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Intravitreal (IVT) drug delivery now surpasses cataract surgery as the most commonly performed ophthalmic procedure worldwide. In 2020, nearly 23 million IVT injections were given globally,1 with m...

Uveitis refers to a diverse group of several dozen disorders characterized and connected by the shared presence of intraocular inflammation.1,2 While the etiology of infectious uveitis is often cle...

Tocilizumab (TCZ; Actemra®; Roche/Genentech in the US; Chugai Pharmaceutical Co. in Japan) is a recombinant, humanized monoclonal antibody directed against the interleukin-6 (IL-6) receptor and cur...

To report the clinical findings, anatomical features, and treatment outcomes in subjects with ocular tuberculosis (OTB) at 24 months in the Collaborative Ocular Tuberculosis Study (COTS)-1. Of the ...

Epstein-Barr Virus (EBV), also known as Human HerpesVirus-4 (HHV-4), is a γ-type herpesvirus with a global infection prevalence of over 95%.1,2 Infection, which occurs nasopharyngeally via either a...

Immune checkpoints are endogenous, inhibitory, receptor-mediated regulators of the immune system known to be central to controlling the duration and extent of normal immune responses, thereby maint...

Ultra-wide-field (UWF) imaging has been used clinically in retina practices for nearly two decades to achieve rapid, single-frame photographic access to the mid- and far-retinal periphery.1–5 These...

To review the systemic and ocular manifestations of specific emergent viral infectious diseases relevant to the ophthalmologist with particular emphasis on anterior uveitis Methods: Review of literature.Arboviral diseases are among the most important emergent and resurgent human infections, occurring mostly in tropical and subtropical zones, but appearing in virtually all regions of the world as a result of climate change, travel, and globalization. Arboviral infections are transmitted to humans by the bite of hematophagous arthropods, mainly mosquitoes. Systemic disease may range from asymptomatic to life-threatening. A wide variety of ocular manifestations, including uveitis, has been reported in association with these emerging viral diseases. Numerous viruses other than arboviruses also have been recently recognized as a potential cause of uveitis.Proper clinical diagnosis of any emerging infectious disease is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular involvement. The diagnosis is usually confirmed by detection of virus-specific DNA or antivirus antibodies in serum.

December 2021 will mark the second anniversary of initial reports from Wuhan, China, of human infection by Severe Acute Respiratory Distress Syndrome Coronavirus-2 (SARS-CoV-2), a novel positive-se...

To report a case of ocular Gnathostomiasis presenting as branch retinal artery occlusion.Observational case report.A 22-year-old Asian woman presented to her ophthalmologist with redness, tearing, and decreased vision in her left eye. Examination revealed anterior uveitis and branch retinal artery occlusion associated with both intra-retinal and vitreous hemorrhage. The patient was treated with topical corticosteroids and cycloplegics. After 3 weeks, she presented in our emergency, with further decrease in vision and worsening pain in the left eye. Slit lamp examination revealed a brown colored live worm on the posterior corneal surface, anterior uveitis, multiple iris holes, and vitreous cells. Indirect ophthalmoscopy showed focal retinal hemorrhages, subretinal tracts, and vitreous hemorrhage. Surgical removal of the worm from anterior chamber was done immediately.Branched retinal artery occlusion with intraretinal and vitreous hemorrhage, panuveitis, and multiple iris holes may suggest the presence of an intraocular parasite.

To examine disease profile of tubercular uveitis (TBU) in Paediatric population. Among 945 patients of the retrospective multinational study by the Collaborative Ocular Tuberculosis Study (COTS)-1,...

The term vitamin D refers to a family of secosteroid compounds derived from cholesterol that are best known for facilitating intestinal absorption of calcium and phosphate required for normal bone ...

Background: Tuberculosis (TB) is a major infection that can affect the eye as first and sole presentation without features of systemic disease. Controversy exists regarding diagnosis and management of tubercular uveitis (TBU), further compounded by regional variations in disease expression. Purpose: Collaborative Ocular Tuberculosis Study (COTS)-1 aims to address knowledge deficits through collaboration amongst uveitis specialists across the globe by sharing the data of patients with TBU presented at participating centers from January 2004 to December 2014. Methods: Data collection was facilitated by a novel method of real-time encrypted web-based data entry allowing regular updates as new data and recommendations become available. Results: Information on clinical features, investigation findings, management, and treatment outcomes were reviewed to get an idea about real world scenario. Conclusion: The current review aims to focus on methodology and briefing of published reports from COTS group in COTS-1 study to highlight key messages from this large data.

