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Öğe Importance of proper diagnosis for management: multifocal choroiditis mimicking ocular histoplasmosis syndrome(Springer Heidelberg, 2011) Hatef, Elham; Turkcuoglu, Peykan; Ibrahim, Mohamed; Sepah, Yasir; Shulman, Matthew; Heo, Jangwon; Lee, Jeong HeePurpose The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNVor lesion activities over the follow-up period. Conclusions MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.Öğe Intercellular Adhesion Molecule Inhibitors as Potential Therapy for Refractory Uveitic Macular Edema(Taylor & Francis Inc, 2010) Wang, Jianmin; Ibrahim, Mohamed; Turkcuoglu, Peykan; Hatef, Elham; Khwaja, Afsheen; Channa, Roomasa; Do, Diana V.Purpose: To describe the bioactivity of an intercellular adhesion molecule inhibitor (efalizumab) in a patient with refractory uveitic macular edema. Methods: A 55-year-old man presented with idiopathic autoimmune uveitis and associated macular edema, which could not be controlled by regional and systemic corticosteroid and selected immunomodulatory therapy. Efalizumab was administered as subcutaneous injections. Results: After 37 weekly injections of efalizumab, the uveitic macular edema was successfully eliminated. Six months following discontinuation of efalizumab, there were no signs of recurrent inflammation. Conclusion: Further investigation of the role of intercellular adhesion molecule inhibitors in the management of uveitic macular edema is indicated.Öğe Mycophenolate Mofetil and Fundus Autofluorescence in the Management of Recurrent Punctate Inner Choroidopathy(Informa Healthcare, 2011) Turkcuoglu, Peykan; Chang, Peter Y.; Rentiya, Zubir S.; Channa, Roomasa; Ibrahim, Mohamed; Hatef, Elham; Sophie, RaafayMethods: Eight patients who had at least two recurrent episodes of increased activity before MMF and 12 months of documented clinical course before and after MMF were included. The frequencies of attacks before and after MMF were compared. FAF images evaluated. Results: Before MMF, the 8 patients experienced 19 attacks of recurrent disease activity; during MMF therapy, 3 (38%) patients experienced 6 recurrent episodes. The attack frequencies were 1.09 +/-+/- 0.75 before and 0.23 +/-+/- 0.32 during treatment (p == .036). Among the 6 patients who had FAF, surrounding hyperautofluorescent halo was detected in 4 and recurrence occurred in 2 who did not show any changes on the intensity during treatment. Conclusion: In the index study, the employment of MMF has decreased frequency of attacks in recurrent PIC. FAF may be employed to monitor and predict the response to treatment.