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Article ; Online: Infectious eye disease in the 21st century-an overview.

Clare, Gerry / Kempen, John H / Pavésio, Carlos

2024

Abstract: Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in ... ...

Abstract	Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in aggregate, may account for a significant portion of the global visual burden. Diagnosis is frequently challenging even in specialist centres, and many disease presentations are highly regional. In an age of globalisation, an understanding of the various modes of transmission and the geographic distribution of infections can be instructive to clinicians. The impact of eye infections on global disability is currently not sufficiently captured in global prevalence studies on visual impairment and blindness, which focus on bilateral disease in the over-50s. Moreover, in many cases it is hard to differentiate between infectious and immune-mediated diseases. Since infectious eye diseases can be preventable and frequently affect younger people, we argue that in future prevalence studies they should be considered as a separate category, including estimates of disability-adjusted life years (DALY) as a measure of overall disease burden. Numbers of ocular infections are uniquely affected by outbreaks as well as endemic transmission, and their control frequently relies on collaborative partnerships that go well beyond the remit of ophthalmology, encompassing domains as various as vaccination, antibiotic development, individual healthcare, vector control, mass drug administration, food supplementation, environmental and food hygiene, epidemiological mapping, and many more. Moreover, the anticipated impacts of global warming, conflict, food poverty, urbanisation and environmental degradation are likely to magnify their importance. While remote telemedicine can be a useful aide in the diagnosis of these conditions in resource-poor areas, enhanced global reporting networks and artificial intelligence systems may ultimately be required for disease surveillance and monitoring.
Language	English
Publishing date	2024-02-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	91001-6
ISSN	1476-5454 ; 0950-222X
ISSN (online)	1476-5454
ISSN	0950-222X
DOI	10.1038/s41433-024-02966-w
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Article ; Online: Conventional immunosuppression: the search for scientific evidence.

Pavesio, Carlos E

Eye (London, England)

2020 Volume 34, Issue 11, Page(s) 1945–1946

MeSH term(s)	Graft Rejection ; Humans ; Immunosuppression Therapy ; Immunosuppressive Agents
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2020-04-27
Publishing country	England
Document type	Editorial
ZDB-ID	91001-6
ISSN	1476-5454 ; 0950-222X
ISSN (online)	1476-5454
ISSN	0950-222X
DOI	10.1038/s41433-020-0875-3
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Article: Recurrence rates in ocular non-infectious uveitis according to US FDA criteria or Rest of World criteria.

Jaffe, Glenn J / Pavesio, Carlos E

Journal of ophthalmic inflammation and infection

2022 Volume 12, Issue 1, Page(s) 30

Language	English
Publishing date	2022-09-14
Publishing country	Germany
Document type	Letter
ZDB-ID	2592309-2
ISSN	1869-5760
ISSN	1869-5760
DOI	10.1186/s12348-022-00307-0
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Article ; Online: Ocular inflammatory events following COVID-19 vaccination: reporting of suspected adverse drug reactions to regulatory authorities in the UK.

Testi, Ilaria / Soomro, Taha / Pavesio, Carlos / Solebo, Ameenat Lola

The British journal of ophthalmology

2024

Abstract: Background/aims: The UK Medicines and Healthcare products Regulatory Agency (MHRA) has published suspected adverse drug reactions to vaccines against COVID-19. Ocular inflammatory events following COVID-19 vaccination have been reported worldwide.: ... ...

Abstract	Background/aims: The UK Medicines and Healthcare products Regulatory Agency (MHRA) has published suspected adverse drug reactions to vaccines against COVID-19. Ocular inflammatory events following COVID-19 vaccination have been reported worldwide. Methods: We analysed MHRA data on spontaneous reports of suspected ocular inflammatory events following COVID-19 vaccination between January 2021 and September 2022. Results: The MHRA received 300 UK spontaneous suspected reports of ocular inflammatory events following COVID-19 vaccination, with a calculated prevalence of 6.6 events per 1 000 000 vaccinated individuals. Anterior uveitis was the most common phenotype (58.3%), followed by optic neuritis in 39.3%. Median number of days between vaccination and onset was 8 days. Resolution of the event was seen in 52.3%. Conclusion: Ocular inflammatory events following COVID-19 vaccination have a very rare prevalence in the UK. There is no increase in the reporting rate of uveitis, optic neuritis and scleritis following COVID-19 vaccination when compared with the range of incidence in the UK population. The Yellow Card System represents a vital instrument within the domain of pharmacovigilance, empowering patients and healthcare professionals to contribute to the ongoing monitoring of medication safety.
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Journal Article
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2023-324503
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Article ; Online: Non-infectious uveitis affecting the posterior segment treated with fluocinolone acetonide intravitreal implant: 3-year fellow eye analysis.

