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Biswas J, Jadhav S, Eswaran BV. Evolution of research in diagnosis and management of uveitis over four decades in India. Indian J Ophthalmol 2024; 72:809-815. [PMID: 38454865 DOI: 10.4103/ijo.ijo_1577_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024] Open
Abstract
Uveitis and its complications are more common in the developing world, in which the condition occurs in up to 714 per 100,000 in the population and accounts for up to 25% of all blindness. In India, the ophthalmic sub speciality of uveitis greatly evolved in the last four decades. In the early decades most of the studies were epidemiological studies. In recent years, more research has been published due to tremendous advancements in clinical diagnosis, laboratory investigations and ancillary test and treatment modalities. In this review article, we did a medline search with key words 'uveitis' and 'India', and selectively incorporated articles showing the evolution of this sub-speciality in India.
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Affiliation(s)
- Jyotirmay Biswas
- Department of Uveitis and Ocular Pathology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Sourabh Jadhav
- Department of Vitreo Retina, Shri Bhagvan Mahavir, Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Sanjay S, Acharya I, Kawali A, Chitturi SP, Mahendradas P. Choroidal and central macular thickness before and after treatment in post fever retinitis. Indian J Ophthalmol 2024; 72:728-734. [PMID: 38648435 DOI: 10.4103/ijo.ijo_1557_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/01/2023] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment. METHODS A retrospective, observational study of patients presenting with PFR from 2013 to 2021 and with spectral domain optical coherence tomography (SD-OCT) (Heidelberg®, SpectralisTM, Heidelberg, Germany) images were included. The CT and CMT were measured at presentation and at the final visit. The CT was measured subfoveally and at points 2000 µm superior, inferior, medial, and lateral from the fovea using the caliper tool. RESULTS Seventy-nine eyes of 65 patients were included for this study. The mean age was 39.03 (±16.00) years with female preponderance of 53.84% (n = 35). Mean follow-up duration was 30 days. Mean CT at presentation and at follow-up was 254.12 µm and 241.51 µm, respectively. CT was decreased in majority of the eyes 67.1% (n = 53) from their baseline value. Mean CMTs at presentation and final visit were 454.8 µm and 223.7 µm, respectively. Best corrected visual acuity had a positive correlation with CMT (r = 0.340; P = 0.002) and negligible correlation with CT. A significant decrease in the mean CT was noted in patients who received doxycycline either alone or in combination with a steroid as compared to those who did not receive any treatment (P < 0.001). The significance of which is unknown presently. CONCLUSION CMT has a greater role in determining the final visual outcome than CT. CT can be reduced post-treatment with no effect on vision.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, India
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Mooss VS, Konana VK, Babu Murthy K. Vascular Changes in Eyes with Post-Fever Retinitis Pre and Post Treatment Demonstrated Using Optical Coherence Tomography Angiography. Ocul Immunol Inflamm 2024:1-5. [PMID: 38607653 DOI: 10.1080/09273948.2023.2268195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/03/2023] [Indexed: 04/13/2024]
Abstract
PURPOSE To document vascular changes in eyes with post-fever retinitis (PFR) pre and post treatment demonstrated using optical coherence tomography angiography (OCTA). METHODS This is a retrospective observational case series wherein patients with PFR were retrospectively evaluated for changes in the retinal vasculature during the course of disease using OCTA. RESULTS At presentation, OCTA revealed flow void areas in superficial and deep capillary plexus (SCP and DCP) corresponding to the areas of retinitis. Post treatment, OCTA showed a significant decrease in the flow void areas with the appearance of new capillary network in both SCP and DCP. The optical coherence tomography also demonstrated normalization of retinal architecture over time. It is speculated that the good visual outcome in PFR could be attributed to the normalization of retinal architecture and remodelling in retinal vasculature. CONCLUSION OCTA being non-invasive can be used to understand and quantify the extent of vascular remodelling in PFR.
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Affiliation(s)
- Vidya S Mooss
- Department of Medical Retina and Uvea, Prabha Eye Clinic, Bangalore, India
| | - Vinaya Kumar Konana
- Department of Vitreo-Retina, Vittala International Institute of Ophthalmology, Bangalore, India
| | - Kalpana Babu Murthy
- Department of Uveitis and Ocular Inflammation, Prabha Eye Clinic and Vittala International Institute of Ophthalmology, Bangalore, India
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Valsecchi N, Veronese C, Roda M, Ciardella AP, Fontana L. Bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus infection: a case report. BMC Ophthalmol 2024; 24:160. [PMID: 38600458 PMCID: PMC11008036 DOI: 10.1186/s12886-024-03423-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 04/01/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND To describe a case of bilateral multifocal chorioretinitis as the only presentation of acute West Nile virus (WNV) infection in the absence of neurological involvement. CASE PRESENTATION A 78-year-old Italian woman was admitted to our emergency department because she noticed blurry vision in both eyes. She did not report fever, fatigue, or neurological symptoms in the last few days. Multimodal imaging showed the presence of bilateral hyperfluorescent lesions with a linear distribution, that corresponded to hypocyanescent spots on indocyanine green angiography. Antibody serology showed the presence of IgM antibodies, IgG antibodies, and ribonucleic acid (RNA) for WNV. Magnetic resonance imaging (MRI) of the brain ruled out central nervous system involvement. Three months later, the patient reported spontaneous resolution of her symptoms and remission of the chorioretinal infiltrates. CONCLUSIONS In endemic areas, it is important to think of acute WNV infection as an explanatory etiology in cases of multifocal chorioretinitis, even without neurological involvement.
