1/9. iritis associated with intravenous cidofovir.OBJECTIVE: To report two patients with AIDS and cytomegalovirus retinitis who developed iritis after receiving intravenous cidofovir. Both experienced recurrent symptoms upon rechallenge. CASE SUMMARIES: Two hiv-positive patients with cytomegalovirus retinitis infections previously controlled with intravenous ganciclovir or foscarnet were treated with intravenous cidofovir. Symptoms of iritis developed after the second or third dose of cidofovir. One patient experienced symptoms unilaterally, while the other patient had bilateral symptoms. In both patients, the iritis resolved with topical ophthalmic therapy, but recurred following subsequent infusions of cidofovir. Therapy with cidofovir was discontinued, and no further recurrences of iritis were noted. One patient had post-inflammatory fixed dilated pupils. CONCLUSIONS: iritis can uncommonly occur in patients receiving intravenous cidofovir and oral probenecid. With prompt drug discontinuation and administration of topical corticosteroids and/or mydriatic agents, symptoms are usually reversible.- - - - - - - - - - ranking = 1keywords = cytomegalovirus retinitis, retinitis, cytomegalovirus (Clic here for more details about this article) |
2/9. Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis.PURPOSE: To identify and describe long-term posterior and anterior segment complications of immune recovery uveitis in patients with inactive cytomegalovirus retinitis who are undergoing highly active antiretroviral therapy-mediated recovery of immune function.methods: A prospective cohort study at a university medical center. Twenty-nine eyes of 21 patients with immune recovery uveitis and inactive cytomegalovirus retinitis were followed for 14.5 to 116 weeks (median, 43 weeks) after diagnosis of immune recovery uveitis. RESULTS: Nine eyes of nine patients developed visually important complications involving the posterior segment, anterior segment, or a combination of both. Posterior segment complications included severe proliferative vitreoretinopathy in three eyes and spontaneous vitreous hemorrhage from avulsion of a blood vessel secondary to contraction of the inflamed vitreous in one eye. Proliferative vitreoretinopathy recurred in all cases after surgery, severely compromising the visual outcome. Anterior segment complications included posterior subcapsular cataracts with vision decrease in five eyes and persistent anterior chamber inflammation after cataract extraction, resulting in posterior synechiae and large visually important lens deposits in three eyes.CONCLUSION: Persistent inflammation in immune recovery uveitis may lead to vision-threatening complications, such as proliferative vitreoretinopathy, posterior subcapsular cataracts, and severe postoperative inflammation. Immune recovery uveitis is a chronic inflammatory syndrome that may result in complications months to years after the onset of inflammation.- - - - - - - - - - ranking = 3keywords = cytomegalovirus retinitis, retinitis, cytomegalovirus (Clic here for more details about this article) |
3/9. Concurrent uveoretinitis and pineocytoma in a child suggests a causal relationship.Uveoretinitis was observed in a 9-year-old girl 6 months prior to the clinical appearance of a pineal tumour. Surgical removal was not successful but biopsy revealed a parenchymal neoplasm with differentiated pinealocytes and absent mitotic activity. Some of the tumour cells contained S-antigen, rhodopsin, and serotonin. Systemic glucocorticoid therapy followed by radiation therapy caused considerable reduction in size of the tumour and a complete normalisation of all eye symptoms. This report demonstrates for the first time that a pineocytoma can occur together with uveoretinitis in humans. The latter resembles the experimentally induced autoimmune uveoretinitis described in animals. It is speculated that the retinitis might reflect an autoimmune response to S-antigen present in some tumour cells of the pineocytoma.- - - - - - - - - - ranking = 0.14482950059796keywords = retinitis (Clic here for more details about this article) |
4/9. Laser photocoagulation in the acute retinal necrosis syndrome.Acute retinal necrosis (ARN) is a syndrome of fulminant necrotizing vaso-occlusive retinitis associated with a high incidence of retinal detachment due to retinal breaks and vitreous traction. We performed argon or krypton laser photo-coagulation to demarcate areas of active retinitis as prophylaxis against retinal detachment in five patients with ARN. patients were concomitantly treated with antiviral agents, systemic steroids, and antiplatelet therapy. One patient required multiple additional treatments as retinal necrosis progressed. The retinas remained attached in all five patients over a mean follow-up period of 15 months. By creating a chorioretinal adhesion in areas of potential retinal break formation, laser photocoagulation may be an effective prophylaxis against retinal detachment in ARN.- - - - - - - - - - ranking = 0.036207375149491keywords = retinitis (Clic here for more details about this article) |