Pavesio, Carlos / Heinz, Carsten

Eye (London, England)

2021 Volume 36, Issue 6, Page(s) 1231–1237

Abstract: Background: Prevention of non-infectious uveitis of the posterior segment (NIU-PS) recurrence using 0.2 μg/day fluocinolone acetonide implant (FAi) was assessed over 3 years (NCT01694186). Outcomes for FAi-treated and fellow eyes with NIU-PS were ... ...

Abstract	Background: Prevention of non-infectious uveitis of the posterior segment (NIU-PS) recurrence using 0.2 μg/day fluocinolone acetonide implant (FAi) was assessed over 3 years (NCT01694186). Outcomes for FAi-treated and fellow eyes with NIU-PS were compared, to evaluate FAi versus conventional treatment strategies. Methods: Eligible subjects had >1-year recurrent NIU-PS history and either ≥2 separate recurrences requiring treatment, or corticosteroid therapy (systemic or ocular) in the 12 months preceding study entry. Bilateral disease was present and analysed in 59/87 FAi-treated participants. Recurrence rates, best-corrected visual acuity (BCVA) changes, cataract surgery, intraocular pressure (IOP) events and adjunctive medication use were compared for FAi-treated and fellow eyes. Results: Over 36 months, more FAi-treated than fellow eyes remained recurrence-free (28.8% vs. 5.1%, P = 0.001; mean 1.9 vs. 4.7 recurrences, respectively, P < 0.0001). FAi-treated eyes gained +9.6 letters BCVA, versus a loss of -4.4 in fellow eyes (P < 0.0001). Systemic medications were given to 42.4% of subjects. Intra/periocular adjunctive injections were lower in FAi-treated than fellow eyes (20.3% vs. 66.1%, P < 0.0001); topical corticosteroid use was also lower in FAi-treated than fellow eyes (27.1% vs 52.5%, P = 0.0041). IOP-related events occurred at similar rates in both FAi-treated and fellow eyes, excepting IOP-lowering surgery (5.1% vs. 15.3%, respectively; P = 0.1251). Cataract surgery occurred in 72.0% of FAi-treated and 37.0% of fellow eyes. Conclusions: In subjects with bilateral NIU-PS, continuous, low-dose corticosteroid with 0.2 μg/day FAi reduced recurrence and adjunctive medication requirements, and improved vision over 36 months, providing greater protection against ocular inflammation than a reactive approach using standard of care.
MeSH term(s)	Cataract ; Drug Implants/therapeutic use ; Eye Infections, Bacterial/drug therapy ; Fluocinolone Acetonide ; Glucocorticoids/therapeutic use ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Recurrence ; Treatment Outcome ; Uveitis/drug therapy ; Visual Acuity
Chemical Substances	Drug Implants ; Glucocorticoids ; Fluocinolone Acetonide (0CD5FD6S2M)
Language	English
Publishing date	2021-06-11
Publishing country	England
Document type	Journal Article
ZDB-ID	91001-6
ISSN	1476-5454 ; 0950-222X
ISSN (online)	1476-5454
ISSN	0950-222X
DOI	10.1038/s41433-021-01608-9
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Article ; Online: June consultation #8.

Barton, Keith / Pavesio, Carlos E

Journal of cataract and refractive surgery

2021 Volume 47, Issue 7, Page(s) 972

Language	English
Publishing date	2021-06-26
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/01.j.jcrs.0000758940.75396.25
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Article: Ocular sarcoidosis in adults and children: update on clinical manifestation and diagnosis.

