AIMTo describe the clinical features, systemic associations, treatment and visual outcomes in Saudi patients with scleritis.METHODSA retrospective chart review was performed for patients with scleritis presenting to t...AIMTo describe the clinical features, systemic associations, treatment and visual outcomes in Saudi patients with scleritis.METHODSA retrospective chart review was performed for patients with scleritis presenting to two tertiary care eye hospitals in Riyadh, Saudi Arabia, from 2001 to 2011. Data were collected on the clinical features of scleritis, subtypes of scleritis, associated systemic disease, history of previous ocular surgery and medical therapy, including the use of immunosuppressants. Treatment outcomes were evaluated based on best-corrected visual acuity (BCVA) and response to treatment.RESULTSOf the 52 patients included in the study, non-necrotizing anterior scleritis was the most common type of scleritis in 22 patients (42.3%), followed by posterior scleritis in 14 patients (26.9%). The majority of cases, 31 patients (59.6%), were idiopathic in nature. Systemic associations were present in 12 patients (23.1%). Infectious scleritis was confirmed in 6 patients (11.5%): 3 with bacterial scleritis after pterygium excision, 2 patients with scleritis related to tuberculosis and 1 patient with scleritis resulting from herpes simplex infection. For the various subtypes of scleritis, BCVA values after treatment and time to remission significantly differed (P<0.05, all cases). Systemic immunosuppressive therapies in addition to steroids were administered to 46.2% of all patients. The T-sign was present on B-scan ultrasonography in 9 (64.3%) of the 14 posterior scleritis patients.CONCLUSIONNon-necrotizing anterior scleritis was the most common subtype of scleritis. Final visual outcome and time to remission differed among the various scleritis subtypes.展开更多
AIM:To investigate the prevalence of ophthalmological extra-intestinal manifestations(O-EIMs) in Chinese patients with inflammatory bowel disease(IBD) and to identify risk factors for the development of O-EIMs.ME...AIM:To investigate the prevalence of ophthalmological extra-intestinal manifestations(O-EIMs) in Chinese patients with inflammatory bowel disease(IBD) and to identify risk factors for the development of O-EIMs.METHODS:The study population consisted of Chinese patients with a definite diagnosis of Crohn's disease(CD) or ulcerative colitis(UC) in a large teaching hospital between January 1995 and December 2014.Demographic and clinical characteristics of patients were extracted retrospectively.RESULTS: In this twenty-year cohort,645 IBD patients(517 with UC,128 with CD) were registered.Among them122(18.9%) exhibited at least one EIM.Of 13 patients(2.0%) developed O-EIMs,7 of CD(5.5%) and 6 of UC(1.2%).Clinical ophthalmological manifestations included redness(76.9%),burning(61.5%),pain(38.5%),itching(15.4%) of eyes and vision change(7.7%).O-EIMs included episcleritis(7),uveitis(5) and dry eye(1).OEIMs were more prevalent in female(odds ratio for male0.61,95% confidence interval 0.52-0.73,P 〈0.0001),and patients who had IBD diagnosis at young age(odds ratio for patients aged 〉30 years 0.76,95% confidence interval0.65-0.88,P 〈0.0001).CONCLUSION: The frequency of O-EIMs in Chinese patients with IBD is lower than the rates reported in the studies of European and American countries.Episcleritisand uveitis are the most common O-EIMs.O-EIMs are more frequent in patients with CD and more prevalent in female and patients who have IBD diagnosis at young age.展开更多
Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of this autoimmune disease vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Their appearance...Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of this autoimmune disease vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Their appearance, as well as their severity are related to RA chronicity and resistance to therapy. The treatment consists of corticosteroids, NSAIDs and cytotoxic drugs, depending on the type of ocular manifestations and the patient’s response to treatment.展开更多