5/9. optic neuritis in a child with herpes zoster.A 9-year-old black boy was admitted to the hospital for treatment of herpes zoster involving the trigeminal nerve distribution on the left half of his face. Consulting examination of his eye on the involved side revealed moderate iritis as well as papillitis and diffuse retinitis.- - - - - - - - - - ranking = 0.018103687574746keywords = retinitis (Clic here for more details about this article) |
6/9. association of foveomacular retinitis, ankylosing spondylitis, iritis, and acquired iris atrophy.A case of foveomacular retinitis, ankylosing spondylitis, iritis, and iris dissociation is described. Only ankylosing spondylitis was present in other family members. The differential diagnosis is discussed. The iritis of ankylosing spondylitis must be considered in cases of developmental full-thickness iris holes.- - - - - - - - - - ranking = 0.090518437873728keywords = retinitis (Clic here for more details about this article) |
7/9. Ocular syphilis. Acute and chronic.We describe our experience over the past 2 years with the ocular manifestations in 32 patients with acute and chronic syphilis. We urge that syphilis be considered in evaluating those patients with recurrent iritis, chorioretinitis, papillitis, optic atrophy, or abnormal pupillary findings. Specific serologic testing (FTA-ABS) must be obtained. Screening serologies (VDRL) are inadequate. We suggest that patients with evidence for CSF involvement or active ocular disease be treated by continuous intravenous infusion of 24 million units penicillin g daily for 10 days.- - - - - - - - - - ranking = 0.018103687574746keywords = retinitis (Clic here for more details about this article) |
8/9. Adverse events and autopsy findings after intravitreous cidofovir (HPMPC) therapy in patients with acquired immune deficiency syndrome (AIDS).OBJECTIVE: The purpose of the study is to evaluate the adverse events and autopsy findings in a series of consecutive 20-microg intravitreous cidofovir injections at a single institution. DESIGN: The study design was a nonrandomized, consecutive case series. PARTICIPANTS: Seventy-six patients with acquired immune deficiency syndrome with cytomegalovirus retinitis were studied prospectively. Sixty-three patients had 1 month's follow-up or longer, and this comprised the study group. In addition, histopathologic findings from 18 eyes of 9 patients were studied at autopsy. INTERVENTION: A total of 296 injections of 20 microg cidofovir were given in 115 eyes. Sixty-three patients who had 246 injections in 93 eyes had 1 month's follow-up or longer for the evaluation of adverse events. MAIN OUTCOME MEASURES: Postinjection chronic hypotony associated with permanent visual loss, transient hypotony, iritis, and its long-term sequela (posterior synechia and cataract, retinal detachment, extraocular cytomegalovirus involvement) were the outcomes of interest in this study. Additionally, light and electron microscopic studies of human eyes were performed. RESULTS: The most severe adverse event was postinjection chronic hypotony. This phenomenon was associated with permanent visual loss. This was observed in 1% of the injections and 3% of the eyes of the patients (95% confidence interval, 0%-6%). Transient hypotony associated with mild-to-moderate visual loss developed in 14%, but vision recovered to baseline levels in these eyes subsequently. Analysis showed that transient hypotony in the injected eye could predict postinjection chronic hypotony in the fellow eye (two-tailed Fisher's exact test, P = 0.02). The incidence of iritis was 32%; posterior synechia and cataract were the long-term sequela of the iritis and developed in 19% and 11% of the eyes, respectively. The incidence of retinal detachment was lower (6%). Histopathologic evaluation of the eyes showed mild-to-moderate atrophy of the nonpigmented epithelium of the ciliary body and no other evidence of intraocular toxicity. CONCLUSIONS: The most serious adverse event was postinjection chronic hypotony, which occurred in 3% of eyes. Episodes of transient hypotony appear to indicate that the fellow eye was predisposed to chronic hypotony. Therefore, it may be prudent to give intravitreous injections at least 2 weeks apart in the fellow eye to evaluate the clinical response of the injected eye.- - - - - - - - - - ranking = 0.5052895705978keywords = cytomegalovirus retinitis, retinitis, cytomegalovirus (Clic here for more details about this article) |
9/9. Cytomegalovirus iritis.We describe a case of focal cytomegalovirus iritis in a patient with acquired immunodeficiency syndrome (AIDS) who had CMV retinitis. The autopsy showed histologic evidence of focal iritis in the left eye. This iritis was characterized by infiltration of acute inflammatory cells mixed with cytomegalic cells, which was confirmed by CMV-specific immunohistochemical staining. The case suggested that cytomegalovirus could be a direct causative agent of infectious iritis in AIDS patients.- - - - - - - - - - ranking = 0.028682828770345keywords = retinitis, cytomegalovirus (Clic here for more details about this article) |