PURPOSE: Retisert(TM) (fluocinolone acetonide implant) has recently been approved for clinical use in patients with noninfectious posterior uveitis. We report a patient with intractable chronic Behcet's panuveitis who underwent Retisert(TM) implantation and showed a favorable outcome. METHODS: A 30-year-old male affected with intractable Behcet's uveitis of both eyes for over one year which did not respond to oral steroids and immunosuppressants; subcutaneous interferon injection caused undesirable side effects such as impotency and pyrexia. Initial visual acuities were 20/1000 in the right eye and 20/100 in the left eye, and both eyes showed severe panuveitis with posterior subcapsular cataract, especially in the right eye. The subtenon triamcinolone injection was performed in the right eye, which was only effective to anterior uveitis, and Retisert(TM) was implanted in the right eye after the cataract operation. Two months later the visual acuity increased to 20/25, and the inflammation was totally controlled. There were no ocular or systemic adverse events. CONCLUSIONS: Retiserttrade mark is a fast, effective, and safe treatment for chronic, non.infectious posterior uveitis.
Adult ; Cataract ; Eye ; Fever ; Fluocinolone Acetonide ; Humans ; Inflammation ; Interferons ; Male ; Panuveitis ; Steroids ; Triamcinolone ; Uveitis ; Uveitis, Anterior ; Uveitis, Posterior ; Visual Acuity

Uveitis is a comprehensive term that indicates the inflammation of not only the uvea but also its adjacent tissues, and its etiology, clinical feature and prognosis are various. Uveitis can be classified in a variety of ways and this fact makes it difficult to compare each result. So we classified uveitis by the location with the method of Henderly, D.E.(1986): ant-, post-, intermediate- and panuveitis. We determined the frequency of occurrence, etiology and clinical characteristics of various forms of uveitis in Korea. We conducted a retrospective analysis of 683 patIents with uveitis seen at Seoul National University Hospital from January 1978 to December 1987 and the results were as follows. 1. 192 cases(29.1%) occurred as anterior uveitis, 218 cases(31.9%) as posterior uveitis, 166 cases(24.3%) as panuveitis and 107 cases(15.7%) as pars planitis: Posterior uveitis was the most common form of uveitis. 2. In cases of anterior uveitis, 142 cases(70.4%) were idiopathic, traumatic uveitis was seen in 18 cases(9.4%). In posterior uveatis, III cases(50.9%) were idiopathic, retinal vasculitis including Eales' disease in 60 cases(27.5%) and toxo-plasmosis in 23 cases(10.6%). In cases of panuveitis, idiopathic form occurred in 80 cases(48.2%), Behcet's disease in 41 cases(24.7%): Idiopathic form was the most common entity in all locations of uveitis.
Classification ; Humans ; Incidence ; Inflammation ; Korea* ; Panuveitis ; Pars Planitis ; Prognosis ; Retinal Vasculitis ; Retrospective Studies ; Seoul ; Uvea ; Uveitis* ; Uveitis, Anterior ; Uveitis, Posterior

Sarcoidosis is a granulomatous disease which frequently involves eyes and adnexal tissues. Its prevalence of ocular involvement is reported as about 20%, although it varies widely according to authors, from 12% to 73%. Ocular sarcoidosis is present as various forms - uveitis, conjunctival involvement, optic nerve involvement, and orbital involvement. All the forms of uveitis - anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis - can be shown in sarcoidosis. Because clinical manifestation, prognosis and treatment are determined by the location of uveitis, it is important to classify uveitis. Conjunctival involvement is not a sight-threatening condition in general, its diagnostic value may be of use. Optic nerve is the most commonly involved cranial nerve, which can impair vision. Subjects with visual impairment without any evidence of uveitis, optic nerve involvement should be suspected. Orbital involvement, especially lacrimal gland involvement is common, and it may cause mass-effect. Besides systemic administration of drugs, there are several localized treatments for ocular sarcoidosis - topical eye drops, intra/peri-ocular injection of agents.
Cranial Nerves ; Granuloma ; Lacrimal Apparatus ; Ophthalmic Solutions ; Optic Nerve ; Orbit ; Panuveitis ; Prevalence ; Prognosis ; Sarcoidosis* ; Uveitis ; Uveitis, Anterior ; Uveitis, Intermediate ; Uveitis, Posterior ; Vision Disorders