Red eye is common in our daily practice.It ranges from non-inflammatory to inflammatory causes.An extended course of disease should prompt suspicion and the possibility of diagnosis revision.A prolonged conjunctivitis...Red eye is common in our daily practice.It ranges from non-inflammatory to inflammatory causes.An extended course of disease should prompt suspicion and the possibility of diagnosis revision.A prolonged conjunctivitis mimicking nodular episcleritis can be presented as a manifestation of granulomatosis with polyangiitis(GPA).A 57-year-old woman complained of eye redness and tearing for two weeks which partially resolved with antibiotics.She was subsequently commenced on topical and oral non-steroidal anti-inflammatory drugs(NSAIDs)and topical anti-allergic.However,in the following reviews she developed cornea thinning and her systemic examination revealed an injected uvula with absence of upper respiratory tract infection.She was investigated for connective tissue disease and found to have raised anti-inflammatory markers and her antinuclear antibody and C-ANCA tests were positive.She was diagnosed with GPA.Her conditions improved followed by the commencement of topical corticosteroid with high dose of systemic corticosteroid,which followed by a tapering regime with oral corticosteroid.Although red eye is common,it is associated with a variety of diseases.GPA manifestation can be as subtle as a red eye.Any prolonged partially treated red eye should prompt suspicion of a more sinister cause.Sensitive detection of other subtle systemic signs is very important.展开更多
AIM:To estimate the magnitude of different ocular manifestation in clinically established herpes zoster ophthalmicus(HZO)patients and assessment of the visual outcome after two months of initial examination.METHODS:An...AIM:To estimate the magnitude of different ocular manifestation in clinically established herpes zoster ophthalmicus(HZO)patients and assessment of the visual outcome after two months of initial examination.METHODS:An observational prospective study was conducted on 42 clinically diagnosed Tzanck smear positive cases HZO to observe the occurrence and frequency of different ocular manifestation and their visual outcome in 10-month period with 2mo follow up.Full ophthalmological examination using slit lamp,non-contact tonometry,applanation tonometry,direct and indirect ophthalmoscope were performed.RESULTS:Out of 42 patients of HZO,33 had one or more type of ocular manifestation staring from lid skin involvement to conjunctivitis,keratitis,uveitis,increased intraocular pressure(IOP)and optic neuritis but no retinal manifestation.More number of HZO cases and ocular manifestation were found with advancement of ages.Young HZO patients were more associated with human immunodeficiency virus(HIV)infection and HIV infected people with HZO infection had more ocular manifestation.Male to female ratio was 2:1 among HZO cases but ocular manifestation occurred more among males.Female with advanced age were involved more.Lid involvement(73.81%),conjunctivitis(69.05%),and keratitis(59.52%)were most common ocular manifestation followed by anterior uveitis(30.95%)and episcleritis(11.90%).Ocular hypertension(42.86%)was associated with almost every ocular manifestation.Among the cases of more than 45 years of age,9.52%patients acquired 6/6 vision compared to 7.14%patients at and below 45 years of age after 8wk of follow up.CONCLUSION:The visual outcomes are poor in HZO with advanced age group.Visual outcome of the affected eyes is poor than unaffected eyes.The loss of vision is mainly due to keratitis,anterior uveitis,posterior uveitis,and optic neuritis.展开更多
文摘AIMTo describe the clinical features, systemic associations, treatment and visual outcomes in Saudi patients with scleritis.METHODSA retrospective chart review was performed for patients with scleritis presenting to two tertiary care eye hospitals in Riyadh, Saudi Arabia, from 2001 to 2011. Data were collected on the clinical features of scleritis, subtypes of scleritis, associated systemic disease, history of previous ocular surgery and medical therapy, including the use of immunosuppressants. Treatment outcomes were evaluated based on best-corrected visual acuity (BCVA) and response to treatment.RESULTSOf the 52 patients included in the study, non-necrotizing anterior scleritis was the most common type of scleritis in 22 patients (42.3%), followed by posterior scleritis in 14 patients (26.9%). The majority of cases, 31 patients (59.6%), were idiopathic in nature. Systemic associations were present in 12 patients (23.1%). Infectious scleritis was confirmed in 6 patients (11.5%): 3 with bacterial scleritis after pterygium excision, 2 patients with scleritis related to tuberculosis and 1 patient with scleritis resulting from herpes simplex infection. For the various subtypes of scleritis, BCVA values after treatment and time to remission significantly differed (P<0.05, all cases). Systemic immunosuppressive therapies in addition to steroids were administered to 46.2% of all patients. The T-sign was present on B-scan ultrasonography in 9 (64.3%) of the 14 posterior scleritis patients.CONCLUSIONNon-necrotizing anterior scleritis was the most common subtype of scleritis. Final visual outcome and time to remission differed among the various scleritis subtypes.
