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PubMed1990

Retinal vasculitis with multifocal retinochoroiditis.

We found a multifocal retinochoroiditis in 16 patients (13 female, 3 male). Patients also showed vitreous cells, in some cases pronounced retinal vasculitis, cystoid macular edema and papilledema. The patients ranged in age from 62 to 77 years. The anterior segment was involved in 13 cases. One patient demonstrated subretinal neovascularisation in both eyes. Fluorescein angiograms showed leakage from the retinal vessels, papilledema, macular edema and subretinal neovascularisation. A convincing classification of the described changes within any known disease entity was impossible. The findings most closely resembled a disease described by Dreyer and Gass in 1984 as 'multifocal choroiditis and panuveitis'.

Aged↗
PubMed1996

Pars plana lensectomy in cases of cataract with juvenile chronic uveitis.

BACKGROUND: Classical cataract extraction in young patients with secondary cataract following juvenile chronic uveitis often is complicated by serious problems such as severe postoperative uveitis, hypotonia oculi and phthisis bulbi. Lensectomy with partial anterior vitrectomy might be a less inflammatory way of handling these cases. METHODS: Over a 15-year period we have treated 10 eyes of 9 young patients (age from 8 to 30 years) with secondary cataract after chronic uveitis by pars plana lensectomy with partial anterior vitrectomy. A classical two-port technique was used with incisions at 4 mm from the limbus. The follow-up period varied from 3 to 12 years with an average of 8 years. There were five patients with chronic iridocyclitis, two with Fuch's heterochromic irridocyclitis, one with sympathetic ophthalmia and one with idiopathic panuveitis. RESULTS: Seven eyes were corrected with contact lenses. During the entire follow-up period six had 20/20 visual acuity and one, 20/40. None of these patients reported tolerance problems with the contact lens. One patient has 20/20 visual acuity with spectacles. One patient who initially had 20/20 visual acuity with a contact lens developed retinal detachment 2 years after surgery, during pregnancy, and now has 20/40 vision after retinal surgery. She prefers not to wear the contact lens any longer because of diplopia. The visual acuity of one patient was no better than hand movement and his aphakia was never corrected. Complications included one vitreous haemorrhage necessitating a second vitrectomy, one retinal detachment during pregnancy and one retinal detachment with proliferative vitreoretinopathy. One patient with sympathetic ophthalmia has 20/20 vision after 9 years' follow-up but still needs systemic steroids and cyclosporine. CONCLUSION: Pars plana lensectomy, with anterior vitrectomy appears to be a relative safe way to treat secondary cataract in patients during the first 30 years of life.

Adolescent↗
PubMed1994

Neuroendocrine alterations in uveitis patients.

Experimental models of autoimmune uveitis are consistently associated with pinealitis. To investigate the interaction between the neuroendocrine and immune systems in humans with uveitis, we measured serum levels of the predominant pineal hormone melatonin (MEL), prolactin (PRL) and interleukin-2 (IL-2). A total of 100 patients with different forms of uveitis and 30 age-matched, healthy blood donors were evaluated retrospectively. The day-time MEL was reduced significantly (P < or = 0.01) in patients with iritis and iridocyclitis, and highly significantly (P < or = 0.001) in patients with intermediate uveitis, chorioretinitis and panuveitis. In 38% of patients day-time MEL levels in plasma were below the limit of detection. PRL was significantly reduced (P < 0.01) in patients with intermediate uveitis. IL-2 was reduced to about 50% of control values in all groups of patients. The results suggest a possible neuroendocrine-immune interaction in uveitis patients.

Adolescent↗
PubMedDate not supplied

Epidemiological characteristics of uveitis in Switzerland.