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Affiliation(s)
- Nicola Valsecchi
- Ophthalmology Unit, Dipartimento Di Scienze Mediche E Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy.
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
| | - Chiara Veronese
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Matilde Roda
- Ophthalmology Unit, Dipartimento Di Scienze Mediche E Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | | | - Luigi Fontana
- Ophthalmology Unit, Dipartimento Di Scienze Mediche E Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
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Wani V, Tenagi A, Bubanale SC, B K B, Mutalik D, Warad C. Post-fever Retinitis With a Positive Weil-Felix Test: A Study From a Tertiary Center in South India. Cureus 2024; 16:e53162. [PMID: 38420096 PMCID: PMC10901253 DOI: 10.7759/cureus.53162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
Background Post-fever retinitis (PFR) is reported two to six weeks after fever and affects one or both eyes. Rickettsial fever is one of the most common causes of PFR. This study aimed to report the clinical features and treatment outcomes of PFR cases with a positive Weil-Felix test. Methodology In this study, we collected demographic data, fever details, eye symptoms, ocular examination findings, optical coherence tomography (OCT) and fundus fluorescein angiography findings, laboratory findings, and length of follow-up of consecutive PFR cases with a positive Weil-Felix test. All cases were treated with oral doxycycline and prednisolone. Final best-corrected visual acuity (BCVA) and ocular examination findings were recorded. Visual field examination and follow-up OCT results were noted if available. Results A total of nine patients (eight males) with a mean age of 39.1 years with fever before ocular symptoms and positive Weil-Felix test were included. Six patients had bilateral disease. The mean initial and final BCVA in the affected eyes was 1.16 and 0.35 logMAR units, respectively (p < 0001). All 15 eyes had typical white retinitis patches and retinal hemorrhages which resolved after treatment. OCT showed hyperreflectivity and inner retinal disorganization over retinitis patches. White subretinal lines were noted in three patients and retinal nerve fiber bundle defect with corresponding visual field defect was seen in one eye. Conclusions In this study, PFR due to rickettsia infections has been reported from our region for the first time. Hence, eye specialists in the region should be aware of this entity.
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Affiliation(s)
- Vivek Wani
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND
| | - Arvind Tenagi
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND
| | | | - Bhagyajyothi B K
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND
| | - Deepashri Mutalik
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND
| | - Chethana Warad
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND
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Mahendradas P, Patil A, Kawali A, Rathinam SR. Systemic and Ophthalmic Manifestations of Chikungunya Fever. Ocul Immunol Inflamm 2023:1-8. [PMID: 37773977 DOI: 10.1080/09273948.2023.2260464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Chikungunya is a re-emerging viral infection across the globe. The purpose of this article is to review the systemic and ophthalmic manifestations associated with chikungunya fever. METHOD A review of literature was conducted using online databases. RESULTS In this report, we have reviewed the presently available literature on uveitis caused by chikungunya and highlighted the current knowledge of its clinical manifestations, imaging features, laboratory diagnostics, and the available therapeutic modalities from the systemic and ophthalmic standpoint. CONCLUSIONS Ocular involvement in chikungunya infection may occur at the time of systemic manifestations or it may occur as a delayed presentation many weeks after the fever. Treatment relies on a supportive therapy for systemic illness. Treatment of ocular manifestation depends on the type of manifestations and usually includes a combination of topical and oral steroids.
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Affiliation(s)
| | - Aditya Patil
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
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Sun CB, Ma Z, Liu Z. Case Report: Optic neuritis as the initial presentation of Orientia tsutsugamushi infection detected by metagenomic next-generation sequencing. Front Immunol 2023; 14:1129246. [PMID: 37256128 PMCID: PMC10225563 DOI: 10.3389/fimmu.2023.1129246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi infection, and typically manifested as fever, eschar, lymphadenopathy, rash, and other flu-like signs. Ocular involvement was not uncommon, and mostly occurred at post-fever or recovery stage in scrub typhus cases. We hereby report a case of scrub typhus presenting as unilateral optic neuritis (ON). A 56-year-old man going wild fishing nearly every day complained of a blurred vision and an inferior visual field defect in the right eye two or three days after an insect-bite like shin induration in his left leg. He was diagnosed as ON, and treated with dexamethasone in the local hospital. Unfortunately, his right eye vision progressively deteriorated during steroid therapy. Three days after steroid therapy ceased, he suffered from a high fever and painful subcutaneous masses in the left groin. Peripheral blood test by metagenomic next-generation sequencing (mNGS) was positive for Orientia tsutsugamushi, but negative for other pathogens. The diagnosis was then revised to scrub typhus and ON. His systemic symptoms rapidly disappeared after oral doxycycline and omadacycline therapy. However, his right eye vision continuously deteriorated to hand motion. Further serum tests for aquaporin 4-IgG antibody and myelin oligodendrocyte glycoprotein-IgG antibody were both negative, but for anticardiolipin IgM and beta-2-glycoprotein-I IgM were both positive. The patient's right eye vision gradually improved after doxycycline combined with steroid pulse therapy. Our case indicates that ON in scrub typhus cases may present as a parainfectious inflammation, and that mNGS is a useful and valuable method for early diagnosis of scrub typhus.
