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Kalpana Babu - One of the best experts on this subject based on the ideXlab platform.

  • In Response to Laovirojjanakul W., Acharya N. and Gonzales J. A.'s "Ultra-Widefield Fluorescein Angiography in Intermediate Uveitis".
    Ocular immunology and inflammation, 2017
    Co-Authors: Kalpana Babu, Mrinalini Kumaradas
    Abstract:

    We read with great interest the article by Laovirojjanakul et al. on ultra-widefield fluorescein angiography in Intermediate Uveitis. We would like to share a similar case of chronic Intermediate Uveitis highlighting a fern-like pattern of diffuse vascular leakage on fluorescein angiography, with good visual acuity, absence of clinically active inflammation, and a similar fluorescein angiography picture over a follow-up of 4 years.

  • Unilateral snow banking in tuberculosis-related Intermediate Uveitis
    Journal of ophthalmic inflammation and infection, 2014
    Co-Authors: Kalpana Babu, Soumya S Bhat
    Abstract:

    Snow banking is usually a term coined to describe the accumulation of vitreous exudates over the pars plana and the peripheral retina in pars planitis. Snow banking is very rare in tubercular Intermediate Uveitis. A 32-year-old male was diagnosed to have Intermediate Uveitis due to tubercular etiology in the right eye. Laboratory investigations include an increased erythrocyte sedimentation rate, positive Mantoux test, and computed tomography thorax showing mediastinal lymphadenopathy. Transbronchial needle aspiration of the lymph nodes showed chronic granulomatous inflammation with caseation. There were no recurrences following antitubercular therapy (ATT). This case report highlights the unique finding of snow banking in tubercular Uveitis and course following treatment with ATT.

Mrinalini Kumaradas - One of the best experts on this subject based on the ideXlab platform.

Aize Kijlstra - One of the best experts on this subject based on the ideXlab platform.

  • Soluble ICAM-1 serum levels in patients with Intermediate Uveitis.
    The British journal of ophthalmology, 1999
    Co-Authors: Anne-marie Klok, L. Luyendijk, Michel J W Zaal, Aniki Rothova, Aize Kijlstra
    Abstract:

    Aim—To investigate whether serum levels of soluble intercellular adhesion molecule 1 (sICAM-1) can serve as a marker of the presence of systemic disease in Intermediate Uveitis. Methods—In a multicentre study sICAM-1 serum levels were measured in 61 patients with idiopathic Intermediate Uveitis, controls included 56 Uveitis patients with a systemic disease (26 sarcoid associated Uveitis and 30 HLA-B27 positive acute anterior Uveitis), 58 Uveitis patients without systemic disease (30 toxoplasma chorioretinitis and 28 Fuchs’ hetrochromic cyclitis), and 21 normal controls. The clinical records of the patients with Intermediate Uveitis were analysed for disease characteristics at the time of blood sampling and for a relation with the development of a systemic disease after a mean follow up of 4.5 years. Results—Increased serum levels of sICAM-1 were found in 34 out of 61 patients with Intermediate Uveitis and were significantly diVerent when compared with toxoplasmosis, Fuchs’ cyclitis, and healthy controls (p

  • Elevated serum IL-8 levels are associated with disease activity in idiopathic Intermediate Uveitis
    The British journal of ophthalmology, 1998
    Co-Authors: Anne-marie Klok, A Rothova, L. Luyendijk, Michel J W Zaal, C.e. Hack, Aize Kijlstra
    Abstract:

    Aim—To find a laboratory indicator for systemic involvement in Intermediate Uveitis. Methods—Interleukin 8 (IL-8) and C reactive protein (CRP) serum levels were measured in patients with idiopathic Intermediate Uveitis (n=61), Uveitis controls (n=143), and normal controls (n=29). The records of those with Intermediate Uveitis were reviewed with the emphasis on disease activity and severity as characterised by the presence of cystoid macular oedema, vitreous exudates or snowbank formation, papillitis, and periphlebitis. Results—Increased serum IL-8 (>20 pg/ ml) was found in 27 out of 61 patients with Intermediate Uveitis (p< 0.01), 12 of 27 patients with sarcoid Uveitis (p