Since January 1990, data from uveitis patients have been systematically stored in a computer data bank. During the period from January 1990 to March 1993, 435 new patients (185 female and 250 male, mean age 43 years; range 6-92) were seen at the Uveitis Clinic of the Hôpital Jules Gonin. These 435 patients (630 eyes) were subdivided into anterior uveitis (268 patients--62%), intermediate uveitis (47 patients--11%), posterior uveitis (89 patients--20%) and panuveitis (31 patients--7%). The incidence of uveitis for the referral area considered was calculated to be 17 per 100,000 inhabitants per year. A specific diagnosis was found in 312 cases (72%). The most frequently diagnosed entities were HLA-B27-associated acute anterior uveitis (67 cases--15.4%), uveitis associated with acute herpes zoster ophthalmicus (40 cases--9.2%), toxoplasmosis (39 cases--9%), typical pars planitis (29 cases--6.7%), sarcoidosis (29 cases--6.7%), Fuchs' heterochromic cyclitis (27 cases--6.2%), herpetic anterior uveitis (21 cases--4.8%) and acute retinal necrosis (11 cases--2.5%). Incidence and distribution of most disease entities correspond to those of other European series.

Adolescent↗
PubMed2003

[Familial uveitis. Forms and incidence in patients at the University Eye Hospital Tubingen].

OBJECTIVE: A familial accumulation in some forms of uveitis has rarely been described. The objective of this study was to identify such cases and to examine both clinical course and similarities in the HLA-pattern. METHODS: From 1993 to 2000 all new uveitis patients, who were examined in the uveitis clinic of the University Eye Hospital Tuebingen, were asked about a positive family history. If possible, all affected family members underwent an ophthalmological examination and HLA-typing was performed. RESULTS: In 7 families we found a familial accumulation of uveitis. The underlying etiologies were anterior uveitis in ankylosing spondylitis with HLA-B27 association, anterior uveitis in Blau syndrome with no HLA association, anterior and intermediate uveitis in sarcoidosis with no HLA association, and panuveitis in Behçet's disease with HLA-B51 association. For familial uveitis we calculated an incidence of 0.03 cases per 100,000 persons and year. CONCLUSION: Our data confirm that familial forms of uveitis are very rare. We suggest that these may be subgroups of known uveitis syndromes (e.g. sarcoidosis, ankylosing spondylitis). The factors causing the inheritance are still unknown. By genetic examination of families with uveitis it may be possible to identify single uveitis genes or possible antigens.

Academic Medical Centers↗
PubMed1997

[Analysis of aqueous humor in intraocular toxoplasmosis].

BACKGROUND: Despite many clinical examinations and laboratory tests, the cause of uveitis is very often not discovered. The examination of local intraocular antibody production is a valuable additional diagnostic means. PATIENTS AND METHODS: Aqueous humor was obtained from 46 eyes with severe uveitis: retinochorioiditis (n = 27), intermediate uveitis (n = 11), iridocyclitis (n = 5), and panuveitis (3). With the enzyme-linked immunosorbent assay (ELISA) the antibodies against Toxoplasma gondii were measured in aqueous humor and serum and the intraocular antibody production was calculated by the formation of an antibody index (AI). As the AI values are corrected for possible polyspecific immune response, the AI index is more sensitive than the Goldmann-Witmer index. RESULTS: An intraocular antibody synthesis against T. gondii could be confirmed in 20 eyes. The serum antibody concentration against T. gondii was in the reference range in 45 patients and only one patient had a very high increase of antibodies. In nine of 20 eyes, intraocular synthesis of antibodies against T. gondii was unexpected due to the lack of clinical evidence. CONCLUSIONS: The aqueous humor analysis is more reliable than the proof of serum antibodies, and it helps to increase the number of eyes with uveitis in which a specific therapy can be established.

Animals↗
PubMed2002

[Ocular toxoplasmosis antibodies in aqueous humor and serum].

