Immune modulator therapy compared with vitrectomy for management of complicated intermediate uveitis: a prospective, randomized clinical study

Shalaby, O; Saeed, Ahmed; Elmohamady, Mohamed Nagy

doi:10.5935/0004-2749.20200079

Cited by 4 publications

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“…The role of PPV in the management of IU has been reported by many authors before whether as a diagnostic or a therapeutic procedure and was associated with a decrease in the severity of inflammation, recurrence rate and the need for immunosuppressives postoperatively [22][23][24]. The surgery is commonly performed as a therapeutic approach in uveitic cases complicated by epimacular membrane, TRD, rhegmatogenous retinal detachment and vitreous hemorrhage [21].…”

Section: Discussionmentioning

confidence: 98%

“…The surgery is commonly performed as a therapeutic approach in uveitic cases complicated by epimacular membrane, TRD, rhegmatogenous retinal detachment and vitreous hemorrhage [21]. Yet, even in the absence of these complications, PPV was also found to be beneficial in improving visual activity and decreasing inflammation in cases of persistent vitreous opacities despite full systemic medical therapy [22,23]. In cases of noninfectious IU, it has been suggested that vitrectomy may be effective in improving vitreous inflammation by removing the antigenic load and reducing the levels of cytokines and interleukins that activate the inflammatory cascade [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of noninfectious IU, it has been suggested that vitrectomy may be effective in improving vitreous inflammation by removing the antigenic load and reducing the levels of cytokines and interleukins that activate the inflammatory cascade [23][24][25]. Accordingly, well-timed PPV after the failure of medical treatment had a beneficial effect on the course, and the prognosis of chronic uveitis and early surgery correlated with the improvement in VA [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Management of presumed trematode-induced granulomatous intermediate uveitis

Amin

Abdullatif

2022

Eye

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Purpose To describe the surgical management of presumed trematode-induced granulomatous intermediate uveitis (PTIGIU) not responding to medical treatment in controlling the inflammation. Methods A prospective, interventional, single-center study in which patients with a history of fresh canal water contact and PTIGIU were enrolled. All patients underwent lensectomy–pars plana vitrectomy (PPV) and post-operative control of inflammation, functional and anatomical outcomes were assessed. Results Fifteen eyes of 12 patients were included in the study with median age of 11.6 ± 4 yrs. Six months following lensectomy-PPV, inflammation was well controlled in all patients. The eyes were divided into two groups: Group A: 10 patients with an attached retina while Group B: 5 patients who were in the cicatricial stage with tractional retinal detachment. All patients in group A had CDVA of 20/40 or better, unlike patients in group B who failed to achieve a CDVA better than 20/70 throughout their follow-up. In group B, final anatomical success was achieved in only 40% with hypotony occurring in 20%. Conclusion PTIGIU is associated with the presence of ciliary body granuloma which, if left untreated, can lead to drastic outcomes. Early lensectomy-PPV represents a viable management option in cases resistant to medical treatment, with a favorable outcome.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of presumed trematode-induced granulomatous intermediate uveitis

Amin

Abdullatif

2022

Eye

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“…In fact, post-PPV CST may remain near baseline with possible intravitreal drug pharmacokinetic deterioration; for example, triamcinolone acetonide has an 18.6-day half-life in non-vitrectomized eyes versus only 3.2 days in vitrectomized eyes [ 57 ]. A direct comparison of general treatment and PPV favored systemic medication [ 58 ].…”

Section: Surgical Treatment—pars Plana Vitrectomymentioning

confidence: 99%

Update on the Management of Uveitic Macular Edema

Teper

2021

JCM

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Uveitic macular edema (ME) is a frequent complication in 8.3% of uveitis patients and is a leading cause of serious visual impairment in about 40% of cases. Despite the numerous available drugs for its treatment, at least a third of patients fail to achieve satisfactory improvement in visual acuity. First-line drugs are steroids administered by various routes, but drug intolerance or ineffectiveness occur frequently, requiring the addition of other groups of therapeutic drugs. Immunomodulatory and biological drugs can have positive effects on inflammation and often on the accompanying ME, but most uveitic randomized clinical trials to date have not aimed to reduce ME; hence, there is no clear scientific evidence of their effectiveness in this regard. Before starting therapy to reduce general or local immunity, infectious causes of inflammation should be ruled out. This paper discusses local and systemic drugs, including steroids, biological drugs, immunomodulators, VEGF inhibitors, and anti-infection medication.

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Therapeutic Vitrectomy in the Management of Uveitis: Opportunities and Challenges

Vithalani

Basu

2022

Seminars in Ophthalmology

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Immune modulator therapy compared with vitrectomy for management of complicated intermediate uveitis: a prospective, randomized clinical study

Cited by 4 publications

References 0 publications

Management of presumed trematode-induced granulomatous intermediate uveitis

Management of presumed trematode-induced granulomatous intermediate uveitis

Update on the Management of Uveitic Macular Edema

Therapeutic Vitrectomy in the Management of Uveitis: Opportunities and Challenges

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