Characteristics of Childhood Presumed Trematode-Induced Granulomatous Anterior Uveitis Using Ultrasound Biomicroscopy

Hefny, Eman El; Sabry, Dalia; Sewelam, Ashraf; Nokrashy, Amgad El

doi:10.1080/09273948.2021.1922709

Cited by 5 publications

(2 citation statements)

References 11 publications

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“…The same way the AC granuloma is known to cause peripheral anterior synechiae with the formation of retrocorneal vascularized fibrous membrane [1,4], the CB granuloma also excites a similar posterior, intense immune response with fibrous components resulting in various grades of fibrous tissue proliferation. Extension can occur anteriorly to the iris root and the lens as well as posteriorly to the periphery of the choroid and retina [4,8,15]. The longer the periods of untreated inflammation (group B patients), the worse the visual acuity of such patients owing to total lens opacification and the contraction of the fibrous elements responsible for the formation of cyclitic membranes, epiretinal proliferations, or subretinal fibrotic bands predisposing to TRD and eventually phthisis [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…El Hefny E et al recently performed UBM on presumed trematode-induced uveitis patients and demonstrated the presence of the 1 to 2 clock hours CB granuloma in 90% of their patients as a homogenous medium hyperreflective lesion that was commonly found inferiorly between 5 and 7 o'clock. Other findings that were noted included various degrees of anterior extension into the iris, atrophy of the ciliary processes and cyclitic membranes [15]. Treatment of presumed trematode-induced uveitis is challenging.…”

Section: Discussionmentioning

confidence: 99%

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Management of presumed trematode-induced granulomatous intermediate uveitis

Amin

Abdullatif

2022

Eye

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Purpose To describe the surgical management of presumed trematode-induced granulomatous intermediate uveitis (PTIGIU) not responding to medical treatment in controlling the inflammation. Methods A prospective, interventional, single-center study in which patients with a history of fresh canal water contact and PTIGIU were enrolled. All patients underwent lensectomy–pars plana vitrectomy (PPV) and post-operative control of inflammation, functional and anatomical outcomes were assessed. Results Fifteen eyes of 12 patients were included in the study with median age of 11.6 ± 4 yrs. Six months following lensectomy-PPV, inflammation was well controlled in all patients. The eyes were divided into two groups: Group A: 10 patients with an attached retina while Group B: 5 patients who were in the cicatricial stage with tractional retinal detachment. All patients in group A had CDVA of 20/40 or better, unlike patients in group B who failed to achieve a CDVA better than 20/70 throughout their follow-up. In group B, final anatomical success was achieved in only 40% with hypotony occurring in 20%. Conclusion PTIGIU is associated with the presence of ciliary body granuloma which, if left untreated, can lead to drastic outcomes. Early lensectomy-PPV represents a viable management option in cases resistant to medical treatment, with a favorable outcome.

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