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Results for “Retinal Vasculitis”

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PubMedDate not supplied

Profiling of human leukocyte antigens in Eales' disease.

Eales' disease is a primary retinal perivasculitis of an undetermined etiology seen predominantly in the Indian subcontinent and rarely in the West. Strong HLA association has been proven in retinal vasculitis of Behcet's disease. HLA association of Eales' disease is unknown and therefore the present study was undertaken to determine the same. The frequency of 30 HLA antigens (9 HLA-A antigens, 10 HLA-B antigens, 3 HLA-C antigens, 7 HLA-DR antigens and 1 HLA-DQ antigen) was studied by standard micro-lymphocytotoxicity test in 57 patients with Eales' disease and 50 age and sex-matched normal persons as controls. Both the patients and controls underwent complete ocular and clinical examinations and laboratory investigations. Inflammatory diseases similar to Eales' disease were ruled out in the patients before they were enrolled. Statistically significant higher phenotype frequencies of HLA B5 (B51), DR1 and DR4 were observed among patients with Eales' disease as compared to controls. The gene frequency of HLA B5 (B51) in our group of patients and controls was comparable with other earlier studies in the Indian population. The finding of significant association of Eales' patients with positive disequilibrium ( ) haplotypes A3-B44 and A11-B12 may be related to the development of this disease. The presence of the above HLA antigens may be indicative of predisposition to Eales' disease.

Adolescent↗
PubMed1993

[HTLV-I and ocular disease].

Human T-lymphotropic virus type 1 (HTLV-I) has an etiologic role in adult T-cell leukemia (ATL) and HTLV-I associated myelopathy (HAM). This paper reviews the ophthalmic literature relevant to the retrovirus. Patients with ATL may have intraocular invasion of proliferated T lymphocytes, lymphomatous lesion in the ocular adnexa, or cytomegalovirus retinitis due to immunocompromisation. Patients with the chronic neurological disease HAM may present with retinal vasculitis, isolated cotton-wool spots, probably immune-mediated uveitis, and/or retinochoroidal degenerative change. Similar retinal vascular or uveal inflammatory disease is occasionally seen in otherwise healthy HTLV-I carriers. Clinical and epidemiologic data suggest the existence of HTLV-I associated uveitis (HAU) that is assumed to be associated with the retrovirus. Further ophthalmic research is encouraged to elucidate the clinical significance of the worldwide HTLV-I infection.

Carrier State↗
PubMedDate not supplied

Pars plana vitrectomy. Vitrectomy treatment of vitreous opacities.

Twenty-one patients suffering from vitreous opacities caused by central- and branch-vein occlusion, sickle cell retinopathy, retinal vasculitis, endophthalmitis, hypertensive retinopathy, and uveitis underwent pars plana vitrectomy with the vitrophage. Intraoperative complications included retinal tears in two eyes with sickle cell retinopathy and tractional retinal detachment. Both were successfully treated. Postoperative complications were recurrent vitreous hemorrhage, hemolytic glaucoma, and corneal blood staining in a patient suffering from sickle cell retinopathy. Long-standing corneal edema was observed in patients suffering from endophthalmitis. Visual acuity improved in 95% of our patients and was worse in 5% of the patients.

Aged↗
PubMed2005

[Congenital retinal folds in different clinical cases].

We present 12 clinical cases of congenital retinal folds with different etiologies: posterior primitive vitreous persistency and hyperplasia (7 cases),retinocytoma (1 case). retinopathy of prematurity (1 case), astrocytoma of the retina (1 case), retinal vasculitis (1 case), Goldmann-Favre syndrome (1 case). Etiopathogenic and nosological aspects are discussed; the congenital retinal folds are interpreted as a symptom in a context of a congenital or acquired vitreo-retinal pathology.

Adolescent↗
PubMed1987

A microscopic study of herpes simplex virus retinopathy in mice.