Nd-YAG laser is known as a safe and effective treatment for posterior capsular opacity after cataract surgery. We studied the ocular complications after Nd-YAG laser treatment in uveitis patients. From January 1991 to December 1996, we retrospectively investigated the complications of uveitis in 22 persons(25 eyes) after Nd-YAG laser posterior capsulotomy, and also investigated that of nonuveitis in 563 persons(635 eyes) as a control group. The uveitis cases consisted of six anterior uveitis, eight intermediate uveitis, seven Behcet`s syndromes, three panuveitis, and one posterior uveitis. In the uveitis group, the complications(18 eyes) consisted of three retinal detachments, one giant retinal tear, three glaucoma, two aggravations of uveitis, two vitreous opacities, one retinal emorrhage, one proliferative vitreoretinopathy, one hyphema, and four transient high intraocular pressures(IOP), and in the control group, it consisted of two subluxations of intraocular lens(IOL), three glaucomas, one retinal tear, three transient high IOPs, two vitreous opacities, two retinal hemorrhages, three macular holes, two retinal detachments, and five cystoid macular edemas. From our experience, the incidence of complications after Nd-YAG laser posterior capsulotomy in uveitis was higher than that in nonuveitis. It was also noted that it is necessary to follow up thoroughly the complications after Nd-YAG laser posterior capsulotomy in uveitis patients.
Cataract ; Follow-Up Studies ; Glaucoma ; Humans ; Hyphema ; Incidence ; Lasers, Solid-State* ; Macular Edema ; Panuveitis ; Posterior Capsulotomy* ; Retinal Detachment ; Retinal Hemorrhage ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Uveitis* ; Uveitis, Anterior ; Uveitis, Intermediate ; Uveitis, Posterior ; Vitreoretinopathy, Proliferative

PURPOSE: This study was undertaken to evaluate the clinical results of pars plana vitrectomy on posterior segment complications in posterior uveitis. METHODS: We reviewed the records of 20 eyes of 19 uveitis patients who were followed up for 6 months or more after vitrectomy. RESULTS: The mean follow-up period was 20 months. Final visual acuity improved in 10 eyes (50%), was maintained in 6 (30%), and decreased in 4 (20%). The mean improvement of vision was 1.6 lines (p=0.019). Detached retina was reattached in 8 (80%) among the 10 eyes with primary surgery. Postoperative complications were cataract (7 eyes), macular degeneration (2 eyes), retinal detachment (2 eyes), and recurrence (1 eye). CONCLUSIONS: These results suggest that pars plana vitrectomy may be a safe and effective treatment for posterior segment complications in posterior uveitis, but that early and complete vitrectomy should be considered for a better visual prognosis.
Cataract ; Follow-Up Studies ; Humans ; Macular Degeneration ; Postoperative Complications ; Prognosis ; Recurrence ; Retina ; Retinal Detachment ; Uveitis ; Uveitis, Posterior* ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the therapeutic effect and safety of mycophenolate mofetil (MMF) on chronic uveitis in Korean patients. METHODS: This study included 25 patients with chronic uveitis who used MMF and were followed up more than 6 months in 2 referral centers from 2010 to 2014. The medical records were analyzed retrospectively. The therapeutic effect was assessed based on control of inflammation, corticosteroid sparing effects, and discontinuation of MMF, and the safety was assessed based on side effects. Control of inflammation was defined as no active inflammation observed on at least 2 consecutive visits 28 days apart or more. RESULTS: The 25 patients consisted of 18 males and 7 females. The mean age of the patients was 47.52 years. The etiology of uveitis was as follows: Behcet's disease in 15 patients (60%), Vogt-Koyanagi-Harada disease in 4 (16%), sympathetic ophthalmia in 2 (8%), systemic lupus erythematosus in 1 (4%), and idiopathic uveitis in 3 (12%). Anatomic classification was anterior uveitis in 20% and posterior uveitis or panuveitis in 80% of patients. Complete control of inflammation was achieved in 44% and 50% of patients within 6 months and 1 year, respectively. Systemic corticosteroid dosage was reduced to 10 mg of prednisone or less while maintaining sustained control of inflammation in 36% and 45% of patients for 6 months and 1 year, respectively. MMF was discontinued in 3 patients (12%) due to side effects and in 2 patients (8%) due to lack of effectiveness. CONCLUSIONS: MMF was effective and side effects were uncommon when managing chronic uveitis in Korean patients.
Classification ; Female ; Humans ; Inflammation ; Lupus Erythematosus, Systemic ; Male ; Medical Records ; Ophthalmia, Sympathetic ; Panuveitis ; Prednisone ; Referral and Consultation ; Retrospective Studies ; Uveitis* ; Uveitis, Anterior ; Uveitis, Posterior ; Uveomeningoencephalitic Syndrome