BACKGROUND: The diagnosis of ocular toxoplasmosis is mainly based on ophthalmological examination but might be difficult to establish in some cases. The purpose of our study was to evaluate the value of aqueous humor and serum analysis in ocular toxoplasmosis. PATIENTS AND METHODS: We analyzed the avidity of toxoplasma-specific IgG in aqueous humor and serum samples from 50 patients with toxoplasmic retinochoroiditis, with 25 patients with uveitis posterior or panuveitis serving as controls. RESULTS: Specific intraocular antibody synthesis could be confirmed in 49 patients (98%). In two patients (8%) of the control group, antibody synthesis was detected (false positive). Forty-nine patients with diagnoses of ocular toxoplasmosis were positive for serum anti-T. gondii IgG, but only three patients had increased IgM levels. CONCLUSIONS: Analysis of local antibody production is a reliable method for confirming or excluding a suspected clinical diagnosis of toxoplasma retinochoroiditis. The determination of toxoplasma antibodies in the patients' serum is of limited value.

Adolescent↗
PubMed2001

[Immunosuppressive therapy with mycophenolate mofetil (CellCept) in treatment of uveitis].

BACKGROUND: Severe forms of uveitis can often only be managed sufficiently with systemic immunosuppression. All available drugs are known for their relative high rate of side-effects. Mycophenolate mofetil (MMF), an immunosuppressant successfully used in management after organ transplantation and many autoimmune diseases, has shown remarkably less side-effects when used for various forms of uveitis in monotherapy or in combination with corticosteroids. The aim of this multicenter-study was to investigate if monotherapy with MMF is effective in various forms of uveitis. METHOD AND PATIENTS: Ten patients with anterior uveitis (n = 3), intermediate uveitis (n = 2), panuveitis (n = 4) and retinal vasculitis (n = 1) were treated in a prospective study with 2 x 1 g MMF daily. Previous immunosuppression had been discontinued because of side-effects or ineffectivity in all patients. In these patients MMF was given in addition to the other immunosuppressant at the beginning of treatment. RESULTS: The follow-up time ranged from 1 to 12 months (mean 4.5 months). Under therapy with MMF (monotherapy in 4 patients, additional prednisolone in 5 patients and additional metotrexate in 1 patient) 8 patients remained free of recurrences. In one female patient depression of inflammation activity was only achieved after cessation of therapy with Cyclosporin A in combination with MMF and a switch to methotrexate. Another patient with a bilateral uveitis was free of recurrences in only one eye, the second eye did not develop recurrence due to the additional corticosteroid treatment. Side-effects were diarrhoea in one patient and probably gastrointestinal problems in another (leading to cessation of therapy in both patients) and in another case nausea, vomitus and alopecia 10 months after beginning therapy. CONCLUSIONS: MMF as a new immunosuppressant stopped inflammation or drastically reduced the rate of recurrences in 8 out of 10 patients with uveitis which was previously not brought under control by other immunosuppressants. The side-effects were tolerable in comparison with other immunosuppressive agents. More patients, longer follow-up times and a comparative study with Cyclosporin A are required to assess the long-term therapeutical success.

Adult↗
PubMed2001

[Posterior uveitis: sarcoidosis or tuberculosis].

PURPOSE: To demonstrate the difficulties of the differential diagnosis between tuberculosis and sarcoidosis as the cause of posterior uveitis. CASE REPORTS: A 56-year-old woman suffered from bilateral anterior uveitis, snow-ball like infiltrates in the vitreous, and peripheral retinochoroidal granulomas with marked exudation shown in fluorescein angiography. Angiotensin-converting enzyme, as a marker of sarcoidosis, was elevated; the tuberculin test, however, was negative. Chest X-ray revealed an infiltrate and numerous smaller granulomas. The presumptive diagnosis was sarcoidosis. Surprisingly, in the biopsy of the pulmonal lesion tubercle bacilli were detected by Ziehl-Neelsen staining. Thus, a diagnosis of pulmonal and also retinochoroidal tuberculosis was made. After tuberculostatic therapy the choroidal lesions healed off. In a second case, a 30-year-old man suffered from bilateral panuveitis with candle wax exudates near the retinal vessels. Chest X-ray revealed lymphomas in the hilus, and the lymph node biopsy showed granulomas with epitheloid cells, indicating sarcoidosis. Detection of mycobacterium tuberculosis by culture or histological criteria was negative. Only in the PCR was mycobacterium tuberculosis DNA detectable. Tuberculostatic therapy had no benefit. Under therapy with steroids, however, pulmonal and ophthalmologic findings rapidly disappeared. CONCLUSION: The difficult differential diagnosis between sarcoidosis and tuberculosis cannot always be made by laboratory tests or diagnostic imaging alone. Clinical manifestations, including response to therapy, are essential.

