Abstract Purpose To report the successful use of tofacitinib in the treatment of refractory uveitis and scleritis. Observations Two patients, one with scleritis and another with anterior and intermediate uveitis, presented with refractory disease after failure of multiple steroid-sparing therapies. Treatment with tofacitinib led to durable resolution of uveitis and scleritis. Conclusions and importance Tofacitinib is a potential novel treatment option for refractory, noninfectious inflammatory e...
ABSTRACTPurpose: This study aimed to evaluate the safety and efficacy of anakinra for severe and refractory scleritis.Methods: Ten patients with severe (i.e. at least 2 ocular relapses per year despite treatment) and refractory [i.e. at least to one disease modifying antirheumatic drugs (DMARDS)] scleritis were treated with anakinra (100 mg/day subcutaneously). Scleritis was associated with inflammatory systemic diseases in 60% of cases. The remission rate defined the primary outcome.Results: Ni...
Last. Rupesh Agrawal(TTSH: Tan Tock Seng Hospital)H-Index: 30
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AbstractPurpose: To describe the clinical and epidemiological characteristics of patients with posterior scleritis, and to analyze the response to treatment and time to relapse.Methods: Retrospective study of 114 cases of posterior scleritis from two tertiary care, university-affiliated, referral centers in the United Kingdom and India between 2004 and 2013. Data included sociodemographic factors, medical history, clinical, laboratory and ultrasound findings, therapies, and outcomes. LogMAR visu...
Scleritis is an umbrella term for a heterogeneous group of ocular diseases that can be associated with autoimmune or systemic disorders. The purpose of this article was to review the literature regarding the use of biologic drugs to treat refractory scleritis. A search of the MEDLINE, Embase, and LILACS electronic databases was conducted, and the reference lists of published articles were hand-searched. No language filters were used. This search strategy yielded no randomized trials of the use o...
Last. Susan Lightman(UCL: University College London)H-Index: 75
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Purpose To describe the long-term outcome of eyes with uveitis after repeated treatment with dexamethasone implants (Ozurdex; Allergan, Inc., Irvine, CA). Design Retrospective, observational case series. Participants Thirty-eight eyes of 27 patients with uveitis that were treated with 61 dexamethasone implants. Methods All eyes underwent dexamethasone pellet implantation. Anatomic and functional outcomes, as well as ocular complications, were noted. Main Outcome Measures Best-corrected visual ac...
AbstractPurpose: To describe clinical features, ocular complications, and visual outcomes of patients with posterior scleritis.Methods: Clinical characteristics of a subset of 31 patients with posterior scleritis were studied and compared with 469 patients with anterior scleritis.Results: Of 500 patients, 31 (6.2%) had posterior scleritis. Most patients presented with subacute (80.6%), unilateral (61.3%) scleral inflammation. Pain was moderate to severe in 54.8% of patients. Concomitant anterior...
Infection is a very important but rare cause of scleritis, occurring in about 5%–10% of all patients presenting with scleral inflammation. However, due to the similarity of its presentation, infectious scleritis is often initially managed as autoimmune, potentially further worsening its outcome. The overall visual outcome in infectious scleritis is generally worse than its autoimmune counterparts, perhaps because of the delay in diagnosis or because of the aggressive nature of associated microbe...
Uveitis can be a sight-threatening eye disease with significant morbidity. Corticosteroids remain the mainstay of treatment of uveitis and provide an effective treatment against ocular inflammation. However, the various modes available for corticosteroid drug delivery can carry significant ocular and systemic side effects which can limit their use in the treatment of uveitis. In an effort to avoid the damage to ocular structures that can ensue with recurrent episodes of ocular inflammation, the ...
Purpose of reviewImmunosuppressive states and therapies are becoming common in clinical practice. Recent advances and trends in bacterial, fungal, viral and parasitic pulmonary infections in immunosuppressed patients are described.Recent findingsPulmonary infections can jeopardize the prognosis of i