Vogt-Koyanagi-Harada syndrome is characterized by bilateral uveitis, alopecia, poliosis, dysacousia, and sings of meningeal irritation. Vogt-Koyanagi syndrome is a severe anterior uveitis associated with alopecia, vitiligo, poliosis, and dysacousia. On the other hand, Harada's disease is primarily a posterior uveitis accompanied by sings of meningeal irritation and abnormalities of cerebrospinal fluid. The overlapping of clinical manifestations between two entities have justified as part of a spectrum of one disease. The etiology is not clearly determined but two most reliable theories as to the cause of the Vogt-Koyanagi-Harada syndrome have been considered as allergic reaction to the uveal pigment or viral infection. The authors experienced a 27-year-old Korean male who had acute bilateral uveitis, headache, dysacousia, alopecia, poliosis, vitiligo on the back, and retinal pigment epithelial detachment of posterior pole in the fluorescein angiography. Thus the authors present this case with clinical manifestations, fluorescein angiographic findings. our schedule of steroid therapy, and review of literatures.
Adult ; Alopecia ; Appointments and Schedules ; Cerebrospinal Fluid ; Fluorescein ; Fluorescein Angiography ; Hand ; Headache ; Humans ; Hypersensitivity ; Male ; Retinal Detachment ; Uveitis ; Uveitis, Anterior ; Uveitis, Posterior ; Uveomeningoencephalitic Syndrome* ; Vitiligo

We conducted a retrospective analysis of 394 patients with uveitis seen at Kyung Hee University Medical Center from January 1982 to June 1987 to determine the frequency of occurence and to study the clinical characteristiscs of various form of uveitis. The results were as follows; 1. In classification of uveitis by location, 309 patients(78.4%) were anterior uveitis, 41 patients(10.4%) were posterior uveitis, 31 cases(7.9%) occurred as panuveitis. Pars planitis accounted for 13 cases(3.3%). Anterior uveitis was the most common causes of uveitis. 2. In cases of anterior uveitis, 127 cases(32.7%) were idiopathic iridocyclitis, 121 cases(30.7%) were traumatic iridocyclitis. In cases of posterior uveitis, Tuberculous uveitis was seen in 11 cases(2.8%), and Toxoplasmic chorioretinitis occured 10 cases(2.5%). In case of panuveitis, Behcet's disease was observed 10 patients(2.5%), and was the most common cause of panuveitis, pars planitis accounted for 13 cases(13.3%). 3. In aspect of age of uveitis, the peak age was 16~45 yrs.(60.6%). In case of anterior uveitis and pars planitis, peak age group was 16~45 yrs. In case of posterior uveitis and panuveitis, peak age group was 31~60 yrs. 4. In clinical characteristics of uveitis by location, anterior uveitis occurred at mostly younger age than did any uveitis(27.8 yrs.) in average age of diagnosis. In sex ratio, male patient of pars planitis predominated with over 3 times number of female patient. In the average duration of illness from the date of first symptom to date of first recorded quiescence, anterior uveitis was mostly shorter duration than did any uveitis(1.1 Mon.). 5. In the evaluation of laterality, all cases showed binocular equal distribution except pars planitis. 6. The largest number of complication was showed in panuveitis. 7. The most common symptom of uveitis was visual disturbance.
Academic Medical Centers ; Chorioretinitis ; Classification* ; Diagnosis ; Female ; Humans ; Iridocyclitis ; Male ; Panuveitis ; Pars Planitis ; Retrospective Studies ; Sex Ratio ; Telescopes ; Uveitis* ; Uveitis, Anterior ; Uveitis, Posterior

