python3 -c " from pypdf import PdfReader reader = PdfReader('/home/daytona/works…

mkdir -p /home/daytona/workspace/retinitis-pptx

~/retinitis-pptx/create_pptx.js

const pptxgen = require("pptxgenjs");

let pres = new pptxgen();
pres.layout = 'LAYOUT_16x9';
pres.title = 'Retinitis & Choroiditis: Comprehensive Topic Framework';

const FONT = "Times New Roman";
const BG = "FFFFFF";
const TITLE_COLOR = "000000";
const TEXT_COLOR = "222222";
const HEADING_COLOR = "000000";

// Helper: add a standard slide
function addSlide(title, bullets) {
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}

// Helper: section divider slide
function addSectionSlide(sectionNum, sectionTitle) {
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}

// ── TITLE SLIDE ──────────────────────────────────────────────────
let titleSlide = pres.addSlide();
titleSlide.background = { color: BG };

titleSlide.addShape(pres.ShapeType.rect, {
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titleSlide.addText("Retinitis & Choroiditis", {
  x: 0.4, y: 2.05, w: 9.2, h: 0.9,
  fontSize: 38, fontFace: FONT, color: "000000",
  align: "center", valign: "middle", bold: true
});
titleSlide.addText("Comprehensive Topic Framework: Basic Science to Clinical Practice", {
  x: 0.4, y: 2.95, w: 9.2, h: 0.5,
  fontSize: 16, fontFace: FONT, color: "555555",
  align: "center", valign: "middle", italic: true
});
titleSlide.addText("Sections 1–9  |  Anatomy · Physiology · Classification · Management · Recent Advances", {
  x: 0.4, y: 5.0, w: 9.2, h: 0.4,
  fontSize: 11, fontFace: FONT, color: "888888",
  align: "center", valign: "middle"
});

// ── SECTION 1: BASIC SCIENCE FOUNDATION ──────────────────────────
addSectionSlide(1, "Basic Science Foundation");

addSlide("Anatomy of the Posterior Segment", [
  "Eye wall: three coats — sclera, uvea (iris/ciliary body/choroid), and retina",
  "Uveal tract: iris (anterior), ciliary body, choroid (posterior)",
  "Retinal layers: 10 layers from ILM to Bruch's membrane",
  "Choroidal layers: suprachoroid, Haller's, Sattler's, choriocapillaris, Bruch's",
  "Macula/fovea: foveal avascular zone (FAZ), Henle's fibre layer, umbo",
  "Optic disc: cup:disc ratio, physiological blind spot"
]);

addSlide("Retinal & Choroidal Blood Supply", [
  "Retinal supply: central retinal artery (CRA) and central retinal vein",
  "Capillary-free zones surround fovea and large vessels",
  "Choroidal supply: short and long posterior ciliary arteries",
  "Venous drainage via vortex veins",
  "Retinal autoregulation vs pressure-dependent choroidal circulation",
  "RPE functions: phagocytosis, retinoid cycle, fluid transport, VEGF/PEDF"
]);

addSlide("Physiology of Photoreception", [
  "Phototransduction cascade: rhodopsin → transducin → PDE6 → CNG channels",
  "Recovery pathway: GRK1, arrestin, guanylate cyclase, visual cycle (RPE65)",
  "ON and OFF bipolar pathways; ganglion cell types: M, P, K cells",
  "Retinal signal processing: horizontal, amacrine, and Müller cells",
  "Inner BRB (iBRB): tight junction proteins at retinal capillary endothelium",
  "Outer BRB (oBRB): RPE tight junctions separating retina from choroid"
]);

// ── SECTION 2: CLASSIFICATION ──────────────────────────────────────
addSectionSlide(2, "Classification");

addSlide("SUN Workshop Classification", [
  "Anatomical: anterior, intermediate, posterior, panuveitis",
  "Posterior uveitis subtypes: retinitis, choroiditis, retinochoroiditis, neuroretinitis",
  "By aetiology: infectious vs non-infectious",
  "By morphology: granulomatous vs non-granulomatous",
  "By onset/course: acute, recurrent, chronic (SUN 2005, updated 2021)",
  "SUN grading: anterior chamber cells, vitreous cells, vitreous haze"
]);

addSlide("Morphological Patterns", [
  "Retinitis: focal, multifocal, geographic, or diffuse opacification",
  "Choroiditis: focal, multifocal, diffuse, or serpiginous pattern",
  "Retinal vasculitis: periphlebitis (sheathing) or periarteritis",
  "Active lesion: white/yellow opacities with ill-defined, fluffy borders",
  "Healing lesion: clearer borders, reducing vitritis, pigment deposition",
  "Healed lesion: chorioretinal scar with RPE atrophy and pigment clumping"
]);

