Unilateral hypopyon associated acute syphilitic posterior placoid chorioretinitis: Unusual presentation leading to HIV diagnosis

Syphilis has a wide variety of ocular presentations such as anterior or posterior uveitis, chorioretinitis, retinal vasculitis, retinitis, perineuritis, papillitis, retrobulbar neuritis, optic atrophy and optic nerve gumma. Therefore, it is recommended to test every patient with ocular inflammation for syphilis. It is, however, a relatively rare cause of uveitis in HIV disease. A few studies suggested that HIV contributes to the ocular manifestations of syphilis and HIV co-infection in approximately 30%. Acute syphilitic posterior placoid chorioretinopathy is a rare ocular manifestation in immune-competent patients characterised by the development of a deposit in the outer retina. We describe an unusual such presentation with hypopyon.

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Ocular manifestation of rheumatoid arthritis-different forms and frequency

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2010.2680 ◽

2010 ◽

Vol 10 (4) ◽

pp. 323-327 ◽

Cited By ~ 31

Author(s):

Gordana Zlatanović ◽

Dragan Veselinović ◽

Sonja Cekić ◽

Maja Živković ◽

Jasmina Đorđević- Jocić ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Keratoconjunctivitis Sicca ◽

Anterior Segment ◽

Retinal Vasculitis ◽

Applanation Tonometry ◽

Ocular Involvement ◽

Ocular Manifestation ◽

Posterior Scleritis ◽

Ocular Manifestations ◽

Systemic Inflammatory Disease

Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with a number of extra-articular organ manifestations. Ocular manifestations involved with RA are keratoconjunctivitis sicca, episcleritis, scleritis, corneal changes, and retinal vasculitus. The etiopathogenesis of this autoimmune disorder is still unknown. Aim of our study was to present different ocular manifestations of RA and their frequency. We have examined 691 patient with the diagnoses of RA. All examined patients were in I or II stage of the disease according to criteria of The American College of Rheumatology. Ophthalmological exam obtained: visual acuity by Snellen sings, biomicroscopy of anterior segment, Schirmer test, tear break-up time (BUT), applanation tonometry and indirect ophthalmoscopy. In all patients with retinal vasculitis fotofundus and in indicated cases fluorescein angiography was preformed. The most common manifestation of ocular involvement was keratoconjunctivitis sicca. Episcleritis was diagnosed in 5.06% patients with RA, while scleritis was present in 2.06% of patients. Diffuse scleritis was present in one patient, while nodular was present in 13 patients. There were no patients with posterior or necrotizing scleritis among examined patients. Sclerosing keratitis was diagnosed in 11 female patients. It is characterized with peripheral thickening and opacification of the stroma adjacent to the site of inflammation. Posterior scleritis or scleromalacia of cornea was not present in our patients, because all of them were in I or II stage of disease. Retinal vasculitis was present in three patients, two male and one female patient (0.45%). Ocular manifestation was present in 27.2% of patients. Women were more affected.

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Eye in COVID-19: A Brief Review

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.1040 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Muhammad Mohsin Ali ◽

Qudsia Anwar Dar ◽

Zahid Kamal ◽

Alishba Khan

Keyword(s):

Infection Control ◽

Respiratory Symptoms ◽

Literature Search ◽

Control Measures ◽

Transmission Route ◽

Ocular Manifestation ◽

Personal Protection ◽

Personal Protection Equipment ◽

Ocular Manifestations ◽

Infection Control Measures

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during the COVID pandemic is also presented in this review.

