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Nilufer Berker - One of the best experts on this subject based on the ideXlab platform.
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the outcome of initial mitomycin c augmented trabeculectomy with subconjunctival bevacizumab in the management of secondary glaucoma associated with Fuchs Heterochromic Iridocyclitis
International Ophthalmology, 2020Co-Authors: Ufuk Elgin, Kubra Ozdemir, Pinar Ozdal, Emine Sen, Nilufer BerkerAbstract:PURPOSE To investigate the outcome of mitomycin C (MMC)-augmented trabeculectomy with subconjunctival bevacizumab in the management of Fuchs Heterochromic Iridocyclitis (FHI)-related glaucoma in 1-year follow-up period. METHODS This retrospective study included 50 eyes with FHI-related glaucoma those had underwent initial trabeculectomy with MMC (0.2 mg/ml-3 min). Thirty-one of them had single-dose bevacizumab injection (1.25 mg/0.05 ml) into the bleb area just at the end of the surgery, while 19 eyes did not have. The intraocular pressure (IOP) and the mean number of anti-glaucomatous medications were evaluated. The IOP value ≤ 21 mmHg was defined as complete or qualified surgical success in terms of using medical anti-glaucomatous treatment. Bleb height and vascularity were evaluated with Indiana bleb grading system. Paired sample t test, t test, Chi-square and Kolmogorov-Smirnov tests were used for statistical analysis. RESULTS The preoperative IOP values of bevacizumab and without bevacizumab groups were 32.8 ± 4.5 mmHg and 32.8 ± 4.5 mmHg, respectively, and they decreased to 17.5 ± 4.6 mmHg and 17 ± 5.2 mmHg at the final visit (p < 0.001 for all values). There were no significant differences in postoperative IOP and the number of medications between the groups at the final visit. In bevacizumab group, complete success was achieved in 100% within the third month but decreased to 22.5% (complete) and 74.1% (qualified) at the first year. In the other group (without bevacizumab group), complete success was achieved in 94.7% within the third month but decreased to 15.8% (complete) and 84.2% (qualified) at the first year. CONCLUSION Initial trabeculectomy with MMC and subconjunctival bevacizumab injection was found to have lower rates of complete success with relatively acceptable qualified success rates in the management of FHI-related glaucoma. Subconjunctival bevacizumab was not found to have additional effect to improve the surgical success.
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The outcome of initial mitomycin C-augmented trabeculectomy with subconjunctival bevacizumab in the management of secondary glaucoma associated with Fuchs Heterochromic Iridocyclitis
International Ophthalmology, 2019Co-Authors: Ufuk Elgin, Kubra Ozdemir, Pinar Ozdal, Nilufer BerkerAbstract:Purpose To investigate the outcome of mitomycin C (MMC)-augmented trabeculectomy with subconjunctival bevacizumab in the management of Fuchs Heterochromic Iridocyclitis (FHI)-related glaucoma in 1-year follow-up period. Methods This retrospective study included 50 eyes with FHI-related glaucoma those had underwent initial trabeculectomy with MMC (0.2 mg/ml—3 min). Thirty-one of them had single-dose bevacizumab injection (1.25 mg/0.05 ml) into the bleb area just at the end of the surgery, while 19 eyes did not have. The intraocular pressure (IOP) and the mean number of anti-glaucomatous medications were evaluated. The IOP value ≤ 21 mmHg was defined as complete or qualified surgical success in terms of using medical anti-glaucomatous treatment. Bleb height and vascularity were evaluated with Indiana bleb grading system. Paired sample t test, t test, Chi-square and Kolmogorov–Smirnov tests were used for statistical analysis. Results The preoperative IOP values of bevacizumab and without bevacizumab groups were 32.8 ± 4.5 mmHg and 32.8 ± 4.5 mmHg, respectively, and they decreased to 17.5 ± 4.6 mmHg and 17 ± 5.2 mmHg at the final visit ( p
Aize Kijlstra - One of the best experts on this subject based on the ideXlab platform.
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Immune deposits in iris biopsy specimens from patients with Fuchs' Heterochromic Iridocyclitis.
