Unilateral Hypermature Cataract and Uveitis in Dwarf Campbell’s Hamster (Phodopus campbelli)

Background: In the ophthalmological examination of a 1.5-year-old male dwarf Campbell hamster, who was examined with complaints of photophobia, pain, weakness and whitening of the eye color, hypermature cataract and chronic uveitis were observed in the left eye. Methods: Local antibiotic therapy was administered to the patient for the first ten days in order to eliminate a possible microbial agent. In addition, local NSAI drugs were applied to reduce pain and inflammation. Then, peros Prednol (methylprednisolone) was administered at a dose of 0.5 mg/kg for the first ten days and 1 mg/kg for the next ten days in order to suppress the inflammation associated with uveitis. The patient’s body weight and intraocular pressure were measured before the treatment. During the treatment, intraocular pressure values were checked every day. During this period, the patient was fed ad libitum at normal room temperature, in his own cage. Result: As a result of the treatment applied to the patient, who was followed up for more than a month, symptoms such as pain, photophobia and blepharospasm disappeared and the patient’s eating and drinking status improved compared to the past. However, increasing dose of Prednol did not have the expected effect on intraocular pressure values. Due to the very small size of the hamster eye in the treatment of hypermature cataracts, lens removal cannot be performed as easily as in other species.

The treatment method of persistent macula edema after phaco-vitrectomy

Purpose. To show the result of treatment of persistent macular edema as complication of chronic uveitis after phaco-vitrectomy. Material and methods. At this clinical case we show the results of treatment one patient, who was treated at the ophthalmological clinic «EYE Doctor», Almaty, Kazakhstan. He had complication of chronic uveitis as persistent macular edema after phaco-vitrectomy. The complex treatment (instillation of non-steroid anti-inflammation drops and subtenon injection of diprospan) was unsuccessful. Results. The result of treatment is successful; we get stable decrease of severity of cystoid macular edema and stabilization of visual acuity. Conclusion: This method allows to decrease the cystoid macular edema and to stable the visual acuity. It helps us to treat the patients, when other methods are unsuccessful and there is no financial possibility for treatment with intravitreal injection «Ozurdex». Key words: persistent macular edema, chronic uveitis, Diprospan, intravitreal injection.

Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice

Background Surgeries for idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children are complex because of the high risk of inflammatory postoperative complications. There is no consensus about treatment adaptation during the perioperative period. The objectives of this study are to report the therapeutic changes made in France and to determine whether maintaining or stopping immunosuppressive therapies is associated with an increased risk of surgical site infection or an increased risk of uveitis or arthritis flare-up. Methods We conducted a retrospective cohort study between January 1, 2006 and December 31, 2018 in six large University Hospitals in France. Inclusion criteria were chronic idiopathic uveitis or chronic uveitis associated with juvenile idiopathic arthritis under immunosuppressive therapies at the time of the surgical procedure, operated before the age of 16. Data on perioperative treatments, inflammatory relapses and post-operative infections were collected. Results A total of 76 surgeries (42% cataract surgeries, 30% glaucoma surgeries and 16% posterior capsule opacification surgeries) were performed on 37 children. Adaptation protocols were different in the six hospitals. Immunosuppressive therapies were discontinued in five cases (7%) before surgery. All the children in the discontinuation group had an inflammatory relapse within 3 months after surgery compared to only 25% in the other group. There were no postoperative infections. Conclusions The results of this study show varying practices between centres. The benefit-risk balance seems to favour maintaining immunosuppressive therapies during surgery. Further studies are needed to determine the optimal perioperative treatments required to limit post-operative inflammatory relapses.

Clinical cases of rarely diagnosed forms of choroidal osteoma

Purpose. To analyze the 3 cases of choroidal osteomas, revealed in histological study after evisceration of eye. Material and methods. 3 patients (3 eyes) with chronic uveitis of different origin. Results. On histological examination, the bone tissue consisted of a network of bone beams of not fully mature type, with irregularly pronounced fibroreticular tissue between them. There was insignificant proliferation of endosteal cells in the fibroreticular component. There was marked interstitial edema, increased vascularization with hyperemia in the choroidal vascular plate. Conclusion. Preoperative diagnosis of choroidal osteomas is difficult because of the opacity of the eye media. Long term chronic uveitis of different origin was common to all given cases. Choroidal osteomas was an intraoperative finding and ossification process of choroid was indused by inflammatory process of the eye. Key words: choroidal osteomas, chronic uveitis.

