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Results for “Retinal Vasculitis”

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PubMed1990

Pathology of experimental autoimmune uveoretinitis in mice.

The histopathology and immunopathology of murine experimental autoimmune uveoretinitis (EAU) following active immunization with the interphotoreceptor retinoid-binding protein (IRBP) were studied. The methods used included conventional light microscopy and immunoperoxidase staining. Lesions were located mainly in the uvea and the retina and were characteristically focal. The prominent histopathologic findings in the retina were vasculitis, granuloma, retinal fold, focal serous detachment, and loss of photoreceptors. Granulomas, formation of Dalen-Fuchs nodules, inflammatory cellular infiltration and increase in the thickness of the choroid and ciliary body were frequent findings. Subretinal neovascularization occurred in 10% of the experimental animals. Mild to moderate inflammation was also noted in the vitreous. The predominant infiltrating cells in the retinal and uveal granuloma and the Dalen-Fuchs nodules were macrophages. In contrast, the predominant infiltrating cell types in the vitreous were T helper/inducer lymphocytes. T suppressor/cytotoxic cells were rarely seen. Expression of Ia antigens on the ocular cells was confined to the immediate area of the inflammatory sites. The kinetics of histopathology showed two peaks at the 5th and 10th week after immunization, suggesting a relapsing course of the disease.

Animals↗
PubMed2005

Intravitreal triamcinolone acetonide for choroidal granuloma in sarcoidosis.

PURPOSE: To report the clinical course of intravitreal triamcinolone acetonide on choroidal granuloma secondary to sarcoidosis that was refractory to systemic prednisolone DESIGN: Interventional case report. METHODS: A 29-year-old Chinese man with sarcoidosis presented with isolated posterior segment involvement in his left eye as retinal periphlebitis, retinal granulomas, and choroidal granuloma. Retinal periphlebitis and retinal granulomas responded well to oral corticosteroid but not the choroidal granuloma. It gradually grew in size and caused a drop in left-eye vision to 20/70. Intravitreal triamcinolone acetonide (4 mg) was injected three times in total. RESULTS: The choroidal mass began to shrink in size after the second injection and completely regressed after the third. The choroidal granuloma became a scar, with no angiographic leakage. The patient's visual acuity improved and remained stable at 20/40 at the last follow-up, 6 months after the last injection. CONCLUSIONS: Given the encouraging results, further study on intravitreal triamcinolone acetonide for macular and peripapillary choroidal granulomas secondary to systemic sarcoidosis is warranted.

Adult↗
PubMed1997

Retinal perivasculitis in an immunocompetent patient with systemic herpes simplex infection.

PURPOSE: To describe a case of retinal perivasculitis in an immunocompetent patient with systemic herpes simplex infection. METHODS: Polymerase chain reaction amplifications were performed for aqueous and blood samples using primers specific for the following members of the herpesvirus family: cytomegalovirus, Epstein-Barr virus, herpes simplex virus (types 1 and 2), and varicella-zoster virus. The patient was placed on intravenous acyclovir and systemic corticosteroids. RESULTS: A positive polymerase chain reaction signal was found only for herpes simplex virus type 1. Vision in the left eye improved from light perception to 20/25, and signs of retinal perivasculitis resolved. CONCLUSION: The use of molecular diagnostic modalities in clinical practice may aid in determining infectious etiologies in patients with atypical clinical manifestations.

Acyclovir↗
PubMedDate not supplied

Frosted branch angiitis associated with Harada disease-like manifestations recurs 10 years later.

PURPOSE: To describe a case with frosted branch angiitis occurring in association with manifestations of Harada disease. CASE: A 41-year-old man developed marked iridocyclitis, frosted branch angiitis and retinal white dots, together with serous detachment of the sensory retina in the posterior pole of both eyes. OBSERVATIONS: Fluorescein angiography demonstrated multiple retinal pigment epithelial leakage points in the early phase followed by late dye pooling in the serous detachment, consistent with the manifestations of Harada disease. The patient experienced recurrence of the same combination of manifestations 10 years later. On both occasions, he showed mononuclear cell increase and protein elevation in the cerebrospinal fluid on spinal tap. CONCLUSION: Fluorescein angiography and spinal tap supported the diagnosis of Harada disease in the patient. The present patient could be diagnosed as having either Harada disease with frosted branch-like response or frosted branch angiitis with serous retinal detachment as occurs in Harada disease.

Adult↗
PubMedDate not supplied

Retinal microvasculopathy in human immunodeficiency type 1 (HIV)-infected children.

PURPOSE: To report two cases of retinal peripheral lesions in vertically HIV-infected children. METHODS: Complete ophthalmological examinations were performed in both cases over a period of four years. RESULTS: We found retinal peripheral lesions in four eyes of two patients who were referred to us for routine examination. Both cases showed focal, segmental and white patches around the vessel wall in the far periphery and at the equator. These findings hardly changed after 3.5 and 2.5 years of follow-up, respectively. We suppose the cause of these lesions is an immune-mediated reaction. CONCLUSIONS: Even although there is a low incidence of retinal alterations in pediatric patients infected by HIV, we believe that complete and systematic ophthalmic examinations should be performed in these children.