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Affiliation(s)
- Chuan-bin Sun
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiqiong Ma
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhe Liu
- Department of Ophthalmology, Zhejiang Provincial People’s Hospital, People’s Hospitalof Hangzhou Medical College, Hangzhou, China
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Sanjay S, Kawali A, Mahendradas P. COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis. Indian J Ophthalmol 2023; 71:2269-2272. [PMID: 37202968 PMCID: PMC10391377 DOI: 10.4103/ijo.ijo_2064_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ankush Kawali
- Department of Uveitis and Ocular immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Padmamalini Mahendradas
- Department of Uveitis and Ocular immunology, Narayana Nethralaya, Bengaluru, Karnataka, India
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Mahendradas P, Hande P, Patil A, Kawali A, Sanjay S, Ahmed SA, Thomas S, Shetty R. Bilateral Post Fever Retinitis With Retinal Vascular Occlusions Following Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV2) Infection. Ocul Immunol Inflamm 2022; 30:1715-1720. [PMID: 34228600 DOI: 10.1080/09273948.2021.1936564] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION As the world fights the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several reports of retinal manifestations of the disease are emerging. Post fever retinitis is a well reported ocular inflammatory reaction to multiple invasive agents, be it virus, bacteria or other microbial agent. PURPOSE We report an interesting case of bilateral multifocal retinitis with multiple vascular occlusions in a patient, three weeks after a febrile illness. RESULTS Investigations to ascertain the cause of fever resulted in identifying ephemeral seropositivity for several different Ribonucleic acid (RNA) viruses. The retinitis was managed with systemic steroids, doxycycline and anticoagulants with improvement in vision. CONCLUSION High and persistent seropositive response against (SARS-CoV-2) helped us to narrow it as the causative agent but the cross reactivity of SARS-CoV-2 with other viruses can be misleading and needs careful interpretation.
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Affiliation(s)
| | - Prathibha Hande
- Department of Vitreo Retina, Narayana Nethralaya, Bangalore, India
| | - Aditya Patil
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Syed Asrar Ahmed
- Department of Emergency Medicine, Trust Well Hospital, Bangalore, India
| | - Sherina Thomas
- Department of Vitreo Retina, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
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Kawali A, Mahendradas P, Sanjay S, Mohan A, Shetty B. Epidemic Retinitis with Positive or Negative Weil Felix Test - a Comparative Study and Outcome with Doxycycline. Ocul Immunol Inflamm 2022; 30:1582-1587. [PMID: 34003725 DOI: 10.1080/09273948.2021.1909072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare clinical manifestations and disease outcomes in Epidemic Retinitis (ER) with positive or negative Weil Felix Test (WFT). METHODS Retrospective, observational, comparative study. WFT positive or negative patients formed Group 1 and 2, respectively. Patients receiving oral doxycycline monotherapy formed subgroup A and B. Duration of resolution of macular edema and retinitis was compared. RESULTS Novel finding of "ring retinitis" was observed equally in group 1 and 2. Complete resolution of macular edema took 41.3 days (range: 30-60 days) and 43.68 days (range: 20-105 days) (p = .668) and retinitis lesions resolved in 34.3 days (range: 14-65 days) and 34 days (range: 12-60 days) (p = .875) in group A and B, respectively. All (n = 14) eyes with retinitis within 1 disc diameter of fovea improved better than 20/80 except 1. CONCLUSION No significant difference with respect to clinical, imaging findings and the treatment outcome was observed in WFT positive or negative cases.
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Affiliation(s)
- Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ashwin Mohan
- Department of Vitreo-retina, Narayana Nethralaya, Bangalore, India
| | - Bhujang Shetty
- Department of General Ophthalmology, Narayana Nethralaya, Bangalore, India
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Arepalli SR, Thomas AS. Occlusive retinal vasculitis: novel insights into causes, pathogenesis and treatment. Curr Opin Ophthalmol 2022; 33:147-156. [PMID: 35239517 DOI: 10.1097/icu.0000000000000843] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Occlusive retinal vasculitis (ORV) has a large differential diagnosis and varied therapeutic approaches. This review highlights existing and novel causes and treatment options for ORV. RECENT FINDINGS Mutations in CAPN5, TREX1, and TNFAIP3 have been associated with dominantly inherited forms of ORV. Various intraocular therapeutics have been shown to occasionally cause ORV; the most recent medications associated with ORV are vancomycin and brolucizumab. In cases of ORV linked to Behçet's disease, clinical trials support the use of tumor necrosis factor alpha inhibitors. SUMMARY Identification of the underlying etiology of ORV is critical to help guide treatment. Treatment in ORV involves both treatment any underlying infection or autoimmune condition, cessation of the any offending causative agent and local treatment of neovascular complications.