ICR white mice were inoculated with herpes simplex virus (HSV) type I in the anterior chamber of one eye. Animals were killed at intervals of 2, 4, 6, 8, and 10 days and both eyes were obtained for light and electron microscopic study of retinal changes. HSV retinopathy developed in 42 (91%) of 46 inoculated eyes. Fourteen (88%) of sixteen noninoculated eyes examined after the sixth postinoculation day developed HSV retinopathy. The earliest signs of retinopathy in the inoculated eye were peripheral retinal vasculitis and inflammatory cells throughout the nerve fiber layer on day 2. No virus was found in retinal tissue until day 4, at which time disruption of outer retinal layers (outer nuclear layer and layer of rods and cones) was observed in the peripheral retina. The earliest signs of retinopathy in the noninoculated eye were isolated foci of outer retinal disruption in the posterior retina on day 6. The inflammation accompanying early retinal changes of HSV retinopathy were more severe in the inoculated eye. Electron microscopy of both eyes revealed viral particles in the inner nuclear and ganglion cell layers at the time of outer retinal disruption, but viral particles were seen only rarely in the outer retinal layers at this stage. Early disruption of normal retinal architecture may be due to infection and destruction of Muller cells. The retinopathy progressed in both eyes to total destruction of the retina by day 10. Viral infection of the retinal pigment epithelium occurred, but viral particles were seen only rarely in the underlying choroid. This model may be useful for the study of HSV retinopathy in humans.

Animals↗
PubMed1994

Systemic lupus erythematosus and acute demyelinating polyneuropathy.

Guillain-Barré syndrome has been described only rarely in patients with SLE. In this Grand Round we describe a 33-yr-old patient who presented with features of central nervous system lupus, thrombocytopenia, and a severe haemolytic anaemia. Within a few days of her admission, following the commencement of steroid therapy, and a grand mal seizure, the patient developed paralysis of her lower limbs, due to an acute demyelinating polyneuropathy, and subsequently a retinal vasculitis. We discuss the epidemiological and possible immunopathological links between SLE and Guillain-Barré syndrome, and possible treatment strategies.

Adult↗
PubMed1993

Retina and retinal pigment epithelial cell autoantibodies are produced during murine coronavirus retinopathy.

The murine coronavirus, mouse hepatitis virus (MHV), JHM strain, induces a biphasic retinal disease in adult BALB/c mice. In the early phase of the disease, day 1 to 7, a retinal vasculitis is noted and is associated with the presence of virus particles. In the late phase of the disease, day 10 to 140, a retinal degeneration is observed and is associated with the absence of both virus particles and inflammatory cells. We show that the retinal degenerative process is also associated with the presence of antiretinal autoantibodies. In total, 22 of 23 sera collected from 10 to 70 days after JHM virus inoculation contained antiretinal autoantibodies. These autoantibodies are not found in sera from normal or mock-injected mice. Antibodies to retinal tissue were identified as two distinct patterns of immunoperoxidase staining on frozen sections of normal rat eyes, retinal autoantibodies and retinal pigment epithelium (RPE) autoantibodies. The antiretinal autoantibodies first appeared as IgM class antibodies that shifted to IgG class autoantibodies. The anti-RPE cell autoantibodies were predominantly of the IgG class. Sera that were positive for these autoantibodies did not stain with liver or kidney sections but 2 of 3 did react with rat brain sections. A second mouse strain, CD-1, was also evaluated because these animals respond to JHM virus inoculation by developing only the early phase of this disease, i.e. vasculitis. On day 10 postinoculation, the retina architecture has a normal appearance. In these mice, which are free of a retinal degeneration, antiretinal autoantibodies are not produced. However, just as is noted in the BALB/c mice, antivirus neutralizing antibodies are produced in the infected CD-1 mice. These findings suggest a role for autoimmunity in the pathogenesis of murine coronavirus induced retinal degeneration. This study establishes an animal model for the study of humoral autoimmune responses in human retinal degenerations.

Animals↗
PubMed1997

Psoriatic arthritis or overlap syndrome.

In this work we describe a case of papillophlebitis type II according to Hayreh in a young woman affected by psoriatic arthritis. On the basis of an analysis of the patient's HLA system--B7, DR7 (characteristics of psoriatic arthritis) and B51 (present in 81% of patients affected by Behçet's syndrome)--we hypothesize that this may be a case of an 'overlap syndrome'. In rheumatology, this term usually refers to the presence in a single patient of characteristic features of two or more diseases. In fact, papillophlebitis is a complication which has never been described in psoriatic arthritis, while, in Behçet's syndrome, retinal vasculitis is well known.

Adult↗
PubMed2002

Branch retinal vein occlusion in Churg-Strauss syndrome.

The case is reported of a 64-year-old man who was diagnosed as having Churg-Strauss syndrome associated with branch retinal vein occlusion, without accompanying retinal vasculitis. It was assumed that the blood thrombocytosis caused a hypercoagulable state and thromboembolism leading to the branch retinal vein occlusion.

Churg-Strauss Syndrome↗
PubMed1988

Acute retinal necrosis syndrome presenting with papillitis and arcuate neuroretinitis.

