Optical coherence tomography angiography in intermediate uveitis-related cystoid macular edema

Background: Cystoid macular edema (CME) is the leading cause of permanent visual impairment in patients with uveitis, particularly in patients with intermediate uveitis (IU). This study was aimed at comparing the changes in the macular microvasculature in patients with IU with uveitic non-responsive CME and without macular edema. Methods: In this case-control study, 55 eyes of patients with IU were assessed for macular microvascular structures, including vascular density, foveal avascular zone (FAZ) measurement, and vascular morphological changes, using spectral-domain optical coherence tomography angiography (OCT-A) with the AngioVue OCT-A system. We divided patients into the following two groups: the case group, including 30 eyes with IU-related non-responsive CME, and the control group, including 25 eyes with IU without macular edema. Results: Participants in the case and control groups had comparable age (P = 0.753) and sex (P = 0.124) distributions. Superficial capillary plexus vessel density in the case group was significantly decreased in the whole image (P = 0.027) and the parafoveal area (P  = 0.001) compared to the control group. However, there were no statistically significant differences between the two groups in terms of foveal superficial vessel density, deep capillary plexus vessel density, FAZ area, FAZ perimeter, FAZ acircularity index, or foveal vessel density in a 300-µm-wide annulus around the FAZ (all P > 0.05). Vascular morphological changes, such as the capillary tuft, telangiectatic vessels, or micro-aneurism, were not different in the overview images of the OCT-A printout between the two groups. Conclusions: The mean superficial capillary plexus vessel density was lower in eyes with IU-related nonresponsive CME than in those without macular edema. We observed more cystoid spaces in SCP than in DCP. Microcystic changes in the inner retina and ischemia may be the underlying cause in eyes with nonresponsive CME. Future prospective longitudinal studies with healthy, matched controls are warranted to confirm our findings

Pattern and Visual Prognostic Factors of Behcet’s Uveitis in Northwest Iran

Purpose: To investigate the pattern of ocular involvement in Behcet’s disease (BD) with predictors of patients’ final state of vision. Methods: This historical cohort encompassed the clinical records of 200 patients diagnosed according to the International Criteria for BD (ICBD), over a period of 17 years between 2004 and 2021. Results: The prevalence of Behcet’s uveitis (BU) was more common in females and patients in the fourth decade of life. Ninety-five patients (47.5%) had evidence of ocular involvement in the initial ophthalmologic evaluation, and 171 patients (85.5%) manifested evidence of BU during the follow-up visits of which bilateral non-granulomatous panuveitis was the most common anatomical pattern of involvement (32.9%) followed by posterior (27.6%), anterior (26.5%), and intermediate (13.8%) uveitis. The prevalent accompanying signs were oral aphthous (67%), skin lesions (29%), and genital ulcers (19.5%). Cystoid macular edema (CME) was the most frequent ocular complication (62%), followed by cataract (57.5%) and epiretinal membranes (ERM) (36.5%). Univariate analysis showed the following determinants: male gender, younger age at onset, panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis as poorer visual prognostic factors of the disease. Multivariate analysis demonstrated a higher chance of poor visual prognosis of BD in patients with panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis. Conclusion: This cohort study demonstrated an overview on epidemiological patterns of BU along with the visual prognostic factors in Iranian patients

Comparison of Azithromycin and Pyrimethamine/Sulfadiazine Treatment in Ocular Toxoplasmosis in North West of Iran

Objective: Ocular toxoplasmosis (OT), characterized by necrotizing retinochoroiditis, scar formation and decreased vision, is recognized as the most prevalent cause of posterior uveitis in Iran. Although pyrimethamine/sulfadiazine combination remains the standard treatment particularly for patients with sight-threatening lesions, intolerance, inaccessibility and adverse drug reactions to this regimen have imposed us to seek for alternative treatments. Materials and Methods: In this prospective randomized control clinical trial study, 72 patients with active, non-vision threatening toxoplasmic chorioretinitis were randomly divided into 2 treatment regimen: 36 patients treated with standard protocol with pyrimethamine/sulfadiazine, and 36 patients received azithromycin for 6 weeks. All patients were followed up for 24 months. The clinical outcomes measured before and after intervention were, time to disease inactivity (lesion borders sharpening and scarring), changes in the size of retinochoroidal lesion, rate of recurrence, adverse drug reactions and visual acuity (VA). Results: No significant difference was noted between the 2 groups regarding age, gender, and VA before treatment. Significant improvement was noted in VA for each group during treatment. VA increased by 0.39 logMAR units in group 1 (P = 0.00) and 0.35 logMAR units in group 2 (P = 0.00). There was no statistically significant difference between the 2 groups concerning visual improvement (P = 0.33) and reduction in retinal lesion size and activity. There were totally 22 cases who experienced recurrences during the follow up period (4 [11.1%] patients of control group and 18 [50%] of intervention group [P = 0.00]), indicating significant lower recurrence in control group. Treatment tolerance was significantly better for the azithromycin group due to lower adverse drug reactions (P = 0.00). Conclusion: Azithromycin at a dose of 250 mg/d was shown to be effective for the treatment of active, non-vision threatening toxoplasmic retinochoroiditis similar to classic treatment with Pyrimethamine/Sulfadiazine regimen. However, recurrences and adverse drug reactions seem to differ significantly which notes the need for further studies and also vigilant selection of treatment protocols

