OBJECTIVE: To describe the visual and clinical outcomes of 3 patients with sympathetic ophthalmia treated with a combination of systemic steroids and methotrexate. METHODS: This was a small, descriptive case series. RESULTS: We reported 3 cases of post-traumatic sympathetic ophthalmia treated with steroids and methotrexate. Two patients had inciting eyes with no light perception on presentation, while one had a best-corrected visual acuity (BCVA) of counting fingers. The initial BCVA of the sympathizing eyes ranged from 20/20 to 20/50. Control of ocular inflammation was achieved using methotrexate (12.5 to 15 mg weekly) in addition to oral steroids and topical therapy. The final BCVA of the sympathizing eyes ranged from 20/20 to 20/30, indicating that good visual outcomes were attainable with steroids and methotrexate as part of the maintenance regimen. None of the patients developed adverse side-effects from methotrexate. CONCLUSION: This small case series demonstrated the effectiveness and safety of methotrexate for control of intraocular inflammation in sympathetic ophthalmia.
Ophthalmia, Sympathetic ; Methotrexate ; Panuveitis ; Steroids

PURPOSE: The aim of this study is to determine the soluble Fas (sFas) levels in both sera and aqueous humor in patients with uveitis and compare them to the uveitis severity. METHODS: We measured the sFas levels in both sera and aqueous humor (AH) of patients (n=40) with uveitis and non-uveitis controls (n=27). The patients with uveitis comprised 24 Behcet's disease, 6 panuveitis, 5 anterior uveitis, 2 lens induced uveitis, 1 Vogt-Koyanagi-Harada-disease, 1 sarcoidosis, and 1 retinal vasculitis. The severity of uveitis was determined by the Hogan's grading method (0~4 grade) at the time of sampling. RESULTS:The concentration of aqueous sFas in uveitis patients was significantly higher than that in nonuveitis controls, while there was no difference in the serum concentration of sFas between the two groups. In the paired samples of serum and AH, obtained simultaneously, the aqueous sFas levels were higher than serum Fas levels in patients with uveitis, whereas the non-uveitis controls displayed significantly lower sFas levels in AH than in the serum. The sFas levels in AH or serum were not different between Behcet's uveitis and non-Behcet's uveitis. However, in patients with Behcet's uveitis, circulating sFas strongly correlated with aqueous sFas, which was not so in those with non-Behcet's uveitis. Patients (n=29) with more active (grade> or =2) uveitis had significantly higher levels of aqueous sFas than those (n=11) with less active (grade<2) uveitis. After treatment with steroid and/or immunosuppressive agents, aqueous sFas levels were decreased in parallel with a reduction in the number of inflammatory cells in the anterior chamber. CONCLUSIONS: The levels of sFas were elevated in patients with uveitis and correlated well with uveitis severity.
Anterior Chamber ; Aqueous Humor ; Humans ; Immunosuppressive Agents ; Panuveitis ; Retinal Vasculitis ; Sarcoidosis ; Uveitis* ; Uveitis, Anterior

PURPOSE: We report a case of intraocular Thelazia callipaeda infestation in a patient with panuveitis who had a successful recovery after pars plana vitrectomy. METHODS: A 73-year-old female patients complained of a floating sensation and gradually decreasing visual acuity in her right eye. On slit lamp examination, severe intraocular inflammatory reaction was observed. Fundus examination revealed severe vitreous haze with mobile linear structure. Three-port pars plana vitrectomy was performed and then the worm was removed. RESULTS: The worm was confirmed to be Thelazia callipaeda. At postoperative 2 months, the patient's visual acuity was 0.6 and intraocular pressure 14 mmHg. There was no evidence of intraocular inflammatory reaction. CONCLUSIONS: Thelazia callipaeda usually lie in the conjunctival sac or lacrimal apparatus, causing ocular surface disease, but intraocular infestation rarely occurs. If intraocular infestation does occur, early surgical removal should be performed.
Aged ; Female ; Humans ; Intraocular Pressure ; Lacrimal Apparatus ; Panuveitis ; Sensation ; Thelazioidea ; Visual Acuity ; Vitrectomy

Multifocal choroiditis and panuveitis(MCP) is a clinical syndrome characterized by vitritis, and punched-out fundus lesions mimicking presumed ocular histoplasmosis. We diagnosed MCP in a twenty-eight years old woman with the complaint of decreased vision and floater symptom. Retinochoroidal anastomosis via one of retinochoroidal scars was noted in this case. The patient was treated with oral and periocular steroid and ws observed for 11 months during which choroidal neovascularization and macular edema ws not developed. We present this case because, as far as our knowledge goes, There has been no reported case of MCP with retinochoroidal anastomosis.
Choroid* ; Choroidal Neovascularization ; Choroiditis* ; Cicatrix ; Female ; Histoplasmosis ; Humans ; Macular Edema ; Panuveitis*

