logging in or signing up Intermediate Uveitis ppt drbillal Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Copy Does not support media & animations WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 1077 Category: Education License: All Rights Reserved Like it (1) Dislike it (0) Added: February 21, 2011 This Presentation is Public Favorites: 1 Presentation Description No description available. Comments Posting comment... By: dhruvworah (23 month(s) ago) email id is: dhruvworah@rediffmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: dhruvworah (23 month(s) ago) gr8 presentation sir... cud u plz email d ppt 2 my email id? Saving..... Post Reply Close Saving..... Edit Comment Close By: ayurraga (27 month(s) ago) please send me the ppt to my email address ayurraga@gmail.com thanking you Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Intermediate Uveitis: Intermediate Uveitis Dr. Billal Hossain National Institute of Ophthalmology and HospitalIntroduction: Introduction Idiopathic relapsing chronic disease Intraocular inflammation Centered around parsplanaDr Charles Schepens: Dr Charles SchepensHistory: History 1908: Fuchs - Cyclitis 1950: Schepens - Peripheral Uveitis 1960: Brockhurst - Peripheral Cyclitis 1960: Welch - Pars Planitis 1987: IUSG - Intermediate UveitisDefinition: Definition Predominantly Vitreous InflammationSITE OF INFLAMMATION: SITE OF INFLAMMATION Ciliary body Vitreous Peripheral retinaEpidemiology: Epidemiology 15% of uveitis patients 20% of Paediatric uveitis Bimodal presentation Bilateral 80% - asymmetricPathogenesis: Pathogenesis Cell mediated immunity Preponderance of T-helper cells HLA assosciation- A 28, DR 15Presentation: Presentation Floaters Blurring of visionClinical Findings: Clinical Findings Anterior Segment - Small KP - Epithelial oedemaClinical Findings: Clinical Findings Vitreous - Vitreous cell - Vitreous condensation - Snow ballsSnowball Exudate: Snowball ExudateClinical Findings: Clinical Findings Posterior segment - Periphlebitis - Snowbanking - Neovascularization - Disc oedemaSNOW BANKING : SNOW BANKINGClinical Findings: Clinical FindingsPARS PLANITIS: PARS PLANITIS Intermediate uveitis + snow bank - idiopathicClinical courses: Clinical courses Benign course Prolong course Variable courseComplications: Complications CME ERM Cataracts and Glaucoma Peripheral retinal vasoproliferative tumours Retinal Detachment and retinoschisis Optic Disc Edema Vitreous haemorrhageComplications: CME: Complications: CME 30% patientsComplications: CME: Complications: CMEComplications: CME: Complications: CMECME – Macular hole : CME – Macular holeComplications: ERM: Complications: ERMComplications: ERM: Complications: ERMComplications: ERM: Complications: ERMComplications: Cataracts: Complications: Cataracts 50% pt of uveitisComplications: Glaucoma: Complications: Glaucoma ? Herpes Gonioscopy ? Steroid responderComplications: RVPT: Complications: RVPT Dr. Shields and Associates 113 tumors- 13% IUComplications: Disc oedema: Complications : Disc oedema 20% of eye Secondary inflammation.Complications: RD: Complications: RD Exudative RD Tractional RD Rhegmatogenous RD RetinoschisisComplications: vitreous hge: Complications: vitreous hge Snowbank NVD NVE ChildrenComplications: Venous Sheathing: Complications: Venous Sheathing Vs.Cyclitic membrane: Cyclitic membraneHEALED PARSPLANITIS: HEALED PARSPLANITIS Aggregates cicatrize to form a limited membrane( gray or translucent) Associated slight atrophy of the parsplana or choroidHEALED PARSPLANITIS: HEALED PARSPLANITISSystemic associations: Systemic associations Multiple sclerosis SarcoidosisSarcoidosis: SarcoidosisDifferential Diagnosis: Differential Diagnosis Fuchs uveitic syndrome Primary intraocular lymphoma Peripheral toxocara granulomaFuchs uveitic syndrome: Fuchs uveitic syndromeInvestigations: Investigations General OcularFFA IN IU: FFA IN IUOCT IN PP: OCT IN PPUBM IN PARS PLANITIS: UBM IN PARS PLANITISBASIC APPROACH: BASIC APPROACH Is it uveitic or nonuveitic entity? What part or parts of uvea is involved? What is the stage of the disease? What is the cause of uveitis?Treatment: Treatment General Rules: - Always suppress the AC reaction - Obtain a dry macula.Four step approach: Four step approach 1. Post. Subtenon injection 2. Oral prednisolone 3. Immunosuppresive Agent 4. Indirect laser, Cryo, VitrectomyCATARACT EXTRACTION: CATARACT EXTRACTION Wait for burnt out stage May need to combine with PPV Counseling Counseling CounselingVR Surgery / combined : VR Surgery / combined Intractable inflammation Unresolved vit hge Retinal detachmentPrognosis: Prognosis Promptness and adequacy of treatmentSlide 50: Thank you