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Uveitic diseases are quite common and potentially blinding ocular disorders. Prompt and accurate diagnosis with appropriate investigations and adequate treatment is the key issue in successful management of such cases. Anatomically Uveitis can be classified as Anterior uveitis (Iritis, Anterior cyclitis, Iridocyclitis), Intermediate uveitis (Pars planitis), Posterior uveitis (Focal, multifocal or diffuse choroiditis, Chorioretinitis, Retinochoroiditis Neuroretinitis) and Panuveitis (VKH syndrome, Sympathatic ophthalmia, Sarcoidosis, Behcet’s disease) Due to the vastness of the subject and complexities involved in the long-term management of these cases, uveitis has emerged as a sub-speciality in ophthalmology.
It is very important to differentiate conditions like AMPPE, Multifocal choroiditis, Birdshot chorio-retinopathy, Serpiginous choroiditis, ocular tuberculosis, Vogt-Koyanagi Harada disease and Punctate inner choroidopathy etc from each other as they may all look quite similar in the initial stages and on ophthalmoscopy but each carries different prognosis and requires a different treatment approach.. Facilities like FFA, ICG, High Resolution OCT and B–scan that are essential in making a proper diagnosis and are available at our centre.
It is also important to be able to order only the essential pathological tests in order to save the patient’s time and money. Specialized Laboratory investigations like C-reactive protein, RA factor, Anti-nuclear Antibody (ANA), serum Angiotensin Converting Enzyme (ACE), ELISA for Toxoplasma / Rubella / CMV and HIV, Quanti-FERON test for TB and Polymerase chain reaction (PCR) analysis of ocular fluid for HSV / VZV / CMV / M-TB / Eubacterial genome / Pan-fungal genome are being done with the collaboration of a reliable Lab.
Proper management not only requires the above mentioned investigations but also a specially trained professional with adequate knowledge and experience in uveitis and ocular immunology. This is available at Mansarovar through Dr.Prabhat Ranjan who is the only ophthalmologist in U.P. with specialized training and exclusive experience in Uveitis and Ocular Immunology. He is in-charge of the uveitis service at our centre.
Treatment in the form of topical steriod, periocular injection of steroid, intravenous methyl prednisolone and oral steroid is given according to the severity and type of inflammation. For recalcitrant cases as well as severe form of autoimmune uveitis Immunosuppressive drugs (Methotrexate, Azathioprine, Cyclophosphamide , Cyclosporin and Mycophenolate Mofetil ) is used at our center with proper monitoring of systemic side effects.
Intravenous antiviral (Acyclovir and Ganciclovir) therapy for deadly infections of retina like Acute Retinal Necrosis (ARN), Progressive Outer Retinal Necrosis (PORN) and CMV retinitis is available here under proper care. Management of all kinds or ocular disorders as well as screening facility for HIV infected patients is provided at our centre. |
