Review of de novo uveitis in older adults presenting to a large tertiary centre

2021 ◽  
pp. bjophthalmol-2020-318657
Author(s):  
Priya Samalia ◽  
Luke Jeffrey Hawley ◽  
Rachael L Niederer ◽  
Joanne Sims
Keyword(s):  
Ocular Hypertension ◽  
Macular Oedema ◽  
Epiretinal Membrane ◽  
De Novo ◽  
Intraocular Lymphoma ◽  
Cystoid Macular Oedema ◽  
Health Board ◽  
Intermediate Uveitis ◽  
District Health ◽  
Posterior Synechiae

Background/aimsThe primary aim of this study was to describe the causes of de novo uveitis in individuals 60 years and older. Secondary objectives were to determine the incidence of intraocular lymphoma and the clinical predictors of lymphoma.MethodsRetrospective chart review of all subjects presenting to the uveitis service at Auckland District Health Board (Auckland, New Zealand) between January 2006 and October 2020Results686 subjects (900 eyes) were aged ≥60 years at first presentation with uveitis, representing 23.4% of all subjects with uveitis during the study period. Non-infectious aetiology occurred in 631 (70.1%) eyes and infectious etiologies occurred in 269 (29.9%) eyes. The most frequent causes were idiopathic (36.3%), herpes zoster (14.8%), HLAB27 (8.7%) and sarcoidosis (4.8%). Twenty (2.2%) eyes of 13 (1.9%) subjects had a diagnosis of lymphoma. Lymphoma represented 11.2% of all intermediate uveitis. Subjects diagnosed with lymphoma did not develop posterior synechiae, epiretinal membrane, cystoid macular oedema or ocular hypertension.ConclusionsIntraocular lymphoma was uncommon in the overall cohort, but an important cause of intermediate uveitis. A diagnosis of lymphoma needs to be considered in any older subject with de novo intermediate uveitis. The lack of posterior synechiae, cystoid macular oedema, epiretinal membrane and ocular hypertension further increases the suspicion for lymphoma.

scholarly journals Uveitis and cystoid macular oedema secondary to topical prostaglandin analogue use in ocular hypertension and open angle glaucoma

2020 ◽  
Vol 104 (8) ◽  
pp. 1040-1044
Author(s):  
Jason Hu ◽  
James Thinh Vu ◽  
Brian Hong ◽  
Chloe Gottlieb
Keyword(s):  
Ocular Hypertension ◽  
Case Studies ◽  
Macular Oedema ◽  
Open Angle Glaucoma ◽  
Experimental Studies ◽  
Cochrane Library ◽  
Cystoid Macular Oedema ◽  
Eye Drops ◽  
Open Angle ◽  
Ocular Surgery

BackgroundOf the side effects of prostaglandin analogues (PGAs), uveitis and cystoid macular oedema (CME) have significant potential for vision loss based on postmarket reports. Caution has been advised due to concerns of macular oedema and uveitis. In this report, we researched and summarised the original data suggesting these effects and determined their incidence.MethodsPreferred Reporting Items for Systematic review and Meta-Analyses guidelines were followed. Studies evaluating topical PGAs in patients with ocular hypertension or open angle glaucoma were included. MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, LILACS and ClinicalTrials.gov were searched between 1946 and 2019. Experimental studies, animal studies and randomised studies with other intraocular pressure-lowering eye drops were excluded.Results214 studies (28 232 patients) met the inclusion criteria. Using prospective data, the incidence of uveitis and CME among PGA users were 62/28 232 (0.22%) and 25/28 232 (0.09%), respectively. A higher frequency of both uveitis and CME were found among latanoprost users compared with bimatoprost. There were 21 case studies reporting CME including 48 eyes in 43 patients. 47 of 48 eyes (97.9%) had previous incisional ocular surgery. 8 eyes were re-challenged, of which 7 (87.5%) recurred. 7 case studies reported uveitis in 15 eyes of 10 patients. 7 of 15 eyes (46.7%) were either pseudophakic or aphakic. 6 eyes were re-challenged, and all 6 (100%) recurred.ConclusionsCases of uveitis or CME revealed a confounding effect of ocular surgery, aphakia or subluxed intraocular lens. PGAs may be used in non-surgical patients without concern of causing CME or uveitis. The incidences of PGA-associated CME and uveitis are rare with limited prospective studies on the cause-effect relationship.

