Proliferative vitreoretinopathy: pathobiology, surgical management, and adjunctive treatment.
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Chemotherapy, Adjuvant↗
Biomedical subjects
D G Charteris
Publications and source records attributed to D G Charteris.
Ophthalmic molluscum contagiosum: clinical and immunopathological features.
AIMS: A study of ophthalmic molluscum contagiosum infection was undertaken to define its clinical presentation and immunopathological features. METHODS: Retrospective analysis of 35 cases of histologically proved molluscum contagiosum infection was carried out. Diagnosis was delayed in 40% of cases resulting in repeated clinic visits. RESULTS: Twenty one patients were noted to have ocular surface changes; two patients were immunocompromised. All cases were eventually treated by excision of the lesion (19 had cautery to the lesion base) and there was recurrence in two cases. Immunohistochemical analysis of biopsy specimens showed that T lymphocytes were a consistent finding in adjacent dermis and epidermis although they did not infiltrate the molluscum lesions. Smaller numbers of macrophages were also demonstrated. There was a notable cross reactivity by a T cell antibody to the molluscum bodies. CONCLUSION: The study shows the varied presentation of molluscum contagiosum infection to the ophthalmologist and the nature of the local immune response to the virus.
Adolescent↗
Comparison of the expression of interferon gamma, IL2, IL4, and lymphotoxin mRNA in experimental autoimmune uveoretinitis.
The aim of this study was to investigate the T lymphocyte subsets involved in experimental autoimmune uveoretinitis (EAU) by quantifying the numbers of cells expressing mRNA for each of the lymphokines interferon gamma, interleukin 2, interleukin 4, and lymphotoxin throughout the disease process. Lewis rats were immunised with retinal S-antigen to provide a model of inflammatory eye disease. In situ hybridisation using cDNA probes specific for interferon gamma, IL2, IL4, and lymphotoxin mRNA were utilised to localise lymphokine mRNA expression by infiltrating cells and the numbers of positive cells counted. Localisation of mRNA for all four probes was found on increasing cell numbers as the disease process progressed. Similar numbers of cells expressed mRNA for each lymphokine, generally a small percentage of the T lymphocyte total. Activated cells within the eye express mRNA for interferon gamma, IL2, IL4, and lymphotoxin in EAU suggesting a mixed population of T lymphocyte subsets.
Animals↗
Suppurative keratitis caused by Streptococcus pneumoniae after cataract surgery.
Six elderly patients are described (age range 76-86 years) in whom a characteristic peripheral suppurative keratitis developed 1-36 months after uncomplicated cataract surgery. A corneal section had been used in all patients and four or five interrupted nylon sutures were present at the time of onset. Streptococcus pneumoniae was cultured from a corneal scrape in all cases. Treatment with appropriate antibiotics resulted in slow resolution though supplementary topical steroids were necessary in five of the six patients, and corneal opacification persists in all cases.
Aged↗
Inflammatory cells in proliferative vitreoretinopathy subretinal membranes.
BACKGROUND: The inflammatory cell content of subretinal membranes occurring in proliferative vitreoretinopathy (PVR) has not yet been well characterized. This study was undertaken to investigate the inflammatory cells present in PVR subretinal membranes. METHODS: Eight subretinal membranes obtained surgically from eyes with PVR complicating rhegmatogenous retinal detachment were studied immunohistochemically using the avidin-biotin complex technique and a panel of monoclonal and polyclonal antibodies. RESULTS: T lymphocytes were found in five of the eight subretinal membranes. CD4+ T cells were demonstrated in four and CD8+ T cells in one of the membranes. T cells bearing the interleukin 2 receptor were found in two of four membranes studied. Macrophages were found in four membranes. No B lymphocytes or neutrophils were demonstrated, and there were no significant deposits of complement or immunoglobulins. Expression of the MHC class II antigen HLA DR was consistently found in frozen specimens. Glial cells and retinal pigment epithelial cells also were present in the membranes, often adjacent to T cells, although overall no obvious relationship was found between glial or retinal epithelial cells and T cells. CONCLUSION: The findings indicate that T lymphocytes are present in PVR subretinal membranes and have the potential to interact with other cell types in the pathogenesis of this condition.
