Polymerase Chain Reaction Confirmed Mycobacterium Tuberculosis Intermediate Uveitis – Analysis of 22 Eyes of 14 Cases From a Tertiary Care Centre in South India.

Background: To report the role of Polymerase Chain Reaction in confirming the diagnosis of presumed mycobacterium Tuberculous Intermediate Uveitis. Method: Retrospective analysis of 22 eyes of 14 cases of presumed tubercular intermediate uveitis wherein intraocular fluid was tested for MTB DNA by Nested & Real time PCR, based on clinical suspicion of tubercular aetiology. QuantiFERON TB gold test and High Resolution CT Chest were done. Patients were treated with anti-tubercular therapy with oral steroids & immunomodulators. In the study, eleven were male (79%) and three female (21%). The median age was 34 years. Nested PCR for both IS 6110 & MPB 64 was positive in 64% of the cases, IS 6110 positive in 23% and MPB 64 positive in 15%. Real time PCR was positive in 48% of the cases. Vision improved in 33% cases, maintained in 57% cases and worsened in 10 % of cases. Conclusion: Presumed Tubercular intermediate uveitis can be confirmed by PCR of intraocular fluids. Anti-tubercular therapy with immunosuppression can improve vision and prevent recurrences in such cases.

P058 Epidemiological clinical, etiologic spectrum and follow-up results of uveitis in children: a single center experience

Background Uveitis refers to the inflammation of the vascular tunic of the eye. This inflammation varies greatly in its clinical expressions and etiologies and is often a majordiagnostic challenge for physicians. These data cover symptoms, clinical examination results, complications, etiologies and treatments Methods A retro-prospective monocentric study was carried out on 22patients hospitalized in the pediatric department of the issaadhassani hospital of Algiers during the period of January 2017 to December 2021. Results The sex ratio is 1,2. Their average age was 8 years (4–15Y). Most of thepatients consulted for the three cardinal signs of uveitis: 81% for a decrease in visual acuity, 59% for redness, and 43% for ocular pain. Uveitis was bilateral in 55% of the cases. Inanatomical localization, 45,5% of patients had total uveitis, 27% had anterior uveitis, and 18% had intermediate uveitis, and 9% had anterior and intermediate uveitis. An etiologic diagnosis was made in 32% of the cases. The most frequent causes were inflammatory. Treatments consisted of local corticosteroid therapy for all thepatients, a general corticoid treatment for all of the patients, associated with an immunosuppressive treatment for 50% and biologic anti TNF α treatment (adalimumab) for23% cases. A good evolution after treatment was noted among patients with visual acuity <3/10 with a substantial decrease from 67% to 2%.77.5% are in remission, 13.5% are improving and 9% are in relapse the duration of the follow-up is 1 ½ years with intervals of 2 months and 5 years. Conclusion The results of the current study are generally compatible with the literature. however. The percentage of etiologies covered remains a point to improve, The pooled prevalence of uveitis in pediatric rheumatic diseases widely varied based on the underlying disease requiring more investigations in different subtypes of rheumatic diseases. The biologic medications, especially Adalimumab are the most effective treatments for uveitis in pediatric rheumatic diseases; however, a combination of the safe, available alternatives is preferred to achieve the most desirable treatment response.

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

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 <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.

Outcomes from a Multi-disciplinary Uveitis Referral Clinic in Tasmania, Australia and adaptation during the COVID-19 pandemic

Background: Uveitis is one of the most common causes of visual impairment, accounting for up to 25% of visual loss in the developing world and 10% in developed countries. There are marked regional differences within Australia, particularly in rural and Indigenous populations. There is no published data on uveitis in Tasmania. Methods: A 5-year retrospective case series review of medical records of all patients reviewed to the clinic was performed. Results: A total of 95 patients were referred to the clinic. Seventy-six (76) patients (123 eyes) had uveitis and were analysed in detail (see table 1). Nineteen (19) patients had a diagnosis other than uveitis or were on immunosuppressive therapy for another ocular inflammatory disorder (detailed in Table 2). The most common anatomical diagnosis was posterior uveitis (29%), followed by pan-uveitis (20%) and intermediate uveitis (17%). Average follow-up was 36.7 months. Conclusion: The most common anatomical diagnosis was posterior uveitis (29%), followed by pan-uveitis (20%) and intermediate uveitis (17%). Telemedicine is a modality that could have application in management of Uveitis in regional areas.