scholarly journals Prevalence of cystoid macular oedema, epiretinal membrane and cataract in retinitis pigmentosa

2018 ◽  
Vol 103 (8) ◽  
pp. 1163-1166 ◽  
Author(s):  
Gerald Liew ◽  
Stacey Strong ◽  
Patrick Bradley ◽  
Philip Severn ◽  
Anthony T Moore ◽  
...  
Keyword(s):  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Epiretinal Membrane ◽  
Autosomal Recessive ◽  
Autosomal Dominant ◽  
Cystoid Macular Oedema ◽  
Dominant Inheritance ◽  
Younger Age ◽  
Multivariable Analyses ◽  
Eye Clinic

Background/AimsTo report the prevalence of treatable complications (cystoid macular oedema, CME; epiretinal membrane, ERM and cataract) in patients with retinitis pigmentosa (RP).MethodsConsecutive patients with RP attending a tertiary eye clinic in 2012. Spectral domain-optical coherence tomography was used to determine presence of CME and ERM. Clinic records were reviewed to identify cataract and pseudophakia. Multivariable analyses adjusted for age, gender and other confounders.ResultsData are presented for 338 eyes from 169 patients. CME was present in 58.6% of patients and 50.9% of eyes and was bilateral in 73.7%. ERM, cataract and pseudophakia were present in 22.8%, 23.4% and 11.2% eyes, respectively. In multivariable analyses, CME was associated with younger age (OR 0.81, 95% CI 0.67 to 0.98) but not with gender. Patients with ERM and cataract/pseudophakia were less likely to also have CME (OR 0.19, 95% CI 0.09 to 0.40 and OR 0.37, 95% CI 0.16 to 0.84, respectively). CME was most prevalent in patients with autosomal-dominant inheritance (71.4%), followed by autosomal recessive/sporadic inheritance (58.9%) and least likely in persons with X linked inheritance (12.5%, p<0.001).ConclusionsThe prevalence of treatable RP complications is high and suggests it may be clinically beneficial to screen patients with RP to identify those who may benefit from current or future interventions.

P059 Etiological profile of childhood uveitis in a Tunisian population: a 12-year retrospective study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
O Jomaa ◽  
I Ksiaa ◽  
S Khochtali ◽  
M Jguirim ◽  
M Khairallah
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Macular Oedema ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Tunisian Population ◽  
Cystoid Macular Oedema ◽  
Intermediate Uveitis ◽  
Infectious Origin ◽  
Female Predominance

Abstract Background Uveitis in children represents 10% of all cases of uveitis. It is a serious condition with an often-insidious onset and evolution, and has a negative impact on visual prognosis with a risk of amblyopia or even blindness. The etiologies are varied. the aim of this study is to describe the epidemiological, clinical, and etiological characteristics of childhood uveitis during a period of 12 years. Methods A descriptive retrospective study including 138 children (276 eyes) with uveitis, was conducted at the Ophthalmology Department of Fattouma Bourguiba University Hospital in Monastir Tunisia between 1 January 2006 and 31 December 2017. Results The patients average age was 10.2 ± 3,58. A female predominance was noted (sex ratio: 0.91). Uveitis was bilateral in 2/3 of cases and unilateral in 1/3 of cases. Vision loss was the most common reason for consultation (52.2%). The mean initial visual acuity was 3,3/10 ± 3,24. Intermediate uveitis was the most common anatomical form (42,02%), followed by anterior uveitis (28,26%), panuveitis (26,08%), and posterior uveitis (3,6%). The infectious origin was the most common aetiology, followed by uveitis related to general condition (13,72%), and uveitis in context of a specific ocular condition (12,3%). Uveitis was idiopathic in 79 patients (57.24%). Periocular injection of triamcinolone acetonide was performed in (29 patients, 21%). The use of immunosuppressives agents was noted in 38 patients (27,5%) (methotrexate: 23 patients, azathioprine: 16 patients, and ciclosporin: 10 patients). The use of intravitreous injections of bevacizumab was noted in 6 patients (4.33%). Anti TNF alpha treatment was used for 2 patients. Post-uveitic complications were noted in 84.3% of cases. They were dominated by cataract (31,88%) at the anterior segment level. Cystoid macular oedema (31,88%) and retinal serous detachment (15,9%) were the major complications in the posterior segment. Mean final visual acuity was 5.98/10 ± 3,54. It was &lt;1/10 in 14 eyes. Conclusion In our study a female predominance was noted. Intermediate uveitis was the most common anatomical form. The infectious origin was preponderant. Post-uveitic complications was dominated at the anterior segment level by cataract and cystoid macular oedema at the posterior segment.

