Unilateral snow banking in tuberculosis-related intermediate uveitis

Snow banking is usually a term coined to describe the accumulation of vitreous exudates over the pars plana and the peripheral retina in pars planitis. Snow banking is very rare in tubercular intermediate uveitis. A 32-year-old male was diagnosed to have intermediate uveitis due to tubercular etiology in the right eye. Laboratory investigations include an increased erythrocyte sedimentation rate, positive Mantoux test, and computed tomography thorax showing mediastinal lymphadenopathy. Transbronchial needle aspiration of the lymph nodes showed chronic granulomatous inflammation with caseation. There were no recurrences following antitubercular therapy (ATT). This case report highlights the unique finding of snow banking in tubercular uveitis and course following treatment with ATT

Precise Modeling of Solar Radiation Pressure for IRNSS Satellite

IRNSS-1A, IRNSS-1B and IRNSS-1C are the first three satellites of Indian Regional Navigation Satellite System (IRNSS) launched in 1st July 2013,4th April 2014 and 16th October 2014 respectively. IRNSS will provide regional navigation services independently over the IRNSS service area. For the precise positioning and navigation applications, precise orbit and clock information of the IRNSS satellites are essential. For High altitude satellites like IRNSS, Solar Radiation Pressure (SRP) force is the second largest perturbation force acting on the satellites after the gravitational attraction from Earth, Sun and Moon. It is the largest error source in the modelling of orbital dynamics of IRNSS, and hence its precise modelling is essential for accurate orbit determination. In this paper different approaches were studied to develop a highly precise solar radiation pressure model for IRNSS satellites using IRNSS-1A and IRNSS-1B observation data. Since IRNSS satellites shape, optical properties, physical properties as well as the attitude information are different from other Indian Communication satellites, a novel approach has been adopted here for precise modelling of SRP. The force due to SRP has been computed analytically for each of the spacecraft surfaces in the satellite body fixed frame which is further resolved in all required directions to compute the net force. To evaluate the performance of the SRP model, the orbit accuracy is derived from 1-day orbit overlaps at day boundaries of 2-day solutions. As a result, an orbit estimation accuracy of 25 meters has been observed by the model alone, while the estimation error is observed as 2.5m.Further beside the model, 3 constant co-efficient has been estimated in the three particular directions (namely DYB) which were following a right handed system. Again the model performance with estimated co-efficient has been analysed and the orbit accuracy is derived from the overlap test. As a result, an orbit estimation accuracy of 10 m has been observed, while the estimation error is about 1m. Keywords: IRNSS, Navigation, Solar Radiation Pressure, orbit accurac

Effectiveness and Safety of Biosimilars in Pediatric Non-infectious Uveitis: Real-Life Data from the International AIDA Network Uveitis Registry

IntroductionSince many biological drug patents have expired, biosimilar agents (BIOs) have been developed; however, there are still some reservations in their use, especially in childhood. The aim of the current study is to evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibitors BIOs as treatment for pediatric non-infectious uveitis (NIU).MethodsData from pediatric patients with NIU treated with TNF inhibitors BIOs were drawn from the international AutoInflammatory Disease Alliance (AIDA) registries dedicated to uveitis and Behcet's disease. The effectiveness and safety of BIOs were assessed in terms of frequency of relapses, risk for developing ocular flares, best-corrected visual acuity (BCVA), glucocorticoids (GCs)-sparing effect, drug survival, frequency of ocular complications, and adverse drug event (AE).ResultsForty-seven patients (77 affected eyes) were enrolled. The BIOs employed were adalimumab (ADA) (89.4%), etanercept (ETA) (5.3%), and infliximab (IFX) (5.3%). The number of relapses 12 months prior to BIOs and at last follow-up was 282.14 and 52.43 per 100 patients/year. The relative risk of developing ocular flares before BIOs introduction compared to the period following the start of BIOs was 4.49 (95% confidence interval [CI] 3.38-5.98, p = 0.004). The number needed to treat (NNT) for ocular flares was 3.53. Median BCVA was maintained during the whole BIOs treatment (p = 0.92). A significant GCs-sparing effect was observed throughout the treatment period (p = 0.002). The estimated drug retention rate (DRR) at 12-, 24-, and 36-month follow-up were 92.7, 83.3, and 70.8%, respectively. The risk rate for developing structural ocular complications was 89.9/100 patients/year before starting BIOs and 12.7/100 patients/year during BIOs treatment, with a risk ratio of new ocular complications without BIOs of 7.1 (CI 3.4-14.9, p = 0.0003). Three minor AEs were reported.ConclusionsTNF inhibitors BIOs are effective in reducing the number of ocular uveitis relapses, preserving visual acuity, allowing a significant GCs-sparing effect, and preventing structural ocular complications.Trial RegistrationClinicalTrials.gov ID NCT05200715

In vivo confocal microscopy in different types of posterior polymorphous dystrophy

Posterior polymorphous dystrophy is a rare corneal dystrophy, usually detected by chance. This case series describes the morphologic features in the three different types of posterior polymorphous dystrophy using confocal microscopy

Medical Management of Uveitis - Current Trends

Uveitis is a challenging disease to treat. Corticosteroids have been used in the treatment of uveitis for many years. Immunosuppressives are gaining momentum in recent years in the treatment of uveitis. In this article we present an overview of current treatment of uveitis and the major breakthroughs and advances in drugs and ocular drug delivery systems in the treatment of uveitis

Atypical Tolosa Hunt syndrome with bilateral sclerokeratitis and optic atrophy in Takayasu's arteritis

Purpose: We report an interesting case of atypical Tolosa Hunt syndrome with bilateral Sclerokeratitis and optic atrophy in a patient with Takayasu's arteritis. Observations: A 31-year- old lady presented with severe retroorbital pain in the right eye and right sided headache of 2 weeks duration. She had a history of 6th and 7th nerve palsies which improved with oral corticosteroids. Her BCVA was no perception of light in OD and 6/6 in OS. Slitlamp examination showed bilateral old sclerokeratitis and fundus examination showed bilateral optic atrophy. Systemic examination revealed BP of 240/100 mm of hg in the right upper limb with absent pulsations in the left radial, bilateral femoral and dorsalis pedis arteries noted. CT aortic angiography confirmed the diagnosis of Takayasu's arteritis. Symptoms improved with oral corticosteroids and azathioprine, which was followed by a renal stenting procedure. At 1 year followup, she is doing well with no recurrences. Conclusions and importance: This case report presents a unique manifestation of atypical Tolosa Hunt syndrome in Takayasu's arteritis. To our knowledge, atypical Tolosa Hunt syndrome in Takayasu'arteritis has not been described in literature