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949. Use of Optical Coherence Tomography Angiography to Assess Microvascular Health Among Persons with HIV: Employing the Retina as a Convenient Window

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1135 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S507-S507

Author(s):

Lauren F Collins ◽

Jessica G Shantha ◽

Peter L Nesper ◽

Anandi N Sheth ◽

Amani A Fawzi ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Retinal Vasculitis ◽

Organ Damage ◽

Screening Tools ◽

Foveal Avascular Zone ◽

Invasive Technique ◽

Optical Coherence ◽

Hiv Diagnosis ◽

The Right

Abstract Background Mechanisms underlying the rising burden of non-AIDS comorbidities (NACM) among persons with HIV (PWH) remain unclear. Microvasculopathy may link HIV-related chronic inflammation and premature multimorbidity, similar to diabetes and other conditions characterized by inflammatory end-organ damage. We used a novel retinovascular imaging tool, optical coherence tomography angiography (OCTA), to evaluate the retina as a convenient assessment of microvascular health among PWH. Methods Data from 4 PWH who underwent OCTA (Zeiss CIRRUSTM HD-OCT 5000) at the Emory Eye Center from 2018-2020 were analyzed. Demographics, HIV-specific indices and NACM were summarized at the time of OCTA. Images were reviewed qualitatively and metrics of microvascular health – the foveal avascular zone (FAZ) area and vessel density (VD) from the superficial capillary plexus (SCP) – were calculated by ImageJ. Results The median age was 39 years, 100% were male, 100% were black, 25% had ever smoked, and median body mass index was 25.4 kg/m2. Median time since HIV diagnosis was 19 years, all patients had a history of clinical AIDS, including 2 with prior cytomegalovirus retinitis. Median current CD4 count was 84 cells/mm3, 100% were prescribed antiretroviral therapy and 50% had HIV viral suppression. Prevalent NACM included (each n=1): hypertension, dyslipidemia, diabetes, chronic kidney disease and asthma. Qualitatively, all 7 of the eyes evaluated by OCTA had evidence of microvascular pathology: 2 eyes demonstrated diffuse capillary nonperfusion, while the remaining 5 eyes had focal areas of nonperfusion around the FAZ. Mean FAZ area was 0.31 (SD±0.10) mm2 and mean VD of the SCP was 43.9% (SD±10.9%). Retinovascular pathology identified by fundoscopy and OCTA is shown in the figure. Figure. Retinal imaging of a PWH with bilateral retinal vasculitis. Fundus photos of the right (A) and left (C) eyes show retinal vasculitis highlighted by the red arrows. OCTA of the right (B) and left (D) maculae (3X3 scan Zeiss AngioplexTM) show the FAZ areas outlined in yellow, both of irregular contour. OCTA of the left macula demonstrates areas of significant flow voids marked by the asterisks and the FAZ area is enlarged. Conclusion Among patients with longstanding HIV, OCTA identified microvascular abnormalities in all retinae examined. Retinovascular evaluation by OCTA is a feasible, non-invasive technique for assessing microvascular health and findings support additional study in a larger, more diverse group of PWH. Screening tools targeting microvasculopathy among PWH may aid in earlier detection of those at greatest risk of NACM and allow for aggressive risk-modification strategies. Disclosures All Authors: No reported disclosures

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335 - BEHÇET DISEASE PRESENTING WITH ACUTE PSYCHOSIS

International Psychogeriatrics ◽

10.1017/s1041610220002355 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 94-94

Author(s):

A.M. Carvalheiro ◽

A.R. Fonseca ◽

J. Maia

Keyword(s):

