PMC9947665_01
a "Cold hypopyon" in the left eye (arrow) in a patient with OBD, which represents the "inconsistency" between the severity of intraocular inflammation (hypopyon in the anterior chamber) and the status of periglobal injection ("white" or "uninjected" eye in a "hot disease"). (Please compare the scleral whiteness of the left eye with hypopyon anterior uveitis with that of her right eye with mild iridocyclitis). b Close-up image of the same left eye with cold macro-hypopyon (arrow). c Pathognomonic sign of mobile hypopyon in OBD, which slowly shifts (within minutes) from its horizontal position into the lateral part of the eye upon permanent leaning to the left side (arrow).
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F1
Biomicroscopic evaluation revealed anterior uveitis bilaterally with left cold-macrohypopyon (Fig. 1a, b) that was shifting temporally with body posture within minutes (Fig. 1c).
PMC9947665_02
a Right refractory CME under the treatment with a combination of systemic conventional immunosuppressants (corticosteroids, azathioprine, cyclosporine-A). b Resolution of right CME following the initiation of infliximab treatment.
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F2
Upon obtaining these findings, a combination of systemic immunosuppressants including corticosteroids (1 mg/kg/d), azathioprine (Imuran , 1-2.5 mg/kg/d), and cyclosporine-A (Sandimmune ; 5 mg/kg/d) were initiated, but she did not respond to this combined therapy after 3 months, and the visual acuities did not increase with refractory bilateral macular edema (Fig. 2a, 3a). Anterior chamber evaluation revealed no active inflammation (no cells and no flare), and both retinal vasculitis and macular edema resolved (Fig. 2b, 3b).
a Left macular edema without cystoid findings in the same patient that was unresponsive to abovementioned medications. b Resolution of macular thickening after the treatment.
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F3
Upon obtaining these findings, a combination of systemic immunosuppressants including corticosteroids (1 mg/kg/d), azathioprine (Imuran , 1-2.5 mg/kg/d), and cyclosporine-A (Sandimmune ; 5 mg/kg/d) were initiated, but she did not respond to this combined therapy after 3 months, and the visual acuities did not increase with refractory bilateral macular edema (Fig. 2a, 3a). Anterior chamber evaluation revealed no active inflammation (no cells and no flare), and both retinal vasculitis and macular edema resolved (Fig. 2b, 3b).