  • elevated serum il 8 levels are associated with disease activity in idiopathic Intermediate Uveitis
    British Journal of Ophthalmology, 1998
    Co-Authors: Anne-marie Klok, A Rothova, L. Luyendijk, Michel J W Zaal, C.e. Hack, Aize Kijlstra
    Abstract:

    Aim—To find a laboratory indicator for systemic involvement in Intermediate Uveitis. Methods—Interleukin 8 (IL-8) and C reactive protein (CRP) serum levels were measured in patients with idiopathic Intermediate Uveitis (n=61), Uveitis controls (n=143), and normal controls (n=29). The records of those with Intermediate Uveitis were reviewed with the emphasis on disease activity and severity as characterised by the presence of cystoid macular oedema, vitreous exudates or snowbank formation, papillitis, and periphlebitis. Results—Increased serum IL-8 (>20 pg/ ml) was found in 27 out of 61 patients with Intermediate Uveitis (p< 0.01), 12 of 27 patients with sarcoid Uveitis (p<0.05), in 19 of 30 patients with HLA-B27 associated acute anterior Uveitis (p<0.05), and in five of 29 healthy controls. Raised IL-8 levels in Intermediate Uveitis were significantly associated with active disease (p<0.001) and the presence of vitreous exudates (p<0.001), papillitis, and periphlebitis (p<0.01). Elevated CRP levels were found in 12 of the 143 Uveitis controls but in none of the Intermediate Uveitis patients or normal controls. During follow up an associated systemic disease was more frequently noticed in patients with an elevated serum IL-8 at entry into the study. Conclusions—Elevated IL-8 serum levels were found in patients with active Intermediate Uveitis of unknown origin. An elevated IL-8 level seems to predispose the patient to a later development of associated systemic disease. (Br J Ophthalmol 1998;82:871‐874)

Marion R. Munk - One of the best experts on this subject based on the ideXlab platform.

  • Swept-source optical coherence tomography angiography reveals vascular changes in Intermediate Uveitis
    Acta ophthalmologica, 2019
    Co-Authors: Meng Tian, Christoph Tappeiner, Martin S. Zinkernagel, Sebastian Wolf, Marion R. Munk
    Abstract:

    PURPOSE To evaluate retinal and choroidal vascular changes in patients with Intermediate Uveitis with/without concomitant retinal vasculitis using wide field swept-source optical coherence tomography angiography (OCTA). METHODS In this study consecutive patients with Intermediate Uveitis ± vasculitis and healthy age-matched controls were evaluated using central 3 × 3 mm OCTA scans and montage scans. Differences among the groups as well as the association between central changes assessed by 3 × 3 scans and wide field OCTA were evaluated. RESULTS 93 eyes of 58 patients with Intermediate Uveitis and 33 healthy age-matched controls were included. The presence of a cystoid macular oedema (CME) was associated with capillary non-and reduced perfusion of the superficial capillary plexus (SCP) (p = 0.03 and 0.02, respectively), and deep capillary plexus (DCP) (p = 0.02 and p ≤ 0.0001, respectively) of the 3 × 3 mm scans. The raw length, circularity and size of foveal avascular area (FAZ) significantly differed among the three groups. (p = 0.01, p = 0.045 and p = 0.004, respectively). Multivariable regression analysis revealed that the presence of epiretinal membranes (ERM) and CME rather than the disease entity contributed to the changes of FAZ size (R  = 0.15, p = 0.0003) The mean vessel density (VD) of the SCP significantly differed among the three groups (Intermediate Uveitis with concomitant vasculitis: 16.8 ± 3.8 mm vs Intermediate Uveitis only: 15.6 ± 4.4 mm versus control: 18 ± 3.5 mm , p = 0.046). Multivariable regression analysis showed that the presence of CME rather than the disease entity impacted vessel density of SCP (R  = 0.1, p = 0.016). There was no association between peripheral non- or reduced perfusion of the wide field OCTA slabs of the SCP and DCP and the VD of the 3 × 3 slabs. CONCLUSION Although patients with Intermediate Uveitis and vasculitis present with reduced central vessel density compared to healthy age-matched controls, these changes are presumably contributed to the presence of CME.