Adult↗
PubMed2003

[Treatment of primary systemic vasculitis with TNF alpha-antagonists].

After the introduction of the TNF alpha blocking drugs Etanercept and Infliximab for the standard therapy of rheumatoid arthritis these effective substances have also been used successfully in many patients with primary systemic vasculitides, who were unresponsive to standard therapy. From pathophysiologic findings their use is justified by the prominent role of TNF alpha in the inflammation of small and large vessels. So far only open studies with a maximum of 20 patients and case reports are published. In summary there are reports of the successful treatment of 7 patients with rheumatoid vasculitis, 39 patients with Wegener's granulomatosis, 3 patients each with microscopic Polyangiitis, and 5 patients each with temporal Arteritis or Takayasu disease with Etanercept as well as with Infliximab. In addition, Infliximab was also used with a good response in severe Polymyalgia rheumatica in 4 cases and in one case of a cryoglobulinemic vasculitis. More than 60 patients with Panuveitis and other manifestations of Behçet's disease were treated with Infliximab or Etanercept according to preliminary reports. Because of the overall positive reports with TNF alpha collected in this review controlled investigations for their use in primary systemic vasculitis are necessary.

Antibodies, Monoclonal↗
PubMed2003

Plasma and whole-blood chemokine levels in patients with Behcet's disease.

BACKGROUND: Chemokines are a family of chemoattractants of leukocytes that play a critical role for leukocyte recruitment in various inflammatory diseases. The purpose of this study is to investigate the involvement of chemokines, interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in the peripheral blood, with a special reference to disease activities of the patients with Behçet's disease (BD). METHODS: The study population consisted of totally 55 patients with BD who had panuveitis (20 patients with active BD, 35 patients with inactive BD) as well as 19 healthy volunteers as control. Disease activity was defined according to the existence of ocular inflammation. IL-8 and MCP-1 concentration levels in the plasma and whole-blood samples were measured by enzyme-linked immunosorbent assay. Whole-blood samples were obtained by lysing cell membranes of peripheral blood cells. RESULTS: Most of the plasma IL-8 samples were below the detectable limit. Whole-blood IL-8 levels were readily measured. The levels in the patients with active BD were significantly higher than the other two groups. The patients with active and inactive BD showed higher plasma and whole-blood levels of MCP-1 than controls. The plasma and whole-blood MCP-1 levels of the samples collected at the same time showed a linear correlation. CONCLUSION: A close relationship was found to exist between the cell-associated IL-8 and the disease activity, while a persistent role of MCP-1 was observed in BD. Measuring the whole-blood levels of chemokines is useful for monitoring the disease activity.

Adolescent↗
PubMed2004

Visual outcome of patients with macular edema after pars plana vitrectomy and indocyanine green-assisted peeling of the internal limiting membrane.

