Fundus topographical distribution patterns of ocular toxoplasmosis

BACKGROUND: To establish topographic maps and determine fundus distribution patterns of ocular toxoplasmosis (OT) lesions. METHODS: In this retrospective study, patients who presented with OT to ophthalmology clinics from four countries (Argentina, Turkey, UK, USA) were included. Size, shape and location of primary (1°)/recurrent (2°) and active/inactive lesions were converted into a two-dimensional retinal chart by a retinal drawing software. A final contour map of the merged image charts was then created using a custom Matlab programme. Descriptive analyses were performed. RESULTS: 984 lesions in 514 eyes of 464 subjects (53% women) were included. Mean area of all 1° and 2° lesions was 5.96±12.26 and 5.21±12.77 mm2, respectively. For the subset group lesions (eyes with both 1° and 2° lesions), 1° lesions were significantly larger than 2° lesions (5.52±6.04 mm2 vs 4.09±8.90 mm2, p=0.038). Mean distances from foveola to 1° and 2° lesion centres were 6336±4267 and 5763±3491 µm, respectively. The majority of lesions were found in temporal quadrant (p<0.001). Maximum overlap of all lesions was at 278 µm inferotemporal to foveola. CONCLUSION: The 1° lesions were larger than 2° lesions. The 2° lesions were not significantly closer to fovea than 1° lesions. Temporal quadrant and macular region were found to be densely affected underlining the vision threatening nature of the disease

Ocular Cicatricial Pemphigoid: Clinical Manifestations, Diagnosis and Current Management

El penfigoide ocular cicatricial es una enfermedad crónica, bilateral, y progresiva, de etiología autoinmune, en la que se observan depósitos de autoanticuerpos en el epitelio de la membrana basal de las mucosas. Se considera un subtipo del penfigoide de las membranas mucosas (PMM), una dermatosis bullosa, caracterizada por ampollas en diferentes tejidos mucosos como nariz, boca, tracto respiratorio, y genitales. El compromiso ocular en estos casos se encuentra en un 70% de los pacientes con PMM. En contrapartida, el compromiso ocular sin manifestación sistémica se observa hasta en un tercio de los pacientes. Las manifestaciones oftalmológicas inician de forma asimétrica con una conjuntivitis que progresa hacia la fibrosis, provocando insuficiencia de la superficie ocular, y complicaciones inflamatorias e infecciosas, así como una pérdida visual potencialmente devastadora. El diagnóstico oportuno, con un abordaje interdisciplinario y un tratamiento sistémico adecuado, son sumamente importantes y requieren un alto nivel de experiencia, ya que esta condición puede ser extremadamente difícil de identificar y tratar.Ocular cicatricial pemphigoid is a progressive, bilateral, chronic disease, of autoimmune etiology, in which autoantibody deposits are observed in mucosal basement membranes. It is regarded as a mucous membrane pemphigoid subtype, a bullous dermatitis, characterized by blistering in mucosal tissues of nose, mouth, respiratory tract, and genitalia. As a counterpart, ocular involvement without systemic manifestations is observed up to one third of the patients. Ophthalmological presentation is asymmetric, with a conjunctival inflammation which evolves to fibrosis, leading to an ocular surface insufficiency, and infectious and inflammatory complications, as well as a potentially devastating visual loss. A timely diagnosis, with an interdisciplinary approach and a suitable systemic treatment, are pivotal and they require a high level of experience, since this condition may be extremely difficult in identifying and treating.Fil: Schlaen, Bernardo Ariel. Universidad Austral. Hospital Universitario Austral; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Montoya, Juliana. Universidad Austral. Hospital Universitario Austral; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Heredia, Milagros. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Ficoseco, Carla. Universidad Austral. Hospital Universitario Austral; Argentina. Hospital Alemán; ArgentinaFil: Dominguez, Lucia. Universidad Austral. Hospital Universitario Austral; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentin

Ocular Cicatricial Pemphigoid: Clinical Manifestations, Diagnosis and Current Management

