The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Henry A Leder - One of the best experts on this subject based on the ideXlab platform.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, Millena Bittencourt, James P. Dunn, Mohamed Ibrahim, Roomasa ChannaAbstract:Background The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, James P. Dunn, Theresa Gan, Brian H Cho, Mohamed IbrahimAbstract:The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality. Seventy-one visits from 23 patients were reviewed and analyzed. Based on examination plus ultra-wide-field imaging and ultra-wide-field angiography, disease activity was detected in 48/71 (68%) compared with 32/71 (45%) based on examination and standard FA (P = 0.0095). Based on the clinical examination alone, the decision to alter management was made in 4 of 71 visits (6%), and an additional 3 of 71 (4%) based on simulated standard FA. The addition of ultra-wide-field SLO pseudo-color images altered management in an additional 10/71 visits (14%), and 36/71 (51%) with the addition of ultra-wide-field FA. Ultra-wide-field fluorescein imaging and angiography can provide additional information that may be important and relevant in the management of Retinal Vasculitis.
Stephen C Foster - One of the best experts on this subject based on the ideXlab platform.
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characteristics and visual outcome of refractory Retinal Vasculitis associated with antineutrophil cytoplasm antibody associated vasculitides
American Journal of Ophthalmology, 2018Co-Authors: Miaoli Lin, Stephen D Anesi, Aseef Ahmed, Karen Small, Stephen C FosterAbstract:Purpose To describe the clinical characteristics, therapies, visual outcomes, and prognoses of patients with Retinal Vasculitis associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV). Design Retrospective case series. Methods Patients diagnosed with Retinal Vasculitis associated with AAV and at least 6 months of follow-up were included. Demographic data, systemic and ocular features, best-corrected visual acuity at the initial visit and latest visit, fluorescein angiography (FA) and indocyanine green angiography (ICGA) findings, therapy regimen, and outcome were collected from the Massachusetts Eye Research and Surgery Institution (MERSI) database from 2006 to 2017. Results Fourteen patients (22 eyes) were identified. Twelve had granulomatosis with polyangiitis (GPA) and 1 each had microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). FA showed that AAV affected small-to-medium-size Retinal vessels. Seven cases (50%) had both vein/venule and artery/arteriole involvement. Four cases co-presented with choroidal Vasculitis. All of them failed various immunomodulatory therapies prior to referral to MERSI. Six patients received rituximab plus prednisone as their final therapy and 5 of them achieved remission. Four patients who failed cyclophosphamide previously were induced into remission by rituximab. Patients were followed for 33.4 ± 25.5 (range 6–84) months. Nine of 14 patients (64.3%) achieved remission at their latest visit. Seventeen of 22 eyes (77.3%) met the criteria for a good (≥20/40) visual outcome. Conclusion The majority of patients enjoyed a good visual outcome and achieved remission after aggressive treatment. Rituximab should be considered as an initial treatment for patients with refractory Retinal Vasculitis associated with AAV.
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visual outcome and poor prognostic factors in isolated idiopathic Retinal Vasculitis
Retina-the Journal of Retinal and Vitreous Diseases, 2016Co-Authors: Arash Maleki, Jennifer H Cao, Sukhum Silpaarcha, Stephen C FosterAbstract:Purpose: To describe the clinical course, visual outcome, and prognosis of isolated, idiopathic Retinal Vasculitis. Methods: Eighty patients (150 eyes) with isolated, idiopathic Retinal Vasculitis were included. Demographic data, clinical data, complications at the initial visit and during follow-up, fluorescein angiography, and optical coherence tomography findings were collected from the Massachusetts Eye Research and Surgery Institution (MERSI) database from September 2005 to February 2015. Results: Seventy-five (93.7%) patients required treatment with immunomodulatory therapy. Of those 75 patients, 60 (75%) patients were able to achieve durable remission. Factors which were independently significant predictive of poor visual outcome were lower initial visual acuity (OR: 3.78; 95% CI: 1.75–8.16; P = 0.001), cystoid macular edema (OR: 5.54; 95% CI: 1.81–16.99; P = 0.003), and macular ischemia (OR: 5.12; 95% CI: 1.12–23.04; P = 0.036). Conclusion: The majority (67.25%) of our patients enjoyed a good visual outcome (most recent visit best-corrected visual acuity equal to or better than 20/40 and within one line or better from the baseline) with immunomodulatory therapy. We found that cystoid macular edema, macular ischemia, and lower best-corrected visual acuity during the first consultation visit were significant independent risk factors for poor visual outcome.
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long term efficacy of systemic infliximab in recalcitrant Retinal Vasculitis
Retina-the Journal of Retinal and Vitreous Diseases, 2015Co-Authors: Pramod Sharma, Gueorgui T Markov, Asima Bajwa, Stephen C FosterAbstract:PURPOSE To evaluate the efficacy of systemic infliximab for the induction of remission in patients with Retinal Vasculitis, inadequately responsive to other immunomodulatory therapy, based on fluorescein angiography grading for Retinal Vasculitis evaluation. METHODS We analyzed 60 patients with Retinal Vasculitis, from the Massachusetts Eye Research and Surgery Institution in Cambridge, MA. Response to therapy was based on analysis of serial fluorescein angiography and fundus photography, including a baseline angiogram before initiation of infliximab. RESULTS Sixty patients received infliximab therapy between July 2007 and July 2012 at Massachusetts Eye Research and Surgery Institution for a diagnosis of Retinal Vasculitis. All had previously showed a poor clinical response to other immunomodulatory regimens, or ceased therapy due to intolerable side effects. The initial dose of infliximab was 5 mg/kg in all patients and remained at this dose for the extent of treatment in 57 (95%) patients. At 6 months, 45 of 51 (88.23%) patients were maintaining remission with therapy, 5 (9.8%) were in partial remission, and 1 patient had failed. At 12 months, 39 of 39 (100%) patients were maintaining remission with therapy. CONCLUSION Infliximab is effective for the treatment of recalcitrant noninfectious Retinal Vasculitis, refractory to conventional immunomodulatory therapy.