PURPOSE: To evaluate the efficacy of inner limiting membrane (ILM) peeling in persistent macular edema. METHODS: This retrospective review analyzed a series of 23 eyes from 23 patients with persistent macular edema treated by pars plana vitrectomy (PPV) with indocyanine green (ICG)-assisted peeling of the ILM. Thirteen female and 10 male patients with a mean age of 57.2+/-15.6 (24-77) years underwent operation between May 2000 and October 2001. The main diagnoses were uveitis (anterior, intermediate, posterior and panuveitis) ( n=9), central retinal vein occlusion (CRVO) (n=4), diabetic retinopathy (DR) ( n=5), vitreoretinal traction syndrome ( n=2), and Irvine-Gass syndrome ( n=3). Nine eyes had undergone phacoemulsification (PE) previously and two eyes had been subjected to combined PE and ILM peeling. The eyes were tamponaded with gas (3), silicone oil (5) or air (11). In four cases no endotamponade was used. Improvement in visual acuity of 2 lines or more was regarded as significant. RESULTS: Visual acuity improved after 3 months in 9 of the 23 patients. After 6 months and at the follow-up, a significant improvement was found in 6/21 and 7/21 patients. This improvement was predominantly seen in patients with uveitis (5/9), or diabetic maculopathy (3/5); One patient with Irvine-Gass syndrome showed a significant reduction, one with vitreoretinal traction an improvement in visual acuity. The group of patients with CRVO showed no significant change during the follow-up. The choice of endotamponade did not alter the visual acuity outcome. CONCLUSIONS: Different patient groups respond differently to ILM peeling. Although overall significant visual acuity improvement was observed in only one third of all cases 12 months after ILM peeling for persistent macular edema, patients with uveitis and nonproliferative diabetic maculopathy demonstrated a benefit. The lack of long-term improvement in the majority of cases is in accordance with the hypothesis that ILM peeling may reduce the intraretinal edema, but does not affect the underlying mechanism causing macular edema. So far, only diabetics have shown improvement (still unproven) from ILM peeling, and this study provides no justification for extending the treatment to macular edema of other causes. Large-scale investigations are needed to evaluate the efficacy in certain diagnosis groups.

Adult↗
PubMed2003

Long-term results after photodynamic therapy with verteporfin for choroidal neovascularizations secondary to inflammatory chorioretinal diseases.

BACKGROUND: To evaluate the safety and the long-term effect on visual acuity of photodynamic therapy (PDT) for sub- and juxtafoveal choroidal neovascularizations (CNV) secondary to inflammatory conditions. METHODS: In a prospective pilot study, 19 patients with CNV due to inflammatory conditions underwent PDT treatment with verteporfin with standard parameters. Regular follow-up was carried out every 3 months with ETDRS visual acuity measurement and fluorescein angiography. The initial diagnosis included punctate inner choroidopathy (PIC) ( n=7), presumed ocular histoplasmosis syndrome (POHS) (6), multifocal choroiditis with panuveitis (MCP) (2) and other inflammatory conditions (4). RESULTS: All patients had a minimum follow-up of one year. After a mean follow-up of 22.1 months, the mean change in visual acuity was +1.63 ETDRS lines. At their last visit, all eyes showed a disappearance of pretreatment leakage in fluorescein angiography and 63.2% (12/19) eyes had an improvement of 2 or more lines, while 26.3% (5/19) remained stable (+/-1 line) and 10.5% (2/19) lost 2 or more lines. A mean of 2.0 (1-5) treatments was performed. No clinically relevant side effects or complications were observed. CONCLUSIONS: PDT is a safe and effective treatment option for CNV secondary to inflammatory conditions. The results are better than for CNV secondary to AMD. For juxtafoveal CNV, the results are similar to those of subfoveal CNV with no additional safety concerns. Based on this observation, we consider PDT as treatment of choice for subfoveal CNV secondary to inflammatory chorioretinal diseases and for selected cases with juxtafoveal CNV.

Adolescent↗
PubMed2005

Mycophenolate mofetil is a highly effective and safe immunosuppressive agent for the treatment of uveitis : a retrospective analysis of 106 patients.