Varicella Zoster Virus (VZV)-associated uveitis1–3 may occur in utero; during primary systemic infection – most common in children with chickenpox; or following viral reactivation along the first, ...

PURPOSE: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. METHODS: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. RESULTS: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. CONCLUSIONS: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.

This coming year will mark the 40th anniversary of the first reports by the Centers for Disease Control (CDC) of the otherwise rare skin cancer Kaposi sarcoma (KS) and an equally uncommon form of p...

Vaccines have had an enormously positive impact on global health, saving an estimated two to three million lives worldwide each year.1 In 2017 the World Health Organization (WHO) estimated that ove...

Ocular hypertension (OHT) and glaucoma are common and often serious complications of uveitis.1–9 Cross-sectional clinic-based studies have suggested a prevalence of OHT among uveitis referral patie...

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder that affects approximately 5 per 100,000 persons per year in the United States, and roughly half as many in Europe and Japan....

Macular edema (ME) is a leading cause of vision loss in both children and adults with uveitis.1–7 Reported rates of uveitic ME (UME) from tertiary referral clinics have ranged from roughly 20% to 3...

Human leukocyte antigen (HLA)-B27-associated anterior uveitis (AU) is the most commonly diagnosed form of AU and represents the largest entity of non-infectious uveitis around the world. The most typical ocular manifestation associated with HLA-B27 consists of unilateral AU of acute onset. The HLA-B27-associated acute AU represents a distinct clinical entity occurring typically in young adults between the ages of 20 and 40 years. HLA-B27-associated acute AU is typically unilateral and lasts usually several weeks and diminishes within 3 months in the majority of patients. The anterior chamber shows typically severe cellular reaction and flare, as well as a fibrinous exudate. Frequently, posterior synechiae are formed and occasionally hypopyon is present. The pattern of the disease is recurrent with a full remission between the attacks. Intraocular pressure during active periods is typically low due to inflammation of ciliary body and decreased aqueous production. Less typical presentations are also recognized and include the development of chronic inflammation, posterior segment involvement, episcleritis, and scleritis. An isolated retinal vasculitis in HLA-B27-positive patients may develop, mostly in those with inflammatory bowel disease. Chronic AU, which may be either unilateral or bilateral affects up to 20% of patients. Ocular complications of HLA-B27-associated AU are diverse and include commonly posterior synechiae, cataract, glaucoma and/or hypotony. The visual outcome and complications of HLA-B27-associated AAU are frequently being compared with HLA B27-negative patients with AU and show that the prognosis of HLA-B27-associated uveitis is rather favorable, as

A number of authors have reviewed the epidemiology, diagnosis, and treatment of uveitis in children and adolescents.1–16 Data from both clinic- and population-based surveys have shown that children...

Purpose: To contribute a global description of the spectrum of choroidal involvement in tubercular uveitis (TBU).Methods: Retrospective cohort study of TBU patients with choroidal involvement from ...

The retinal pigment epithelium (RPE) and its underlying elastin- and collagen-rich Bruch’s membrane together constitute the outer blood-retinal barrier (BRB).1,2 Functions of the RPE/Bruch’s comple...

This issue of Ocular Immunology & Inflammation (OII) contains ten original, retrospective, clinic-based surveys reporting on various aspects of the demographic and clinical features of uveitis subj...

The choroidal vasculature is the primary source of both oxygen and blood-borne nutrients to the outer retina, including the retinal pigment epithelium (RPE), photoreceptors, and otherwise avascular...

Multiple sclerosis (MS) is a neuroinflammatory condition characterized by repeated, focal demyelination in the central nervous system (CNS).1 The disease is defined clinically as either relapsing-r...

Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disorder characterized in its complete form by the occurrence of bilateral uveitis accompanied by dermatologic as well as neurologic or auditory ...

Infectious keratitis is a potentially blinding corneal condition caused by a diverse array of organisms, including bacteria, viruses, fungi, protozoa, and parasites.1–3 Prompt antimicrobial therapy...