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PubMed2003

Rhegmatogenous retinal detachment and uveitis.

PURPOSE: To evaluate the frequency, high-risk factors, and visual prognosis of rhegmatogenous retinal detachment (RRD) in patients with uveitis. DESIGN: Retrospective case-control study. PARTICIPANTS: We included 1387 consecutive patients with uveitis who consulted our uveitis clinic from January 1990 through December 1997 of whom 43 patients (46 eyes) with RRD were identified. The retinal detachment (RD) controls were 212 consecutive patients with RRD (221 eyes, first occurrence of RD, not associated with uveitis) who were admitted for surgery in the period from April 1999 to April 2000. The uveitis control group consisted of 150 age-matched patients (210 eyes) selected from the entire uveitis series. INTERVENTION: Retrospective analysis of clinical data. MAIN OUTCOME MEASURES: The presence of RRD and eventual risk factors for RRD, such as myopia, retinal lattice degeneration, prior intraocular surgery, anatomic location of uveitis, its specific diagnosis, and clinical manifestations. Furthermore, the surgical and nonsurgical outcomes of RRD, as well as the results of various treatment regimens, were analyzed. RESULTS: RRD was identified in 3.1% of the patients with uveitis. RRD was most frequently associated with panuveitis (6.6%). RRD was associated more frequently with infectious (7.6%) than noninfectious uveitis (2.1%). At the onset of RRD, uveitis was active in most (46%) affected eyes. Proliferative vitreoretinopathy was present in 30% of the uveitic RRD eyes at presentation in contrast to 12% of the RRD control eyes. In uveitic RRD, the retina was reattached in 59% of eyes with a single operation; the final anatomic reattachment rate was 88%. Finally, a visual acuity of less than 20/200 was present in 71% of the uveitic RRD eyes, 10% of which had no light perception. CONCLUSIONS: We discovered a high prevalence of RRD in patients with active panuveitis and infectious uveitis and document that uveitis in itself is a risk factor for the development of RRD. The visual prognosis of RRD in uveitis was poor because of the uveitis itself and the frequent development of proliferative vitreoretinopathy.

Adolescent↗
PubMed2005

[Epidemiology of uveitis in juvenile idiopathic arthritis from a national paediatric rheumatologic and ophthalmologic database].

BACKGROUND: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. METHODS: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. RESULTS: Uveitis was documented in 12 % of a total of 3271 JIA patients: extended oligoarthritis (25 %), persistent oligoarthritis (16 %), seronegative polyarthritis (4 %), seropositive polyarthritis (2 %), psoriatic arthritis (10 %), enthesitis-related arthritis (ERA) (7 %), systemic arthritis (1 %), other arthritis forms (11 %). Ophthalmologic data were available from 115 uveitis patients (28 %). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63 %) or ANA-positive (86 vs. 42 %) than the patients without uveitis. Uveitis complications were present in 45 % at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56 %, and included band keratopathy (29 %), posterior synechiae (27 %), cataract (26 %), glaucoma (8 %), and macula oedema (6 %). Final visual acuity was less than 20/50 in 31 % and less than 20/200 in 12 % of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75 % vs. 43 %). CONCLUSIONS: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.

Adolescent↗
PubMed1998

Retinal immunopathology in horses with uveitis.

BACKGROUND: Equine uveitis is a spontaneous disorder of horses that can serve as a model for the study of human uveitis. Although the initial presentation is that of an anterior uveitis, retinal involvement has been noted in some cases. We report here the immunohistopathology of retinas from horses with uveitis. METHODS: Sections of eyes recovered from horses with naturally occurring uveitis and from Shetland ponies with experimental leptospira-induced uveitis were stained by hematoxylin and eosin for histopathological evaluation. Immunohistochemistry was used to evaluate retinas for MHC Class II antigen expression and infiltration of T and B lymphocytes. RESULTS: Histopathological abnormalities in retinas from horses with uveitis ranged from minimal to total loss of retinal tissue. MHC Class II antigen-positive round and dendritiform cells were seen in these retinas, but were not seen in retinas from horses without uveitis. There was no significant reactivity noted in the retinal pigment epithelial cells or Muller cells. Numbers of MHC Class II antigen-expressing cells and T lymphocytes correlated with the extent of retinal histopathology. B lymphocytes were seen primarily in retinas from horses that were seroreactive for Leptospira interrogans serovar pomona. Retinas from ponies with experimental uveitis had changes similar to those from horses with spontaneous uveitis. CONCLUSIONS: These results suggest that retinal pathology may be a primary immunological event in equine uveitis, provide evidence that leptospira-associated uveitis may be a distinct subset of equine uveitides, underscore the relevance of the study of equine uveitis to human uveitis, and support the plausibility of a post-infectious immunopathogenesis of some naturally occurring uveitides in both humans and horses.