BACKGROUND: We evaluated the outcomes of patients with different forms of chronic uveitis treated with mycophenolate mofetil (MMF) as an immunomodulatory and steroid-sparing agent. The multi-system side effects that arise after long-term treatment with corticosteroids and other immunosuppressants prompted us to use MMF. MMF is a selective inhibitor of inosine monophosphate dehydrogenase, thus blocking purine synthesis via the de novo pathway preferentially used by T and B lymphocytes. METHODS: Between 1998 and 2003, 106 patients were treated for uveitis (anterior n=26, intermediate n=51, posterior n=23, panuveitis n=6) with MMF at a dose of 1g twice daily. Treatment duration was at least 6 months (n=10), in most cases greater than 12 months (n=77) and in 25 cases between 24 months and 41 months, when the present retrospective evaluation was undertaken. Patient charts were analysed according to a standardized evaluation protocol. RESULTS: In 95 patients MMF was combined with prednisolone at a dosage of 2.5-10 mg per day. In 8 patients MMF was used as a monotherapy, and in 3 cases one further systemic immunosuppressant was required. The number of recurrences during MMF treatment was none or one in 92 patients, two in 6 cases and three or more in 8 patients. In none of the patients had MMF been stopped at the time of data analysis. The most frequently observed side effects were gastrointestinal upset (15%), followed by headache (9.3%), fatigue (5.7%), eczema (5%), and hair loss (3.5%). Other side effects were sporadic. Most of these phenomena were transitory. Forty-two patients experienced no side effects at all. In 4 patients MMF was judged ineffective due to failure to reduce the number of recurrences of severe inflammation compared with the previous therapeutic regime, or indeed occurrence of persistent macular oedema. CONCLUSIONS: Our results show that MMF is an effective immunosuppressant in patients with uveitis. We provide evidence that MMF controls the disease in the majority of patients with an acceptable profile of side effects.

Adolescent↗
PubMed2005

Syphilitic uveitis in patients infected with human immunodeficiency virus.

BACKGROUND: This work investigates the incidence and clinical features of syphilitic uveitis in patients infected with human immunodeficiency virus (HIV). MATERIAL AND METHODS: We retrospectively reviewed syphilitic uveitis in patients coinfected with HIV that presented at a referral center between July 2001 and November 2003. RESULTS: Twelve patients (20 eyes) were included. The ocular manifestations of syphilis led to the discovery of HIV-1 seropositivity in three patients. All patients were male and homosexual. One patient has been previously treated for syphilis with benzathine penicillin G. One patient presented with anterior uveitis and 11 patients had panuveitis or posterior uveitis. Necrotizing retinitis was noted in seven eyes (35%), posterior placoid chorioretinitis in six eyes (30%) and optic nerve involvement in five eyes (25%). Of nine patients with available cerebrospinal fluid (CSF) studies, seven (77.8%) had CSF abnormalities. Eleven patients were treated with intravenous penicillin G and one with intravenous ceftriaxone sodium. One patient required a second course of antibiotics to control uveitis. Ocular inflammation decreased and visual acuity improved in all nine patients for whom follow-up was available after treatment. CONCLUSION: Manifestations of syphilitic uveitis in HIV-infected patients are multiple, with high frequencies of posterior uveitis, posterior placoid chorioretinitis, necrotizing retinitis and optic nerve involvement. Syphilitic uveitis in HIV-infected patients seems to have a more severe course and may relapse despite high-dose intravenous penicillin therapy.

Adult↗
PubMed2006

Results of interferon-alfa therapy in patients with Behçet uveitis.

PURPOSE: To report on the results of interferon-alpha 2a (IFNalpha) treatment in patients with Behçet uveitis unresponsive to conventional immunosuppressive therapy. METHODS: We retrospectively analyzed the medical records of 44 patients who had been treated with IFNalpha between September 2001 and May 2005. The initial dose of IFNalpha was 6 MU/day in 37 patients (84.1%) and 3 MU/day in 7 patients (15.9%), and was gradually tapered after ocular inflammation was suppressed. Immunosuppressive agents were discontinued. Oral corticosteroids were discontinued or maintained at a dosage of less than 10 mg prednisone equivalent per day. Main outcome measures were recurrence of posterior or panuveitis attacks and changes in visual acuity. RESULTS: Sixteen patients (36.4%) remained relapse free during treatment, whereas 28 (63.6%) patients had recurrent uveitis attacks. Four of these were considered treatment failures and were switched to other treatments. In the remaining 40 patients, the mean duration of treatment was 12.4+/-10.8 months (range 3-45 months). In 9 of 40 patients (22.5%) treatment could be discontinued 22.2+/-13.4 months after therapy, and 8 (20%) of these patients had sustained remission for up to 24 months. Three patients (7.5%) were switched to other therapies because of side effects. The frequency of uveitis attacks per 6 months was reduced from 1.6+/-1.2 to 0.8+/-0.9 in 26 patients who had a minimum follow-up of 6 months before and after IFNalpha therapy (p<0.05). There was a significant improvement in visual acuity and this was preserved throughout follow-up in 38 (95%) of 40 patients. CONCLUSIONS: A partial or complete response was obtained with IFNalpha therapy in 91% of Turkish patients with Behçet uveitis refractory to conventional immunosuppressive treatment. Our results suggest that there may be differences in therapeutic efficacy and side-effect profile of IFNalpha in different patient populations. Comparative studies are needed to investigate this hypothesis.