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Ayachit A, Joshi M, Ayachit G, Joshi S, Shah P. Presumed Post COVID- Infection Retinitis – Clinical and Tomographic Features of Retinitis as a Post-COVID Syndrome. Ocul Immunol Inflamm 2022:1-5. [PMID: 35404760 DOI: 10.1080/09273948.2022.2060264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To study clinical and imaging features of presumed post-COVID infection retinitis. METHOD Retrospective case series of patients presenting with retinitis lesions with evidence of recent COVID infection. Retinal findings and optical coherence tomography (OCT) features were studied at baseline and follow-ups. RESULTS Twenty-four eyes of 17 patients were included. Mean age was 36.57 ± 11.78 years. Baseline visual acuity (VA) was log MAR 0.97 ± 0.43. Fundus findings included retinitis patches (n = 24),hard exudates (n = 8), and superficial hemorrhages (n = 16). OCT features included neurosensory detachment (NSD, n = 20), hyperreflective inner layers (n = 24), acute macular neuroretinopathy (AMN, n = 8), hyperreflective foci (n = 20). At final follow-up, VA was logMAR 0.43 ± 0.27. Retinitis patches persisted in four eyes, AMN in three eyes, and NSD in five eyes. Conclusion- Post- COVID infection retinitis adds to existing literature on post COVID syndromes.
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Affiliation(s)
- Apoorva Ayachit
- Department of Vitreoretina, M. M. Joshi Eye Institute, Hubballi, India
| | - Madan Joshi
- Department of Vitreoretina, M. M. Joshi Eye Institute, Hubballi, India
| | | | - Shrinivas Joshi
- Department of Vitreoretina, M. M. Joshi Eye Institute, Hubballi, India
| | - Priya Shah
- Department of Vitreoretina, M. M. Joshi Eye Institute, Hubballi, India
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Karkhur S, Soni D. Clinical spectrum, disease course and management outcome of post-fever retinitis cases: experience from a tertiary eye institute in central India. Int Ophthalmol 2022; 42:2697-2709. [PMID: 35391586 PMCID: PMC8989109 DOI: 10.1007/s10792-022-02258-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
Purpose To report a series of five cases with retinitis following episodes of febrile illness, its evaluation, management and outcome. Method Retrospective, consecutive case series of five patients presenting with acute retinitis, following a febrile illness. Results The retinal lesions had a sudden onset with rapid evolution, preceded by a febrile episode within one month of presentation, in all cases. Extensive serology and PCR testing were non-contributory toward identifying the etiology and guiding therapy. Systemic corticosteroid therapy was effective in hastening the resolution of lesions. Conclusion Post-fever retinitis appears to be a distinct clinical form of acute hemorrhagic non-necrotizing retinitis without a uniformly identifiable cause, and some evidence pointing toward a para-infectious etiology secondary to flu-like illnesses. With an unusual morphological presentation and annual seasonal patterns in the endemic areas, it is important to differentiate this entity, from other forms of infectious retinitis, before initiating corticosteroid therapy.
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Affiliation(s)
- Samendra Karkhur
- Retina & Uveitis Service, Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS) Bhopal, AIIMS Road, Saket Nagar, Bhopal, Madhya Pradesh, 462 020, India.
| | - Deepak Soni
- Retina & Uveitis Service, Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS) Bhopal, AIIMS Road, Saket Nagar, Bhopal, Madhya Pradesh, 462 020, India
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Kawali A, Sanjay S, Mahendradas P, Mohan A, Shetty B. Epidemic retinitis - Factors associated with poor visual outcomes. Indian J Ophthalmol 2022; 70:897-901. [PMID: 35225539 PMCID: PMC9114578 DOI: 10.4103/ijo.ijo_1153_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To identify factors other than macular edema and retinitis location responsible for poor visual outcomes in epidemic retinitis (ER). Methods: A retrospective, observational, comparative study. Eyes with corrected distant visual acuity (CDVA) 20/200 or worse at resolution formed Group A. Eyes with central macular thickness (CMT) 600 μm or worse and retinitis within 1500 μm to foveal center at the presentation, but improved to CDVA 20/200 or better at the resolution formed Group B. The patient’s history, clinical presentation, imaging, and treatment outcomes were studied and the factors responsible for the final visual outcomes were compared in both groups. Results: Groups A and B included 25 eyes each. The mean CDVA at the presentation was 20/400 (range: 20/125–20000) and 20/320 (range: 20/80–20000), and mean CMT at the presentation was 948.5 μm (range: 520–1553) and 912.2 μm (range: 615–1250) in Groups A and B, respectively. All eyes except 1 (Group A) had retinitis lesions within 1500 μm of foveal center. The mean CDVA at the resolution was 20/400 (range: 20/200–20/20000) and 20/40 (range: 20/20–20/80) in Groups A and B, respectively. Older age, male gender, diabetic status, delayed presentation, poor presenting CDVA, bilaterality, presence of keratic precipitates, disk pallor, retinal thinning, and subfoveal deposits had a statistically significant association, whereas the absence of skin rash, ellipsoid zone loss, negative WIDAL, Weil-Felix test, and delayed doxycycline therapy or use of steroids without doxycycline had a statistically insignificant association with poor visual outcomes. Conclusion: Apart from presenting CMT and location of retinitis, multiple demographic, clinical, and imaging factors can be implicated for poor visual outcomes.