  • Evaluation of vascular changes in Intermediate Uveitis and retinal vasculitis using swept-source wide-field optical coherence tomography angiography.
    The British journal of ophthalmology, 2018
    Co-Authors: Meng Tian, Christoph Tappeiner, Martin S. Zinkernagel, Sebastian Wolf, Wolfgang Huf, Marion R. Munk
    Abstract:

    Purpose To evaluate vascular changes in patients with Intermediate Uveitis with or without retinal vasculitis using swept-source wide-field optical coherence tomography angiography (OCTA). Methods This is a prospective cross-sectional study. Consecutive patients with Intermediate Uveitis were evaluated using wide-field OCTA. Wide-field OCTA and en-face OCT images were analysed for the presence of capillary non-perfusion and reduced perfusion, disruption of ellipsoid zone, and abnormalities on en-face wide-field retinal thickness maps, respectively, and compared with fluorescein angiography (FA) findings in a subcohort. Results 164 eyes of 88 patients with Intermediate Uveitis were included. Areas of capillary non-perfusion and reduced perfusion were more frequently observed in the choroidal OCTA slab (33.3% and 49.4%), choriocapillaris (CC; 31.4% and 48%) and deep capillary plexus (DCP; 9.6% and 34.6%) than in the superficial capillary plexus (SCP; 5% and 26.3%), respectively. Intermediate Uveitis with vasculitis presented more frequently with non-perfusion and hypoperfusion in the DCP (p=0.003 and p=0.05, respectively) and SCP (p=0.007 and p=0.005, respectively) than Intermediate Uveitis without vasculitis. Peripheral capillary leakage on FA correlated with the presence of perivascular, macular and generalised thickening on en-face wide-field thickness maps (p=0.007). Ischaemia on FA was significantly associated with non-perfusion on wide-field OCTA in SCP and DCP (p=0.019 and p=0.027, respectively). Conclusion Changes in the choroid, CC and DCP are more frequently found than in the SCP on wide-field OCTA in Intermediate Uveitis. While wide-field OCTA is a reliable tool to detect capillary non-perfusion in Intermediate Uveitis, it was not helpful in determining disease activity. Trial registration number NCT02811536.

Jyotirmay Biswas - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy and Safety of Mycophenolate Mofetil in the Treatment of Recalcitrant Intermediate Uveitis.
    Ocular immunology and inflammation, 2018
    Co-Authors: Sowkath Ali, Ranju Kharel Sitaula, Jyotirmay Biswas
    Abstract:

    ABSTRACTPurpose: To evaluate the efficacy and safety of mycophenolate mofetil (MMF) in the treatment of recalcitrant Intermediate Uveitis in a tertiary referral eye-care center over a 1-year period...

  • Patterns of Intermediate Uveitis in Children Presenting at a Tertiary Eye Care Center in South India.
    Middle East African journal of ophthalmology, 2017
    Co-Authors: Radha Annamalai, Jyotirmay Biswas
    Abstract:

    Purpose: To study the patterns of Intermediate Uveitis in the pediatric age group in a referral eye care center in South India. Methods: This is a study of twenty consecutive patients under 16 years of age with Intermediate Uveitis, conducted at a tertiary referral center. Numerous variables were assessed, including age and gender distribution, laboratory data, the presence of systemic diseases, onset and course of ocular inflammation, clinical features, their complications, therapeutic strategies with their outcomes, remission, final visual acuity (VA), and characteristics associated with poor visual outcome. Results: Bilateral involvement was observed in 80% of the patients. Remission was observed in five out of 7 patients (78%) with completed follow-up of 5 years. Final VA improved by at least two lines in 11 patients, remained stable in 6 patients, and worsened in 3 patients. The etiological diagnosis showed one patient with Bechet's disease, one with juvenile idiopathic arthritis, 1 with human leukocyte antigen B27 associated Uveitis, 9 with laboratory proven tuberculosis, and 3 with sarcoidosis and 5 where it was idiopathic. The mean follow-up was 4.8 years (range 3–8 years). Cataract was the most frequent complication observed (40%). Glaucoma, choroidal neovascularization, and amblyopia accounted for worsening of vision in three patients. Conclusion: Median time of development of complications is about 3 years based on our study. Intermediate Uveitis of childhood might exhibit a self-limiting course after several years. Visual recovery is good in the majority, and visual loss is limited despite the high rate of ocular complications.