// ── SECTION 3: RETINITIS ──────────────────────────────────────────
addSectionSlide(3, "Retinitis");

addSlide("Infectious Retinitis: Toxoplasma & CMV", [
  "Toxoplasma gondii: 'headlight in fog' — active white focus adjacent to old scar",
  "Treatment: pyrimethamine-sulfadiazine or TMP-SMX; clindamycin as alternative",
  "CMV retinitis: pizza-pie (haemorrhagic) vs granular pattern; AIDS-defining",
  "CMV management: valganciclovir PO; foscarnet or ganciclovir IV for resistant cases",
  "HAART-induced immune recovery uveitis (IRU) — paradoxical worsening",
  "Intravitreal ganciclovir/foscarnet for immediate sight-threatening CMV lesions"
]);

addSlide("Infectious Retinitis: Herpetic & Others", [
  "ARN (HSV-1/2): peripheral retinal necrosis, occlusive arteritis, rapid progression",
  "ARN treatment: IV acyclovir 10 mg/kg TDS × 7–14 d, then oral valacyclovir",
  "VZV: ARN in immunocompetent; PORN (bilateral, no vitritis) in AIDS",
  "Syphilitic retinitis: 'great imitator'; IV penicillin G 18–24 MU/day × 14 days",
  "Candida retinitis: fluffy vitreous balls/'string of pearls'; IV antifungal ± vitrectomy",
  "Bartonella: cat-scratch neuroretinitis with Leber's stellate maculopathy"
]);

addSlide("Non-Infectious Retinitis", [
  "Retinitis Pigmentosa (RP): rod-cone degeneration; genes: RHO, RPGR, USH2A",
  "ERG shows reduced/extinguished rod responses; OCT shows outer retinal thinning",
  "Usher syndrome: RP + sensorineural hearing loss (USH1, 2, 3)",
  "Leber congenital amaurosis: severe childhood RP; RPE65, CEP290 mutations",
  "Cancer-associated retinopathy (CAR): anti-recoverin antibodies; paraneoplastic",
  "Melanoma-associated retinopathy (MAR): anti-bipolar cell antibodies (TRPM1)"
]);

// ── SECTION 4: CHOROIDITIS ────────────────────────────────────────
addSectionSlide(4, "Choroiditis");

addSlide("White Dot Syndromes", [
  "APMPPE: placoid RPE lesions; FFA — early block/late stain; CNS vasculitis risk",
  "Serpiginous choroiditis: peripapillary spread, relentless recurrence, triple IST",
  "Birdshot chorioretinopathy: HLA-A29, cream oval spots; ERG monitoring",
  "Multifocal choroiditis (MFC): punched-out scars, vitritis, high CNV risk",
  "Punctate inner choroidopathy (PIC): no vitritis, myopic females, high CNV risk",
  "MEWDS: unilateral, outer retina involvement, typically self-resolving"
]);

addSlide("Infectious Choroiditis", [
  "TB choroiditis: choroidal tubercle, Dalen-Fuchs nodules, serpiginous-like TB",
  "TB management: ATT (HRZE × 2 months, HR × 4 months) + adjunct steroids",
  "Sarcoidosis: snowball vitreous opacities, candle-wax drippings; ACE elevated",
  "Syphilis (ASPPC): bilateral placoid pigment epitheliopathy — universal screening",
  "Histoplasmosis (OHS): peripapillary atrophy + HRC spots + macular CNV, no vitritis",
  "Cryptococcus/Candida choroiditis in immunosuppressed — systemic antifungals"
]);

addSlide("Other Important Entities", [
  "VKH disease: 4 phases (prodromal, uveitic, convalescent, chronic); sunset glow fundus",
  "Sympathetic ophthalmia: bilateral panuveitis post-penetrating trauma; enucleation timing",
  "Behcet's disease: HLA-B51, occlusive vasculitis, hypopyon uveitis; colchicine + biologics",
  "Posterior scleritis: T-sign on B-scan ultrasound; NSAIDs + oral steroids",
  "Neuroretinitis: Bartonella, syphilis, sarcoid; macular star from disc leakage",
  "AZOOR: acute zonal occult outer retinopathy — outer retinal involvement, visual field loss"
]);