Acute retinal necrosis (ARN) syndrome is a diffuse uveitis characterized by a peripheral necrotizing retinitis and retinal vasculitis. The authors document and discuss a case of ARN syndrome that initially presented with remarkable changes in the peripapillary retinal nerve fiber layer that they have termed arcuate neuroretinitis. These changes consisted of a well-defined arcuate band of retinitis paralleling the course of a parafoveal nerve fiber bundle. Evaluation of serial serum antibody titers suggests HSV-2 as a possible causative agent in this unique presentation of ARN syndrome.

Acute Disease↗
PubMed1990

Vascular permeability and coagulation during Rickettsia rickettsii infection in dogs.

The vascular permeability of the ocular fundus, alterations in the coagulation system, and plasma concentrations of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) were studied in dogs following intradermal inoculation with 5 x 10(5) TCID50 of Rickettsia rickettsii. Twenty-four to 48 hours after the onset of fever and rickettsemia, multifocal areas of retinal vasculitis were evident, which corresponded to areas of altered vascular permeability demonstrated by fluorescein angiography. The number and intensity of retinal vessels with sodium fluorescein leakage peaked during the second week after inoculation, and retinal vascular permeability remained altered during the third week of infection, well past the phase of clinical and clinicopathologic recovery. Development of retinal vasculitic foci was associated with thrombocytopenia, increased concentrations of circulating fibrinogen, and slight prolongation of activated partial thromboplastin time. Increased concentrations of fibrin/fibrinogen degradation products were detected in 4 of 9 dogs. Despite the degree of vascular endothelial damage evident on fluorescein angiographic and histologic studies in these dogs, plasma TXB2 and 6-keto-PGF1 alpha concentrations were not increased.

6-Ketoprostaglandin F1 alpha↗
PubMed1993

Ultrastructural pathology of experimental autoimmune uveitis in the rat.

Experimental autoimmune uveoretinitis (EAU) has been extensively studied as a model for human posterior uveitis, however, few ultrastructural studies of EAU in the rat have been reported. In the present report we document a systematic time-course study of the posterior segment changes in the Lewis rat. The disease varied somewhat in severity in animals sacrificed at identical times after immunisation. In the prodromal stage of the disease, usually around day 14, early pathological changes included mild peripapillary vasculitis and low grade mononuclear and neutrophilic infiltration of the subretinal space with phagocytosis of the rod outer segments. The features of the severe or active diseases were most evident on day 21 and included mixed cellular infiltrate of the vitreous, subretinal serohaemorrhagic exudate, focal retinal detachment and necrosis. Outer retinal destruction was often most severe adjacent areas of retinal vasculitis. Focal monocytic subpigment epithelial microgranulomas, reminiscent of Dalen-Fuch's nodules in humans, were also identified. By day 28 and 49 active inflammation had subsided and large segments of the outer retina were completely destroyed. The retinal pigment epithelium (RPE) also showed signs of activation in the vicinity of focal retinochoroidal mononuclear infiltrates including multilayering, proliferation and increased phagocytosis. Finally, neovascularisation of the RPE by non-fenestrated capillaries derived from the retinal vasculature was evident in the late stages of the disease.

Acute Disease↗
PubMed1993

[Ocular involvement in Lyme disease].

Lyme disease is a tick-born multisystemic disease, caused by the Spirochete Borrelia burgdorferi. We examined and treated a 60-year-old woman, who 6 months after a tick bite had developed bilateral uveitis, with the involvement of the anterior segment, vitreous opacities and retinal vasculitis. The ocular involvement was, besides the skin lesion in the first stage of the disease, the only systemic manifestation of the infection.

Eye Diseases↗
PubMedDate not supplied

Lymphomatoid granulomatosis with ocular involvement.

Lymphomatoid granulomatosis is an angiocentric and angiodestructive lymphoproliferative disorder that involves multiple organs including the lung, skin, kidney and central nervous system. A case of lymphomatoid granulomatosis with ocular involvement is reported herein. Bilateral peripheral retinal vasculitis involving both arterioles and veins, with posterior uveitis, is the prominent clinical finding.

Adult↗
PubMed1998

Indocyanine green angiography in inflammatory eye disease.