AIDS Dementia Complex↗
PubMed2003

Eales' disease in Inuit: report of four cases.

PURPOSE: To report four cases of Eales' disease in Inuit from Greenland diagnosed within a 6.5-year period. There are no previous reports on Eales' disease among Greenlanders. METHODS: Four younger Inuit, three males and one female, were diagnosed with Eales' disease based on fundus changes and exclusion of possible differential diagnoses. Several studies point to a possible relation between Eales' disease and tuberculosis (TB); examination of possible exposure to TB was part of the clinical investigation. RESULTS: Retinal changes made panretinal laser photocoagulation necessary in all cases. Four eyes in three patients were vitrectomized. Three patients received oral corticosteroid treatment. The final visual outcome was relatively good, with a visual acuity below 6/60 (3/36) in only one vitrectomized eye. All patients had been exposed to TB. CONCLUSION: Eales' disease seems to be rather common in the small population of Inuit (56,000) in Greenland. Attention is required to ensure diagnosis and appropriate treatment, including laser photocoagulation, leading to a reasonably good prognosis.

Adult↗
PubMed2004

Frosted branch angiitis: a review.

The purpose of this study is to present the first report of a case of primary frosted branch angiitis from the UK and to review the characteristics of this rare disease. Primary frosted branch angiitis causes characteristic florid translucent retinal perivascular sheathing of both arterioles and venules in association with variable uveitis, retinal oedema and visual loss, normally with good recovery. A total of 57 cases have been reported in the world literature. Atypical, typically focal frosted branch angiitis may also occur secondary to other causes of intraocular inflammation, especially cytomegalovirus retinitis. Primary frosted branch angiitis has a characteristic presentation but a variable course, typically affecting children or young adults. The disease is likely to represent a common immune pathway in response to multiple infective agents. The optimal treatment is unclear.

Age Distribution↗
PubMed2005

[Ocular changes in tropical malaria with cerebral involvement--results from the Blantyre Malaria Project].

INTRODUCTION: Malaria is a tropical disease causing an estimated 300 million infections and one million deaths per year. In sub-Saharan Africa, most infections are due to Plasmodium falciparum. The hallmark of the clinical syndrome of cerebral malaria is coma, and the associated mortality rate, even in appropriately treated patients, is 15 - 50 %. Funduscopy plays a major role for the ophthalmologist in the differential diagnosis because of the characteristic changes. METHODS: To date more than 1000 children who satisfied the standard clinical case definition of cerebral malaria were admitted to the Blantyre Malaria Project (Malawi, Africa) for inpatient treatment and examined using indirect ophthalmoscopy through fully dilated pupils. The gender distribution was homogeneous and the children were between 2 and 14 years old. The optic nerve head, central and peripheral retina and central and peripheral vessels were described and photographed using a hand-held fundus camera (KOWA). RESULTS: The spectrum and severity of findings of the ocular fundus in children with CM include the following distinct entities: haemorrhages (with and without a white centre), cotton wool spots, papilloedema, retinal whitening and retinal vessel abnormalities that may appear to be orange or white. Most of the retinal haemorrhages (in 40 %) have white centres and resemble Roth spots. Cotton wool spots were seen in only 5 %. Papilloedema was also not commonly seen (8 %) but is a poor prognostic sign. Retinal whitening (in 50 %) is seen more commonly at the posterior pole than in the periphery. 20 % of patients show retinal vessel abnormalities that may be orange or white in colour. CONCLUSION: Ocular fundus changes in CM can be detected by the ophthalmologist using simple means and are decisive for the prognosis and timely therapy for this potentially lethal disease.

Adolescent↗
PubMed1988

[Pars plana vitrectomy in chronic uveitis].

Statistical analysis of 54 eyes with chronical endogenous uveitis, mostly juvenile, treated with simple or combined pars plana vitrectomy. Most striking is the high frequency of localized or combined cyclitis with good functional results, although complications of the disease (retinal detachment, vasculitis, PVR, macular damage) are extremely frequent in cyclitis, and this group also includes, three cases of postoperative phthisis. The best argument in favor of an chronic uveitis is the fact that an overwhelming majority of the patients were able to switch from rigorous systemic preoperative medication to simple eye drops or no treatment at all.

Adult↗
PubMed1980

[Differential diagnosis of blurred optic disks by fluorescein angiography (author's transl)].