Bazewicz, Magdalena / Heissigerova, Jarmila / Pavesio, Carlos / Willermain, François / Skrzypecki, Janusz

Journal of ophthalmic inflammation and infection

2023 Volume 13, Issue 1, Page(s) 41

Abstract: Sarcoidosis-associated uveitis, is the predominant ocular sarcoidosis presentation, which affects both adults and children. For adults, international ocular sarcoidosis criteria (IWOS) and sarcoidosis-associated uveitis criteria (SUN) are defined. ... ...

Abstract	Sarcoidosis-associated uveitis, is the predominant ocular sarcoidosis presentation, which affects both adults and children. For adults, international ocular sarcoidosis criteria (IWOS) and sarcoidosis-associated uveitis criteria (SUN) are defined. However, for children they are not yet established internationally. Due to the specificity of pediatric manifestations of sarcoidosis, this task is even more challenging. In children, sarcoidosis is subdivided into Blau syndrome and early-onset sarcoidosis (BS/EOS) affecting younger children (< 5 years) and the one affecting older children with clinical presentation resembling adults. Differential diagnosis, clinical work-up as well as diagnostic criteria should be adapted to each age group. In this article, we review the clinical manifestation of sarcoidosis-associated uveitis in adults and children and the sensitivity and specificity of various ocular sarcoidosis diagnostic modalities, including chest X-ray and CT, FDG PET-CT, gallium-67 scintigraphy, bronchoalveolar lavage fluid, genetic testing for NOD2 mutations and serum biomarkers, such as ACE, lysozyme and IL2R.
Language	English
Publishing date	2023-09-18
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2592309-2
ISSN	1869-5760
ISSN	1869-5760
DOI	10.1186/s12348-023-00364-z
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Article: Cytomegalovirus anterior uveitis and occlusive retinal vasculitis without retinitis in a patient on immunomodulatory therapy.

Fabozzi, Lorenzo / Testi, Ilaria / De Benito-Llopis, Laura / Pavesio, Carlos

Journal of ophthalmic inflammation and infection

2023 Volume 13, Issue 1, Page(s) 34

Abstract: Purpose: To describe unusual clinical features and therapeutic management of a case of cytomegalovirus (CMV) ocular disease in a patient on immunomodulatory therapy.: Setting/venue: Moorfields Eye Hospital NHS Foundation Trust, London, UK.: Methods! ...

Abstract	Purpose: To describe unusual clinical features and therapeutic management of a case of cytomegalovirus (CMV) ocular disease in a patient on immunomodulatory therapy. Setting/venue: Moorfields Eye Hospital NHS Foundation Trust, London, UK. Methods: Medical history, clinical findings, investigation results, and multimodal imaging were retrospectively collected. Results: A 61-year-old, South-East Asian man, developed CMV-related endotheliitis and occlusive retinal vasculitis, diagnosed by wide-angle fluorescein angiography. No retinitis was present on the fundus examination. Suspicion of CMV etiology was based on anterior segment findings, especially the presence of coin-shaped endothelial lesions. The diagnosis was confirmed by aqueous polymerase chain reaction (PCR) analysis which was positive for CMV DNA. The combined use of topical and systemic valganciclovir resulted in significant improvement of the picture. Conclusions: CMV can manifest in the eye as occlusive retinal vasculitis without the presence of typical retinitis.
Language	English
Publishing date	2023-08-04
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2592309-2
ISSN	1869-5760
ISSN	1869-5760
DOI	10.1186/s12348-023-00356-z
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Article ; Online: Choroidal Involvement in a Case of Viral Retinitis.

Veeramani, Pratibha / Testi, Ilaria / Rasheed, Rajna / Westcott, Mark / Pavesio, Carlos

Ocular immunology and inflammation

2023 Volume 32, Issue 4, Page(s) 473–474

Abstract: Purpose: To describe a challenging case of acute retinal necrosis.: Methods: Clinical data, including medical history, clinical findings and imaging features were retrospectively collected in a 28-year-old female with unilateral active retinitis.: ... ...