Psychiatric Symptoms ◽

Retinal Vasculitis ◽

Posterior Uveitis ◽

Neurological Involvement ◽

Behçet Disease ◽

Acute Psychosis ◽

Behcet Disease ◽

Persecutory Delusions ◽

Starting Point ◽

History Of

ObjectivesUsing as a starting point a clinical case, the authors performed a literature review to clarify the relationship between Behçet disease and acute psychosis.MethodsAnalysis of the patient's clinical process and brief review of the latest available literature on the subject, published in PubMed/Medline databases.ResultsMale patient, 55 years old, brought to the emergency room by fever, headache, hetero-aggressive behavior, disinhibited behavior, mood swings, euphoria, persecutory delusions and insomnia, in the last 4 days. He had no insight into his illness. There was no personal or family history of psychiatric illness and toxicological habits were irrelevant. Due to the personal history of posterior uveitis with bilateral macular edema, retinal vasculitis, genital aphthosis, papulo-vesicular lesions and recurrent bipolar aphthosis, the hypothesis of neuro-behçet was raised.ConclusionsBehçet's disease can present with neurological involvement - neuro -behçet - and can manifest itself with several psychiatric symptoms (euphoria, lack of insight, disinhibited behavior, agitation or psychomotor retardation, persecutory delusions, obsessive thoughts, anxiety, depression, insomnia or memory changes). Fever and headache usually appear in the prodromal stage and can be signs of onset or recurrence of the disease. The prevalence of neuro-behçet ranges from 2 to 50% and usually occurs 1 to 10 years after the first symptoms of the disease. Since it appears as the first manifestation of the disease in only 3% of cases, it is difficult to diagnose. The literature suggests that symptoms are generally resistant to treatment with conventional psychotropic drugs and so it is an important cause of morbidity and mortality.”

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Incidence of occult retinal vasculitis revealed on fluorescein angiography in clinically quiescent pediatric posterior uveitis

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2017.07.008 ◽

2017 ◽

Vol 21 (4) ◽

pp. e4

Author(s):

Ashley Abraham ◽

Ujwala S. Saboo ◽

Cristiana Ronconi ◽

Bruna L. Ducca ◽

Araceli T. Lawand ◽

...

Keyword(s):

Fluorescein Angiography ◽

Retinal Vasculitis ◽

Posterior Uveitis

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NUTRITIONAL RETROBULBAR NEURITIS FOLLOWED BY PARTIAL OPTIC ATROPHY

The Lancet ◽

10.1016/s0140-6736(00)83508-4 ◽

1937 ◽

Vol 229 (5934) ◽

pp. 1225-1227 ◽

Cited By ~ 27

Author(s):

D. Fitzgerald Moore

Keyword(s):

Optic Atrophy ◽

Retrobulbar Neuritis

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Epidemiology of disease-activity related ophthalmological manifestations in Systemic Lupus Erythematosus: A systematic review

Lupus ◽

10.1177/09612033211050337 ◽

2021 ◽

pp. 096120332110503

Author(s):

Nitish Jawahar ◽

Jessica K Walker ◽

Philip I Murray ◽

Caroline Gordon ◽

John A Reynolds

Keyword(s):

Systematic Review ◽

Systemic Lupus Erythematosus ◽

Disease Activity ◽

Lupus Erythematosus ◽

Systemic Disease ◽

Retinal Vasculitis ◽

Small Sample ◽

Systemic Lupus ◽

Ocular Manifestations ◽

Ophthalmic Manifestations

Objective Ophthalmic complications in Systemic Lupus Erythematosus (SLE) are broad and can occur in up to a third of patients. The British Isles Lupus Assessment Group (BILAG) 2004 Index identifies 13 ocular manifestations of active SLE, as opposed to those related to previous disease activity and/or the consequences of therapy. We conducted a systematic review of published literature to determine the frequency of ophthalmic manifestations of active SLE. Methods A systematic literature search of Ovid MEDLINE and EMBASE from their respective inceptions to July 2020 was conducted to identify cohort, case–control and cross-sectional studies. Results 22 studies meeting eligibility criteria were included. Most studies featured small sample sizes and were judged to have a high risk of methodological bias. The number and quality of studies did not allow us to confidently estimate the incidence of the conditions. No studies reported epidemiological data for orbital inflammation/myositis/proptosis. The prevalence of each of the other ocular manifestations, with the exception of retinal vaso-occlusive disease, was consistently less than 5%. Retinal vasculitis, uveitis and isolated cotton wool spots tended to be associated with more active SLE disease. Conclusion The prevalence of eye disease due to SLE activity is uncommon, but clinicians should be aware that some conditions tend to be associated with more active systemic disease. Further studies to determine the incidence and risk factors for these ophthalmic manifestations are needed.

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