American Journal of Ophthalmology, 2014Co-Authors: P.t.v.m. De Jong, E. La Hey, Cornelia M. Mooy, G. S. Baarsma, J. De Vries, Aize KijlstraAbstract:To investigate whether Fuchs' Heterochromic Iridocyclitis may be an immune complex vasculitis, we used an immunofluorescence technique to detect immunoglobulins and complement in iris biopsy specimens from nine patients with Fuchs' Heterochromic Iridocyclitis, 12 patients with other types of uveitis, and nine patients with glaucoma but without uveitis. No specific immune deposits were observed in the irises of the patients with Fuchs' Heterochromic Iridocyclitis. Immunoglobulin G, IgA, IgM, and complement were detected in patients with Fuchs' Heterochromic Iridocyclitis and patients with uveitis, and these results differed significantly (P
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Polymorphisms of TNFAIP3 gene in a Chinese Han population with Fuchs Heterochromic Iridocyclitis.
Ophthalmic Genetics, 2013Co-Authors: Hong Li, Liping Du, Qingyun Zhou, Aize KijlstraAbstract:ABSTRACTPurpose: This study was performed to evaluate the potential association of the tumor necrosis factor alpha inducible protein 3gene (TNFAIP3) polymorphisms with Fuchs’ Heterochromic Iridocyclitis (Fuchs’ Syndrome) in a Chinese Han population.Methods: Five single-nucleotide polymorphisms (SNPs), rs10499194, rs610604, rs7753873, rs5029928 and rs9494885 of TNFAIP3 were genotyped in 225 Fuchs’ syndrome patients and 651 healthy controls using a PCR-restriction fragment length polymorphism assay. All control subjects were matched ethnically and geographically with the patients. Genotype counts in patients and controls were analyzed by the χ2 test.Results: All genotypic and allelic frequencies of the tested TNFAIP3 polymorphisms were in Hardy–Weinberg equilibrium. The genotypic and allelic frequencies of rs10499194, rs610604, rs7753873, rs5029928 and rs9494885 of TNFAIP3 were not different between patients with Fuchs’ syndrome and controls.Conclusions: Our results suggest that rs10499194, rs610604, rs7753...
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treatment and prognosis of secondary glaucoma in Fuchs Heterochromic Iridocyclitis
American Journal of Ophthalmology, 1993Co-Authors: E. La Hey, G. S. Baarsma, J. De Vries, C T Langerhorst, Aize KijlstraAbstract:After reviewing the records of 111 patients with Fuchs' Heterochromic Iridocyclitis, we studied the therapy and prognosis of secondary glaucoma in 30 of these 111 patients (27%) who had glaucoma or could be considered glaucoma suspects. Maximal medical therapy was unsuccessful in 22 of the 30 patients (73%). Surgical intervention (mostly trabeculectomies, half with 5-fluorouracil) successfully controlled intraocular pressure (≤ 21 mm Hg with or without medication) in 13 of the 18 operated-on patients (72%) after a mean follow-up of 26 months. All successfully operated-on patients retained a visual acuity of 20/80 or better. We had favorable results, possibly because of modern surgical techniques (use of 5-fluorouracil, sodium hyaluronate) or earlier surgical intervention, or both.
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Fuchs Heterochromic Iridocyclitis is not associated with ocular toxoplasmosis
Archives of Ophthalmology, 1992Co-Authors: E. La Hey, Aniki Rothova, Seerp G Baarsma, Jelle De Vries, Frans Van Knapen, Aize KijlstraAbstract:• To analyze the association between Fuchs' Heterochromic Iridocyclitis (FHI) and toxoplasmosis, we performed ocular examinations and used various specific laboratory tests to establish a role for Toxoplasma gondii in the pathogenesis of FHI. Results were compared with those for other types of uveitis and healthy controls. Of the 88 patients with FHI, nine (10.2%) had toxoplasmosislike scars, but an association could not be proved by the indirect immunofluorescence antibody test or enzyme-linked immunosorbent assay, or by a test for cellular immunity to Toxoplasma antigen. Analysis of aqueous humor samples for Toxoplasma antibodies in patients with FHI also yielded negative results. On the basis of the negative results of these laboratory tests, we concluded that FHI is not associated with ocular toxoplasmosis.
Soon-phaik Chee - One of the best experts on this subject based on the ideXlab platform.