B-Lymphocytes↗
Orbital volume measurement in the management of pure blowout fractures of the orbital floor.
With the recent advent of accurate orbital volume assessment by computed tomography, a retrospective analysis was made of 31 patients with 'pure' blowout fracture of the orbital floor, managed either surgically or conservatively, to determine whether orbital volume measurement could provide an additional parameter of use in the management of such fractures. There was a significant difference in orbital volume discrepancy between patients managed surgically or conservatively suggesting that this investigation may be of use in decision making on surgical intervention in patients with orbital blowout fractures.
Anthropometry↗
In vivo lymphokine production in experimental autoimmune uveoretinitis.
Experimental autoimmune uveoretinitis (EAU) is a well-characterized model of immune-mediated intraocular inflammation. The intraocular infiltrate in EAU consists predominantly of T lymphocytes. The in vivo production of interleukin-2 (IL-2), lymphotoxin and IL-4 by these T cells was investigated by in situ hybridization using cDNA probes to lymphokine mRNA. Localization of lymphokine mRNA was found simultaneous with disease onset in areas of T-cell infiltration. Positive signal was seen over cells in the uveal tract, retina and extraocular region. Less than 10% of the population of T cells defined immunohistochemically had positive localization of mRNA for these lymphokines. The number of positive cells was similar for each of the three probes and increased as the disease progressed. The findings suggest that these lymphokines are produced in vivo in immune-mediated intraocular inflammation and may play a role in the immunopathology seen in these conditions.
Animals↗
Proliferative vitreoretinopathy. Lymphocytes in epiretinal membranes.
BACKGROUND: To investigate the potential contribution of inflammatory and immune-mediated processes contributing to the pathogenesis of proliferative vitreoretinopathy (PVR), an immunohistochemical study was undertaken to characterize the infiltrating inflammatory cells in epiretinal membranes surgically removed from the eyes of patients with PVR. METHODS: Twenty-one epiretinal membranes obtained surgically from eyes with PVR complicating rhegmatogenous retinal detachment were studied immunohistochemically using the ABC technique and a panel of monoclonal and polyclonal antibodies. RESULTS: T lymphocytes were found in 18 of the 21 specimens and generally constituted a small percentage of the total cell number. CD4+ T cells were found in 14 of the 18 membranes containing T cells. Three of six frozen membranes contained T cells that were positive for the interleukin-2 receptor. In 5 of 16 membranes studied, cells positive for the macrophage/monocyte marker were found. No B lymphocytes or neutrophils were identified, and there were no deposits of complement or immunoglobulins. Positive staining for the class II MHC antigen HLA-DR was found in 7 of the 21 membranes, a result that was more consistent in frozen than in fixed tissues. CONCLUSION: The study suggests that T lymphocytes are present in PVR epiretinal membranes and may be activated. These cells have the potential to play a role in the pathobiology of PVR.
Cell Membrane↗
Behçet's disease: activated T lymphocytes in retinal perivasculitis.
A 38-year-old man who died from systemic Behçet's disease had previously suffered from severe, recurrent bilateral retinal vasculitis, and anterior uveitis for 10 years. Immunopathological examination of the eyes postmortem revealed marked hyaline thickening of the retinal and optic nerve vessels. The vessels had an intramural and perivascular infiltrate of T lymphocytes which stained positively for CD4 and IL2 receptor surface markers. Small numbers of cells in the optic nerve head, retinal vascular endothelium, and retinal pigment epithelium were HLA DR positive.
Adult↗
CD4+ lymphocyte involvement in ocular Behçet's disease.
Despite extensive study, the pathogenic mechanisms of Behçet's disease remain uncertain. The ocular inflammation caused by this disease is severe, often causing significant visual loss and, although the nature of the cellular infiltrate has been examined in many of the involved organs, the infiltrating cells in inflamed eyes have not. To investigate the mechanisms involved in perpetuating the ocular inflammation, five enucleated eyes from patients with Behçet's disease were examined by immunohistochemical staining using a panel of monoclonal and polyclonal antibodies. Control eyes from patients with chronic intraocular inflammation from other causes were also examined. Cellular infiltrates were a consistent finding in choroid and periretinal scar tissue, formed almost entirely by mononuclear cells. T lymphocytes were found to predominate (largely the CD4+ subset). B lymphocytes and NK cells were infrequent findings but macrophages were present in significant numbers. No complement or immunoglobulin deposits were found. Infiltrating lymphocytes and macrophages were HLA DR positive. Retinal vascular and retinal pigment epithelium were only occasionally positive. Our findings suggest that cell mediated immunity, rather than immune complex deposition is responsible for the perpetuation of the ocular inflammation in Behçet's disease and that CD4+ T lymphocytes play a central role in this.