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Affiliation(s)
- Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Padmamalini Mahendradas
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Ashwin Mohan
- Department of Vitreo-retina, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Bhujang Shetty
- Department of General Ophthalmology, Narayana Nethralaya, Bangalore, Karnataka, India
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Pichi F, Curi ALL, Vasconcelos-Santos DV, Marchese A, Cicinelli MV, Miserocchi E, Schlaen A. Optical Coherence Tomography Findings in Infectious Posterior Uveitis. Ocul Immunol Inflamm 2022; 30:652-663. [PMID: 35226572 DOI: 10.1080/09273948.2022.2032197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis. METHODS Narrative review. RESULTS Posterior segment OCT in patients with infectious uveitis reveals posterior hyaloid face precipitates, superficial retinal precipitates and infiltrates, foveolitis, retinitis, neuro-retinitis, choroidal granulomas, and choroiditis as main imaging biomarkers. Some of these features are specific to the underlying causing etiology and may support the diagnosis and the initiation of treatment. Some OCT features disappear completely with resolution; some others are associated with irreversible retinal damage. CONCLUSIONS OCT identifies different features of infectious uveitis into the vitreous, the retina, and the choroid. OCT characteristics, combined with other multimodal imaging features, are helpful in the differential diagnosis of infectious uveitis, the early detection of complications, and the assessment of the response to therapy.
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Affiliation(s)
- Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - André Luiz Land Curi
- Research Laboratory of Infectious Diseases in Ophthalmology, National Institute of Infectious Diseases - Ini - Fiocruz, Rio de Janeiro, Brazil
| | - Daniel Vitor Vasconcelos-Santos
- Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alessandro Marchese
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisabetta Miserocchi
- Department of Ophthalmology, Irccs Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Ariel Schlaen
- Department of Ophthalmology, Hospital Universitario Austral, Derqui-Pilar, Argentina
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16
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Shivaji S, Jayasudha R, Prashanthi GS, Arunasri K, Das T. Fungi of the human eye: Culture to mycobiome. Exp Eye Res 2022; 217:108968. [PMID: 35120870 DOI: 10.1016/j.exer.2022.108968] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 11/02/2021] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
The focus of the current review is multi-fold and compares the diversity and abundance of fungi on the ocular surface by the conventional culture-based method with the more sensitive, high throughput, culture-independent NGS method. The aim is to highlight the existence of a core ocular mycobiome and explore the transition of the ocular fungal microbiota from the normal eye to the diseased eye. PubMed, Google Scholar and Medline were used to search for publications and reviews related to cultivable fungi and the mycobiome of the normal and diseased eye. The conventional cultivable approach and the NGS approach confirm that the eye has its own mycobiome and several confounding factors (age, gender, ethnicity etc.) influence the mycobiome. Further, dysbiosis in the mycobiome appears to be associated with ocular diseases and thus impacts the health of the human eye. Considering that the mycobiome of the eye is influenced by several confounding factors and also varies with respect to the disease status of the eye there is a need to extensively explore the mycobiome under different physiological conditions, different ethnicities, geographical regions etc. Such studies would unravel the diversity and abundance of the mycobiomes and contribute to our understanding of ocular health. Research focused on ocular mycobiomes may eventually help to build a targeted and individualized treatment.
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Affiliation(s)
- Sisinthy Shivaji
- Prof. Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
| | - Rajagopalaboopathi Jayasudha
- Prof. Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
| | - Gumpili Sai Prashanthi
- Prof. Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
| | - Kotakonda Arunasri
- Prof. Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
| | - Taraprasad Das
- Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
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17
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Infection of Human Retinal Pigment Epithelial Cells with Dengue Virus Strains Isolated during Outbreaks in Singapore. Microorganisms 2022; 10:microorganisms10020310. [PMID: 35208767 PMCID: PMC8878224 DOI: 10.3390/microorganisms10020310] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Prevalence of dengue retinopathy varies across epidemics, with the disease linked to circulation of dengue virus serotype 1 (DENV-1). The retinal pigment epithelium has been implicated in the pathology. We investigated infectivity, molecular response, and barrier function of epithelial cells inoculated with DENV strains from different outbreaks in Singapore. Monolayers of human retinal pigment epithelial cells (multiple primary cell isolates and the ARPE-19 cell line) were inoculated with six DENV strains, at multiplicity of infection of 10; uninfected and recombinant strain-infected controls were included where relevant. Infectivity and cell response were assessed primarily by RT-qPCR on total cellular RNA, and barrier function was evaluated as electrical resistance across monolayers. Higher viral RNA loads were measured in human retinal pigment epithelial cells infected with DENV-1 strains from the 2005 Singapore epidemic, when retinopathy was prevalent, versus DENV-1 strains from the 2007 Singapore epidemic, when retinopathy was not observed. Type I interferon (IFN) transcripts (IFN-β and multiple IFN-stimulated genes) were up-regulated, and impact on barrier function was more pronounced, for cells infected with DENV-1 strains from the 2005 versus the 2007 Singapore epidemics. Aside from serotype, strain of DENV may determine the potential to induce retinal pathology. Identification of molecular markers of disease-associated DENV strains may provide insights into the pathogenesis of dengue retinopathy.
