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Segment Inflammation (segment + inflammation)
Selected AbstractsGlobal angiographic scoring system for inflammatory diseasesACTA OPHTHALMOLOGICA, Issue 2009M KHAIRALLAH Purpose Fundus fluorescein and indocyanine green angiography are essential imaging techniques in the appraisal of posterior segment inflammation. A combined fluorescein and indocyanine green angiographic scoring system has been developed in order to provide semi-quantitative data for follow-up of disease progression, monitoring response to treatment, and comparison between clinical studies. We tested interobserver variations in the semi-quantitative scoring of dual fluorescein/indocyanine green angiograms. Methods Four observers scored 32 dual fluorescein and indocyanine green angiograms. Spearman rank correlation was used to analyze correlation between scores assigned to each angiographic sign. We used the Kappa statistics to test agreement between pairs of observers in comparative total fluorescein and indocyanine green angiographic scores. Results We found a significant correlation between pairs of observers in scores assigned to each fluorescein angiographic sign and the total score of fluorescein angiograms. A significant correlation was found only between 2 separate pairs of observers in scores assigned to early stromal vessel hyperfluoresence on indocyanine green angiography. However, a significant correlation was found in other indocyanine green angiographic signs and the total score of indocyanine green angiograms. There was a good agreement between observers in comparative fluorescein , indocyanine green angiographic total scores. Conclusion Further experience with the scoring system, especially with the indocyanine green angiographic scoring, may improve its reproducibility. [source] The present role of corticosteroids in uveitisACTA OPHTHALMOLOGICA, Issue 2009M KHAIRALLAH Corticosteroids are the most widely used anti-inflammatory and immunosuppressant drugs in ophthalmology in general, and remain the mainstay of therapy for patients with uveitis. An infectious etiology for intraocular inflammation should be adequately excluded or appropriately covered with anti-infectious therapy before administration of corticosteroid therapy. Topical corticosteroids alone are usually effective in the management of anterior uveitis and have little activity against intermediate or posterior uveitis. Ocular adverse effects of topical steroid therapy mainly include ocular hypertension and cataract. The use of periocular steroid injections (subconjunctival, anterior or posterior subtenon, orbital floor) are important modalities in the management of anterior uveitis refractory to topical treatment and intermediate or posterior uveitis, particularly unilateral cases. Systemic corticosteroids remain the initial drug of choice for most patients with severe bilateral intermediate or posterior uveitis. Therapy is initiated with 1.0 to 2.0 mg/Kg of oral prednisone or prednisolone as a single morning dose, followed by a slow taper. Use of intravenous pulse steroid therapy is an important option in acute, severe, bilateral posterior segment inflammation. In several cases, the level of systemic steroid required to control the inflammation is too high and unacceptable. Immunosuppressive drugs as steroid-sparing agents are indicated is such cases. Intravitreal injection of triamcinolone acetonide and slow-release intraocular devices are therapeutic options that can be used in selected uveitis cases refractory to conventional therapy and biologic agents. [source] Longitudinal study of anterior segment inflammation by ultrasound biomicroscopy in patients with acute anterior uveitisACTA OPHTHALMOLOGICA, Issue 2 2009Yang Peizeng Abstract. Purpose:, This study aimed to investigate dynamic changes in the anterior segment in patients with acute anterior uveitis (AAU) using ultrasound biomicroscopy (UBM). Methods:, Acute anterior uveitis was diagnosed in 18 patients according to history and ocular examinations. Ultrasound biomicroscopy was performed and the results at three time-points (within 2 weeks of the uveitis attack, and at 2,4 weeks and 6 weeks after it) were analysed. The relationships between clinical manifestations and UBM findings were also evaluated. Results:, All investigated AAU patients showed severe ciliary injection, numerous dust keratic precipitates (KPs), aqueous flare and inflammatory cells, and were treated predominantly with corticosteroid and cycloplegic eyedrops. Ultrasound biomicroscopy showed a large number of cells in the anterior and posterior chamber, marked oedema and exudates in and around the iris and ciliary body within 2 weeks of AAU onset. These abnormalities were dramatically improved at 2,4 weeks and almost resolved at 6 weeks and thereafter. Conclusions:, Ultrasound biomicroscopy reveals severe inflammatory changes in and around the ciliary body in patients with AAU. These signs rapidly resolve upon treatment. [source] Acute anterior uveitis in primary careCLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 2 2007Ian F Gutteridge MScOptom FAAO Acute anterior uveitis is an important ocular disease of considerable interest to therapeutically and non-therapeutically qualified optometrists. This review examines the role of optometrists in the primary care setting and gives guidelines for appropriate care of patients with anterior uveitis. Diagnosis and differentiation from other forms of anterior segment inflammation are the initial requirement. In parallel, possible medical conditions associated with acute anterior uveitis must be considered, with appropriate referral to medical practitioners. In uncomplicated cases of recurrent acute anterior uveitis, optometrists can initiate topical treatment and monitor resolution of inflammation, while being aware of possible complications of both the disease and its treatment. It is especially important in new attacks of anterior uveitis to liaise with the patient's general practitioner about medical investigation for underlying disease. Atypical, complicated or severe anterior uveitis should be promptly referred for specialist care. [source] | ||||||||||