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intermediate uveitis and Retinal Vasculitis as manifestations of cat scratch disease
American Journal of Ophthalmology, 1996Co-Authors: Masoud Soheilian, Nikos N Markomichelakis, Stephen C FosterAbstract:Purpose To study the ocular manifestations of systemic Rochalimaea infection. Methods We examined a healthy 21-year old woman who had floaters in both eyes. A bilateral mild vitreitis and multiple foci of Retinal Vasculitis were found; during the ensuing two weeks, exudates appeared over the inferior pars plana. The patient owned five kittens but had no history of cat bites or scratches. Serum levels of antibodies to Rochalimaea were elevated. Result The Retinal Vasculitis and vitreitis resolved after three weeks of therapy with ciprofloxacin hydrochloride without concomitant anti-inflammatory therapy. Conclusion Rochalimaea infection should be considered in the differential diagnosis of intermediate uveitis and Retinal Vasculitis.
Susan G Elner - One of the best experts on this subject based on the ideXlab platform.
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Retinal Vasculitis in Toxocara canis neuroretinitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: Cagri G Besirli, Susan G ElnerAbstract:Background The purpose of this case report is to describe clinical and angiographic findings of Retinal Vasculitis in acute Toxocara canis neuroretinitis associated with systemic infection. Findings A 16-year-old male presented with a 1 week history of left eye pain, floaters, and decreased visual acuity. Ocular examination was consistent with neuroretinitis and Retinal Vasculitis. Fluorescein angiography demonstrated leakage of fluorescein from the optic nerve and the Retinal veins. Clinical and laboratory evaluation were consistent with systemic Toxocara canis infection. Conclusions Ocular T. canis may present with Retinal Vasculitis in young patients in the setting of acute systemic infection.
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Retinal Vasculitis in Toxocara canis neuroretinitis.
Journal of ophthalmic inflammation and infection, 2013Co-Authors: Cagri G Besirli, Susan G ElnerAbstract:Background The purpose of this case report is to describe clinical and angiographic findings of Retinal Vasculitis in acute Toxocara canis neuroretinitis associated with systemic infection.
John P Campbell - One of the best experts on this subject based on the ideXlab platform.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, Millena Bittencourt, James P. Dunn, Mohamed Ibrahim, Roomasa ChannaAbstract:Background The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, James P. Dunn, Theresa Gan, Brian H Cho, Mohamed IbrahimAbstract:The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality. Seventy-one visits from 23 patients were reviewed and analyzed. Based on examination plus ultra-wide-field imaging and ultra-wide-field angiography, disease activity was detected in 48/71 (68%) compared with 32/71 (45%) based on examination and standard FA (P = 0.0095). Based on the clinical examination alone, the decision to alter management was made in 4 of 71 visits (6%), and an additional 3 of 71 (4%) based on simulated standard FA. The addition of ultra-wide-field SLO pseudo-color images altered management in an additional 10/71 visits (14%), and 36/71 (51%) with the addition of ultra-wide-field FA. Ultra-wide-field fluorescein imaging and angiography can provide additional information that may be important and relevant in the management of Retinal Vasculitis.
Mohamed Ibrahim - One of the best experts on this subject based on the ideXlab platform.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, Millena Bittencourt, James P. Dunn, Mohamed Ibrahim, Roomasa ChannaAbstract:Background The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality.
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ultra wide field Retinal imaging in the management of non infectious Retinal Vasculitis
Journal of Ophthalmic Inflammation and Infection, 2013Co-Authors: John P Campbell, Henry A Leder, Elham Hatef, Yasir J. Sepah, James P. Dunn, Theresa Gan, Brian H Cho, Mohamed IbrahimAbstract:The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious Retinal Vasculitis. In this prospective observational cohort series, patients with non-infectious Retinal Vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field SLO (Optos Panoramic 200MA™, Optos PLC, Dunfermline, Scotland, UK). A standardized questionnaire was completed by each investigator at the time of the clinical evaluation. The primary outcome was the percentage of patients whose management was changed by clinical examination and standard FA, compared with clinical examination plus ultra-wide-field imaging. The secondary outcome was the percentage of patients whose disease was determined to be active based on each modality. Seventy-one visits from 23 patients were reviewed and analyzed. Based on examination plus ultra-wide-field imaging and ultra-wide-field angiography, disease activity was detected in 48/71 (68%) compared with 32/71 (45%) based on examination and standard FA (P = 0.0095). Based on the clinical examination alone, the decision to alter management was made in 4 of 71 visits (6%), and an additional 3 of 71 (4%) based on simulated standard FA. The addition of ultra-wide-field SLO pseudo-color images altered management in an additional 10/71 visits (14%), and 36/71 (51%) with the addition of ultra-wide-field FA. Ultra-wide-field fluorescein imaging and angiography can provide additional information that may be important and relevant in the management of Retinal Vasculitis.