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18
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Abroug N, Khairallah M, Zina S, Ksiaa I, Amor HB, Attia S, Jelliti B, Khochtali S, Khairallah M. Ocular Manifestations of Emerging Arthropod-Borne Infectious Diseases. J Curr Ophthalmol 2021; 33:227-235. [PMID: 34765808 PMCID: PMC8579803 DOI: 10.4103/joco.joco_134_21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/25/2021] [Accepted: 04/25/2021] [Indexed: 11/04/2022] Open
Abstract
Purpose To review the clinical features, diagnosis, treatment modalities, and prognosis of arthropod-borne infectious diseases. Methods This is a narrative review on arthropod-borne infectious diseases including general and ophthalmological aspects of these infectious diseases. A comprehensive literature review between January 1983 and September 2020 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of arthropod-borne infectious diseases were reviewed. Results Emergent and resurgent arthropod-borne infectious diseases are major causes of systemic morbidity and death that are expanding worldwide. Among them, bacterial and viral agents including rickettsial disease, West Nile virus, Dengue fever, Chikungunya, Rift valley fever, and Zika virus have been associated with an array of ocular manifestations. These include anterior uveitis, retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement. Proper clinical diagnosis of any of these infectious diseases is primarily based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular involvement. The diagnosis is confirmed by laboratory tests. Ocular involvement usually has a self-limited course, but it can result in persistent visual impairment. Doxycycline is the treatment of choice for rickettsial disease. There is currently no proven specific treatment for arboviral diseases. Prevention remains the mainstay for arthropod vector and zoonotic disease control. Conclusions Emerging arthropod vector-borne diseases should be considered in the differential diagnosis of uveitis, especially in patient living or with recent travel to endemic countries. Early clinical diagnosis, while laboratory testing is pending, is essential for proper management to prevent systemic and ocular morbidity.
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Affiliation(s)
- Nesrine Abroug
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Molka Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sourour Zina
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Imen Ksiaa
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Hager Ben Amor
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sonia Attia
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Bechir Jelliti
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sana Khochtali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.,Departement of Ophthalmology, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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19
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Biswal S, Gondchawar A, Ravishankar HN, Sagar P, Shanmugam PM, Shah A, Tekade P, Mooss V. Predictors of visual outcome in post-fever retinitis: a retrospective analysis. Int Ophthalmol 2021; 41:4099-4109. [PMID: 34546494 DOI: 10.1007/s10792-021-01983-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify the predictors of final visual outcome in cases with post-fever retinitis (PFR). METHODS This is a retrospective study of cases with diagnosis of post-fever retinitis. Colour fundus photograph and optical coherence tomography (OCT) parameters at presentation and final visit were analysed. Various factors at presentation [age, systemic illness, best-corrected visual acuity (BCVA), area of retinitis and hard exudates, OCT parameters], at final visit (OCT parameters) and the treatment modalities used were correlated with BCVA at final visit. RESULTS Twenty-four eyes of 16 patients with PFR were included in the study. Median BCVA at presentation was 6/60 and at final visit was 6/9. By multiple linear regression after adjusting for other variables, for every 1 unit increase in height of subretinal fluid (SRF) at fovea at presentation, the value of final BCVA decreased by 0.001 unit. For every 1 unit increase in extent of ellipsoid zone (EZ) loss and subfoveal deposit height, the value of final BCVA decreased by 0.0001 unit and 0.004 unit, respectively. The baseline OCT parameters that had negative correlation with final BCVA included central macular thickness (r: - 0.5182, p: 0.02), maximum SRF height (r: - 0.5539, p < 0.01) and SRF height at fovea (r: - 0.582, p < 0.01). The OCT parameters at final visit which had a negative correlation with final BCVA included disorganisation of retinal inner layers (DRIL) within 1000 microns from centre of fovea (r: - 0.6494, p < 0.01), height of subfoveal deposit (r: - 0.7627, p < 0.01), horizontal extent of subfoveal deposit (r: - 0.6695, p < 0.01) and extent of EZ loss (r: - 0.8216, p < 0.01). CONCLUSION Height of SRF at presentation, extent of EZ loss and subfoveal deposit height at final visit were associated with poor final BCVA in PFR.
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Affiliation(s)
- Suchitra Biswal
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
| | - Ankush Gondchawar
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
| | - H N Ravishankar
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
| | - Pradeep Sagar
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India.