In order to evaluate association of particular HLA typing with certain uveitis in Korean population, HLA antigens were analyzed in 114 uneitis patients(acute anterior uveitis: 32 cases, Behcet`s disease: 25 cases, intermediate uveitis: 19 cases, Vogt-Koyanagi-Harada (V-K-H) syndrome: 10 cases, retinal vasculitis: 12 cases, Eale`s disease: 3 cases, posterior uveitis: 9 cases, pan.uveitis: 4 cases). The stronger association between acute anterior uveitis and HLA-B27 was statistically significant, and this result was similar to reports in other ethnic groups. Also, the association between V-K-H syndrome and HLA-DR4 showed same results. But the high frequency of HLA-DR7 in the patients with V-K-H syndrome was unque in patients of Korean popjlation and statistically significant. The association between HLA-A2 and posterior uveitis was high in patients of Korean population and statistically significant. Behcet`s disease was stronger association with HLA-B51 but not statistically significant and much weaker association than reports in Japanese group. Although many similarities of associations between particular uveitis and HLA typing were detected as compared with other ethnic groups, distinctive HLA associations were demonstrated in Korean population. Additional cases and long-term follow-up are required to confirm the association with HLA typing and the relationship with prognosis including clinical and laboratory variabilities.
Asian Continental Ancestry Group ; Ethnic Groups ; Follow-Up Studies ; Histocompatibility Testing ; HLA Antigens ; HLA-A2 Antigen ; HLA-B27 Antigen ; HLA-B51 Antigen ; HLA-DR4 Antigen ; HLA-DR7 Antigen ; Humans ; Prognosis ; Retinal Vasculitis ; Uveitis* ; Uveitis, Anterior ; Uveitis, Intermediate ; Uveitis, Posterior

PURPOSE: To investigate the clinical effects and side effects of Tacrolimus for ocular Behcet's disease. METHODS: Eight patients (male: 5, age: 35+/-7.5 (25-48) years) with Behcet's uveitis, refractory posterior uveitis unresponsive to combination treatment with cyclosporine, azathioprine, and oral steroid or significant cyclosporine-related adverse effects were recruited prospectively, and cyclosporine was switched to Tacrolimus. Visual acuity, degree of anterior chamber, and vitreous haze were compared before the conversion and three months after. Oral glucose tolerance, plasma insulin, cholesterol, creatinine, and aspartate (AST)/alanine aminotransferase (ALT) were measured to monitor systemic effects. RESULTS: Visual acuity did not change significantly after conversion to Tacrolimus. Anterior chamber (seven patients) and vitreous (four patients) inflammation were found before conversion and decreased or disappeared after conversion. Overall plasma levels of glucose, insulin, creatinine, and AST/ALT were similar before and after conversion. However, cholesterol was significantly decreased after conversion (p=0.028). One patient developed diabetes mellitus. CONCLUSIONS: Tacrolimus may be effective for Behcet's uveitis unresponsive to or intolerable of traditional treatments. In addition, periodic monitoring for side effects, such as hyperglycemia and diabetes mellitus, may be necessary.
Anterior Chamber ; Aspartic Acid ; Azathioprine ; Cholesterol ; Creatinine ; Cyclosporine ; Diabetes Mellitus ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Inflammation ; Insulin ; Plasma ; Prospective Studies ; Tacrolimus* ; Uveitis* ; Uveitis, Posterior ; Visual Acuity