// ── SECTION 5: INVESTIGATIONS ────────────────────────────────────
addSectionSlide(5, "Investigations");

addSlide("Ocular Imaging Modalities", [
  "FFA: characterises retinitis/choroiditis/vasculitis — early block, late stain/leak",
  "ICGA: choroidal assessment, dark spots, choriocapillaris ischaemia — gold standard for APMPPE",
  "OCT (SD-OCT/EDI-OCT): retinal and choroidal layer-by-layer analysis",
  "OCT-Angiography: CNV detection, FAZ integrity, choriocapillaris flow deficits",
  "Fundus autofluorescence (FAF): RPE activity — hyper/hypo-AF patterns",
  "B-scan ultrasound: vitreous opacities, choroidal detachment, posterior scleritis T-sign"
]);

addSlide("Laboratory Investigations", [
  "Serology: VDRL/RPR + FTA-ABS, QuantiFERON-TB Gold, HIV Ag/Ab, Toxoplasma IgG/IgM",
  "Autoimmune panel: ANA, ANCA, HLA-A29/B27/B51, serum ACE, lysozyme",
  "Aqueous tap PCR: CMV, HSV, VZV, Toxoplasma, TB; Goldmann-Witmer coefficient",
  "Vitreous biopsy: cytology + IL-10:IL-6 ratio (raised >1 suggests intraocular lymphoma)",
  "Metagenomic next-generation sequencing (mNGS): identifies rare/novel pathogens",
  "Electrophysiology: full-field ERG, mfERG, PERG, VEP (ISCEV standards)"
]);

// ── SECTION 6: MANAGEMENT ────────────────────────────────────────
addSectionSlide(6, "Management");

addSlide("Medical Treatment", [
  "Corticosteroids: topical, periocular, oral, IV pulse; intravitreal Ozurdex / Yutiq implant",
  "Pathogen-specific antimicrobials given before/with steroids in infectious uveitis",
  "Steroid-sparing IST: MTX, MMF, azathioprine, cyclosporine, tacrolimus, chlorambucil",
  "Biologics: adalimumab (VISUAL I/II RCTs), infliximab, rituximab, tocilizumab",
  "Anti-VEGF (bevacizumab, ranibizumab, aflibercept, faricimab) for secondary CNV",
  "JAK inhibitors (upadacitinib, baricitinib) — ongoing trials; IFN-α2a/2b for Behcet's"
]);

addSlide("Surgical & Interventional Treatment", [
  "Pars plana vitrectomy: diagnostic biopsy, vitreous haemorrhage, RD repair, ERM peel",
  "Scleral buckle for rhegmatogenous retinal detachment",
  "Prophylactic laser retinopexy in ARN to reduce retinal detachment risk",
  "Photodynamic therapy (PDT): subfoveal CNV complicating choroiditis",
  "Glaucoma surgery (trabeculectomy/tube implant) for refractory secondary glaucoma",
  "Cataract surgery: ideally after ≥3 months of disease quiescence"
]);

// ── SECTION 7: RECENT ADVANCES ────────────────────────────────────
addSectionSlide(7, "Recent Advances & Clinical Trials");

addSlide("Gene Therapy", [
  "Luxturna (voretigene neparvovec): RPE65-LCA — FDA approved; durable 5-year outcomes",
  "RPGR-XLRP: XIRIUS trial (cotoretigene toliparvovec), HORIZON trial (AGTC-501)",
  "Botaretigene sparoparvovec for RPGR — Phase 3 data under review",
  "USH2A, CRB1, CEP290 programmes: sepofarsen (antisense) and EDIT-101 (CRISPR)",
  "BRILLIANCE trial: in vivo CRISPR editing (EDIT-101) for CEP290-LCA10",
  "Ongoing: AAV-based therapies for >25 RP gene targets in pipeline"
]);

