scholarly journals Long-Term Control of Macular Edema With Adalimumab After Cataract Surgery in a Japanese Child With Juvenile Idiopathic Arthritis: Case Report and Review of 26 Japanese Patients

2020 ◽  
Vol 8 ◽  
pp. 232470962095328
Author(s):  
Toshihiko Matsuo ◽  
Masato Yashiro
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Japanese Literature ◽  
Oral Prednisolone ◽  
Japanese Patients ◽  
Final Visit ◽  
Oral Methotrexate

Juvenile idiopathic arthritis–associated uveitis is rare in the Japanese population. In this article, we report a child whose macular edema was controlled for years after cataract surgery with adalimumab, and reviewed 26 Japanese patients in the literature. In this case report, a 4-year-old boy developed band keratopathy, posterior iris synechiae, and complicated cataract in both eyes. Oral prednisolone prescribed at another hospital was discontinued due to high intraocular pressure in both eyes as a steroid responder. At the age of 5 years, he started oral methotrexate 8 mg weekly for recurrent bilateral iridocyclitis and then underwent lensectomy with core vitrectomy in both eyes. Planned intraocular lens implantation was cancelled at surgery because the anterior vitreous had severe inflammatory opacity with diffuse retinal edema in both eyes. Due to persistent macular edema in both eyes 5 months postoperatively, at the age of 6 years, he began to use adalimumab injection 20 mg every 2 weeks. The macular structure depicted by optical coherence tomography became normal in 2 months. At final visit at the age of 11 years, he had the best-corrected visual acuity of 0.8 in the right eye and 0.4 in the left eye, with adalimumab 40 mg every 2 weeks and methotrexate 8 mg weekly. In conclusion, macular edema persistent despite oral methotrexate after cataract surgery could be controlled for long term by adalimumab in a child with juvenile idiopathic arthritis. In the Japanese literature, only 26 additional cases with juvenile idiopathic arthritis–associated uveitis have been reported so far.

scholarly journals Long-term Clinical Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 62 (7) ◽  
pp. 931-938
Author(s):  
Ji Hyun Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Outcomes ◽  
Cystoid Macular Edema ◽  
Final Visit ◽  
Short Term ◽  
The Mean

Purpose: The long-term clinical outcomes of cataract surgery in patients with retinitis pigmentosa (RP) were evaluated. Methods: A retrospective analysis of medical records was performed for patients who were diagnosed with RP and underwent cataract surgery. Preoperative best-corrected visual acuity (BCVA) was compared with BCVA at 1 month postoperatively and at the final visit. The proportion of patients with cystoid macular edema development or aggravation after surgery was evaluated, as was the proportion of patients with intraocular lens subluxation/dislocation. For patients who underwent optical coherence tomography, factors associated with a BCVA of 0.5 or better at 1 month were analyzed. Results: In total, 133 eyes were included and the mean follow-up period was 58.7 months. The mean logarithm of minimal angle of resolution BCVA was 0.69 ± 0.65 at diagnosis. The BCVA was significantly improved to 0.51 ± 0.47 at 1 month postoperatively (p < 0.001). However, the BCVA at the final visit (0.70 ± 0.81) was similar to the baseline value (p = 1.000). Cystoid macular edema development or aggravation was noted in 8 eyes (6.0%) and intraocular lens subluxation/dislocation was noted in 4 eyes (3.0%). A subgroup analysis involving 108 eyes revealed that preoperative BCVA (p < 0.001) and ellipsoid zone status (p = 0.001) were associated with postoperative visual acuity. Conclusions: Short-term outcomes of cataract surgery in patients with RP were comparatively good. However, long-term visual deterioration was noted with disease progression. Preoperative BCVA and ellipsoid zone status are useful markers for predicting short-term visual outcomes.

scholarly journals Phenylketonuria and juvenile idiopathic arthritis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Ting Zhu ◽  
Jin Wu ◽  
Li Yuan Wang ◽  
Xiao Mei Sun
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Autoimmune Diseases ◽  
Hip Joint ◽  
Metabolic Disorder ◽  
Rare Case ◽  
Molecular Data ◽  
Methotrexate Therapy ◽  
Case Presentation

Abstract Background Phenylketonuria (PKU) is a genetic metabolic disorder in which patients have no ability to convert phenylalanine to tyrosine. Several autoimmune diseases have been reported to combine with PKU, co-existent of PKU and Juvenile Idiopathic Arthritis (JIA) has not been presented. Case presentation The girl was diagnosed with PKU at the age of 1 month confirmed by molecular data. At the age of 3.5 years, she presented with pain and swelling of her right ankle, right knee, and right hip joint. After a serial of examinations, she was diagnosed with JIA and treated with a nonsteroidal anti-inflammatory drug. Conclusions We report a rare case of a 4-year-old girl with PKU and JIA, which supports a possible interaction between PKU and JIA. Long-term metabolic disturbance may increase the susceptibility to JIA. Further chronic inflammation could alter the metabolism of tryptophan and tyrosine to increase blood Phe concentration. In addition, corticosteroid and methotrexate therapy for JIA may increase blood Phe concentration.

scholarly journals Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 67-68
Author(s):  
Abdul Nasser ◽  
Faheem Raja
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Early Recognition ◽  
Systemic Toxicity ◽  
Peribulbar Block ◽  
Local Anesthetic Systemic Toxicity ◽  
Symptoms And Signs

ABSTRACT Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae. How to cite this article Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. J Med Acad 2020;3(2):67–68.