| | - P Mahesh Shanmugam
- Department of Vitreo-Retina and Ocular Oncology, Sankara Eye Hospital, Bangalore, India
| | - Aanal Shah
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
| | - Pradeep Tekade
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
| | - Vidya Mooss
- Department of Vitreo-Retina, Sankara Eye Hospital, Harakere, Shimoga, Karnataka, 577202, India
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20
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Shenoy P, Kohli GM, Kerketta A, Pathak P, Shetty S, Barde P, Chakma T, Sen A. Clinical profile and response to steroids in post-fever retinitis: a nine-year experience from a referral institute in the rural hinterland of Central India. Int Ophthalmol 2021; 41:4055-4063. [PMID: 34297305 DOI: 10.1007/s10792-021-01978-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To describe the demographics, clinical features, and treatment outcomes with systemic steroids in eyes presenting with post-fever retinitis (PFR) from Central India. METHODS Single-center, retrospective analysis of 147 eyes of 98 PFR cases between 2011 and 2019. RESULTS Mean age of the study cohort was 33.46 ± 12.76 years, with 72 males and 26 females. The mean interval between the onset of fever and the diminution of vision was 21.10 ± 13.54 days (range 0-60 days). The number of PFR cases increased over the nine years with 89 cases (90.1%) presenting during winters. Unilateral involvement was seen in 49 cases, while 49 had bilateral involvement. Clinical characteristics included: multifocal retinitis (n = 122; 61.2%), hemorrhages (n = 132; 89.8%), disc edema (n = 57; 38.8%), anterior chamber reaction (n = 28; 19%), and vitritis (n = 103; 70.1%). Treatment included intravenous followed by oral steroids in 70 patients and oral steroids exclusively in 23; five patients denied treatment. The visual acuity improved from 1.09 ± 0.52 LogMAR to 0.29 ± 0.42 LogMAR (p < 0.05). CONCLUSION There has been an increase in the prevalence of PFR cases over the last decade with clustering during the winters. Multifocal retinitis, retinal hemorrhages, and vitritis were the most common clinical findings in our series. The retinitis resolved with improvement in vision following steroid therapy in all eyes.
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Affiliation(s)
- Pratik Shenoy
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India
| | - Gaurav Mohan Kohli
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India.,Hind institute of medical science, Attaria, Sitapur, Uttar pradesh, 261303, India
| | - Aarti Kerketta
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India
| | - Parul Pathak
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India
| | - Sachin Shetty
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India
| | - Pradip Barde
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, 482003, India
| | - Tapas Chakma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, 482003, India
| | - Alok Sen
- Department of Vitreo-Retina and Uveitis. Shri Sadguru Seva Sangh Trust, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, 210204, India.
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21
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Sanjay S, Reddy NG, Kawali A, Mahendradas P, Pulipaka RS, Shetty R, Yadav NK, Venkatesh R. Role of multicolour imaging in post-fever retinitis involving posterior pole. Int Ophthalmol 2021; 41:3797-3804. [PMID: 34263386 DOI: 10.1007/s10792-021-01951-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe composite multicolour (MC) imaging features along with the monocoloured fundus reflectance images in active and resolving stages of post-fever retinitis (PFR). METHODS Retrospective image analysis of cases of PFR who underwent dilated retinal clinical examination followed by optical coherence tomography and MC imaging. RESULTS Twenty-five eyes of 18 patients diagnosed with PFR were included. There were 11 males and 7 females. Mean age of patients was 30.63 years. The retinitis lesion appeared bright white on MC image and white mainly on blue and green reflectance images during the active stages of PFR. The lesion appeared dull-grey to greyish white during the resolving stages and as dull-green in resolved cases. The active stages showed the presence of intraretinal/subretinal fluid which appeared as green colour on MC images and less green to normal during resolving stages. Hard exudates were seen as bright yellow- or orange-coloured spots on MC image during the resolving stages of the disease. CONCLUSION The different stages of PFR show different colour on multicolour image and different reflectance patterns on individual colour reflectance channels. Hence, multimodal fundus imaging with different wavelength can be helpful for differentiation of activity in PFR.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Nikitha Gurram Reddy
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | - Ram Snehith Pulipaka
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India.,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Rohit Shetty
- Department of Cornea-Refractive Services, Narayana Nethralaya, Bangalore, India
| | - Naresh Kumar Yadav
- Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Ramesh Venkatesh
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India. .,Department of Vitreo-Retinal Services, Narayana Nethralaya, #121/C, 1st R Block, Chord road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
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22
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Sanjay S, Mahendradas P, Kawali A, Gadde SGK. Comments on: Optical coherence tomography in epidemic retinitis. Indian J Ophthalmol 2021; 69:181-182. [PMID: 33323628 PMCID: PMC7926117 DOI: 10.4103/ijo.ijo_2757_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Srinivasan Sanjay
- Department of Uvea and Ocular Iimmunology, Narayana Nethralaya, Bangalore, Karnataka, India
| | | | - Ankush Kawali
- Department of Uvea and Ocular Iimmunology, Narayana Nethralaya, Bangalore, Karnataka, India
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23
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Ranjith K, Sharma S, Shivaji S. Microbes of the human eye: Microbiome, antimicrobial resistance and biofilm formation. Exp Eye Res 2021; 205:108476. [PMID: 33549582 DOI: 10.1016/j.exer.2021.108476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The review focuses on the bacteria associated with the human eye using the dual approach of detecting cultivable bacteria and the total microbiome using next generation sequencing. The purpose of this review was to highlight the connection between antimicrobial resistance and biofilm formation in ocular bacteria. METHODS Pubmed was used as the source to catalogue culturable bacteria and ocular microbiomes associated with the normal eyes and those with ocular diseases, to ascertain the emergence of anti-microbial resistance with special reference to biofilm formation. RESULTS This review highlights the genetic strategies used by microorganisms to evade the lethal effects of anti-microbial agents by tracing the connections between candidate genes and biofilm formation. CONCLUSION The eye has its own microbiome which needs to be extensively studied under different physiological conditions; data on eye microbiomes of people from different ethnicities, geographical regions etc. are also needed to understand how these microbiomes affect ocular health.
