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Results for “Uveitis, Intermediate”
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The syndrome of glaucomatocyclitic crises.
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Iridoschisis; report of an additional case.
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[Cellular characteristics of cultured non-pigmented ciliary epithelium from adult pigs].
PURPOSE: To compare the reactive proliferation of non-pigmented ciliary epithelial cells in patients with cyclitis, or after cyclophotocoagulation and cyclocryocoagulation, and the cultured non-pigmented ciliary epithelial cells from adult pigs. METHODS: Porcine ciliary epithelial cells were cultured and non-pigmented ciliary epithelial cells were isolated. Detection of DNA synthesis, morphological observation by a phase contrast microscope and a transmission electron microscope, and staining of senescence-associated beta-galactosidase were carried out. RESULTS: The cells proliferated without showing contact inhibition of growth or reconstitution of epithelial morphology. With a decrease of proliferative activity, the cultured cells expressed senescence-associated beta-galactosidase. Although DNA synthesis persisted for a long time, some cells in later culture periods showed morphologically abnormal nuclei or plural nuclei indicating dysfunction of cell division, or apoptotic features. CONCLUSION: The uncontrolled growth and loss of the epithelial nature of non-pigmented ciliary epithelial cells in vitro resembles the process of formation of cyclitic membrane and proliferation of ciliary epithelium after cyclophotocoagulation and cyclocryocoagulation in patients. Observatin of the behavior of cultured non-pigment epithelial cells could aid in understanding the mechanism of cyclitic membrane formation.
[The nature of changes in the local and systemic fibrinolytic activity in patients with retinal angiitis of various genesis].
The mechanism responsible for the development of occlusive processes on the fundus of the eye in different forms of retinal angiitis remains unknown. So the purpose of this study was to investigate the local and systemic fibrinolytic activity in 10 patients with optic disk vasculitis (ODV), 16 patients with peripheral uveitis (PU), 21 patients with isolated retinal angiitis (IRA), 17 patients with systemic lupus erythematosus (SLE) versus 8 healthy donors (a control group). Fibrinolytic activity was determined by the area of lysis, which appeared on the fibrin plate around the 2x2-mm filter paper previously placed in tear or blood. Fibrinolytic activity was ascertained to be decreased if the area of lysis was less than 30 mm2. There was a significant reduction in local fibrinolytic activity in the eyes with occlusive retinal vasculitis (RV) compared with the eyes with RV without occlusions by PU (60 and 9.1%, respectively; p = 0.0048), IRA (61.5 and 12.5%, respectively; p = 0.0056), and as compared to the eyes without vasculitis by ODV (70 and 0%, respectively, p = 0.0031). In SLE, the decrease in local fibrinolytic activity was detected significantly less frequently (33.3 and 16.6% with and without retinal vascular occlusion (RVO), respectively). Blood fibrinolytic activity was lowered only in patients with SLE (with 100 and 16.7% with and without RVO, respectively; p = 0.0151) and remained unchanged in those with ODV, PU, and IRA (more than 50 mm2). Thus, RVO is associated with impaired local reactions in patients with PU, ODV, and IRA and with impaired systemic reactions in those with SLE.
[Use of distant thermography in uveitis in children].
Forty-four children aged 6 months to 14 years, suffering from endogenous uveitis of various sites were examined at different phases of the diseases by a scanning type apparatus, AGA-780M-thermographer (Sweden). The results permit a conclusion that long-distance thermography may be effectively used to assess the ocular status even in small restless children. Uveitis active phase was found associated with a hyperthermal reaction in all the examined sites. Hyperthermia was found related to uveitis localization. The authors suggest that thermoasymmetry parameters and the corneolimbic gradient be used as additional objective criteria for the assessment of uveitis activity and dissemination in children.
[Ocular sarcoidosis].
Sarcoidosis is a multisystem granulomatous disorder of unknown origin that most commonly affects young adults. Ocular involvement occurs in about 30% of patients. Acute or chronic anterior uveitis are the most common ocular manifestations of sarcoidosis but all the ocular tissues can be involved. Diagnosis is based on several investigations which the most interesting are biopsy of sarcoid granuloma and bronchoalveolar lavage. Treatment is topical or systemic corticosteroid therapy.
[Value of serodiagnosis of Lyme disease in the evaluation of uveitis].
PURPOSE: This study was designed to assess results of Lyme serology among all the specific tests routinely performed for exploring uveitis. METHODS: Sixty-seven patients examined for uveitis had a serological diagnosis of Lyme's disease with haemagglutination test and ELISA IgG test. This group included 34 patients with unclassified uveitis. Thirty-seven healty individuals served as control subjects. RESULTS: There was no statistical difference between the three groups in terms of positive serological diagnosis occurrence: control subjects (13.5%), patients with classified uveitis (12.1%) and patients with unclassified uveitis (11.8%). CONCLUSION: It appears to be more adequate to reserve this serological test for Lyme's disease for patients who have a suggestive history or additional symptoms.