Vision loss in anterior uveitis

2020 ◽  
Vol 104 (12) ◽  
pp. 1652-1657
Author(s):  
Haya H Al-Ani ◽  
Joanne L Sims ◽  
Oren Tomkins-Netzer ◽  
Susan Lightman ◽  
Rachael L Niederer
Keyword(s):  
Anterior Uveitis ◽  
Vision Loss ◽  
Cumulative Risk ◽  
Cystoid Macular Oedema ◽  
Health Board ◽  
District Health ◽  
Common Cause ◽  
Uveitic Glaucoma ◽  
Infectious Aetiology

AimsTo evaluate the long-term risk of permanent vision loss in subjects with anterior uveitis.MethodsRetrospective study of subjects attending uveitis clinic at Auckland District Health Board and Moorfields Eye Hospital between 2008 and 2018. Main outcome measures were: best corrected visual acuity (BCVA); moderate vision loss (MVL ≤20/50); and severe vision loss (SVL ≤20/200).Results2526 eyes of 1814 subjects were included with a mean follow-up of 6.8 years (17 235.4 eye-years of follow-up). MVL occurred in 240 eyes (9.5%) during the follow-up period, of which 97 (3.8%) had permanent MVL due to uveitis. The incidence of permanent MVL due to uveitis was 0.006 per eye-year with a cumulative risk at 10 years of 6.6% (5.2%–8.4%). The most common cause of permanent MVL due to uveitis was uveitic glaucoma (31.3%), followed by cystoid macular oedema (27.1%) and corneal scar (21.9%). SVL occurred in 80 eyes (3.2%) during the follow-up period, of which 39 (1.5%) had permanent SVL due to uveitis. The incidence of permanent SVL due to uveitis was 0.002 per eye-year with a cumulative risk at 10 years of 2.6% (1.8%–3.7%). Multivariate analysis showed older age at presentation, chronic anterior uveitis (CAU), infectious aetiology and poor presenting BCVA were all risk factors for permanent MVL due to uveitis.ConclusionsAlthough vision loss is an uncommon complication in anterior uveitis, the risk is greatest in those with CAU, infectious aetiology and poor presenting BCVA. Uveitic glaucoma is the most common cause of vision loss.

Registered nurse prescribing: A descriptive survey of prescribing practices in a single district health board in Aotearoa New Zealand

2020 ◽  
Vol 36 (3) ◽  
pp. 61-72
Author(s):  
Melinda McGinty ◽  
◽  
Betty Poot ◽  
Jane Clarke ◽  
◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Registered Nurse ◽  
Health Conditions ◽  
Health Board ◽  
Prescribing Practices ◽  
District Health ◽  
Survey Tool ◽  
Aotearoa New Zealand ◽  
Descriptive Survey

The expansion of prescribing rights in Aotearoa New Zealand has enabled registered nurse prescribers (RN prescribers) working in primary care and specialty teams, to enhance nursing care, by prescribing medicines to their patient population. This widening of prescribing rights was to improve the population’s access to medicines and health care; however, little is known about the medications prescribed by RN prescribers. This paper reports on a descriptive survey of self-reported RN prescribers prescribing in a single district health board. The survey tool used was a Microsoft Excel spreadsheet to record nurse’s area of practice, patient demographic details, health conditions seen, and medicines prescribed and deprescribed. Simple data descriptions and tabulations were used to report the data. Eleven RN prescribers consented to take part in the survey and these nurses worked in speciality areas of cardiology, respiratory, diabetes, and primary care. Findings from the survey demonstrated that RN prescribers prescribe medicines within their area of practice and within the limits of the list of medicines for RN prescribers. Those working in primary care saw a wider range of health conditions and therefore prescribed a broader range of medications. This survey revealed that the list of medications available for RN prescribers needs to be updated regularly to align with the release of evidence-based medications on the New Zealand Pharmaceutical Schedule. It is also a useful record for both educational and clinical settings of the types of medications prescribed by RN prescribers.

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