Follow up – After 11 Months July 2011

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Presentation transcript:

Follow up – After 11 Months July 2011 VA: OD/OS 20/20 OD/OS no anterior chamber cells OD/OS no vitreous cells, dry macula without therapy

Follow up – After 16 Months December 2011 VA: OD/OS 20/25 and 20/40 OD/OS anterior chamber cells (1+) OD/OS snowballs OS macular cyst Diagnosis: mild recurrence

Follow Up – December 2011– OCT OS

Follow up – After 16 Months December 2011 Therapy: rimexolone topical 2x/d, systemic prednisolone 70mg/d systemic acetazolamide(125mg 2x/d)

Follow up – After 17 Months January 2012 VA: OD/OS 20/20 OD/OS no anterior chamber cells OD/OS dry macula Therapy: rimexolone topical 2x/d, reduction of systemic prednisolone (12.5mg/d for 2 weeks, then 10mg/d) and acetazolamide (62.5mg/d)

Follow Up – After 17 Months January 2012 – OCT OS

Follow up – After 21 Months Mai 2012 VA: OD/OS 20/20 OD/OS no anterior chamber cells OD/OS dry macula Therapy: systemic prednisolone 7.5mg/d, stop of topical rimexolone and systemic acetazolamide

Follow up – After 28 Months December 2013 VA: OD/OS 20/20 OD/OS no anterior chamber cells OD/OS dry macula Therapy: stop of systemic prednisolone 5mg/d

Follow up – After 29 Months January 2014 VA: OD/OS 20/20 OD/OS anterior chamber cells (2+), iris nodules OD/OS dry macula Recurrence of anterior uveitis Therapy: topical prednisolone 5x/d

Follow up – After 29 Months January 2014

Follow up –After 32 Months April 2014 VA: OD/OS 20/20 OD/OS anterior chamber cells (1+), no iris nodules OD/OS dry macula Improvement of anterior chamber cell numbers Therapy: reduction of topical prednisolone

Last follow up – After 39 Months November 2014 VA: OD/OS 20/20 OD/OS anterior chamber cells (1-2+) OD/OS dry macula mild recurrence therapy: topical prednisolone 1x/d

Final Diagnosis Tubulointerstitial nephritis and uveitis syndrome (TINU) Differential diagnosis sarcoidosis tuberculosis

Conclusion rare disease often misdiagnosed most often anterior, but occ. intermediate uveitis typical finding: increased beta-2-microglobuline in urine good response to corticosteroids but recurrences are often, may be treated with immunosuppressents