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Tubulointerstitial nephritis and uveitis with bilateral multifocal choroiditis.
L Derzko-Dzulynsky1, T Rabinovitch
1Royal College of Surgeons of Canada, University of Toronto, Toronto, Canada. larissa-myron-dzuynsky@sympatico.ca
American Journal of Ophthalmology
|August 6, 2000
Summary
Tubulointerstitial nephritis and uveitis (TINU) can cause multifocal choroiditis, a posterior uveitis. Early recognition and appropriate immunosuppressive therapy are crucial for managing this rare ocular complication.
Area of Science:
- Ophthalmology
- Nephrology
- Immunology
Background:
- Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare condition typically affecting the anterior uvea.
- Posterior segment involvement in TINU is uncommon but has been reported.
Observation:
- A 16-year-old female with a history of TINU and bilateral anterior uveitis developed bilateral multifocal choroiditis.
- Initial treatment with topical steroids was insufficient, necessitating systemic prednisone.
Findings:
- Intensive steroid treatment led to glaucoma, requiring bilateral trabeculectomies.
- Despite complications, the uveitis eventually became inactive with normal intraocular pressure and residual depigmented chorioretinal lesions.
Implications:
- This case highlights the potential for posterior uveal involvement, specifically multifocal choroiditis, in TINU syndrome.
- Ophthalmologists must consider posterior segment inflammation in TINU and tailor immunosuppressive strategies accordingly.