You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Intermediate Uveitis ppt drbillal Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Copy Does not support media & animations WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 1077 Category: Education License: All Rights Reserved Like it (1) Dislike it (0) Added: February 21, 2011 This Presentation is Public Favorites: 1 Presentation Description No description available. Comments Posting comment... By: dhruvworah (23 month(s) ago) email id is: dhruvworah@rediffmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: dhruvworah (23 month(s) ago) gr8 presentation sir... cud u plz email d ppt 2 my email id? Saving..... Post Reply Close Saving..... Edit Comment Close By: ayurraga (27 month(s) ago) please send me the ppt to my email address ayurraga@gmail.com thanking you Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Intermediate Uveitis: Intermediate Uveitis Dr. Billal Hossain National Institute of Ophthalmology and HospitalIntroduction: Introduction Idiopathic relapsing chronic disease Intraocular inflammation Centered around parsplanaDr Charles Schepens: Dr Charles SchepensHistory: History 1908: Fuchs - Cyclitis 1950: Schepens - Peripheral Uveitis 1960: Brockhurst - Peripheral Cyclitis 1960: Welch - Pars Planitis 1987: IUSG - Intermediate UveitisDefinition: Definition Predominantly Vitreous InflammationSITE OF INFLAMMATION: SITE OF INFLAMMATION Ciliary body Vitreous Peripheral retinaEpidemiology: Epidemiology 15% of uveitis patients 20% of Paediatric uveitis Bimodal presentation Bilateral 80% - asymmetricPathogenesis: Pathogenesis Cell mediated immunity Preponderance of T-helper cells HLA assosciation- A 28, DR 15Presentation: Presentation Floaters Blurring of visionClinical Findings: Clinical Findings Anterior Segment - Small KP - Epithelial oedemaClinical Findings: Clinical Findings Vitreous - Vitreous cell - Vitreous condensation - Snow ballsSnowball Exudate: Snowball ExudateClinical Findings: Clinical Findings Posterior segment - Periphlebitis - Snowbanking - Neovascularization - Disc oedemaSNOW BANKING : SNOW BANKINGClinical Findings: Clinical FindingsPARS PLANITIS: PARS PLANITIS Intermediate uveitis + snow bank - idiopathicClinical courses: Clinical courses Benign course Prolong course Variable courseComplications: Complications CME ERM Cataracts and Glaucoma Peripheral retinal vasoproliferative tumours Retinal Detachment and retinoschisis Optic Disc Edema Vitreous haemorrhageComplications: CME: Complications: CME 30% patientsComplications: CME: Complications: CMEComplications: CME: Complications: CMECME – Macular hole : CME – Macular holeComplications: ERM: Complications: ERMComplications: ERM: Complications: ERMComplications: ERM: Complications: ERMComplications: Cataracts: Complications: Cataracts 50% pt of uveitisComplications: Glaucoma: Complications: Glaucoma ? Herpes Gonioscopy ? Steroid responderComplications: RVPT: Complications: RVPT Dr. Shields and Associates 113 tumors- 13% IUComplications: Disc oedema: Complications : Disc oedema 20% of eye Secondary inflammation.Complications: RD: Complications: RD Exudative RD Tractional RD Rhegmatogenous RD RetinoschisisComplications: vitreous hge: Complications: vitreous hge Snowbank NVD NVE ChildrenComplications: Venous Sheathing: Complications: Venous Sheathing Vs.Cyclitic membrane: Cyclitic membraneHEALED PARSPLANITIS: HEALED PARSPLANITIS Aggregates cicatrize to form a limited membrane( gray or translucent) Associated slight atrophy of the parsplana or choroidHEALED PARSPLANITIS: HEALED PARSPLANITISSystemic associations: Systemic associations Multiple sclerosis SarcoidosisSarcoidosis: SarcoidosisDifferential Diagnosis: Differential Diagnosis Fuchs uveitic syndrome Primary intraocular lymphoma Peripheral toxocara granulomaFuchs uveitic syndrome: Fuchs uveitic syndromeInvestigations: Investigations General OcularFFA IN IU: FFA IN IUOCT IN PP: OCT IN PPUBM IN PARS PLANITIS: UBM IN PARS PLANITISBASIC APPROACH: BASIC APPROACH Is it uveitic or nonuveitic entity? What part or parts of uvea is involved? What is the stage of the disease? What is the cause of uveitis?Treatment: Treatment General Rules: - Always suppress the AC reaction - Obtain a dry macula.Four step approach: Four step approach 1. Post. Subtenon injection 2. Oral prednisolone 3. Immunosuppresive Agent 4. Indirect laser, Cryo, VitrectomyCATARACT EXTRACTION: CATARACT EXTRACTION Wait for burnt out stage May need to combine with PPV Counseling Counseling CounselingVR Surgery / combined : VR Surgery / combined Intractable inflammation Unresolved vit hge Retinal detachmentPrognosis: Prognosis Promptness and adequacy of treatmentSlide 50: Thank you