Clinical Course of Uveitis in Children in a Tertiary Ophthalmology Center in Northwest Iran

Objective: In the present research, the clinical course of pediatric uveitis was studied by examining the demographic characteristics of afflicted children, the results of clinical examinations, and uveitis complications. Materials and Methods: The present research was a retrospective study in which the medical records of 243 children who had been visited and diagnosed as uveitis in the uveitis clinic of Nikookari Eye hospital of Tabriz in 2003-2015, were reviewed. The data were statistically analyzed by descriptive statistics and mean comparison tests in IBM-SPSS 23 and the significance level of P<0.05. Results:According to the results, 73 (30%), 146 (60.1%), 12 (4.9%), and 12 (4.9%) eyes diagnosed with uveitis had anterior, intermediate, posterior, and panuveitis type, respectively. In addition, 73 cases of uveitis (30%) were acute and 170 cases (70%) were chronic. Based on the LogMAR chart, the mean visual acuity before and after treatment was 0.39 and 0.15 for the right eye and 0.4 and 0.09 for the left eye, which suggests a significant difference. The most common complications observed in this study were macular edema (32.5%) and cataract (22.6%). Conclusion: This study indicates that intermediate uveitis is the most common type of pediatric uveitis, while anterior uveitis is the second. Posterior and panuveitis are less common in our study. The prevalence of chronic uveitis is significantly high in pediatric group which could justify the higher rate of complications in this age group

Use of poultry pre-cooked slaughterhouse waste as ruminant feed to prevent environmental pollution

The generation of poultry slaughterhouse waste from poultry production is not only unavoidable but the amount and kinds of waste can cause environmental problems. In the present study, the potential rumen digestion of poultry slaughterhouse waste which consists of protein-rich organic residues was evaluated. The chemical composition, amino acid profile and Cornell Net Carbohydrate and Protein System fractions of these wastes was determined. Rumen digestion of poultry slaughterhouse waste was compared with two common protein sources (fish meal and roasted soybean). Three poultry slaughterhouse waste samples were collected from industrial poultry slaughter-houses and the in situ degradation was done using rumen cannulated sheep. The protein (50e63%), ether extracts (18e27%) and ash (9e15.5%) contents of different poultry slaughterhouse waste samples were different (P < 0.05). Methionine and lysine contents were similar among different poultry slaughterhouse waste sources. Difference were observed for cystine (1.2e1.7%), threonine (1.9e2.2%), arginine (3e3.5%), leucine (3.5e4.1%) and valine (2.8e3.3%) (P < 0.05). Ruminal degradation rate for dry matter, organic matter and protein were different among poultry slaughterhouse waste, fish meal and roasted soybean. The degradation parameter for protein degradation was 76% for poultry slaughterhouse waste, 79% for fish meal and 98% for roasted soybean (P < 0.05). Results revealed that there was great variation in chemical composition, protein fractioning, and amino acid profiles of different poultry slaughterhouse waste sources. Poultry slaughterhouse waste is slowly-degraded protein in the rumen and thus can be an economical and rich source of rumen undegradable protein in ruminant nutrition. This implies that the use of poultry slaughterhouse waste in ruminant nutrition has a huge potential as a cleaner product of animal feeding and prevention environmental pollution. However, further studies are warranted to evaluate the digestibility of poultry slaughterhouse waste amino acids escaping the rumen into the intestine in ruminants and to compare the biological values for the amino acids in these waste material with common ruminant feedstuffs

Evaluation of IFN-gamma and HSP70 level in the saliva of Behcet’s disease patients with active oral lesions

Introduction:\ua0Behcet’s disease (BD) is a multi-systemic inflammatory disorder. Evaluating the production of cytokines such as interferon gamma and biomarkers such as heat shock protein-70 (HSP70)is an important way to study the pathogenesis and development of BD. This study aimed to compare the salivary level of interferon gamma and HSP70 between patients infected with BD and healthy individual.Methods:\ua0This case-control study was performed on 35 patients with Behcet’s syndrome and 70 healthy individuals as the control group, who were selected from those referring to the Department of Oral Medicine of Tabriz University of Medical Sciences. The levels of interferon gamma and HSP70 were measured in the whole unstimulated saliva through enzyme-linked immunosorbent assay (ELIZA). In order to compare the quantitative variables between two groups, independent samples t-test or its nonparametric equivalent, Mann-Whitney U test, was used in SPSS software version 16.0. In this study, a\ua0P\ua0value less than 0.05 was considered statistically significant.Results:\ua0There was no significant difference between the study groups in terms of age and gender, as well as salivary interferon gamma and HSP70 levels. Interferon gamma level was 15.16±3.38 pg/mg in the case group and 5.27±1.21 pg/mg in the control group, and salivary HSP70 level was found to be 45.50±17 ng/mL and 19.5±5.2 ng/mL in the case and control groups, respectively.Conclusions:\ua0The results of this study showed that interferon gamma and HSP70 levels in patients with Behcet’s syndrome are high and can be evaluated as an important tool for the treatment and evaluation of disease development in future studies