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Purpose To analyze the etiology, clinical characteristics, complications, treatments, and outcomes of patients with intermediate uveitis examined in a uveitis referral center in Bogotá, Colombia. Patients and Methods We conducted a retrospective descriptive study. We reviewed systematically the clinical records of patients attending a uveitis referral center in Bogotá, Colombia from 2013 to 2020. Data analysis included demographics, etiology, clinical characteristics, treatment modalities, best-corrected visual acuity, and complications. For categorical variables, absolute and relative frequencies were used while for continuous variables mean and standard deviations were calculated. Results We identified 18 patients with intermediate uveitis. The mean age at disease onset was 19.4 years. There was no sex predominance. Two-thirds of the patients presented bilateral involvement. The mean initial best-corrected visual acuity was 0.19 LogMAR. The most common etiology was idiopathic followed by undetermined, tuberculosis, multiple sclerosis, and juvenile idiopathic arthritis. The most common characteristics were insidious onset, chronic course, and persistent duration. The complications found were macular edema, optic disk edema, cataract, epiretinal membrane, among others. Corticosteroids and immunosuppressive therapy were the most common treatments. Mean follow-up time was 24.4 months, and the mean final best-corrected visual acuity was 0.12 LogMAR. Conclusion This is the first study describing intermediate uveitis features in South America. In our context, intermediate uveitis is infrequent. Polyautoimmunity and familial autoimmunity phenomena were found in some patients. These may require a multidisciplinary approach. Ophthalmologists should promptly diagnose, treat, and refer patients with this disease to avoid common complications. Further studies are required to determine the disease relation with polyautoimmunity.
Purpose: The aim of the study was to report the first case of a patient with Terrien’s Marginal Degeneration (TMD) who developed necrotizing anterior scleritis without systemic disease association, requiring systemic immunosuppressive treatment. Case Report: A 32-year-old female consulted for bilateral ocular burning and hyperemia. Initially, she was diagnosed with conjunctivitis and treated with topical antibiotics and corticosteroids, with mild transitory improvement but the progression of the disease. Years later, she attended the ocular immunology consultation for a second opinion where TMD with ocular inflammatory component OU was diagnosed. Seven months later, she presented with severe pain, decreased visual acuity, and photophobia in OS. At the slit-lamp examination, necrotizing anterior scleritis with a high risk of perforation in OS was observed. The patient was referred to the rheumatologist and started treatment with systemic corticosteroids and cyclophosphamide, exhibiting a clinical improvement. The patient did not meet the criteria for any systemic illness associated with scleritis, such as autoimmune diseases or vasculitis. Thus, scleritis was related to the adjacent inflammatory process associated with TMD, as an atypical presentation of this disease. Conclusion: Although an inflammatory type of TMD has been proposed, it is essential to follow up closely these patients and consider necrotizing anterior scleritis, a severe ocular disease that requires prompt immunosuppressive management, as a possible atypical associated presentation of this disease.
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