scholarly journals Clinical Manifestations, Outcomes, and Histopathology of Recurrent Uveitis in Patients Underwent Pupil Coroplasty Combined with Cataract Surgery

Author(s):  
Hui Lu ◽  
Doudou Chen ◽  
Siquan Zhu

Abstract Purposes: This study was aimed to evaluate the clinical manifestations of recurrent uveitis in patients underwent pupil coroplasty combined with cataract surgery, and discovery the histopathological changes of iris tissues. Methods: There 28 patients with recurrent uveitis-induced cataract, who had underwent pupil coroplasty, phacoemulsification, and intraocular lens implantation were enrolled in this study. The clinical manifestations and outcomes of the enrolled patients were analyzed. The histopathological changes of iris tissues were observed by hematoxylin and eosin (HE) staining. Results: The uveitis were idiopathic in 89.29% cases (n = 25). Before the surgery, 20 cases had no topical medication for at least 3 months. The preoperative BCVA was > 0.5 in all cases. During the follow-up of 5-10 years, no recurrence of uveitis was found in 96.43% cases (n = 27). Uveitis only recurred in one case along with the onset of ankylosing spondylitis at the 6th week after the surgery. HE staining showed obvious atrophy of iris stroma in all samples. The hyperplasia of pigment cells was observed in the pigment epithelium (n = 9) and even invaded into stroma (n = 19). The infiltration of inflammatory cells in iris tissues was found in 7 cases, and neovascularization in the surface of the iris was found in 2 cases. Conclusion: Recurrent uveitis was characterized by the atrophy of iris stroma, and some cases also exhibited hyperplasia of pigment cells and infiltration of inflammatory cells. The surgery proposed in this study can effectively prevent the long-term recurrence of uveitis.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Cuilan Li ◽  
Shiyan Tang ◽  
Xingcheng Gao ◽  
Wanping Lin ◽  
Dong Han ◽  
...  

Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum.Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS), and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery.Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05), respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40). Three patients (3/40 = 7.5%) developed partial improvement, and 1/40 (2.5%) was lost to follow-up.Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.


2019 ◽  
Author(s):  
Piotr Kanclerz ◽  
Christoph Leisser ◽  
Andrzej Grzybowski ◽  
Paweł Lipowski

Abstract Background Cataract development is common in phakic eyes filled with silicone oil (SO), necessitating subsequent cataract removal. This study evaluated the refractive outcome in eyes filled with SO undergoing phacoemulsification cataract surgery (PCS). Methods This retrospective study evaluated patients with SO tamponade who were scheduled for PCS. Results Subjects (n=26) were followed-up for 29.5 ± 13.9 months after cataract surgery. The median spherical equivalent refraction (SER) was +5.3 D (interquartile range [IQR] +2.9 to +6.7) before PCS, and +3.4 D (IQR +2.0 to +4.4) after PCS. Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes (57.7%). In 13 eyes assessment of refraction after SO-removal was possible, and showed a myopic shift of -4.6 D (IQR -2.9 to -7.3) in the SER. After SO removal, 5 of 13 eyes (38.5%) were within ±1.0 D of the target refraction, while 9 out of 13 eyes (69.2%) were within ±2.0 D. Conclusions The refractive outcome after PCS for eyes filled with SO is less predictable than that for normal eyes. Some of the eyes undergoing silicone oil injection may require long-term tamponade.


2018 ◽  
Vol 27 (3) ◽  
pp. 435-446 ◽  
Author(s):  
Massimo Accorinti ◽  
Michela Cecere ◽  
Andrea Scala ◽  
Maria Pia Pirraglia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Martin Stattin ◽  
Stefan Hagen ◽  
Daniel Ahmed ◽  
Eva Smretschnig ◽  
Florian Frommlet ◽  
...  

Purpose. To evaluate normalized short-wavelength fundus autofluorescence (SW-FAF) imaging changes over time as a predictive parameter for the retinal pigment epithelium (RPE) function in eyes compromised by acute central serous chorioretinopathy (CSCR) after indocyanine green angiography-guided verteporfin (Visudyne®, Novartis Pharma, Basel, Switzerland) photodynamic therapy (PDT) with a half-fluence rate (25 J/cm2). Methods. Quantitative data of SW-FAF grey values (SW-FAF GV) from a 350 μm (SW-350) and 1200 μm (SW-1200) diameter circle centered on the fovea and normalized with the level of SW-FAF GV in a 30° image of 20 eyes in 11 patients initially treated for unilateral acute symptomatic CSCR were collected and retrospectively analyzed after 7 years. A 2-sided t-test was calculated to explore the differences of SW-350 and SW-1200 between one month and the long-term follow-up. Results. Mean differences (95% CI) in SW-FAF GV between 1 month and 7 years after half-fluence PDT were 0.07 ± 0.11 for SW-350 ([95% CI: −0.002; 0.14], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.03). Mean differences in SW-FAF GV of the contralateral untreated eye were 0.06 ± 0.14 for SW-350 ([95% CI: −0.04; 0.17], p=0.22) and 0.05 ± 0.13 for SW-1200 ([95% CI: −0.04; 0.15], p=0.22). Conclusion. After 7 years, normalized SW-FAF GV were significantly lower in eyes with resolved acute CSCR treated with reduced-fluence PDT compared to the follow-up after 1 month without correlation to explicit pattern changes or structural damages. Half-fluence PDT remains a safe and considerable treatment option in acute CSCR.


Author(s):  
N Vaninetti ◽  
S Mustafa ◽  
S Doucette ◽  
R Glasgow ◽  
L Tramble ◽  
...  

Background: Secondary hormonal deficiency (SHD) in patients with sellar masses (SM) is associated with significant morbidity. Purpose: to compare long-term risk of new-onset SHD in SM found incidentally (ISM) versus those clinically manifesting (CMSM). Methods: From the Halifax Neuropituitary Program’s database, we identified all patients having non-functioning and non-pituitary SM from January 1, 2006, with ≥ 12 months follow-up. Results: There were 214 CMSM (108 with baseline SHD) and 148 ISM (37 with baseline SHD) patients (mean follow-up: 5.7 and 5.0 years, respectively). In patients who underwent early surgery (<90 days from diagnosis), 3-month post-op hormonal function was considered baseline. Despite unchanged tumour size in over 95%, 129 (35.6%) developed new-onset SHD at up to 120 months. The risk of developing new-onset SHD was similar in CMSM and ISM groups (HR = 1.10; CI= 0.69-1.75; p= 0.7), and in surgical and nonsurgical patients (HR=1.24; CI= 0.59-2.61; p = 0.58). Conclusions: More than one third of patients with non-functioning or non-pituitary SM, presenting either with clinical manifestations or as incidental lesions, will develop new-onset SHD. Furthermore, SHD may develop several years later and despite stability of tumors, highlighting the need for ongoing, long-term hormonal assessment.


Lupus ◽  
2019 ◽  
Vol 28 (4) ◽  
pp. 555-559 ◽  
Author(s):  
D Martín-Iglesias ◽  
J Artaraz ◽  
A Fonollosa ◽  
A Ugarte ◽  
A Arteagabeitia ◽  
...  

Objective The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). Methods SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. Results We studied 110 patients and 195 eyes. No cases of HCQ toxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. Conclusions This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.


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