Features of primary IOL implantation in patients with history of chronic uveitis

Purpose. To determine possible postoperative complications and methods of their prevention in patients with history of chronic uveitis who underwent Phacoemulsification of cataract with primary IOL implantation. Material and methods. In this article we give clinical analysis of complications after phacoemulsification with primary IOL implantation in patients with history of chronic uveitis. 5 patients with this pathology were hospitalized during 2020. Results. In this work, we provide literature data on the topic of primary IOL implantation in such patients. Currently there is no united opinion on managing such patients. Nevertheless, many authors agree that by using acrylic lenses, prolonged pharmacotherapy, uveitis remission of more than 3 months primary IOL implantation can be safe, and we can get high visual acuity [14]. In hard cases, some authors used primary IOL implantation with primary posterior capsulorhexis, which helped them to lower rate of postoperative complications [2, 3, 11, 21, 24]. Nevertheless, there are cases where IOL cause untreatable uveitis and therefore the question of lens explanation arises [8]. Conclusion. When solving the question of primary IOL implantation during extracting cataract in patients with chronic uveitis for maximum safety we should consider the following: history of the patient's background disease and systemic treatment he is getting, frequency of former uveitic attacks, laboratory data at the time of operation. The patient needs preliminary sanitation of all possible sources of inflammation and infection, pharmacotherapeutical preparation (both topical and general). After operation patient is needed prolonged anti-inflammatory therapy (NAIDS and Corticosteroids) and dynamic observation despite calm eye condition. Key words: uveitis, cataract phacoemulsification, iol implantation.

Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children—a nationwide follow-up study

Background Only a few studies reporting the long-term outcome of children with idiopathic tubulointerstitial nephritis (TIN) and uveitis syndrome (TINU) are available. We studied the long-term kidney and ocular outcome in a nationwide cohort of children with TIN or TINU. Methods All patients followed up for a minimum of 1 year by a paediatrician and an ophthalmologist were enrolled. The data on plasma creatinine (P-Cr), estimated glomerular filtration rate (eGFR), proteinuria, hypertension and uveitis were collected retrospectively. Results Fifty-two patients were studied. Median age at time of diagnosis was 13.1 (1.8–16.9) years and median follow-up time was 5.7 (1.1–21.2) years. Forty-five (87%) patients were initially treated with glucocorticoids. The median of the maximum P-Cr was 162 μmol/l (47–1,016) and that of eGFR 47 ml/min/1.73m2 (8–124). Uveitis was diagnosed in 33 patients (63%) and 21 (40%) patients developed chronic uveitis. P-Cr normalised in a median of 2 months. Eleven (21%) patients had nephritis recurrence during or after discontinuation of glucocorticoids. At the latest follow-up, 13 (25%) patients had eGFR < 90 ml/min/1.73m2 (median 83; 61–89 ml/min/1.73m2). Six patients had tubular proteinuria; all presented with TIN without uveitis. Seven (13%) patients were hypertensive. Eleven (21%) patients had uveitis. One patient developed uraemia and was later transplanted. Conclusions Our study questions the previously reported good long-term kidney and ocular outcome of patients with TIN/TINU. Decreased kidney function and/or ocular co-morbidities may persist for several years; thus, both kidney and ocular follow-up for at least 1 year is warranted. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

New Hyaluronic Acid Preparations in the Treatment of Children with Dry Eye Syndrome

The aim of the study was to evaluate the effectiveness of the preparations Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) in the treatment of children with dry eye syndrome (DES) and to determine the indications for prescribing these drugs for various etiologies and clinical course of the disease.Patients and methods. The study involved 56 children aged 4–17 years with DES, which were divided into 3 groups, depending on its pathogenetic type. The first consisted of 24 children with DES, which developed on the basis of chronic blepharitis, the second — 12 children with neuroparalytic keratitis, and the third — 18 children with chronic uveitis, in whom DES was caused by prolonged instillations of eye drops with benzalkonium chloride. Each group was divided into 2 more equal subgroups, the first of which was prescribed the drug Optinol® Express Moisture, and the second — Optinol® Deep Moisture with a frequency of 4 times a day.Results. In all children, from the very first days of instillation of the studied drugs, a decrease in the severity of subjective signs of DES (OSDI) was noted, as well as a gradual decrease in the degree of xerotic changes in the ocular surface (severity of its staining with vital dyes) and an increase in the stability of the tear film (M.Norn). At the same time, the positive dynamics of the controlled parameters increased with the continuation of therapy, reaching a maximum by the 30th day of treatment. Moreover, the effectiveness of therapy depended on the severity of xerosis of the ocular surface: it was maximal in children with mild, and minimal in children with an extremely severe form of xerosis (with neuroparalytic keratitis). Moreover, the drug Optinol® Express Moisture was more effective in the treatment of children with mild and extremely severe forms of DES, and Optinol® Deep Moisture — with moderate and severe xerosis.Conclusion. The preparations Optinol® Express Moisture and Optinol® Deep Moisturization are effective in the treatment of children with DES, which has developed on the basis of pathology of the ocular surface of neurotrophic and artifact genesis, as well as increased volatility of the precorneal tear film against the background of chronic blepharitis.