addSlide("Biologics & Imaging Advances", [
  "VISUAL I/II: adalimumab reduces uveitic flares and corticosteroid use (noninfectious uveitis)",
  "SHIELD trial: secukinumab (IL-17A inhibitor) for non-infectious posterior uveitis",
  "Wide-field OCT-A and AI-based analysis for monitoring choriocapillaris flow",
  "Adaptive optics: single-cell photoreceptor and RPE imaging",
  "mNGS: detects rare pathogens in aqueous/vitreous — superior to conventional PCR",
  "Sustained-release platforms: Xipere (triamcinolone suprachoroidal), Susvimo (ranibizumab)"
]);

addSlide("Emerging Therapies", [
  "Optogenetics: MCO-010 and GS030/ChrimsonR — Phase 2/3 for end-stage RP",
  "PRIMA subretinal photovoltaic prosthesis — bipolar cell stimulation",
  "iPSC-RPE transplantation (ORBIT trial): autologous patch for Stargardt/AMD/RP",
  "Oral small molecules: emixustat (RPE65 inhibitor), N-acetylcysteine (antioxidant)",
  "Nanoparticle drug delivery for targeted retinal/choroidal therapy",
  "Suprachoroidal space injections: expanding route for corticosteroids and gene vectors"
]);

// ── SECTION 8: SPECIAL TOPICS ────────────────────────────────────
addSectionSlide(8, "Special Topics");

addSlide("Paediatric, Pregnancy & Systemic Disease", [
  "Paediatric uveitis: JIA-associated (ANA-positive, female, oligoarticular) — silent AC cells",
  "JIA uveitis management: topical steroids → MTX → adalimumab (first-line biologic)",
  "Pregnancy: MMF is contraindicated (teratogenic); adalimumab generally considered safe",
  "Uveitis in AS, IBD, psoriasis — seronegative spondyloarthropathy-associated",
  "HIV: CMV retinitis, PORN, immune recovery uveitis — HAART timing critical",
  "Frosted branch angiitis: bilateral severe periphlebitis, usually viral aetiology"
]);

addSlide("Masquerade Syndromes", [
  "Primary vitreoretinal lymphoma (PVRL): IL-10:IL-6 > 1; MYD88 mutation on vitreous biopsy",
  "Leukaemia, retinoblastoma, uveal melanoma — mimic uveitis clinically",
  "Neuroretinitis: disc swelling + macular star — Bartonella first consideration",
  "AZOOR: zonal outer retinal dysfunction; enlarged blind spot; ERG abnormal",
  "Frosted branch angiitis: widespread retinal vascular sheathing; viral triggers",
  "Always consider masquerade in atypical/treatment-resistant posterior uveitis"
]);

// ── SECTION 9: PROGNOSIS & PREVENTION ────────────────────────────
addSectionSlide(9, "Prognosis & Prevention");

addSlide("Visual Prognosis & Recurrence Prevention", [
  "Poor prognosis: macular/optic disc involvement, delayed treatment, immunosuppression",
  "Prophylactic TMP-SMX (low dose, thrice-weekly) reduces toxoplasma recurrence",
  "Maintenance valganciclovir for AIDS-related CMV until CD4 > 100 cells/μL on HAART",
  "Oral valacyclovir long-term prophylaxis following ARN to prevent fellow eye involvement",
  "Genetic counselling for RP, Usher syndrome, and LCA — family cascade testing",
  "Low vision rehabilitation: optical aids, eccentric viewing training, orientation & mobility"
]);

addSlide("Summary: Key Take-Home Points", [
  "Classify uveitis anatomically and aetiologically before treatment — imaging and lab work are essential",
  "Infectious uveitis requires pathogen-specific antimicrobials; steroids must not be used alone",
  "White dot syndromes share similar fundus appearances — ICGA differentiates choriocapillaris involvement",
  "Biologics (adalimumab) are now standard steroid-sparing agents supported by Level 1 evidence",
  "Gene therapy (Luxturna) has transformed management of RPE65-LCA — pipeline expanding rapidly",
  "Masquerade syndromes must be excluded in all atypical or steroid-unresponsive posterior uveitis"
]);

// ── WRITE FILE ────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/retinitis-pptx/Retinitis_Choroiditis_Framework.pptx" })
  .then(() => console.log("DONE: /home/daytona/workspace/retinitis-pptx/Retinitis_Choroiditis_Framework.pptx"))
  .catch(err => { console.error("ERROR:", err); process.exit(1); });

cd /home/daytona/workspace/retinitis-pptx && node create_pptx.js

ls -lh /home/daytona/workspace/retinitis-pptx/Retinitis_Choroiditis_Framework.pp…