Aim. The aim of this study was to evaluate if patients with Behcet's disease who have ocular involvement have a more severe form of this disease as compared to patients with Behcet's disease alone. Methods. A total of 99 patients were included in the study. 76 patients were used as part of the examined group, and 23 patients formed a control group. Results. The following are the results of examined and control groups, respectively: recurrent oral aphthous ulcers 89.5%, 95.7%; genital ulcers 61.8%, 97.0%; articular involvement 72.4%, 65.2%; vasculitis 81.6%, 60.9%; positive pathergy test 25.0%, 47.8%. Higher frequency of genital ulcerations was noted in control group (P = 0.001). More than two major criteria were met in 100% of the cases. HLA B51 was present in 78.9% of the cases in the examined group and 43.5% of the cases in control group; thus there is significant difference between them (P = 0.001). Visual acuity >0.5 occurred in 76% (examined group). Most frequent ocular manifestations in the examined group were retinal periphlebitis 81.6%, periphlebitis and periarteritis 65%, and serofibrinous uveitis 63.2%. Macular edema as a complication was present in 63.2%. The majority of patients (55.3%) were treated with combined therapy consisting of cyclosporine A and systemic corticosteroids. In 38.2% of patients, laser photocoagulation was used on retinal periphery.
According to the International Headache Society Classification of 2004, THS is an entity that occurs rarely, its etiopathogenesis is unknown, it is manifested clinically by unilateral orbital pain associated with simple or multiple oculomotor paralyses, which resolves spontaneously but may recur. MRI orbital phlebography and biopsy are the recommended methods for making diagniosis. In our patient MRI findings and positive response to the corticosteroide treatment were relevant for making the diagnosis.
Systemic diseases such as Behcet's syndrome, collagen vascular diseases, systemic granulomatous diseases (sarcoidosis and tuberculosis) were the main causes of retinal vasculitis. Knowledge of the symptomatology and pathogenesis of retinal vasculitis is of the major significance for the diagnosis and therapy of the disease.
Sarcoidosis is a chronic systemic autoimmune disease which belongs to a group of systemic granulomatous diseases. It can be confirmed through characteristic systemic and ocular manifestations and histological findings. Biopsy is the golden standard for diagnosing sarcoidosis. Ocular sarcoidosis can be confirmed, probable, or possible. Over a two-year period, ocular manifestations were studied on a sample of 52 patients, each followed for four months and diagnosed with some form of systemic sarcoidosis. Most frequent systemic manifestations in patients with ocular sarcoidosis were pulmonary, skin, glandular, and systemic generalized sarcoidosis. The disease was diagnosed four times more frequently in females than males (42:10, respectively; p < 0.05). Most frequent, and statistically significant, manifestation of ocular sarcoidosis is anterior uveitis (64.61%; p < 0.01). Macular edema and periphlebitis associated with periarteritis were frequent, and statistically significant (43.90% and 29.26%, respectively; p < 0.05). Overall, with regards to gender and location (right eye; left eye), visual acuity was >0.5 and of statistical significance (76.92%; p < 0.01). The most common therapy consisted of systemic corticosteroids (26.67%) and/or a combination of corticosteroids and immunosuppressive drugs (23.33%). In 16 eyes treated with repeated doses of sub-Tenon's injections, both initial and control visual acuity correlated with average thickness. There was positive correlation between several optical coherence tomography findings before and after treatment.
Neoplasm, neovascular glaucoma, acute eye injury and atrophy of the eye ball are the most common causes of enucleation.
The aim of this study was to analyze ocular manifestations, their complications, and treatment in a sample of 40 patients with confirmed Behcet's disease. Results. Serofibrinous iridocyclitis was the most common form of uveitis (60%). Retinal periphlebitis manifested in 92.5% of cases, and periphlebitis in conjunction with periarteritis was diagnosed in 72.5% of cases. Macular edema was the most frequent complication on the posterior segment (60%) and it correlated with periphlebitis (P = 0.45) and periphlebitis associated with periarteritis (P = 0.51). Cyclosporine A and corticosteroids were used in the majority of cases (67%). Following six months of therapy, a significant improvement of visual acuity occurred in patients with initial visual acuity >0.5 on both eyes. Level of visual acuity before and after treatment had a strong significant correlation coefficient with various ocular complications. Previously proven significant increase of visual acuity in patients with macular edema depicts effectiveness of treatment in these types of ocular manifestations of Behcet's disease. Conclusions. Significant improvement of visual acuity occurred in patients with initial visual acuity >0.5 on both eyes. The highest increase in visual acuity was achieved by laser photocoagulation in combination with triamcinolone acetonide P = 0.038 < 0.050.
Epiretinal membrane or macular pucker is avascular, fibrocellular membrane that develops on the inner surface of the retina that can result in various stages of macular dysfunction. Fine epiretinal membranes lead to minimal visual loss, whilst epiretinal membranes (that may or may not bridge the fovea) are, in their more severe stages, accompanied by macular edema and image distortion that is caused by pronounced tractional membranes and perifoveal capillary leakage. Macular edema and its' type, as well as epiretinal membrane bridging the fovea can precisely be defined and monitored via optical coherence tomography.This study included a total of 138 patients (188 eyes) with epiretinal membranes (95 on the right and 93 on the left eye). Macular edema was present in 144 eyes with, and 69 eyes without, epiretinal membranes. Data obtained for both eyes indicates that upon analysis number of patients in both examined groups (epiretinal membrane bridged and did not bridge the fovea) increases exponentially with increased visual acuity, and suggests that there is no considerable difference in distribution of visual acuity with regards to patients in both examined groups. This data also indicates that patients with the worst central macular thickness (>500 μ) are represented only in the group of patients where epiretinal membrane had bridged the fovea, but that in both examined groups there is a difference in prevalence of patients with central macular thickness of 400 to 499 μ (more common in the group that did, than in the group that did not, bridge the fovea). Hence, there exists a relationship between epiretinal membrane that bridges the fovea and central macular thickness.Aim of this study is to determine the extent in which epiretinal membrane bridging or not bridging the fovea influences visual acuity and to determine the relationship between them; central macular thickness; and visual acuity.
Retinal vein occlusion (RVO) is one of the most common vascular diseases of the eye and a frequent cause of severe visual loss. It is multifactorial in origin with both local factors and systemic diseases being of etiological importance. Many thrombophilic conditions have recently been identified and studies looking at their potential role in RVO have been undertaken. The aim of this study was to investigate the role of methylenetetrahydrofolate reductase (MTHFR) heterozigosity associated with normal homocysteine level in blood as risk factor for thromboembolic retinal/vitreal manifestations in patients with retinal vasculitis (RV) and RVO where the other risk factors (such as hypertension; atherosclerosis; diabetes; antiphospholipid syndrome) are excluded. Second question was if anticoagulation treatment should be applied together with systemic corticosteroids and/ immunosuppressive therapy? Results obtained from the examined group showed that heterozigosity for MTHFR C677T gene is of statistical significance and correlates with raised values of homocysteine (correlation coefficient = 0.23). At the same time increased levels of homocysteine correlate (correlation coefficient = 0.01) with appearance of RVO. At r = 0.67, if there is no RV present, existence of a single mutated allele for MTHFR C677T gene does not correlate with RVO. There is however significant correlation between the mutation for MTHFR and hemorrhagic type of RV associated with RVO and/ with isolated hemorrhagic vasculitis without RVO (correlation coefficient = 0.33; correlation coefficient = 0.27; respectively).
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