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Lawrence A Yannuzzi - One of the best experts on this subject based on the ideXlab platform.

  • multimodal imaging of multifocal Chorioretinitis secondary to endogenous candida infection
    International Ophthalmology, 2019
    Co-Authors: Chiara Veronese, Chiara Maiolo, Annalisa Gurreri, Mariachiara Morara, Antonio P Ciardella, Lawrence A Yannuzzi
    Abstract:

    To present multimodal imaging of multifocal Chorioretinitis secondary to endogenous candida infection in a young adult. A 49-year-old woman who presented for evaluation of bilateral endogenous candida Chorioretinitis underwent complete ophthalmic examination, in addition to fundus photography (FP), enhanced depth imaging optical coherence tomography, fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA). Multimodal imaging of both eyes of the patient affected by endogenous candida Chorioretinitis was performed. FP showed multiple white chorioretinal lesions at the posterior pole, FAF showed dark dot at the posterior pole surrounded by hyperautofluorescence area, FA showed early hyperfluorescence round perifoveal lesion at the posterior pole and small hyperfluorescence dots under the inferior retinal vessels. Early ICGA showed hypofluorescence dots at the posterior pole. Late ICGA showed dark hypofluorescence dots at the posterior pole surrounded by faint hyperautofluorescent ring. OCTA showed dark areas corresponded to hypoperfusion areas seen with early ICGA. We reported multimodal imaging of an unusual occurrence of multifocal Chorioretinitis due to immunosuppression. These findings suggested that the infection resulted from choroidal infiltration via the short posterior ciliary arteries with resultant breakthrough into the retina, rather than via the central retinal artery. By comparing findings on OCTA with data obtained from traditional systems, we are gaining essential information on the pathogenesis of endogenous candida Chorioretinitis.

  • acute syphilitic posterior placoid Chorioretinitis report of a case series and comprehensive review of the literature
    Retina-the Journal of Retinal and Vitreous Diseases, 2012
    Co-Authors: Chiara M Eandi, Ron A. Adelman, Lawrence A Yannuzzi, Piergiorgio Neri, Emmett T Cunningham
    Abstract:

    Purpose:To describe the clinical and angiographic features of a series of patients with acute syphilitic posterior placoid Chorioretinitis (ASPPC) in the context of previously published cases.Methods:A retrospective, noncomparative, multicenter chart review was performed on 16 patients with active A

  • relentless placoid Chorioretinitis a new entity or an unusual variant of serpiginous Chorioretinitis
    Archives of Ophthalmology, 2000
    Co-Authors: Lee M. Jampol, Lawrence A Yannuzzi, Janet L Davis, Eric B Jones, Michael Tittl, Mark W Johnson, Dennis P Han, David F Williams
    Abstract:

    Objective: To characterize an unusual clinical entity resembling acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis but with an atypical clinical course. Patients: We describe 6 patients, aged 17 through 51 years, exhibiting this unusual entity who were seen at 6 different centers from 1984 to 1997. Results: The acute retinal lesions in this series were similar to those of APMPPE or serpiginous choroiditis, both clinically and on fluorescein and indocyanine green angiography. However, the clinical course, number of lesions, and location of these lesions were atypical. These patients had evidence of numerous posterior and peripheral retinal lesions predating or occurring simultaneously with macular involvement. Older, healing pigmented lesions were often accompanied by the appearance of new active white placoid lesions. Additionally, these cases all demonstrated prolonged periods of activity resulting in the appearance of more than 50 and sometimes hundreds of lesions scattered throughout the fundus. Growth of subacute lesions and the appearance of new lesions continued for 5 to 24 months after initial examination, and relapses were common. Conclusions: This entity has clinical features similar to APMPPE and serpiginous choroiditis but has a prolonged progressive clinical course and widespread distribution of lesions. It may represent a variant of serpiginous choroiditis or may be a new entity. We call it relentless placoid Chorioretinitis.

Emmett T Cunningham - One of the best experts on this subject based on the ideXlab platform.

Jennifer E Thorne - One of the best experts on this subject based on the ideXlab platform.