Evaluation of Macular Changes in Long Term Period Following Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Diabetic Macular Edema

2021 ◽  
Author(s):  
Betul Onal Gunay ◽  
Gurkan Erdogan
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Additional Treatment ◽  
Final Visit ◽  
Ilm Peeling ◽  
Pars Plana

Aim: To evaluate long term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME) Methods: Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT) and 5-mm macular volume (5-MV) were examined preoperatively and at postoperative 1st, 2nd, 3rd, 6th, 12th, 24th months and final visits. Response to surgical treatment was considered as recurrence, reincrease and recovery of DME based on macular changes. Results: Mean follow-up time was 51.1±19.0 months following surgery. Recurrence (n=5) and reincrease (n=17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final visit mean BCVAs (logMAR) were 1.08±0.37 and 0.93±0.45, respectively (p=0.02). Preoperative and final visit mean CMTs were 514.74±155.65 µm and 281.87±112.58 µm, respectively (p<0.001). The 5-MV significantly decreased following surgery (8.18±1.57 mm3 to 6.52±1.39 mm3) (p<0.001). DME was present in 12 eyes (%30) at final visit. Conclusion: Although PPV with ILM peeling had an efficacy in DME management, this effect tends to decrease over time such that considerable amount of patients required additional treatment.

scholarly journals Psoriatic Juvenile Idiopathic Arthritis Associated with Uveitis: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Davide Moretti ◽  
Ilaria Cianchi ◽  
Gaia Vannucci ◽  
Rolando Cimaz ◽  
Gabriele Simonini
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Unknown Etiology ◽  
Acquired Disability ◽  
Chronic Uveitis ◽  
Short And Long Term ◽  
Inflammatory Drugs ◽  
Chronic Rheumatic Disease ◽  
International League

According to the definition proposed by the International League of Associations for Rheumatology (ILAR), juvenile idiopathic arthritis (JIA) is defined as an arthritis of unknown etiology, starting under 16 years of age and lasting for at least 6 weeks, once other known conditions have been excluded. JIA represents the most common chronic rheumatic disease of childhood and is considered an important cause of short- and long-term acquired disability in children. It is currently estimated that psoriatic JIA represents up to 10% of all JIA subtypes, and chronic uveitis may occur in 10 to 15% of children with psoriatic JIA. In this report we describe a case of psoriatic JIA complicated by uveitis, in a child failing previous treatments with nonsteroidal anti-inflammatory drugs, methotrexate, and etanercept. Finally, adalimumab was prescribed, which led to sustained clinical remission in both arthritis and uveitis.

Long-term results after primary intraocular lens implantation in children with juvenile idiopathic arthritis–associated uveitis

2018 ◽  
Vol 29 (5) ◽  
pp. 494-498 ◽  
Author(s):  
Urszula Kulik ◽  
Anna Wiklund ◽  
Maria Kugelberg ◽  
Anna Lundvall
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Long Term Results ◽  
Posterior Capsular Opacification ◽  
Intraocular Lens Implantation ◽  
Lens Implantation ◽  
Primary Intraocular Lens Implantation

Purpose: To evaluate the long-term outcome after cataract surgery with primary intraocular lens implantation in children with juvenile idiopathic arthritis–associated uveitis. Methods: The medical records of all 24 children (34 eyes) with chronic juvenile idiopathic arthritis–associated uveitis who underwent cataract surgery between 1990 and 2013 were reviewed retrospectively. Primary intraocular lens implantation was performed in all patients. Results: Median age at diagnosis of uveitis in the first eye was 5.3 years (range: 2.7–9.4 years) and median age at the time of cataract surgery in the first eye was 9.7 years (range: 4.1–16.9 years). Postoperative follow-up time ranged from 1 to 23.1 years, with a median of 10.9 years. Best corrected visual acuity at the last follow-up was good (⩾20/40) in 65% of the eyes. Postoperatively, glaucoma developed in 8 eyes (24%), posterior capsular opacification and secondary membrane formation requiring surgery in 15 eyes (44%), macular oedema in 5 eyes (15%) and phthisis in 2 eyes (6%). Conclusion: This study shows a favourable visual outcome in most of the cases. Primary intraocular lens implantation may be considered in juvenile idiopathic arthritis–associated uveitis complicated by cataract in patients with well-controlled inflammation.

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