  • Efficacy of Ozurdex implant in treatment of noninfectious Intermediate Uveitis.
    Indian journal of ophthalmology, 2015
    Co-Authors: Swetha Palla, Jyotirmay Biswas, Chokkahalli K Nagesha
    Abstract:

    Aims: To report our experiences using Ozurdex, a biodegradable implant, containing 0.7 mg of dexamethasone in the treatment of noninfectious Intermediate Uveitis. Settings and Design: Retrospective study design. Methods: We conducted a retrospective study of medical records of patients with noninfectious Intermediate Uveitis having either cystoid macular edema (CME) or vitritis who were not responsive to standard treatment and subsequently received Ozurdex implant from March 2011 to April 2013. The outcomes measured were best-corrected visual acuity, central retinal thickness (CRT), and vitreous haze score. Statistical Analysis Used: Paired t-test was used to test the significance of difference between quantitative variables. A P < 0.05 is taken to denote significant relationship. Results: Twenty eyes of 15 patients with mean age of 39.8 years who received Ozurdex implant were included in the study. The mean baseline visual acuity improved from 0. 666 logarithm of the minimum angle of resolution (logMAR) units to 0.479 logMAR units at 6 weeks after the implant. The mean CRT improved from 536.1 to 361.4 microns at 6 weeks postimplant both parameters were statistically significant. The ocular inflammation was controlled in almost all the patients. Cataract and raised intraocular pressure were documented complications. Conclusion: Ozurdex implant is a promising treatment option and efficient in controlling the inflammation and CME in cases of noninfectious Intermediate Uveitis not responding to standard treatment.

  • Evaluation of cataract surgery in Intermediate Uveitis.
    Ophthalmic surgery and lasers, 1999
    Co-Authors: Rajesk Fogla, Jyotirmay Biswas, Sudha K Ganesh, K Ravishankar
    Abstract:

    ■ BACKGROUND AND OBJECTIVE: The authors analyzed the results of cataract surgery performed on patients with Intermediate Uveitis from January 1990 through January 1997. ■ MATERIALS AND METHODS: Fifty-two eyes of 44 patients with Intermediate Uveitis underwent cataract surgery during this period. These patients were evaluated with respect to duration of Intermediate Uveitis, treatment regimen, intraoperative complications and final visual results. ■ RESULTS: Visual acuity improved following surgery in 94.2% eyes and 71.2% eyes achieved a final visual acuity better than or equal to 20/60. Intraocular lens implantation accompanied the surgery in 24 eyes. Regional and systemic steroids were required for control of inflammation. The factors that limited visual recovery were severe cystoid macular edema, epiretinal membrane formation, and secondary retinal detachment. Recurrence of Uveitis was noted in 6 cases. ■ CONCLUSION: Absolute control of inflammation, atraumatic surgery, and regular postoperative follow-up can improve the results of cataract extraction. Intraocular lens implantation in selected cases is well tolerated with good visual results.

  • Intermediate Uveitis of pars planitis type in identical twins
    International Ophthalmology, 1998
    Co-Authors: Jyotirmay Biswas, S. Ramesh Raghavendran, R. Vijaya
    Abstract:

    The occurrence of Intermediate Uveitis in monozygotic twins has rarely been reported in literature. We report the occurrence of this disease condition in identical twins. Twin sisters presented with typical features of Intermediate Uveitis, which appeared three years earlier in one of the sisters. They were treated with posterior subtenon injection of triamcinolone acetonide and recovered well. Systemic evaluation and laboratory investigations did not reveal any etiology. Cytogenetic high-resolution analysis did not reveal any chromosomal abnormalities. Pedigree analysis revealed no specific transmission pattern. No other family members in three generations had similar ocular disease. Our report indicates that a detailed family history should be taken in Intermediate Uveitis and examination of other siblings of patients with Intermediate Uveitis should be performed.