Differential Diagnosis - Pacific University

5/29/2012
PGs and uveitis
Study No. of eyes Time Uveitic response
Warwar 1998 163 normals 1 year 6.4%
Smith 1999 505 normals 1 year 1.0%
Smith 1999 13 uveitics 1 year 23.1% Mostly mild cases
Chang 2008 163 uveitics 3 mos.
Markomichelakis
2008 58 uveitics 6 mos.
equal to
control
equal to
control
Control = fellow eye, non PG
glaucoma medication
Control =
dorzolamide/timolol
medication
PGs and uveitis
• Case studies describe patients in whom
uveitis occurs in the ipsilaterally treated
eye, and patients in whom the uveitis
improves after cessation and recurs after
rechallenge.
• Latanoprost may not lower IOP during a
uveitic flare.
Goldberg 2008 5,856 normals 5 years OD
laser burns OS peripheral retina, no tear
Case #2: HF
• Assessment: herpes simplex keratitis OS.
• Plan: Rx Viroptic q2h OS, acyclovir
400mg bid po, and erythromycin ung qhs
OS.
Case #2: HF
Date VA OS Assessment Current medications
10/25/07 20/200 Acute HSK OS TravatanZ qhs OU, timolol 0.5%
GFSqam OU (continued)
10/29/07 20/200 “Improving” Viroptic q2hr OS, erythromycin ung
qhs OS (continued)
11/02/07 20/200 “Improving” Viroptic 5x/day OS with taper,
acyclovir 400 mg po bid
11/09/07 4/300 “No improvement” Viroptic 5x/day OS, acyclovir 400mg
po bid (continued)
11/13/07 5/200-1 “Improving” Taper Viroptic over 4 days
11/16/07 5/200-1 “Slowly improving” Viroptic qd x 2 days then d/c
11/19/07 5/200- “Resolving” Refresh tears qid OS
11/26/07 5/250 “Resolving” no change
11/30/07 5/200 “no improvement” Replace erythro with bacitracin ung
12/3/07 5/200- “Resolving” no change
12/7/07 5/225 “Resolved” Replace baci with erythro ung qhs OU
Case #2: HF
Date VA OS Assessment Plan
12/14/07 4/160 “Resolving” TravatanZ qhs OU, timolol 0.5% GFSqam
OU, acyclovir 400 mg po bid (continued)
12/31/07 4/160 “Resolving” no change
2/5/08 5/700 Active disciform
HSK
Viroptic 5x/day OS,
acyclovir 400 mg po bid (continued)
2/8/08 2/125 “Resolving” Viroptic 5x.day OS
2/11/08 2/125 “Resolving” Viroptid qid OS
2/15/08 3/400 “Resolving” Viroptic qd OS x 1 day then d/c
2/20/08 3/350 “Improving” D/c Viroptic. D/c TravatanZ OS
2/25/08 3/350 “Improving” no change
3/4/08 5/350 “improvement” D/c TravatanZ OD
3/7/08 5/350 “continued
no change
improvement”
3/14/08 5/300 “stable” no change
Coursebook Page 39 of 139
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