[Results of pars plana vitrectomy in chronic uveitis in childhood].
During 1986-1991 vitreous surgery was performed in 5 girls and 8 boys (age range 2-15 years) with chronic uveitis. In 6 cases a combined lensectomy-vitrectomy was performed because cataract was present, so that the results generally refer to 19 eyes. We found a low rate of postoperative complications. During a follow-up period of 6 months to 5 years (average 2 years and 1 month), 12 of the 19 eyes showed a significant visual improvement. Preoperatively, 8 eyes were found to be affected by cystoid macular edema; in 7 of these cases remarkable regression of the edema was observed after surgery. In two-thirds of cases the intensity of the inflammation decreased, so that the dose of corticosteroids could be reduced postoperatively. Our results suggest that vitrectomy for chronic uveitis in children is a relatively safe and successful treatment. In order to prevent irreversible complications and amblyopia surgery should be performed in an early stage of the disease.
Uveitis: a global perspective.
PURPOSE: To study the patterns of uveitis in various geographic regions. METHODS: A systematic literature review was performed using the MEDLINE database, from 1966 to present. Studies that satisfied our described selection criteria were analyzed to provide a global perspective on uveitis. RESULTS: Twenty-two studies, which were the best available representatives of Australia, North and South America, Europe, Asia, and Africa, were included in the final analysis. The distribution of uveitis cases according to the anatomical site of inflammation in the various regions, and the causes and clinical disease associations of anterior, intermediate, posterior, and pan-uveitis were studied for each of the regions and a comparative analysis was performed. CONCLUSIONS: There are similarities and distinct differences in the patterns of uveitis in the various geographic regions. Such patterns of uveitis are influenced by combinations of geographical, environmental, and genetic factors.
Elevated levels of interleukin 6 in the vitreous fluid of patients with pars planitis and posterior uveitis: the Massachusetts eye & ear experience and review of previous studies.
INTRODUCTION: Although the exact mechanisms that lead to uveitis are not entirely known, the role of cytokines in the pathogenesis of this disease has been shown to be important. Prior studies described the presence of an array of cytokines in the intraocular fluid of patients with uveitis. Review of these studies indicate that Interleukin-6 (IL-6) is present, and animal data suggest the important role of IL-6 in the regulation of ophthalmologic immune responses. PURPOSE: We investigated whether IL-6, TNF-alpha, IL-1 alpha, beta, IL-2 are present in the vitreous of patients with active intermediate and posterior uveitis. METHODS: Vitreous specimens were collected from 23 eyes of patients with active intermediate and posterior uveitis who underwent diagnostic or therapeutic vitrectomies. TNF-alpha, IL-1 alpha and beta, IL-2 and IL-6 were measured by enzyme-linked immunosorbent assay. Eight vitreous fluid samples from eye bank eyes were used as control. RESULTS: IL-6 was higher in the vitreous of patients with uveitis compared to control samples (p = 0.0119). No TNF-alpha, IL-2, IL1-alpha or beta was detected. The levels of IL-6 did not correlate with a specific clinical diagnosis, but patients with pars planitis and panuveitis had the highest levels (p = 0.58) CONCLUSIONS: IL-6 is elevated in the vitreous of patients with active intermediate and posterior uveitis.
[Laser tyndallometry and monitoring of treatment in 20 children with juvenile uveitis].
BACKGROUND: Treatment of children with juvenile uveitis requires adequate control of inflammation while minimizing systemic or ocular side effects. The study was performed to evaluate the potential use of the laser flare-cell meter in monitoring and adjustment of therapy in juvenile uveitis. PATIENTS AND METHODS: Retrospectively, we monitored 20 children (11 girls and 9 boys) with an age range from 3 to 15 years presenting with juvenile iridocyclitis (10/20), intermediate (5/20) or posterior (5/20) uveitis. During the follow-up period (median 25.2 months, range: 2 to 83 months) multiple clinical controls were performed. We recorded clinical data, present therapy, and measurements using the laser flare-cell meter (Kowa FC-1000). RESULTS: Laser flare-cell meter measurements were easily obtained and highly reliable even in these young patients. During follow-up, 36 recurrences of intraocular inflammation were detected in 19 eyes. Relapses of inflammation as well as a response to treatment were seen at an early stage. Semiquantitative observations of cells and aqueous flare in the anterior chamber, or visual acuity of patients were less reliable in predicting recurrences. CONCLUSIONS: Laser tyndallometry offers a reliable, examiner-independent method to assess intraocular inflammation in children with juvenile uveitis and to adjust the necessary treatment.
Laser interferometry and visual prognosis in uveitis.
