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477 results on '"Rajak, Saul"'

15. Probable IGG4 related ophthalmic disease presenting with uveitis.

Author

Murphy, George S. P., Gounder, Pav A, Good, Catriona D., Hajela, Vijay, Koenig, Michael, Hughes, Edward, and Rajak, Saul

Subjects
IRIDOCYCLITIS, UVEITIS, DISEASE progression, VISION disorders, ORBITAL diseases, PROGNOSIS
Abstract

We present a case of an uncommon presentation of IgG4-related ophthalmic disease (ROD). A 58-year-old female presented with unilateral acute anterior uveitis of the right eye, which progressed to scleritis with the development of an associated orbital mass despite treatment with oral glucocorticoid. Initial histopathology of an orbital biopsy was non-diagnostic and continued progression of the disease lead to complete loss of vision in the right eye. The development of uveitis in the previously unaffected left eye led to the decision for enucleation of the right globe and further orbital biopsy. Histopathology revealed features supporting IgG4-related ophthalmic disease. Oral glucocorticoid therapy failed to induce remission, and rituximab therapy was initiated, leading to a rapid resolution in her symptoms. Other cases with a similar presentation report a poor visual prognosis, highlighting the need for prompt diagnosis and treatment of uveitis associated with signs of orbital or scleral involvement. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Optical frequency domain imaging (OFDI) represents a novel technique for the diagnosis of giant cell arteritis

Author

Cox, Laurence, Schulz, Christopher B., Slaven, James, Gounder, Pav, Arunothayaraj, Sandeep, Alsanjari, Osama, Cockburn, James, Wright, David A., Oliphant, Huw, and Rajak, Saul

Abstract

Background/Objectives: Giant cell arteritis (GCA) is an inflammatory vascular disease in which prompt and accurate diagnosis is critical. The efficacy of temporal artery biopsy (TAB) is limited by ‘skip’ lesions and a delay in histological analysis. This first-in-man ex-vivo study aims to assess the accuracy of optical frequency domain imaging (OFDI) in diagnosing GCA. Subjects/Methods: 29 TAB samples of patients with suspected GCA were submerged in 0.9% sodium chloride and an OFDI catheter was passed through the lumen to create cross-sectional images prior to histological analysis. The specimens were then preserved in formalin for histological examination. Mean intimal thickness (MIT) on OFDI was measured, and the presence of both multinucleate giant cells (MNGCs) and fragmentation of the internal elastic lamina (FIEL) was assessed and compared with histology, used as the diagnostic gold standard. Results: MIT in patients with/without histological evidence of GCA was 0.425 mm (±0.43) and 0.13 mm (±0.06) respectively compared with 0.215 mm (±0.09) and 0.135 mm (±0.07) on OFDI. MIT measured by OFDI was significantly higher in patients with histologically diagnosed arteritis compared to those without (p= 0.0195). For detecting FIEL and MNGCs, OFDI had a sensitivity of 75% and 28.6% and a specificity of 100% and 77.3% respectively. Applying diagnostic criteria of MIT > 0.20 mm, or the presence of MNGCs or FIEL, the sensitivity of detecting histological arteritis using OFDI was 91.4% and the specificity 94.1%. Conclusions: OFDI provided rapid imaging of TAB specimens achieving a diagnostic accuracy comparable to histological examination. In-vivo imaging may allow imaging of a longer arterial section.

Published
2024
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41. Acute Bilateral Orbital Myositis Following Covid 19 Vaccination.

Author

Murphy, George S. P., Gounder, Pav A, and Rajak, Saul

Subjects
COVID-19, COVID-19 vaccines, ASYMPTOMATIC patients, MYOSITIS, EXOPHTHALMOS, METHYLPREDNISOLONE, THYROID eye disease
Abstract

The authors present a case of acute bilateral orbital myositis occurring 24 hours after the administration of the mRNA1273 vaccination for COVID 19. The patient was presented with right proptosis, with orbital imaging demonstrating bilateral enlargement of all the extraocular muscles. Serological investigation did not reveal a precipitating cause or underlying disease process. The presenting features resolved entirely following treatment with methylprednisolone and the patient remains asymptomatic. [ABSTRACT FROM AUTHOR]

Published
2023
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