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presumed Fuchs Heterochromic Iridocyclitis and posner schlossman syndrome comparison of cytomegalovirus positive and negative eyes
American Journal of Ophthalmology, 2008Co-Authors: Soon-phaik CheeAbstract:Purpose To compare the characteristics of cytomegalovirus (CMV)-positive and negative eyes with presumed Posner-Schlossman syndrome (PSS) and Fuchs Heterochromic Iridocyclitis (FHI). Design Retrospective interventional case series. Methods One hundred and three eyes of 102 patients with presumed PSS or FHI, seen at the Singapore National Eye Centre, underwent aqueous analysis for CMV by polymerase chain reaction (PCR). Their records were reviewed for clinical features and human immunodeficiency virus (HIV) status of the CMV-positive patients. The main outcome measures were age, gender, maximum intraocular pressure, endothelial cell count, endothelial changes, PCR results, and presence of uveitic cataract and/or glaucoma. Results Sixty-seven eyes with presumed PSS were tapped, of which 35 (52.2%) were CMV-positive. There were 36 eyes of 35 patients with presumed FHI, of which 15 (41.7%) were CMV-positive. All the CMV-positive patients were HIV negative. Nodular endothelial lesions were seen in 18 eyes (36.0%) with CMV infection, and reticulate deposits were seen in all the presumed FHI eyes. CMV-positive and CMV-negative PSS eyes were clinically similar. Older age at diagnosis, male gender, and nodular endothelial lesions were significantly associated with CMV infection in presumed FHI eyes (age: odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0 to 1.2; P = .01; male gender: OR, 9.4; 95% CI, 1.0 to 88.6; P = .049; nodular endothelial lesions: OR, 13.9; 95% CI, 1.5 to 132.7; P = .02). Conclusions There are no clinically detectable differences between CMV-positive and negative presumed PSS eyes. CMV-positive presumed FHI patients are more likely to be male, older at diagnosis or have nodular endothelial lesions.
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clinical features of cytomegalovirus anterior uveitis in immunocompetent patients
American Journal of Ophthalmology, 2008Co-Authors: Soon-phaik Chee, Kristine Bacsal, Suyun Sethoe, Ching Li ChengAbstract:PURPOSE: To describe the clinical presentation of cytomegalovirus (CMV) anterior uveitis in human immunodeficiency virus (HIV)-negative patients. DESIGN: Retrospective, interventional case series. METHODS: HIV-negative patients with anterior uveitis associated with elevated intraocular pressure (hypertensive anterior uveitis) seen at the Singapore National Eye Centre had their aqueous analyzed for viral deoxyribonucleic acid by polymerase chain reaction, and their records were reviewed for demographic data, ocular findings, laboratory results, and treatment. RESULTS: Aqueous was obtained from 105 of 106 eligible eyes. Twenty-four eyes demonstrated positive results for CMV (22.8%). Eighteen eyes had Posner-Schlossman syndrome (PSS; 75%) at presentation, five eyesba had Fuchs Heterochromic Iridocyclitis (FHI; 20.8%), and one eye had a presumed herpetic anterior uveitis. Twelve of the 24 eyes were treated with ganciclovir. Of the 12 who completed treatment, all responded clinically, and their aqueous demonstrated negative results for CMV on repeat testing. However, nine had recurrences within eight months of stopping treatment and required further courses of ganciclovir. The 81 CMV-negative eyes included 30 with PSS, 11 with FHI, 27 with uveitic glaucomas of unknown cause, and 13 with presumed herpetic anterior uveitis. CONCLUSIONS: CMV anterior uveitis is not uncommon in our immunocompetent patients and it may present as a recurrent acute or chronic inflammation, resembling PSS, herpetic anterior uveitis, or FHI.
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Presumed Fuchs Heterochromic Iridocyclitis and Posner-Schlossman syndrome: comparison of cytomegalovirus-positive and negative eyes.