PURPOSE: The choroid plays an integral role in the evolution of a number of inflammatory eye diseases but only limited information is provided on the choroidal vasculature by fluorescein angiography. METHODS: This study used indocyanine green (ICG) videoangiography to assess the degree of choroidal vascular involvement in inflammatory eye diseases and the results obtained were compared with fluorescein angiography. RESULTS: A total of 34 patients were examined: 6 with retinal vasculitis and 28 with chorioretinitis of various aetiologies. Areas of active involvement of the choroid were seen as areas of hypofluorescence on ICG angiography, representing areas of inflammatory infiltrate and/or choroidal hypoperfusion. No leakage of ICG occurred from large choroidal vessels at any stage in any disease. In contrast to sodium fluorescein, there was no leakage of ICG from retinal vessels in active inflammation. An inflammatory choroidal neovascular membrane leaked fluorescein and fluoresced late with ICG. CONCLUSION: ICG videoangiography provides useful information on the degree of choroidal involvement in inflammatory eye disease and is a valuable adjunct to fluorescein angiography.

Adult↗
PubMed1993

Ocular presentation of polyarteritis nodosa. Clinical course and management with steroid and cytotoxic therapy.

BACKGROUND: Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small-sized arteries throughout the body, including ocular tissues. Untreated polyarteritis nodosa carries a very poor prognosis. Treatment with steroids increases the 5-year survival to 48%, whereas addition of cytotoxic immunosuppressive treatment improves the outcome dramatically. METHODS: The authors reviewed five cases of polyarteritis nodosa with a spectrum of ocular findings which preceded and contributed to its diagnosis. RESULTS: The ophthalmic manifestations of polyarteritis nodosa in these patients included scleritis, peripheral ulcerative keratitis, nongranulomatous uveitis, retinal vasculitis, pseudotumor of the orbit, and central retinal artery occlusion associated with temporal arteritis. In four patients, cytotoxic immunosuppressive therapy was begun promptly, and elimination of inflammation was achieved. CONCLUSIONS: The authors' presentation of these cases is intended to emphasize the fact that ocular inflammation can be the earliest presenting manifestation of polyarteritis nodosa and that its recognition may lead to the early institution of therapy, which can decrease morbidity and mortality in this disease.

Adult↗
PubMed1989

Naturally occurring antibodies to bovine and human retinal S antigen: a comparison between uveitis patients and healthy volunteers.

The antibody responses to human and bovine retinal S antigen in the sera of patients with uveitis from various causes were compared with those of a group of healthy volunteers who were fully screened for signs of eye disease. Antiretinal antibodies were found with equal frequency and through the same range of titres in patients and controls, irrespective of the nature or activity of the uveitis. These findings were confirmed by spectrotypic analysis of sera from patients and controls where the predominant serum antibody response was polyclonal. In a small group of patients with retinal vasculitis there was an additional monoclonal response, indicating clonal expansion of a single lymphocyte subset. The prevalence of serum antibodies to retinal antigens in the normal population may indicate a protective role for 'natural' autoantibodies, as has recently been suggested for autoimmune diseases generally.

Animals↗
PubMed2000

Human neural retinal transplantation.

PURPOSE: A pilot study of human neural retinal transplantation was undertaken to investigate three major issues: whether a safe surgical procedure could be devised for transplantation of neural retinal tissue into the subretinal space, whether the transplant would be accepted in the subretinal space, and whether an improvement in vision could be achieved. METHODS: Eight patients with bare light perception (LP) vision due to retinitis pigmentosa (RP) and one patient with bare LP vision due to advanced neovascular age-related macular degeneration (AMD) received subretinal transplants of human fetal retinal microaggregate suspensions without postoperative systemic immunosuppression. The patient with AMD also received a fetal retinal sheet transplant. The ages of the patients ranged from 31 to 94 years (median, 55 years). The pre- and postoperative evaluations included visual function testing, detailed fundus examinations, fundus photography, fluorescein angiography, macular perimetry using a scanning laser ophthalmoscope (SLO), and full field and focal electroretinograms (ERGs). RESULTS: Three of the eight RP patients demonstrated possible improved light sensitivity during the initial months of follow-up. However, visual improvement disappeared between 3 and 13 months of follow-up. After transplantation, no subject showed any changes in the ERG recordings or SLO macular perimetry relative to their preoperative baseline. No patient experienced a retinal detachment, infection, or extensive bleeding. None of the patients developed retinal vasculitis or intraocular inflammation. In one RP patient, fluorescein angiography and fundus photography documented the formation and maturation of new host retinal vessels in the area of the transplant. CONCLUSIONS: Transplantation of fetal retinal photoreceptor suspensions into the subretinal space was achieved safely in nine subjects. Although a definite positive effect on visual function could not be demonstrated, the apparent high tolerance for graft tissue is promising for future efforts in the field of neural retinal transplantation.

Adult↗