  • classification criteria for birdshot Chorioretinitis
    American Journal of Ophthalmology, 2021
    Co-Authors: Douglas A Jabs, Antoine P Brezin, Ralph D Levinson, Peter Mccluskey, Neal Oden, Alan G Palestine, Russell W Read, Jennifer E Thorne, Brett E Trusko, Albert T Vitale
    Abstract:

    Purpose To determine classification criteria for birdshot Chorioretinitis. Design Machine learning of cases with birdshot Chorioretinitis and 8 other posterior uveitides. Methods Cases of posterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the infectious posterior/panuveitides. The resulting criteria were evaluated on the validation set. Results One thousand sixty-eight cases of posterior uveitides, including 207 cases of birdshot Chorioretinitis, were evaluated by machine learning. Key criteria for birdshot Chorioretinitis included a multifocal choroiditis with: 1) the characteristic appearance a bilateral multifocal choroiditis with cream-colored or yellow-orange, oval or round choroidal spots ("birdshot" spots); 2) absent to mild anterior chamber inflammation; and 3) absent to moderate vitreous inflammation; or multifocal choroiditis with positive HLA-A29 testing and either: 1) classic "birdshot spots" or 2) characteristic imaging on indocyanine green angiography. Overall accuracy for posterior uveitides was 93.9% in the training set and 98.0% (95% confidence interval 94.3, 99.3) in the validation set. The misclassification rates for birdshot Chorioretinitis were 10% in the training set and 0% in the validation set. Conclusions The criteria for birdshot Chorioretinitis had a low misclassification rate and appeared to perform sufficiently well for use in clinical and translational research.

  • spectral domain optical coherence tomography findings in acute syphilitic posterior placoid Chorioretinitis
    Journal of Ophthalmic Inflammation and Infection, 2014
    Co-Authors: Bryn M Burkholder, Jennifer E Thorne, Theresa G Leung, Trucian A Ostheimer, Nicholas J Butler, James P Dunn
    Abstract:

    Background We describe the spectral domain optical coherence tomography (SD-OCT) findings in three patients with acute syphilitic posterior placoid Chorioretinitis (ASPPC). The SD-OCT images demonstrate the pathologic changes in ASPPC with a high level of anatomic detail and may provide information about the pathophysiology of the disease.

  • postoperative outcomes after fluocinolone acetonide implant surgery in patients with birdshot Chorioretinitis and other types of posterior and panuveitis
    Retina-the Journal of Retinal and Vitreous Diseases, 2013
    Co-Authors: Bryn M Burkholder, Quan Dong Nguyen, Jiangxia Wang, James P Dunn, Jennifer E Thorne
    Abstract:

    Purpose To evaluate outcomes following placement of fluocinolone acetonide (FA) implants in eyes with Birdshot Chorioretinitis (BSCR) and to compare these outcomes with eyes with posterior and panuveitis.

Thomas G. Ksiazek - One of the best experts on this subject based on the ideXlab platform.

  • Congenital lymphocytic choriomeningitis virus: an underdiagnosed cause of neonatal hydrocephalus.
    The Pediatric infectious disease journal, 2006
    Co-Authors: Danica Jenine Schulte, Thomas G. Ksiazek, James A. Comer, Bobbie R. Erickson, Pierre E. Rollin, Stuart T. Nichol, Deborah Lehman
    Abstract:

    We report a case of congenital hydrocephalus caused by lymphocytic choriomeningitis virus with severe neurologic sequelae, including hydrocephalus, Chorioretinitis, blindness and developmental delay. This is the first report of lymphocytic choriomeningitis virus isolation in the cerebrospinal fluid of a congenitally infected infant.

  • Lymphocytic choriomeningitis virus: an underdiagnosed cause of congenital Chorioretinitis.
    American journal of ophthalmology, 2000
    Co-Authors: Marilyn B. Mets, Leslie L. Barton, Ali S. Khan, Thomas G. Ksiazek
    Abstract:

    Abstract PURPOSE: To elucidate the role and clinical spectrum of congenital lymphocytic choriomeningitis virus infection as a cause of chorioretinopathy, congenital hydrocephalus, and macrocephaly or microcephaly in the United States. METHODS: We performed complete ophthalmologic surveys of all residents at Misericordia, a home for the severely mentally retarded in Chicago, and prospectively evaluated all patients with Chorioretinitis or chorioretinal scars during a 36-month period at Children's Memorial Hospital, also located in Chicago. Sera for patients demonstrating chorioretinal scars (a sign of intrauterine infection) were tested for Toxoplasma gondii , rubella virus, cytomegalovirus, and herpes simplex virus and lymphocytic choriomeningitis virus antibodies. RESULTS: Four of 95 patients examined at the home had chorioretinal scars, and two of these patients had normal T. gondii , rubella virus, cytomegalovirus, and herpes simplex virus titers and dramatically elevated titers for lymphocytic choriomeningitis virus. Three of 14 cases of Chorioretinitis at the hospital had normal T. gondii , rubella virus, cytomegalovirus, and herpes sim-plex virus titers and elevated lymphocytic choriomeningitis virus antibody titers. (A fourth case, diagnosed in 1996, was reported 2 years ago.) CONCLUSIONS: Lymphocytic choriomeningitis virus was responsible for visual loss in two of four children secondary to Chorioretinitis in a population of severely retarded children. The six new cases of lymphocytic choriomeningitis virus Chorioretinitis identified in these two populations over the last 3 years, compared with the total number ever reported in the United States (10 cases), suggests that lymphocytic choriomeningitis virus may be a more common cause of congenital Chorioretinitis than previously believed. Because its consequences for visual and psychomotor development are devastating, we conclude that the workup for congenital Chorioretinitis should include lymphocytic choriomeningitis virus serology, especially if T. gondii , rubella virus, cytomegalovirus, and herpes simplex virus titers are negative.

