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Medicina
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Clinical Analysis of Treatment of Uveitis Complicated with Cataract
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Clinical Analysis of Treatment of Uveitis Complicated with Cataract

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 October 2023) | Viewed by 4467

Special Issue Editors

Dr. Nenad Vukojević

E-Mail Website
Guest Editor
Department of Ophthalmology, School of Medicine University of Zagreb, UHC Zagreb, Zagreb, Croatia
Interests: uveitis; medical retina; pediatric retina; intraocular tumors
Dr. Nataša Vidovič-Valentinčič

E-Mail Website
Guest Editor
Univerzitetni Klinični Center Ljubljana, Ljubljana, Slovenia
Interests: ocular tuberculosis; uveitis; tuberculostatic agent

Special Issue Information

Dear Colleagues,

Uveitis, both non-infectious and often infectious, is a chronic and progressive disease that represents a permanent threat to visual function. Treatment of uveitis with the aim of minimizing inflammation and avoiding complications represents a huge challenge for ophthalmologists.

One of the most common complications of chronic uveitis is a complicated cataract that occurs as a result of inflammation and local and systemic corticosteroid therapy. Although our therapy is aimed at controlling inflammation using non-steroidal immunosuppressive therapy, especially biological drugs, and minimizing systemic and local exposure to corticosteroids, cataracts in uveitis often cannot be avoided. We should think about minimizing the risk of complicated cataracts before their appearance, especially in small children and young patients. However, when a cataract becomes a problem for visual function, knowledge of the etiology, the clinical course of uveitis, careful evaluation of other complications, and condition of the anterior and posterior eye segment help to choose the optimal time for surgery with careful preoperative management of the patient. The strict control of inflammation before the surgery, adequate surgical technique, and intensive postoperative anti-inflammatory therapy with early recognition and prompt treatment of complications contribute to a better outcome of the surgery.

The goal of this Special Issue is to collect scientific and professional articles that are focused on minimization of the risk of developing complicated cataracts and surgical management of cataracts with adequate inflammation control in patients with uveitis.

Dr. Nenad Vukojević
Dr. Nataša Vidovič-Valentinčič
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • uveitis
  • intraocular inflammation
  • cataract
  • immunosuppressive drugs
  • surgery
  • complications
  • visual function

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Published Papers (2 papers)

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11 pages, 632 KiB  
Article
Early and Late Complications after Cataract Surgery in Patients with Uveitis
by Gentian Bajraktari, Tomislav Jukić, Miro Kalauz, Martin Oroz, Andrea Radolović Bertetić and Nenad Vukojević
Medicina 2023, 59(10), 1877; https://doi.org/10.3390/medicina59101877 - 23 Oct 2023
Cited by 1 | Viewed by 2771
Abstract
Background and Objectives: Uveitis, a prevalent eye disorder characterized by inflammatory processes, often leads to cataract formation and significant visual impairment. This study aimed to evaluate preoperative conditions and postoperative outcomes following cataract surgery in uveitis patients. Materials and Methods: A [...] Read more.
Background and Objectives: Uveitis, a prevalent eye disorder characterized by inflammatory processes, often leads to cataract formation and significant visual impairment. This study aimed to evaluate preoperative conditions and postoperative outcomes following cataract surgery in uveitis patients. Materials and Methods: A retrospective study was conducted at the University Hospital Center Rebro Zagreb, Croatia, involving uveitis patients who underwent cataract surgery between 2013 and 2022. Eligible patients had uveitic cataracts affecting visual acuity or posterior segment visualization in a “quiet eye” and were disease-inactive for at least three months. Patients with certain pre-existing ocular conditions were excluded. The data collected included patient demographics, uveitis type, preoperative therapy, preexisting lesions, and postoperative outcomes such as visual acuity, intraocular pressure, central macular thickness, and complications. Statistical analysis was performed to identify risk factors associated with complications. Results: This study included 105 patients. The most common uveitis types were idiopathic uveitis, HLA-B27-associated uveitis, and JIA uveitis. After cataract surgery, there was a significant improvement in visual acuity at various time points, with 90% of eyes showing improvement. Intraocular pressure decreased over time. Central macular thickness increased at three months post-surgery but remained stable thereafter. Early and late complications were observed in 52.4% and 63.8% of eyes, respectively. The most common complications were posterior capsular opacification (53.3%), macular edema (26.6%), and epiretinal membrane formation (9.52%). The factors associated with complications varied between early and late stages but included age, age at the onset of uveitis, and the uveitis type. Conclusions: In patients with quiescent uveitis undergoing cataract surgery, significant visual improvement was achieved. This study highlights the importance of careful patient selection, preoperative and postoperative inflammation management, and precise surgical techniques. Although complications were common, the risk of capsular opacification, macular edema, and epiretinal membrane formation after surgery increased. However, future investigations should address this study’s limitations and further refine perioperative strategies. Full article
(This article belongs to the Special Issue Clinical Analysis of Treatment of Uveitis Complicated with Cataract)
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7 pages, 3957 KiB  
Case Report
Management of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP)—A Case Report
by Nataša Drača, Emma Grace Orešković, Ratimir Lazić, Marija Vukojević, Andrea Radolović Bertetić and Nenad Vukojević
Medicina 2023, 59(12), 2158; https://doi.org/10.3390/medicina59122158 - 13 Dec 2023
Viewed by 1217
Abstract
Background and Objectives: This study reports a case of a 62-year-old patient experiencing a significant decline in vision over the past three months. The initial best-corrected visual acuity (BCVA) of 20/20 in both eyes diminished to 20/200 in the right eye (RE) [...] Read more.
Background and Objectives: This study reports a case of a 62-year-old patient experiencing a significant decline in vision over the past three months. The initial best-corrected visual acuity (BCVA) of 20/20 in both eyes diminished to 20/200 in the right eye (RE) and counting fingers (CF) in the left eye (LE) within this timeframe. The patient was diagnosed with stage 4 ovarian cancer just one month before the significant vision deterioration. Materials and Methods: A thorough ophthalmologic examination revealed a notable progression of cataracts and the presence of subretinal fluid on the posterior pole, accompanied by choroidal thickening. The right eye exhibited multifocal, orange-pigmented, and elevated choroidal lesions, while the left eye’s fundus examination was impeded by dense cataracts. Optical coherence tomography (OCT) revealed bilateral choroidal thickening with overlying folds and subretinal fluid, and ultrasound imaging of the choroidal lesions indicated moderate homogenous internal reflectivity. Results: The patient received a diagnosis of BDUMP (bilateral diffuse uveal melanocytic proliferation), a paraneoplastic syndrome marked by simultaneous, bilateral, painless vision loss and the rapid onset of bilateral cataracts with serous retinal detachments. Despite cataract extraction, the expected visual recovery was not achieved (RE: CF; LE: 2/200, respectively). Plasmapheresis showed some success in stabilizing vision loss attributed to serous retinal detachments. Conclusions: BDUMP necessitates addressing the underlying malignancy for effective treatment. Left untreated, it can lead to near blindness within a year. The prognosis remains grim, with an average survival time ranging from 12 to 15.7 months from the time of diagnosis. Considering this case report, it is crucial to establish effective management plans and further investigate potential treatment methods and predictive markers centered around BDUMP. Collaboration between healthcare professionals and researchers is crucial in addressing the complexities of BDUMP, as the timely diagnosis and treatment of the disease remains a top priority. Full article
(This article belongs to the Special Issue Clinical Analysis of Treatment of Uveitis Complicated with Cataract)
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