文摘AIM:To investigate the prevalence of ophthalmological extra-intestinal manifestations(O-EIMs) in Chinese patients with inflammatory bowel disease(IBD) and to identify risk factors for the development of O-EIMs.METHODS:The study population consisted of Chinese patients with a definite diagnosis of Crohn's disease(CD) or ulcerative colitis(UC) in a large teaching hospital between January 1995 and December 2014.Demographic and clinical characteristics of patients were extracted retrospectively.RESULTS: In this twenty-year cohort,645 IBD patients(517 with UC,128 with CD) were registered.Among them122(18.9%) exhibited at least one EIM.Of 13 patients(2.0%) developed O-EIMs,7 of CD(5.5%) and 6 of UC(1.2%).Clinical ophthalmological manifestations included redness(76.9%),burning(61.5%),pain(38.5%),itching(15.4%) of eyes and vision change(7.7%).O-EIMs included episcleritis(7),uveitis(5) and dry eye(1).OEIMs were more prevalent in female(odds ratio for male0.61,95% confidence interval 0.52-0.73,P 〈0.0001),and patients who had IBD diagnosis at young age(odds ratio for patients aged 〉30 years 0.76,95% confidence interval0.65-0.88,P 〈0.0001).CONCLUSION: The frequency of O-EIMs in Chinese patients with IBD is lower than the rates reported in the studies of European and American countries.Episcleritisand uveitis are the most common O-EIMs.O-EIMs are more frequent in patients with CD and more prevalent in female and patients who have IBD diagnosis at young age.
文摘Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of this autoimmune disease vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Their appearance, as well as their severity are related to RA chronicity and resistance to therapy. The treatment consists of corticosteroids, NSAIDs and cytotoxic drugs, depending on the type of ocular manifestations and the patient’s response to treatment.
文摘Red eye is common in our daily practice.It ranges from non-inflammatory to inflammatory causes.An extended course of disease should prompt suspicion and the possibility of diagnosis revision.A prolonged conjunctivitis mimicking nodular episcleritis can be presented as a manifestation of granulomatosis with polyangiitis(GPA).A 57-year-old woman complained of eye redness and tearing for two weeks which partially resolved with antibiotics.She was subsequently commenced on topical and oral non-steroidal anti-inflammatory drugs(NSAIDs)and topical anti-allergic.However,in the following reviews she developed cornea thinning and her systemic examination revealed an injected uvula with absence of upper respiratory tract infection.She was investigated for connective tissue disease and found to have raised anti-inflammatory markers and her antinuclear antibody and C-ANCA tests were positive.She was diagnosed with GPA.Her conditions improved followed by the commencement of topical corticosteroid with high dose of systemic corticosteroid,which followed by a tapering regime with oral corticosteroid.Although red eye is common,it is associated with a variety of diseases.GPA manifestation can be as subtle as a red eye.Any prolonged partially treated red eye should prompt suspicion of a more sinister cause.Sensitive detection of other subtle systemic signs is very important.
文摘AIM:To estimate the magnitude of different ocular manifestation in clinically established herpes zoster ophthalmicus(HZO)patients and assessment of the visual outcome after two months of initial examination.METHODS:An observational prospective study was conducted on 42 clinically diagnosed Tzanck smear positive cases HZO to observe the occurrence and frequency of different ocular manifestation and their visual outcome in 10-month period with 2mo follow up.Full ophthalmological examination using slit lamp,non-contact tonometry,applanation tonometry,direct and indirect ophthalmoscope were performed.RESULTS:Out of 42 patients of HZO,33 had one or more type of ocular manifestation staring from lid skin involvement to conjunctivitis,keratitis,uveitis,increased intraocular pressure(IOP)and optic neuritis but no retinal manifestation.More number of HZO cases and ocular manifestation were found with advancement of ages.Young HZO patients were more associated with human immunodeficiency virus(HIV)infection and HIV infected people with HZO infection had more ocular manifestation.Male to female ratio was 2:1 among HZO cases but ocular manifestation occurred more among males.Female with advanced age were involved more.Lid involvement(73.81%),conjunctivitis(69.05%),and keratitis(59.52%)were most common ocular manifestation followed by anterior uveitis(30.95%)and episcleritis(11.90%).Ocular hypertension(42.86%)was associated with almost every ocular manifestation.Among the cases of more than 45 years of age,9.52%patients acquired 6/6 vision compared to 7.14%patients at and below 45 years of age after 8wk of follow up.CONCLUSION:The visual outcomes are poor in HZO with advanced age group.Visual outcome of the affected eyes is poor than unaffected eyes.The loss of vision is mainly due to keratitis,anterior uveitis,posterior uveitis,and optic neuritis.