Interobserver Agreement Among Uveitis Experts on Uveitic Diagnoses:The Standardization of Uveitis Nomenclature Experience

• PURPOSE: To evaluate the interobserver agreement among uveitis experts on the diagnosis of the specific uveitic disease. • DESIGN: Interobserver agreement analysis. • METHODS: Five committees, each comprised of 9 individuals and working in parallel, reviewed cases from a preliminary database of 25 uveitic diseases, collected by disease, and voted independently online whether the case was the disease in question or not. The agreement statistic, κ, was calculated for the 36 pairwise comparisons for each disease, and a mean κ was calculated for each disease. After the independent online voting, committee consensus conference calls, using nominal group techniques, reviewed all cases not achieving supermajority agreement (> 75%) on the diagnosis in the online voting to attempt to arrive at a supermajority agreement. • RESULTS: A total of 5766 cases for the 25 diseases were evaluated. The overall mean κ for the entire project was 0.39, with disease-specific variation ranging from 0.23 to 0.79. After the formalized consensus conference calls to address cases that did not achieve supermajority agreement in the online voting, supermajority agreement overall was reached on approximately 99% of cases, with disease-specific variation ranging from 96% to 100%. • CONCLUSIONS: Agreement among uveitis experts on diagnosis is moderate at best but can be improved by discussion among them. These data suggest the need for validated and widely used classification criteria in the field of uveitis

Junctional changes in retinal vessels of a monkey with IRBP-induced retinouveitis

info:eu-repo/semantics/nonPublishe

Angiography with fluorescein labelled dextrans in a primate model of uveitis

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Annals of Alquds Medicine Pseudomonas aeruginosa distribution in clinical sample and their antibiogram from Al-Shifa Hospital, Gaza, PNA

Abstract Objective: To assess antibiotic resistance of Pseudomonas aeruginosa isolates from four types of clinical specimen at Al-Shifa hospital, and to compare susceptibilities of those isolates according to their source. Method: Clinical specimens from Al-Shifa hospital in Gaza were analyzed between January and December 2002. Pseudomonas aeruginosa were isolated and identified by conventional methods. The antibiotic resistance rates were measured by modified Kirby-Bauer disk diffusion method. Data were analyzed statistically using SPSS (version 11). Results: The number of isolated P. aeruginosa was 541, obtained from 4 types of clinical specimens. Pus was the major source of P. aeruginosa isolates (64%), followed by urine (24%), sputum (7.0%) and Blood (5.0%). However, considering the number of specimens cultured, sputum showed the highest Pseudomonas isolation rate (49%), followed by Pus (23%), urine (8.0%) and Blood (6.0%). The highest percentage rates of resistance were found against amoxicillin (99% of all isolates), cephalexin (98.5%), cefaclor (97.4%), doxycycline (96.2%), trimethoprim/ sulfamethoxazole (94.7%) and nalidixic acid (93.5 %). Ciprofloxacin was the most effective of all the tested antimicrobials, followed by Gentamicin and Amikacin. Significant statistical (P 0.05) difference in isolated strain susceptibility was detected among some of the antimicrobials depending on the specimen source. Conclusion: This study showed that antimicrobial resistance of Pseudomonas aeruginosa was high and alarming. Significant difference in the resistance pattern of isolates from different specimen type can be useful in clearing the picture of resistance problem and suggests that due care must be taken in hospital settings to adequately diagnose pseudomonal infections and prescribe the antibiotic treatment most effective in preventing the increase in multidrug resistant organisms

Subretinal Fibrosis and Uveitis: A Spectral Domain OCT Study of Its Evolution and the Minimal Therapeutic Effect of the Off-label Treatment with Ranibizumab

Purpose: The subretinal fibrosis and uveitis (SFU) syndrome is a rare multifocal posterior uveitis characterized by progressive subretinal fibrosis and significant visual loss. Methods: Slit-lamp examination, dilated fundoscopy, fluorescein angiography, Spectral Domain-Optical Coherence Tomography (SD-OCT) and laboratory testing were employed. Results: A 52-year-old male presented with bilateral (best-corrected visual acuity: 2/10) visual loss. Clinical examination revealed bilateral anterior uveitis with posterior synechiae and posterior uveitis. Medical workup revealed no pathologic findings. Treatment included 1 gr intravenous prednisone followed by oral prednisone, immunosuppresive therapy and three ranibizumab injections in the right eye with no improvement. One year later, there was significant subretinal fibrosis. In the second year follow-up, the picture was slightly worse, with persisting bilateral macular edema and fibrosis. Conclusions: This is the first SFU syndrome report monitored with SD-OCT. This novel imaging modality can localize the lesion level, guide the therapeutic approach and may prove helpful in assessing disease prognosis