Humans ; Panuveitis/etiology* ; Retinal Detachment/etiology* ; Typhoid Fever/diagnosis* ; Visual Acuity

PURPOSE: To characterize the clinical presentation and visual prognosis of punctate inner choroidopathy in Korean patients. METHODS: Eleven patients (seventeen eyes) with punctate inner choroidopathy (PIC) and four (six eyes) with multifocal choroiditis with panuveitis (MCP) were analyzed retrospectively. RESULTS: The mean age of the PIC patients was 32.2 +/- 9.3 years and the mean refractive error was -4.79 +/- 3.18 diopters. In all PIC eyes, fundus photographs showed multiple yellowish white punctate lesions and punched-out scars at the level of the inner retina and choroid. There was no significant difference between the mean initial visual acuity (0.67 +/- 0.40) and the mean final visual acuity (0.56 +/- 0.41). The major cause of visual deterioration was choroidal neovascularization (CNV) which developed in 4 eyes. In PIC, the lesions were located in the more posterior retina and the incidence of CNV was higher than in MCP. CONCLUSIONS: PIC affects young women with moderate myopia and shows the characteristic chorioretinal lesion. Although the eye with PIC usually maintains stable vision after initial attack, CNV may cause complications and significant visual loss.
Choroid ; Choroidal Neovascularization ; Choroiditis ; Cicatrix ; Female ; Humans ; Incidence ; Korea* ; Myopia ; Panuveitis ; Prognosis ; Refractive Errors ; Retina ; Retrospective Studies ; Visual Acuity

PURPOSE: Despite ocular immune privilege, noninfectious chronic uveitis is relatively common. To investigate spontaneous turning on and off of noninfectious chronic uveitis, we examined the nature and apoptosis of infiltrating inflammatory cells from the anterior chamber of patients with chronic uveitis. METHODS: Aqueous humors were obtained with consent from patients with chronic recurrent uveitis at the time of active intraocular inflammation. Apoptosis of the infiltrating cells in aqueous humor was analyzed by flow cytometry, using fluorescence-labeled anti-CD95 antibody, anti-CD95L antibody, and Annexin V. RESULTS: Of total 35 patients recruited, 19 patients had anterior uveitis, 4 patients had intermediate uveitis, and 12 patients had panuveitis. The proportions of Fas+cell and FasL+ cell were over 90% independent of clinical characteristics of uveitis. Annexin V+ cells occupied 31.3% of all cells in aqueous humor. CONCLUSION: The high proportions of CD95+ cell, CD95L+ cell, Annexin+ cell suggest that there is an active apoptosis of inflammatory cells in anterior chamber of noninfectious chronic uveitis.
Annexin A5 ; Anterior Chamber* ; Apoptosis ; Aqueous Humor ; Flow Cytometry ; Humans ; Inflammation ; Panuveitis ; Uveitis* ; Uveitis, Anterior ; Uveitis, Intermediate

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

PURPOSE: To report one case of unilateral intraocular involvement of the MALToma (Mucosa Associated Lymphoid Tissue Lymphoma) in the patient with bilateral conjunctival MALToma which was cured by radiation therapy 8 years ago. METHODS: A 64 year old woman who was in remission status after radiation therapy of the bilateral conjunctival MALToma presented with vitreous opacity, inflammatory reaction in anterior chamber, iris posterior synechiae and keratic precipitate in her left eye. Visual acuity of her left eye decreased from 20/33 to 20/100. Pars planar vitrectomy and cytologic analysis of the vitreous sample were performed. RESULTS: Cytologic analysis of the vitreous sample showed atypical lymphoid cells containing vacuolar nuclei which were stained positive at CD20 marker in the immunohistochemistry. So radiation therapy of the left eye was performed in the diagnosis of intraocular involvement of the MALToma. CONCLUSIONS: If severe panuveitis occurs in the patient with radiation therapy of the conjunctival MALToma, intraocular involvement of the MALToma should be considered as one of the differential diagnosis.
Anterior Chamber ; Conjunctiva ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Iris ; Lymphocytes ; Lymphoid Tissue ; Middle Aged ; Panuveitis ; Visual Acuity ; Vitrectomy

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