Uveitis Awareness Month: A Complex Case
Uveitis Awareness Month: A Complex Case Highlights the Importance of Specialized Inflammatory Eye Care
October is Uveitis Awareness Month, an opportunity to increase awareness of inflammatory eye conditions, their potential impact on vision, and the importance of timely evaluation and appropriate treatment.
Inflammatory eye conditions can present with a range of symptoms and vary considerably in severity. In some cases, inflammation affecting the retinal blood vessels can compromise blood flow to the retina and place vision at significant risk. Recognizing these findings and initiating appropriate treatment can be critical to managing disease and preserving sight.
A Change in Vision Leads to Further Evaluation
A 50-year-old male presented with blurred vision in both eyes. His visual acuity was 20/100 in the right eye and 20/20 in the left eye.
Given the presentation, an extensive diagnostic evaluation was undertaken to investigate the underlying cause. Testing included optical coherence tomography (OCT), OCT angiography, fundus photography, fundus autofluorescence, indocyanine green angiography, fluorescein angiography, and laboratory studies.
Fluorescein angiography revealed severe vascular nonperfusion involving much of the retina, alongside severe, diffuse vasculopathy and vasculitis affecting both retinal arterioles and venules. These findings demonstrated the extent and severity of the retinal vascular involvement and the potential threat to vision.
A Comprehensive, Individualized Treatment Approach
Managing complex ocular inflammation may require a multifaceted approach that evolves according to the patient's clinical response and treatment needs.
In this case, treatment included systemic corticosteroids, antiviral therapy, intravitreal and topical corticosteroids, and panretinal photocoagulation (PRP) in both eyes. Immunomodulatory therapy was also initiated, including adalimumab (Humira) and methotrexate. When weekly adalimumab treatment could not be approved, the treatment regimen was transitioned to infliximab (Remicade).
Maintaining Stability and Protecting Vision
With continued treatment and monitoring, the patient has remained stable for one year. Without aggressive evaluation and treatment, the patient was at high risk for complete vision loss.
This case underscores the potential severity of retinal vascular inflammation and the importance of identifying significant findings, determining an appropriate treatment strategy, and continuing care to help manage disease activity and protect vision.
Specialized Care for Inflammatory Eye Disease
Uveitis and other inflammatory eye conditions can be challenging to diagnose and manage. Symptoms and clinical findings vary, and some conditions can threaten vision if not appropriately evaluated and treated.
At Tennessee Retina, our uveitis specialist, Dr. Akshay Thomas, and his team provide specialized evaluation and treatment for complex inflammatory eye conditions. Through comprehensive diagnostic assessment, individualized treatment planning, and continued monitoring, the team works to manage inflammation and help preserve vision.
During Uveitis Awareness Month, our team encourages patients and referring eye care professionals to remain attentive to changes in vision and findings that may indicate ocular inflammation. Timely evaluation and appropriate specialty care can be important in managing these complex conditions.
Learn more about our uveitis team and care: tnretina.com/retinal-care/uveitis
