamber inflammation, and very rarely to macular edema Conclusion We plan a worldwide prospective trial for reaching more information about the role of virus in Anterior Uveitis, with tap of the Anterior chamber and evaluation of the antigen and the antibody response.

George L. Spaeth - One of the best experts on this subject based on the ideXlab platform.

  • Metipranolol-associated nongranulomatous Anterior Uveitis.
    American journal of ophthalmology, 1997
    Co-Authors: Niraj P. Patel, Ketan H. Patel, Marlene R. Moster, George L. Spaeth
    Abstract:

    Purpose To describe the findings in a patient with a nongranulomatous Anterior Uveitis, presumed to be induced by metipranolol. Method A 69-year-old woman developed bilateral, nongranulomatous, Anterior Uveitis while undergoing treatment with metipranolol 0.3% for primary open-angle glaucoma. Four months after resolution of the initial episode, the patient was challenged with metipranolol 0.3% in the right eye. Result On reinstituting metipranolol 0.3%, the patient once again developed a unilateral, nongranulomatous, Anterior Uveitis in the challenged eye. Conclusion Metipranolol 0.3% eyedrops, used to treat primary open-angle glaucoma, appear to cause a nongranulomatous Anterior Uveitis.