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Affiliation(s)
- Konduri Ranjith
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
| | - Sisinthy Shivaji
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India.
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24
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Sundar M D, Chawla R, Balaji A, Garg I, Kalathil R, Hasan N, Vikas SJ, Kumar A. Clinical features, optical coherence tomography findings and treatment outcomes of post-fever retinitis. Ther Adv Ophthalmol 2021; 12:2515841420979111. [PMID: 33415316 PMCID: PMC7750750 DOI: 10.1177/2515841420979111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives: To study the clinical features, optical coherence tomography (OCT) findings,
treatment options and follow-up outcomes of post-fever retinitis (PFR). Subjects: A total of 19 eyes of 13 patients, diagnosed with PFR (retinitis following
febrile episode) over 2 years were retrospectively studied. Methods: Documented history, baseline clinical features and systemic investigations
performed for PFR were reviewed. Fundus findings, foveal architecture on
swept-source OCT, the treatment options and the follow-up outcomes including
best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were
reviewed and analyzed. Results: Common fundus findings included whitish retinitis lesions (100%), macular
star (95%, 18eyes), retinal flame-shaped hemorrhages (63%, 12 eyes),
inflammatory retinal vessels (30%, 6 eyes), vitreous hemorrhage (one eye)
and OCT findings included neuro-sensory detachment (79%, 15 eyes),
intraretinal white dots (89.5%,17 eyes). The baseline median log MAR BCVA
and CFT were 1.30 (interquartile range (IQR):0.8–1.8) and 423 microns
(IQR:182–555). Overall, nine patients (12 eyes) received a combination of
oral doxycycline and oral steroids and four patients (7 eyes) received a
combination of oral doxycycline, oral steroid and intravitreal anti-vascular
endothelial growth factor (IVA). Significant improvement was evident at 8
weeks in median BCVA (0.50, IQR: 0.3–0.8, p < 0.05) and
median CFT (223 micron, IQR: 170–256, p < 0.05) though
only 26% (5 eyes) attained BCVA > = 6/12. Conclusion: Our study puts forth certain characteristic fundus and OCT features of PFR. A
combination of oral doxycycline and oral steroids as a treatment option
showed improvement in BCVA and CFT. Additional IVA helps in faster visual
recovery in patients presenting with severe macular edema at onset.
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Affiliation(s)
- Dheepak Sundar M
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), Ansari Nagar, Delhi 110029, India
| | - Akshaya Balaji
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Itika Garg
- Harvard Retinal Imaging Lab, Boston, MA, USA; Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Reshmi Kalathil
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Nasiq Hasan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - S J Vikas
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Science (AIIMS), New Delhi, India
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25
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Patel A, Kelgaonkar A, Kaza H, Tyagi M, Murthy S, Pathengay A, Basu S. Recent Advances in Diagnosis and Treatment of Infectious Uveitis Prevalent in Asia-Pacific Region. Asia Pac J Ophthalmol (Phila) 2021; 10:99-108. [PMID: 33512831 DOI: 10.1097/apo.0000000000000367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The role of infections in intraocular inflammation is being increasingly recognized across the world. The Asia-Pacific region, being the single largest and most populous geographical entity on the planet, is home to a wide variety of such infections. Not surprisingly, there has been an explosion in the literature on infectious uveitis emerging from Asia-Pacific countries. In this review, we have covered recent advances in the diagnosis, treatment, and pathogenesis of common forms of infectious uveitis from the Asia-Pacific region. Much of the literature is focussed on the diagnosis of these infections by clinical criteria and laboratory investigations. There has also been an increased emphasis on the application of newer modes of ocular imaging and understanding pathomechanisms of ocular inflammation in these infections. Together this research has significantly improved our understanding of the diagnosis and management of infectious uveitis.
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Affiliation(s)
- Anamika Patel
- Uveitis services, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakhapatnam, India
| | - Anup Kelgaonkar
- Uveitis services, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, India
| | - Hrishikesh Kaza
- Uveitis services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Mudit Tyagi
- Uveitis services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Somasheila Murthy
- Uveitis services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Avinash Pathengay
- Uveitis services, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakhapatnam, India
| | - Soumyava Basu
- Uveitis services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
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Sheth JU, Narayanan R. Response to comments on: Retinal vein occlusion in COVID 19: A novel entity. Indian J Ophthalmol 2020; 69:193-194. [PMID: 33323641 PMCID: PMC7926125 DOI: 10.4103/ijo.ijo_3221_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jay U Sheth
- Department of Vitreoretinal Services, Surya Eye Institute and Research Center, Mumbai, Maharashtra; Clinical Research Lead, Chaitanya Eye Hospital and Research Center, Trivandrum, Kerala, India
| | - Raja Narayanan
- General Secretary, Vitreoretinal Society of India; Suven Clinical Research Center, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Honavar S, Sengupta S. Exploring a New Era in Uveitis. Indian J Ophthalmol 2020; 68:1721-1722. [PMID: 32823381 PMCID: PMC7690528 DOI: 10.4103/ijo.ijo_2691_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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