Adolescent↗
PubMed2006

High incidence of antibodies to lens proteins in sera from patients with uveitis.

BACKGROUND: Uveitis is an intraocular inflammatory disease in which autoimmune reactions have been discussed in playing an important role. Many data in this respect derived from the animal model of "experimental autoimmune uveitis", where several organ-specific autoantigens have been described such as the retinal S-antigen and the interphotoreceptor retinoid-binding protein. However, their diagnostic and pathogenic role in humans has been controversially discussed. In recent studies, the possible relevance of betaB1-crystallin, present in lens and ciliary body, has been outlined. We, therefore, wanted to analyse whether sera from patients with uveitis might contain antibodies to lens proteins METHODS: Human lenses from cadaveric eyes were shock frozen, homogenized, and resuspended. The resulting suspension (human lens protein fraction--HLPF) was analyzed for antigenicity by ELISA and Western blotting with patients' sera. A total of 165 patients with uveitis, 54 patients with scleritis and episcleritis, 56 patients with other eye diseases, and 112 healthy blood donors were studied. RESULTS: Twenty-six (49%) of the 53 patients with anterior uveitis, 17 (32%) of the 53 patients with intermediate uveitis and 7 (22%) of 32 patients with posterior uveitis reacted in the ELISA with the HLPF. Antibodies to lens antigens were detected in one-third of patients with panuveitis and retinal vasculitis. In contrast, only 12% of the healthy blood donors were positive in the ELISA. The number of patients with an autoimmune response to alpha-crystallins in Western blot predominated in all investigated groups. CONCLUSIONS: These data indicate that antibodies to lens proteins occur in a high incidence in sera from patients with uveitis. Forty-nine percent of the patients with anterior uveitis and only 12% of healthy controls were positive in the ELISA. In our groups of patients and controls the autoantibodies reacted in the Western blot predominantly with alpha-crystallin. Further studies are required to analyze in more detail the clinical and etiopathogenetic relevance of the antilens antibodies in uveitis.

Autoantibodies↗
PubMed1998

Cicatrization of cytomegalovirus retinitis following introduction of highly active anti-retroviral therapy: uveitis as a possible indicator of good ocular prognosis.

PURPOSE: To quantify the inflammatory reaction that can be seen in HIV-infected patients with cytomegalovirus (CMV) retinitis after the introduction of an HIV protease inhibitor and correlate it with ocular findings and systemic HIV parameters. METHODS: Report of a patient with CMV retinitis systematically followed by slit-lamp examination, funduscopy, fundus photographs and laser flare photometry before and after introduction of an HIV protease inhibitor. RESULTS: Manifest granulomatous panuveitis developed 2 months after the introduction of the protease inhibitor indinavir (CD4 rise from 2 to 64 CD4/mm3) and coincided with cicatrization of the CMV retinitis in the absence of efficient anti-CMV therapy. CONCLUSION: Occurrence of uveitis in patients with CMV retinitis following the introduction of HIV protease inhibitors may be a factor indicating a good ocular prognosis, possibly pointing to the presence of the anti-CMV repertoire in the reconstituting CD4 cell population.

Adult↗