Visual Outcome and Poor Prognostic Factors in Isolated Idiopathic Retinal Vasculitis

Maleki, Arash; Cao, Jennifer H.; Silpa-archa, Sukhum; Foster, C. Stephen

doi:10.1097/iae.0000000000001019

Cited by 18 publications

(14 citation statements)

References 12 publications

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“…Perivascular leak caused by retinal vasculitis usually occurs as a manifestation of an underlying systemic condition or ocular syndrome 31 ; alternatively, retinal vessels can also be involved as primary isolated or single-organ vasculitis, a category recently included in the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. 32 Unlike the condition idiopathic retinal vasculitis, in which the presence of phlebitis was reported in 100%, 33 vitreous cells in 58-100%, 33,34 and ischemic lesions in 21-37% of cases, 31,34,35 our study found no evidence of vitreous cells nor signs of hypoperfusion/ischemia in any of the patients examined. Furthermore, perivenous leak was detected in only 30.4% of the study eyes of our series.…”

Section: Discussioncontrasting

confidence: 63%

Fluorescein Angiography Findings in Eyes With Lamellar Macular Hole and Epiretinal Membrane Foveoschisis

dell’Omo

Filippelli

Turris

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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The purpose of this paper was to study fluorescein angiography (FA) findings in eyes with lamellar macular hole (LMH), and epiretinal membrane (ERM) foveoschisis. METHODS.In this prospective, observational case series, 46 eyes of patients affected by either LMH or ERM foveoschisis were examined using optical coherence tomography (OCT) and FA. All patients underwent a comprehensive ophthalmological examination and a general workup to exclude uveitis. Main outcome measures were: presence of FA abnormalities, measurements of the areas of vascular leakage, and intensity of pixels in the vitreous. RESULTS. Twenty-four (52.2%) eyes with LMH and 22 (47.8%) with ERM foveoschisis were studied. Overall, FA abnormalities were found in 20 (83.3%) eyes with LMH and 18 (81.8%) with ERM foveoschisis. The median areas of posterior pole and peripheral leakage were 7.52 vs. 1.07 mm 2 (P = 0.03) and 21.8 vs. 3.74 mm 2 (P = 0.02) in the LMH and ERM foveoschisis group, respectively. Disk hyperfluorescence was found in 8 and 4 eyes and perivascular leak in 10 and 4 eyes with LMH and ERM foveoschisis, respectively. OCT-derived measurements of vitreous intensity did not differ between the two groups, and the investigational workup for uveitis was negative in all patients. CONCLUSIONS. Discrete areas of central and peripheral leakage are commonly found in eyes with LMH and ERM foveoschisis, whereas perivascular leak and hyperfluorescence of the disc are less frequently observed. These findings suggest that breakdown of the retinal blood barrier, involving the posterior pole and the periphery, is frequently associated with these two vitreoretinal disorders.

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Section: Discussioncontrasting

confidence: 63%

Fluorescein Angiography Findings in Eyes With Lamellar Macular Hole and Epiretinal Membrane Foveoschisis

dell’Omo

Filippelli

Turris

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…Patients with a large area of retinal ischemia and/or macular ischemia generally have poor visual outcome. 20 FFA can also detect subclinical RV in patients thought to be otherwise clinically inactive. FFA findings in patients with RV include retinal vascular leakage/staining, optic disc leakage/staining, macular leakage, capillary drop out, vascular occlusion, and blockage.…”

Section: Fundus Fluorescein Angiography (Ffa)mentioning

confidence: 99%

“…40 Other biologics in addition to anti-TNF-α agents have been used to treat RV, including rituximab (anti-CD20), daclizumab (anti-CD25), and tocilizumab (IL-6R inhibitor). 3,20,41…”

Section: Immunomodulatory Therapymentioning

confidence: 99%

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Antimicrobial Resistance Patterns Amid Community-Acquired Uropathogens in Outpatient Settings of a Tertiary Care Hospital in Thailand