Adolescent↗
Interferon-gamma (IFN-gamma) production in vivo in experimental autoimmune uveoretinitis.
Experimental autoimmune uveoretinitis (EAU) is a well-characterized model of immune-mediated intraocular inflammation. The intraocular infiltrate in EAU consists predominantly of T lymphocytes. The in vivo production of interferon-gamma (IFN-gamma) by these T cells was investigated immunohistochemically and by in situ hybridization using a cDNA probe to rat IFN-gamma mRNA. Positive localization of IFN-gamma mRNA began simultaneously with disease onset and increased as the inflammatory tissue destruction progressed. The positive signal was seen on cells in the retina, uveal tract and extraocular region where collections of inflammatory cells contained many T lymphocytes. Numerous cells in these locations also stained positively immunohistochemically for IFN-gamma. These results indicate that the in vivo production of IFN-gamma within the eye could play a role in the immune regulation of intraocular inflammatory disease.
Animals↗
Effect of sodium hyaluronate on trabeculectomy filtration blebs.
A prospective, randomized study was carried out to investigate the effect of 1% sodium hyaluronate on the formation and function of trabeculectomy filtration blebs. Using a standardized operation, a group of patients had sodium hyaluronate introduced below the scleral and conjunctival flaps. In a control group the operation was done without sodium hyaluronate. Analysis of anterior chamber depth, postoperative intraocular pressure and the size and appearance of the bleb was carried out. The results showed that the use of sodium hyaluronate gives a significantly deeper postoperative anterior chamber but also suggested that it results in a filtration bleb which tends to be thinner walled and loculated.
Drainage↗
Multifocal posterior uveitis: clinical and pathological findings.
A pathological study was performed on the necropsy eyes of a 59-year old-woman who had suffered for nine years from multifocal posterior uveitis. The disease had been controlled by steroid therapy with good preservation of visual function. Extensive investigation did not reveal the aetiology. On macroscopic examination numerous focal lesions with various degrees of pigmentation were observed scattered across the fundi. These lesions were studied by light and electron microscopy and immunohistochemistry. There was ongoing chorioretinal inflammation in the foci, producing destruction of Bruch's membrane, the retinal pigment epithelium (RPE), and the outer retina. The focal scars showed migration of RPE and glial cells and neovascularisation. Capillary and venule endothelial cells were swollen at the inflammatory sites. Attempts to establish a cause for this condition were unsuccessful.
Choroid↗
Progression of an iris melanoma over 41 years.
An iris melanoma first recorded in 1945 progressed over a period of 41 years to produce secondary glaucoma resulting in enucleation. The case illustrates the advancing nature of such lesions.
Adult↗
Acute posterior multifocal placoid pigment epitheliopathy complicated by central retinal vein occlusion.
A case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) complicated by a central retinal vein occlusion five weeks after presentation is described. After eight months' follow-up there was mild residual visual impairment, macular scarring, and angiographic changes. The association of these two conditions is discussed.
Adult↗
Ocular injuries caused by a suction toy.
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Child↗
Posterior penetrating injury of the orbit with retained foreign body.
A case of a retained orbital foreign body following a penetrating injury in a 2-year-old boy is described. Diagnosis and management of such cases is discussed.
Child, Preschool↗
Retinal detachment neuropathology and potential strategies for neuroprotection.
Understanding the neuropathology of retinal detachment from postmortem and animal models allows identification of cellular targets, receptors and mediators for pharmacological manipulation. In this review, concepts of retinal detachment and neuropathology are examined at cellular and structural anatomical levels using postmortem and animal model data. Possible neuroprotective strategies are reviewed in the setting of the new environment created by successful retinal reattachment surgery.
Animals↗