Fluorescein angiography has been underrated as an exploratory tool in the diagnosis of blurred optic disks. The ten cases presented here had blurred disks of diverse etiology; fluorescein angiography helped in the differential diagnosis and therapeutic approach. Irrigation of the disk, type, magnitude and location of dye leakage, as well as objectivation of peripapillary and retinal vascular characteristics all help to explain the pathogenic mechanisms leading to different types of optic disk edema. Although it is known tha papilledema due to increased intracranial pressure can not be differentiated from locally caused blurring of disks, there remain a number of mechanical, ischemic and inflammatory conditions that can be diagnosed by means of fluorescein angiography. Thus, optic neuritis, ischemic optic neuropathy, papillovasculitis and juxtapapillary chorioretinitis are some of the diseases in which chorioretinitis are some of the diseases in which angiography may help in differential diagnosis and lead to adequate therapeutic approaches.

Adolescent↗
PubMed1997

Eales' disease: accumulation of reactive oxygen intermediates and lipid peroxides and decrease of antioxidants causing inflammation, neovascularization and retinal damage.

PURPOSE: To measure the blood levels of oxygen and lipid-free radicals as lipid peroxidation products and of vitamins E, C and A, in order to explain intraocular inflammation, retinal neovascularization and detachment in Eales' disease. METHODS: Levels of the lipid peroxidation products produced by oxygen and lipid free radicals (estimated as thiobarbituric acid reactive substances-TBARS), vitamin E with ferric chloride, vitamin C with 2,6-dichlorophenol-indophenol and vitamin A with antimony trichloride were all evaluated in three groups of subjects between 20 and 40 years of age. Twenty three were patients with Eales' disease in the active perivasculitis stage (Group I), 19 were patients with Eales' disease in the healed-perivasculitis stage (Group II), and 46 were healthy volunteers (Group III), used as normal controls. Patients in each group were subdivided into two age groups, 20-30 and 31-40 years, each group containing both sexes. RESULTS: The results showed a 4.6- and 5.6-fold increase in the levels of TBARS in erythrocytes of patients with Eales' disease in the active perivasculitis stage (Group I) and a 2-fold increase in patients with Eales' disease in the healed perivasculitis stage (Group II), when compared to levels in the controls (Group III). On the other hand, there was a decrease of 75 and 76.2% in the levels of vitamin E in serum, 34 and 40.9% of vitamin C in plasma and 72.8 and 67% of vitamin A in serum in patients with Eales' disease in the active perivasculitis stage (Group I), as compared to the controls (Group III). Also decreases of 56 and 43.5% of vitamin E in serum, 26.8 and 12.5% of vitamin C in plasma and 50.5 and 49.4% of vitamin A in serum were found in patients with Eales' disease in the healed perivasculitis stage (Group II) as compared to the healthy controls (Group III). The two values of variations between the patients and the normal control group given above for TBARS, vitamins E,C and A are for the two age groups, 20-30 and 31-40 respectively. The differences were statistically significant (P < 0.01 to 0.001). CONCLUSIONS: Lowered levels of antioxidant vitamins E and C and consequent accumulation of oxygen and lipid free radicals, or vice versa, could explain the inflammation, neovascularization and retinal pathology in patients with Eales' disease. Also, vitamin A deficiency could aggravate retinal illness.

Adult↗
PubMed2002

Immunolocalization and quantification of advanced glycation end products in retinal neovascular membranes and serum: a possible role in ocular neovascularization.

PURPOSE: Earlier studies have revealed the association of advanced glycation end products (AGE) with the pathogenesis of various micro and macro vascular complications. The purpose of the present study is to localize AGEs, namely carboxy methyl lysine (CML-AGE) and methyl glyoxal-derived AGEs (MG-AGE), in retinal neovascular membranes and to quantify them in serum samples. METHODS: Surgically excised retinal neovascular membranes and serum samples obtained from patients with diabetic retinopathy, Eales' disease and nondiabetics were studied. Immunolocalization of AGEs namely CML-AGE and MG-derived AGEs was done using avidin biotin complex method and quantification was done by enzyme linked immunosorbent assay (ELISA). RESULTS: CML-AGE immunoreactivity was detected in all cases of Eales' disease and 61% cases of diabetic retinopathy and none in idiopathic epiretinal membrane (ERM). MG-AGE immunoreactivity was observed in approximately 15% of diabetic retinopathy and none in Eales' disease and and idiopathic ERM. Quantification of AGEs in serum samples revealed statistically significant increased levels of MG-AGE in diabetes, in relation to nondiabetics with idiopathic ERM and CML-AGE in Eales' disease, in relation to diabetics and nondiabetics with idiopathic ERM. CONCLUSION: Results from this study suggest that AGEs formed through glycation and glycoxidation may play an important role in the development of retinal neovascularization. The immunoreactivity of CML-AGEs in neovascular membrane and its increased levels in serum suggest that inspite of the normoglycemic status, glycoxidation and lipid peroxidation due to oxidative stress may trigger retinal neovascularization in Eales' disease, while MG-AGEs in diabetic membrane and serum suggest the role of glycation. Thus the mechanism of neovascularization in different pathological conditions could be different.

Adolescent↗