Key Concepts Behçet disease is a multisystem disease, with imminently vision-threatening posterior ocular complications. The posterior pole disease should not be treated with corticosteroids alone. Tumor necrosis factor (TNF) inhibitors have been suggested as first-line immunosuppressives for ocular Behçet disease.…
Key Concepts Human leukocyte antigen (HLA)-A29 is very strongly associated with birdshot chorioretinopathy. Birdshot chorioretinopathy can lead to severe visual handicap. Long-term therapy is often needed to control the disease. The spectrum of posterior uveitic entities is quite broad, with…
Key Concepts Vogt-Koyanagi-Harada (VKH) syndrome is a systemic autoimmune disease, which targets melanin containing cells. Typical manifestations include uveitis with exudative retinal detachments, headache, tinnitus, poliosis, and vitiligo. Posterior pole disease should be treated very aggressively. Vogt-Koyanagi-Harada (VKH) syndrome is…
Key Concepts Sympathetic ophthalmia (SO) is a bilateral condition. SO is now more commonly seen after vitrectomy than after accidental injury. Dalen-Fuchs nodules are commonly seen in the retinal periphery of eyes with SO, but they are not pathognomonic for…
Key Concepts Presumed ocular histoplasmosis syndrome (POHS) is characterized by a triad of peripapillary pigment changes, white round chorioretinal macular and midperipheral scars, and absence of vitritis. Amphotericin therapy does not help. Lesions have a high possibility of choroidal neovascularization.…
Key Concepts Ocular disease can occur with both congenital and acquired diseases. Disease is often unilateral, and the majority of recurrences are seen as satellite lesions. Immunodeficient patients are at risk for acquired disease, reactivation of old disease, and bilateral…
Key Concepts Inflammatory disease needs to be clinically quiescent for at least 3 months before elective surgery is considered. Adequate immunosuppressive therapy perioperatively is very important. Surgery needs to be considered when there is something to save, not when the…
Key Concepts Therapy is guided by the etiology of the inflammation (infectious versus noninfectious), severity, and anatomic location. Corticosteroid therapy can be used to quiet acute inflammation, but steroid-sparing therapies must be added if systemic corticosteroids cannot be tapered successfully…
Key Concepts T cells play an important role in the pathogenesis of uveitis. The eye is very active immunologically, with ocular resident cells interacting with the immune system. Uveitogenic antigens are expressed in the eye, and immunization of animals with…