Sangsuwan¹,

Jariyasoonthornkit²,

Jamulitrat³

2021

SMJ

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Retinal vasculitis is inflammation of retinal blood vessels typically resulting from infection or immune-mediated inflammatory processes. It may present as isolated ocular inflammation or as a part of severe or potentially fatal systemic disease. Ocular complications of retinal vasculitis include cystoid macular edema, neovascularization, tractional retinal detachment, and vitreous hemorrhage, which all greatly threaten vision. Multimodal imaging and thorough systemic investigations are the main tools for making a precise diagnosis, which aids in predicting disease prognosis and visual outcome as well as preserving a patient’s vision and possibly their life. This review aims to discuss the current understanding of retinal vasculitis as well as current diagnostic tools and treatments.

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“…At diagnosis, all patients underwent a comprehensive ophthalmologic examination that included best-corrected visual acuity (BCVA) measured on the Snellen chart, intraocular pressure (IOP) by applanation tonometry, a complete biomicroscopic assessment, ocular motility, visual field testing, fluorescein or indocyanine green angiography, and optical coherence tomography. The patients were grouped according to their BCVA grade as follows: grade I, 20/25 or better; grade II, 20/30 to 20/40; grade III, 20/50 to 20/160; grade IV, 20/200 or worse [ 14 , 15 ]. All tests were performed or repeated as required at any time during the course of the disease.…”

Section: Methodsmentioning

confidence: 99%

The eye is a common site of granulomatosis with polyangiitis. A collaborative study

et al. 2023

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Background Ocular manifestations of granulomatosis with polyangiitis (GPA) have been reported in a limited number of studies and with largely variable frequency. Here we report on the clinical, diagnostic, and therapeutic features of a cohort of 63 GPA patients, with particular regard to 22 of them with ophthalmic involvement (35%). Methods Clinical manifestations, results of immunological findings, histopathological pictures, imaging data, Birmingham Vasculitis Activity Score, therapeutic regimens, and outcomes were retrospectively analyzed. At diagnosis, in addition to a structured clinical assessment, all patients underwent a comprehensive ophthalmologic examination. Results The most frequently involved organs were kidneys, lungs, ear/nose/throat, and eyes. Ocular manifestations were bilateral in 32%. The three most commonly diagnosed ophthalmologic manifestations were scleritis (36%), retro-orbital pseudotumor or orbital mass (23%), and episcleritis (13%). Ocular and systemic involvement were simultaneously present at onset in 41% of the patients; systemic involvement was followed by ocular lesions in 36%; ocular inflammation was followed by systemic manifestations in 18%; and an orbital mass in the absence of systemic disease characterized 5%. Glucocorticoids plus cyclophosphamide and glucocorticoids plus rituximab were the combined therapies most frequently employed during remission induction and remission maintenance, respectively. Persistent ophthalmologic and extra-ocular remissions were achieved in 77 and 64% of the patients, respectively. One to three systemic relapses were diagnosed in 7 patients (31.8%). At the last follow-up, a visual outcome 20/40 or better in 31 (70%) of 44 eyes was determined. Conclusions The eye was involved in over one third of our patients with GPA. Increased awareness, early diagnosis, and multi-specialty collaboration are critical in achieving a favorable outcome of GPA.

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Visual Outcome and Poor Prognostic Factors in Isolated Idiopathic Retinal Vasculitis

Cited by 18 publications

References 12 publications

Fluorescein Angiography Findings in Eyes With Lamellar Macular Hole and Epiretinal Membrane Foveoschisis

Fluorescein Angiography Findings in Eyes With Lamellar Macular Hole and Epiretinal Membrane Foveoschisis

Antimicrobial Resistance Patterns Amid Community-Acquired Uropathogens in Outpatient Settings of a Tertiary Care Hospital in Thailand

The eye is a common site of granulomatosis with polyangiitis. A collaborative study

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