El penfigoide ocular cicatricial es una enfermedad crónica, bilateral, y progresiva, de etiología autoinmune, en la que se observan depósitos de autoanticuerpos en el epitelio de la membrana basal de las mucosas. Se considera un subtipo del penfigoide de las membranas mucosas (PMM), una dermatosis bullosa, caracterizada por ampollas en diferentes tejidos mucosos como nariz, boca, tracto respiratorio, y genitales. El compromiso ocular en estos casos se encuentra en un 70% de los pacientes con PMM. En contrapartida, el compromiso ocular sin manifestación sistémica se observa hasta en un tercio de los pacientes. Las manifestaciones oftalmológicas inician de forma asimétrica con una conjuntivitis que progresa hacia la fibrosis, provocando insuficiencia de la superficie ocular, y complicaciones inflamatorias e infecciosas, así como una pérdida visual potencialmente devastadora. El diagnóstico oportuno, con un abordaje interdisciplinario y un tratamiento sistémico adecuado, son sumamente importantes y requieren un alto nivel de experiencia, ya que esta condición puede ser extremadamente difícil de identificar y tratar.Ocular cicatricial pemphigoid is a progressive, bilateral, chronic disease, of autoimmune etiology, in which autoantibody deposits are observed in mucosal basement membranes. It is regarded as a mucous membrane pemphigoid subtype, a bullous dermatitis, characterized by blistering in mucosal tissues of nose, mouth, respiratory tract, and genitalia. As a counterpart, ocular involvement without systemic manifestations is observed up to one third of the patients. Ophthalmological presentation is asymmetric, with a conjunctival inflammation which evolves to fibrosis, leading to an ocular surface insufficiency, and infectious and inflammatory complications, as well as a potentially devastating visual loss. A timely diagnosis, with an interdisciplinary approach and a suitable systemic treatment, are pivotal and they require a high level of experience, since this condition may be extremely difficult in identifying and treating.Fil: Schlaen, Bernardo Ariel. Universidad Austral. Hospital Universitario Austral; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Montoya, Juliana. Universidad Austral. Hospital Universitario Austral; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Heredia, Milagros. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Ficoseco, Carla. Universidad Austral. Hospital Universitario Austral; Argentina. Hospital Alemán; ArgentinaFil: Dominguez, Lucia. Universidad Austral. Hospital Universitario Austral; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentin

Fundus Topographical Distribution Patterns of Ocular Toxoplasmosis

Background: To establish topographic maps and determine fundus distribution patterns of ocular toxoplasmosis (OT) lesions.Methods: In this retrospective study, patients who presented with OT to ophthalmology clinics from four countries (Argentina, Turkey, UK, USA) were included. Size, shape and location of primary (1°)/recurrent (2°) and active/inactive lesions were converted into a two-dimensional retinal chart by a retinal drawing software. A final contour map of the merged image charts was then created using a custom Matlab programme. Descriptive analyses were performed.Results: 984 lesions in 514 eyes of 464 subjects (53% women) were included. Mean area of all 1° and 2° lesions was 5.96±12.26 and 5.21±12.77 mm2, respectively. For the subset group lesions (eyes with both 1° and 2° lesions), 1° lesions were significantly larger than 2° lesions (5.52±6.04 mm2 vs 4.09±8.90 mm2, p=0.038). Mean distances from foveola to 1° and 2° lesion centres were 6336±4267 and 5763±3491 µm, respectively. The majority of lesions were found in temporal quadrant (p<0.001). Maximum overlap of all lesions was at 278 µm inferotemporal to foveola.Conclusion: The 1° lesions were larger than 2° lesions. The 2° lesions were not significantly closer to fovea than 1° lesions. Temporal quadrant and macular region were found to be densely affected underlining the vision threatening nature of the disease.Keywords: Choroid; Imaging; Infection; Inflammation; RetinaFil: Hasanreisoglu, Murat. Koc University School of Medicine; Turquía. Gazi University School of Medicine; TurquíaFil: Halim, Muhammad Sohail. Ocular Imaging Research and Reading Center; Estados UnidosFil: Cakar Ozdal, Pinar. University of Health Sciences Ankara Ulucanlar Eye Training and Research Hospital; TurquíaFil: Ormaechea, Maria Soledad. Universidad Catolica de Las Misiones. Facultad de Cs. de la Salud; ArgentinaFil: Kesim, Cem. Universidad Nacional de Rosario. Facultad de Ciencias Médicas; ArgentinaFil: Ozdemir, Huseyin Baran. Universidad Austral. Hospital Universitario Austral. Departamento de Cirugía. Servicio de Oftalmologia.; ArgentinaFil: Uludag, Gunay. University of Stanford; Estados UnidosFil: Sredar, Nripun. University of Stanford; Estados UnidosFil: Cankurtaran, Mahmut. University of Health Sciences Ankara Ulucanlar Eye Training and Research Hospital; TurquíaFil: Liu, Xiaoxuan. University Hospitals Birmingham NHS Foundation Trust; Reino Unido. University Of Birmingham; . Moorfields Eye Hospital NHS Foundation Trust; Reino UnidoFil: Denniston, Alastair Keith. University Hospitals Birmingham NHS Foundation Trust; Reino Unido. University Of Birmingham; . Moorfields Eye Hospital NHS Foundation Trust; Reino UnidoFil: Rudzinski, Marcelo Nicolas. Universidad Catolica de Las Misiones; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Colombero, Daniel N.. Universidad Nacional de Rosario; ArgentinaFil: Schlaen, Bernardo Ariel. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Keane, Pearse Andrew. Moorfields Eye Hospital NHS Foundation Trust; Estados UnidosFil: Pavesio, Carlos. Moorfields Eye Hospital NHS Foundation Trust; Estados Unidos. University of Lincoln; Reino UnidoFil: Nguyen, Quan Dong. University of Stanford; Estados Unido