American Journal of Ophthalmology, 2008Co-Authors: Soon-phaik Chee, Aliza JapAbstract:To compare the characteristics of cytomegalovirus (CMV)-positive and negative eyes with presumed Posner-Schlossman syndrome (PSS) and Fuchs Heterochromic Iridocyclitis (FHI). Retrospective interventional case series. One hundred and three eyes of 102 patients with presumed PSS or FHI, seen at the Singapore National Eye Centre, underwent aqueous analysis for CMV by polymerase chain reaction (PCR). Their records were reviewed for clinical features and human immunodeficiency virus (HIV) status of the CMV-positive patients. The main outcome measures were age, gender, maximum intraocular pressure, endothelial cell count, endothelial changes, PCR results, and presence of uveitic cataract and/or glaucoma. Sixty-seven eyes with presumed PSS were tapped, of which 35 (52.2%) were CMV-positive. There were 36 eyes of 35 patients with presumed FHI, of which 15 (41.7%) were CMV-positive. All the CMV-positive patients were HIV negative. Nodular endothelial lesions were seen in 18 eyes (36.0%) with CMV infection, and reticulate deposits were seen in all the presumed FHI eyes. CMV-positive and CMV-negative PSS eyes were clinically similar. Older age at diagnosis, male gender, and nodular endothelial lesions were significantly associated with CMV infection in presumed FHI eyes (age: odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0 to 1.2; P = .01; male gender: OR, 9.4; 95% CI, 1.0 to 88.6; P = .049; nodular endothelial lesions: OR, 13.9; 95% CI, 1.5 to 132.7; P = .02). There are no clinically detectable differences between CMV-positive and negative presumed PSS eyes. CMV-positive presumed FHI patients are more likely to be male, older at diagnosis or have nodular endothelial lesions.
Ufuk Elgin - One of the best experts on this subject based on the ideXlab platform.
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the outcome of initial mitomycin c augmented trabeculectomy with subconjunctival bevacizumab in the management of secondary glaucoma associated with Fuchs Heterochromic Iridocyclitis
International Ophthalmology, 2020Co-Authors: Ufuk Elgin, Kubra Ozdemir, Pinar Ozdal, Emine Sen, Nilufer BerkerAbstract:PURPOSE To investigate the outcome of mitomycin C (MMC)-augmented trabeculectomy with subconjunctival bevacizumab in the management of Fuchs Heterochromic Iridocyclitis (FHI)-related glaucoma in 1-year follow-up period. METHODS This retrospective study included 50 eyes with FHI-related glaucoma those had underwent initial trabeculectomy with MMC (0.2 mg/ml-3 min). Thirty-one of them had single-dose bevacizumab injection (1.25 mg/0.05 ml) into the bleb area just at the end of the surgery, while 19 eyes did not have. The intraocular pressure (IOP) and the mean number of anti-glaucomatous medications were evaluated. The IOP value ≤ 21 mmHg was defined as complete or qualified surgical success in terms of using medical anti-glaucomatous treatment. Bleb height and vascularity were evaluated with Indiana bleb grading system. Paired sample t test, t test, Chi-square and Kolmogorov-Smirnov tests were used for statistical analysis. RESULTS The preoperative IOP values of bevacizumab and without bevacizumab groups were 32.8 ± 4.5 mmHg and 32.8 ± 4.5 mmHg, respectively, and they decreased to 17.5 ± 4.6 mmHg and 17 ± 5.2 mmHg at the final visit (p < 0.001 for all values). There were no significant differences in postoperative IOP and the number of medications between the groups at the final visit. In bevacizumab group, complete success was achieved in 100% within the third month but decreased to 22.5% (complete) and 74.1% (qualified) at the first year. In the other group (without bevacizumab group), complete success was achieved in 94.7% within the third month but decreased to 15.8% (complete) and 84.2% (qualified) at the first year. CONCLUSION Initial trabeculectomy with MMC and subconjunctival bevacizumab injection was found to have lower rates of complete success with relatively acceptable qualified success rates in the management of FHI-related glaucoma. Subconjunctival bevacizumab was not found to have additional effect to improve the surgical success.