Abstract	Purpose: To describe a challenging case of acute retinal necrosis. Methods: Clinical data, including medical history, clinical findings and imaging features were retrospectively collected in a 28-year-old female with unilateral active retinitis. Results: The yellowish area of retinitis surrounding a pigmented chorioretinal scar and the full thickness retinal hyper-reflectivity associated with diffuse increase in choroidal demonstrated a challenging case of necrotising retinitis, where baseline clinical and tomographic features were atypical and misleading towards a toxoplasmic aetiology. The detection of virus genome in ocular samples was necessary to achieve a correct diagnosis of acute retinal necrosis. Conclusion: Although rare, choroidal involvement may occur in acute retinal necrosis along with the well-known retinal features.
MeSH term(s)	Humans ; Female ; Adult ; Eye Infections, Viral/virology ; Eye Infections, Viral/diagnosis ; Retinal Necrosis Syndrome, Acute/diagnosis ; Retinal Necrosis Syndrome, Acute/virology ; Retinal Necrosis Syndrome, Acute/drug therapy ; Choroid/pathology ; Choroid/virology ; Tomography, Optical Coherence/methods ; Fluorescein Angiography/methods ; DNA, Viral/analysis ; DNA, Viral/genetics ; Visual Acuity/physiology ; Retrospective Studies ; Choroid Diseases/diagnosis ; Choroid Diseases/virology
Chemical Substances	DNA, Viral
Language	English
Publishing date	2023-02-01
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.1080/09273948.2023.2172590
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Article: Subretinal abscess: causative pathogens, clinical features and management.

Gallo, Beatrice / Testi, Ilaria / Pavesio, Carlos

Journal of ophthalmic inflammation and infection

2022 Volume 12, Issue 1, Page(s) 40

Abstract: Purpose: To review the literature on endogenous subretinal abscess (SRA).: Methods: We searched in the literature for the terms 'subretinal abscess', 'chorio-retinal abscess' and 'choroidal abscess'.: Results: A total of 122 patients were ... ...

Abstract	Purpose: To review the literature on endogenous subretinal abscess (SRA). Methods: We searched in the literature for the terms 'subretinal abscess', 'chorio-retinal abscess' and 'choroidal abscess'. Results: A total of 122 patients were identified, of whom 20 patients (22 eyes) had no identified systemic infective foci (group 1) and 102 (120 eyes) had systemic infective foci (group 2). The mean age for group 1 was 44.6 years (range 2 weeks-82 years) and for group 2 was 43.2 years (range 1-89 years). The responsible pathogen was identified in 90% and 95% of cases, respectively. In group 1 the most frequent causative agents were Aspergillus and Nocardia, while in group 2 were Nocardia, Mycobacterium Tuberculosis and Klebsiella. In both groups the most common symptoms were reduced vision (70% and 72.5%, respectively), pain (65% and 29.4%, respectively) and redness (35% and 17.6%, respectively). For group 1 there was no difference between mean initial and final visual acuity (1.7 logMAR, range 0-3 logMAR), while for group 2 mean initial and final visual acuities were 0.8 logMAR and 0.6 logMAR, respectively. Final visual acuity was significantly better in group 2 (p = 0.003). Anterior segment inflammation was seen in 77.3% of cases of group 1 and 66.7% of cases of group 2. In both groups the abscess most common locations were posterior pole (45.4% and 32.5%, respectively) and temporal periphery (13.6% and 13.3%, respectively). Clinical features included hemorrhages (76.5% and 76.3%, respectively) and subretinal fluid (75% in both groups). Diabetes mellitus (20% and 25.5%) and immunosuppressive drug intake (35% and 23.5%) were the main predisposing factors for SRA. Combination of systemic and intravitreal antibiotics/antifungals and vitrectomy was the main therapeutic strategy for both groups. Systemic treatment alone was used mainly for cases of tubercular etiology. The timing of vitrectomy differed between the two groups, as it more commonly followed the use of systemic and intravitreal antibiotics in the forms associated with systemic infective foci. Additional abscess drainage or intralesional antibiotics were performed in 23.8% of cases. Conclusion: At present no guideline exists for the treatment of subretinal abscess. Systemic broad-spectrum antibiotic treatment is of primary importance and should be used in all cases unless contraindicated. Combination of systemic and local treatment is the most frequently adopted strategy.
Language	English
Publishing date	2022-11-21
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2592309-2
ISSN	1869-5760
ISSN	1869-5760
DOI	10.1186/s12348-022-00315-0
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