Janet L Davis - One of the best experts on this subject based on the ideXlab platform.

  • diagnostic approaches to severe atypical toxoplasmosis mimicking acute retinal necrosis
    Ophthalmology, 2004
    Co-Authors: Darius M Moshfeghi, Emilio M. Dodds, Careen Y. Lowder, Cristobal Couto, Carmen Santos, Don H Nicholson, Janet L Davis
    Abstract:

    Abstract Purpose To describe the means of diagnosis and clinical features of atypical toxoplasmic Chorioretinitis mimicking acute retinal necrosis. Design Observational case series. Participants Twenty-two patients (25 eyes) with widespread Chorioretinitis resulting from toxoplasmosis examined between 1990 and 2001. Testing Patients were diagnosed by various techniques, including polymerase chain reaction (PCR) of aqueous and vitreous, serum and intraocular antibody determination, culture of intraocular fluid, retinal biopsy, histopathologic examination, therapeutic trial of antibiotics active against toxoplasmosis, or a combination thereof. Main outcome measures The primary outcome measure was diagnosis of disseminated toxoplasmic Chorioretinitis by any combination of tests or by empiric use of specific antibiotics. The secondary outcome measure was visual and anatomic outcome of treatment. Results Mean age was 53.5 years (range, 19–77 years), with a median of 59.5 years. There were 9 women and 13 men. Six patients were infected with HIV, and 3 patients, 1 with HIV, had bilateral disease. Mean initial vision was 20/110 (median, 20/400; range, 20/20 to no light perception [NLP]). Sixteen patients (73%) had received oral or injectable corticosteroids and 11 (50%) had received antiviral therapy before the diagnosis of toxoplasmosis. Diagnosis was made solely by clinical response to antitoxoplasmosis medications in 4 patients. Sixteen patients were diagnosed based on evaluation of intraocular fluids and tissue by antibody determinations, culture, PCR, histopathologic examination, or a combination thereof. Visual acuity improved after treatment in 7 of 25 eyes (28%). Mean final visual acuity was 20/156 (median, 20/2500; range, 20/30 to NLP). Anatomically, 18 of 23 eyes with follow-up had healed or improved Chorioretinitis. Retinitis was progressive in 1 eye, 2 eyes were enucleated, and 2 were phthisical. Conclusions Diagnosis of atypical toxoplasmic Chorioretinitis that mimics viral retinitis can be accomplished by several means. Prompt diagnosis may help avoid poor visual and anatomic outcomes after prolonged initial treatment with oral prednisone or antiviral medications.

  • relentless placoid Chorioretinitis a new entity or an unusual variant of serpiginous Chorioretinitis
    Archives of Ophthalmology, 2000
    Co-Authors: Lee M. Jampol, Lawrence A Yannuzzi, Janet L Davis, Eric B Jones, Michael Tittl, Mark W Johnson, Dennis P Han, David F Williams
    Abstract:

    Objective: To characterize an unusual clinical entity resembling acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis but with an atypical clinical course. Patients: We describe 6 patients, aged 17 through 51 years, exhibiting this unusual entity who were seen at 6 different centers from 1984 to 1997. Results: The acute retinal lesions in this series were similar to those of APMPPE or serpiginous choroiditis, both clinically and on fluorescein and indocyanine green angiography. However, the clinical course, number of lesions, and location of these lesions were atypical. These patients had evidence of numerous posterior and peripheral retinal lesions predating or occurring simultaneously with macular involvement. Older, healing pigmented lesions were often accompanied by the appearance of new active white placoid lesions. Additionally, these cases all demonstrated prolonged periods of activity resulting in the appearance of more than 50 and sometimes hundreds of lesions scattered throughout the fundus. Growth of subacute lesions and the appearance of new lesions continued for 5 to 24 months after initial examination, and relapses were common. Conclusions: This entity has clinical features similar to APMPPE and serpiginous choroiditis but has a prolonged progressive clinical course and widespread distribution of lesions. It may represent a variant of serpiginous choroiditis or may be a new entity. We call it relentless placoid Chorioretinitis.