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The outcome of initial mitomycin C-augmented trabeculectomy with subconjunctival bevacizumab in the management of secondary glaucoma associated with Fuchs Heterochromic Iridocyclitis
International Ophthalmology, 2019Co-Authors: Ufuk Elgin, Kubra Ozdemir, Pinar Ozdal, Nilufer BerkerAbstract:Purpose To investigate the outcome of mitomycin C (MMC)-augmented trabeculectomy with subconjunctival bevacizumab in the management of Fuchs Heterochromic Iridocyclitis (FHI)-related glaucoma in 1-year follow-up period. Methods This retrospective study included 50 eyes with FHI-related glaucoma those had underwent initial trabeculectomy with MMC (0.2 mg/ml—3 min). Thirty-one of them had single-dose bevacizumab injection (1.25 mg/0.05 ml) into the bleb area just at the end of the surgery, while 19 eyes did not have. The intraocular pressure (IOP) and the mean number of anti-glaucomatous medications were evaluated. The IOP value ≤ 21 mmHg was defined as complete or qualified surgical success in terms of using medical anti-glaucomatous treatment. Bleb height and vascularity were evaluated with Indiana bleb grading system. Paired sample t test, t test, Chi-square and Kolmogorov–Smirnov tests were used for statistical analysis. Results The preoperative IOP values of bevacizumab and without bevacizumab groups were 32.8 ± 4.5 mmHg and 32.8 ± 4.5 mmHg, respectively, and they decreased to 17.5 ± 4.6 mmHg and 17 ± 5.2 mmHg at the final visit ( p
E. La Hey - One of the best experts on this subject based on the ideXlab platform.
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Immune deposits in iris biopsy specimens from patients with Fuchs' Heterochromic Iridocyclitis.
American Journal of Ophthalmology, 2014Co-Authors: P.t.v.m. De Jong, E. La Hey, Cornelia M. Mooy, G. S. Baarsma, J. De Vries, Aize KijlstraAbstract:To investigate whether Fuchs' Heterochromic Iridocyclitis may be an immune complex vasculitis, we used an immunofluorescence technique to detect immunoglobulins and complement in iris biopsy specimens from nine patients with Fuchs' Heterochromic Iridocyclitis, 12 patients with other types of uveitis, and nine patients with glaucoma but without uveitis. No specific immune deposits were observed in the irises of the patients with Fuchs' Heterochromic Iridocyclitis. Immunoglobulin G, IgA, IgM, and complement were detected in patients with Fuchs' Heterochromic Iridocyclitis and patients with uveitis, and these results differed significantly (P
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treatment and prognosis of secondary glaucoma in Fuchs Heterochromic Iridocyclitis
American Journal of Ophthalmology, 1993Co-Authors: E. La Hey, G. S. Baarsma, J. De Vries, C T Langerhorst, Aize KijlstraAbstract:After reviewing the records of 111 patients with Fuchs' Heterochromic Iridocyclitis, we studied the therapy and prognosis of secondary glaucoma in 30 of these 111 patients (27%) who had glaucoma or could be considered glaucoma suspects. Maximal medical therapy was unsuccessful in 22 of the 30 patients (73%). Surgical intervention (mostly trabeculectomies, half with 5-fluorouracil) successfully controlled intraocular pressure (≤ 21 mm Hg with or without medication) in 13 of the 18 operated-on patients (72%) after a mean follow-up of 26 months. All successfully operated-on patients retained a visual acuity of 20/80 or better. We had favorable results, possibly because of modern surgical techniques (use of 5-fluorouracil, sodium hyaluronate) or earlier surgical intervention, or both.
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Fuchs Heterochromic Iridocyclitis is not associated with ocular toxoplasmosis
Archives of Ophthalmology, 1992Co-Authors: E. La Hey, Aniki Rothova, Seerp G Baarsma, Jelle De Vries, Frans Van Knapen, Aize KijlstraAbstract:• To analyze the association between Fuchs' Heterochromic Iridocyclitis (FHI) and toxoplasmosis, we performed ocular examinations and used various specific laboratory tests to establish a role for Toxoplasma gondii in the pathogenesis of FHI. Results were compared with those for other types of uveitis and healthy controls. Of the 88 patients with FHI, nine (10.2%) had toxoplasmosislike scars, but an association could not be proved by the indirect immunofluorescence antibody test or enzyme-linked immunosorbent assay, or by a test for cellular immunity to Toxoplasma antigen. Analysis of aqueous humor samples for Toxoplasma antibodies in patients with FHI also yielded negative results. On the basis of the negative results of these laboratory tests, we concluded that FHI is not associated with ocular toxoplasmosis.