Forty-six eyes in 26 patients with active, intermediate, and/or posterior uveitis with decreased visual acuity were evaluated with the laser interferometer before treatment with systemic cyclosporine. Pretreatment visual acuity (ETDRS), pretreatment laser interferometric visual acuity, and the best visual acuity obtained while under treatment were compared. Eighty-six percent of patients in whom the laser interferometer predicted an improvement of three or more lines did improve. In contrast, 52% of patients in whom no improvement was predicted improved three or more lines with therapy. There was a moderate correlation (R = 0.59) (P less than 0.001) between the number of lines of improvement predicted and the number of lines of improvement obtained. If the laser visual acuity is three or more lines better than the eye chart acuity, the prognosis for vision improvement after cyclosporine therapy is good, even in those patients with cystoid macula edema.
Patterns of uveitis in children presenting at a tertiary eye care centre in south India.
PURPOSE: To study the patterns of uveitis in the paediatric age group in a referral eye care centre in south India. MATERIALS AND METHODS: Thirty-one patients 15 years or younger with uveitis, examined in the year 2000, were included in this study. The uveitis was classified according to the anatomical site of ocular involvement and the most probable aetiological factor. The final diagnosis was based on clinical manifestations and results of specific laboratory investigations. RESULTS: A total 31 (6.29%) paediatric uveitis cases were seen among the 493 uveitic cases in the year 2000. The male:female ratio was 17:14. Anterior (9 cases), intermediate (9 cases) and posterior uveitis (9 cases) were seen in equal number. Four patients had panuveitis. Twenty-seven patients had visual acuity of 6/36 or better at presentation. Approximately 25% (8 of 31) patients had cataract secondary to inflammation. Immunosuppressives were administered in 4 patients and one patient required cataract surgery. CONCLUSION: Uveitis in children comprises approximately 6% of uveitis cases in a referral practice in south India. Anterior, intermediate and posterior uveitis are seen in equal numbers. We recommend that intermediate uveitis be ruled out in all cases of anterior uveitis by careful clinical evaluation including examination under anesthesia (EUA) when required.
Randomized, double-masked study of cyclosporine compared to prednisolone in the treatment of endogenous uveitis.
Fifty-six patients with bilateral sight-threatening noninfectious intermediate or posterior uveitis participated in a randomized double-masked study of the use of cyclosporine vs prednisolone in their treatment. Applying the end-point definitions, visual acuity or vitreal haze improved in only 13 of 28 (46%) patients in each group. The macular edema resolved in seven of 15 patients of the cyclosporine-treated group, and in ten of 16 patients of the prednisolone-treated group (P = .376). Patients whose therapies failed both cyclosporine and prednisolone trials were treated with both drugs, which resulted in additional patient improvements. Secondary effects were observed in both therapeutic alternatives, the most notable being alterations in serum creatinine concentration and hypertension with the dosage of cyclosporine used.
[Immunology in clinical practice. XIII. Immune diseases of the eye].
The eye has a special relationship with the immune system; normally, there appears to be intraocular suppression of inflammatory responses. Studies of the immunological principles of intraocular inflammation (uveitis) are mostly done in animal models. Although very complicated, uveitis appears in any case to be T-cell mediated. Uveitis is classified according to anatomical location as anterior, intermediate, posterior and pan-uveitis. Other immunological disorders are the sicca syndrome, keratitis and scleritis. All these disorders may or may not be associated with systemic autoimmune diseases. The chronic and recurring characteristics make uveitis a serious threat to vision. A rapid diagnosis and adequate treatment are therefore very important.
[Uveitis].
Uveitis are a group of heterogeneous entities, with very diverse causes, sharing intraocular inflammation as a common denominator. Uveitis are uni- or bilateral and the localization of inflammation defines anterior, intermediate or posterior uveitis. The course of the disease can be chronic or acute. Uveitis are isolated or belong to manifestations of a systemic disease. The identification of a cause of uveitis is based on the analysis of ophthalmic signs and on searching for extraocular manifestations. Laboratory tests should be prescribed according to clinically defined hypotheses. Causes are infectious (bacterial, parasitic, mycotic or viral) or only inflammatory. The prognosis of uveitis is mostly based on their consequences to the macula. When the cause of uveitis is determined, therapeutic guidelines may be applied.
[Recurrent uveitis and therapy with monoclonal antibody (daclizumab)].
PURPOSE: Assess the efficacy of monoclonal antibody (daclizumab) therapy in the treatment of patients with non-infectious uveitis who do not respond to other immunosuppressive agents. MATERIAL AND METHOD: Ten patients with non-infectious intermediate and posterior uveitis were treated with intravenous daclizumab (humanized anti-IL-2 receptor monoclonal antibody) monthly for two years. RESULTS: 70% of the patients have had some improvement in their inflammatory activity being maintained without recurrence. 10% of the patients improved their visual acuity in two lines and the macular edema decreased. 20% of the patients continued to have recurrences, but not worse than the year before. 40% of the patients gave up having the treatment with corticosteroids and 30% with minimum dose (5 mg). No secondary effects were noted during the treatment. CONCLUSIONS: Daclizumab is effective and safe for long-term use in the treatment of uveitis which cannot be kept under control by other treatments. In time, it allows the dose of corticosteroids to be decreased or even discontinued.