Animals↗
PubMed2006

Pattern of childhood-onset uveitis in a referral center in Tunisia, North Africa.

PURPOSE: To analyze the pattern of childhood uveitis in a referral center in Tunisia, North Africa. METHODS: The study included 64 patients with uveitis examined at the Department of Ophthalmology of Monastir (Tunisia) from January 1994 to July 2005. All patients had a comprehensive ocular and systemic history, including an extensive review of medical systems. Complete ophthalmic examination was performed in all cases, including best-corrected Snellen visual acuity, slit-lamp examination, applanation tonometry, and dilated fundus examination with 3-mirror lens. Standard diagnostic criteria were employed for all syndromes or entities of uveitis. RESULTS: The mean age at onset of uveitis was 12.4 years. The male-to-female ratio was 0.68. The process was unilateral in 51.6% of patients. Mean follow-up was 43.2 months. Anterior and intermediate uveitis each represented 31.25% of cases, posterior uveitis 20.3%, and panuveitis 17.2%. Noninfectious uveitis (75%) was the most frequent type of inflammation. Idiopathic uveitis was found in 50% of patients. Infectious uveitis was responsible for 25% of the cases, with toxoplasmosis (14.1%) being the most frequent cause. Twenty percent of the patients had systemic associations; juvenile idiopathic arthritis was found in 6.25%. Ocular complications occurred in 74.7% of affected eyes, of which the most common were posterior synechiae (28.4%), cataract (17.9%), cystoid macular edema (19%), and optic disc edema (32.6%). Fifty-seven affected eyes (60%) had a final visual acuity more than 20/40 and nine (9.5%) had a final visual acuity less than 20/200. CONCLUSIONS: In a hospital population in Tunisia, a specific cause of uveitis in children was found in half the patients. Idiopathic intermediate uveitis was the leading cause of uveitis in our study, followed by idiopathic anterior uveitis and toxoplasmosis. Uveitis associated with juvenile idiopathic arthritis was rare. Visual prognosis appeared to be good.

Adolescent↗
PubMed2005

Uveitis in young adults with juvenile idiopathic arthritis: a clinical evaluation of 123 patients.

OBJECTIVE: To examine the prevalence and characteristics of uveitis in young adults with juvenile idiopathic arthritis (JIA). METHODS: The study population consisted of 123 JIA patients born between 1976 and 1980 whose arthritis had been diagnosed and treatment first started at the Rheumatism Foundation Hospital in 1976 to 1995. A clinical re-evaluation was carried out by an ophthalmologist and a paediatric rheumatologist 16 years later on average. RESULTS: The mean age of the patients was 23.5 years, 72% were women, and 63% had oligoarthritis. During the course of the disease, diagnosis of uveitis had been made in 25 patients (20%). Arthritis in the 19 patients with asymptomatic uveitis was more often ongoing than in the 98 patients without uveitis (p = 0.032). Asymptomatic uveitis was persistent in eight of the 19 cases (42%), and arthritis was active in seven of these. Four of the six patients with attacks of symptomatic uveitis had parallel treatment for arthritis. In three of 19 patients with asymptomatic uveitis and in five of six with acute uveitis the eye inflammation had started after the age of 16. At the onset of arthritis the patients with asymptomatic uveitis were younger than those without uveitis (p = 0.002). Complications of uveitis developed in six patients but their sight remained good. CONCLUSIONS: Asymptomatic uveitis continued into adulthood in almost half the uveitis patients. Most also had ongoing arthritis. Acute uveitis was often associated with persistent arthritis.

Acute Disease↗
PubMed2006

Cytokine profile in aqueous humor and sera of patients with infectious or noninfectious uveitis.

PURPOSE: To determine the cytokine expression profile at the protein level in aqueous humor (AqH) and sera of patients with uveitis. METHODS: Patients with various clinical entities of strictly diagnosed infectious or noninfectious uveitis were tested. AqH and sera were collected from patients with uveitis. AqH was also collected during surgery from patients with cataract, as control specimens. Interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-2, -4, -5, and -10 were measured from nondiluted samples simultaneously, with microparticle-based flow cytometric analysis. RESULTS: In AqH IFN-gamma was the most abundant cytokine in both infectious (mean, 3240.5 pg/mL) and noninfectious (mean, 115.6 pg/mL) uveitis, and IL-10 was the second (mean, 402.1 pg/mL, infectious uveitis; 7.5 pg/mL, noninfectious uveitis). The expression level of other cytokines in AqH was generally higher in infectious uveitis than in noninfectious uveitis, but the levels were lower than that of IL-10. There was no remarkable difference, however, in the cytokine expression pattern in AqH of the different clinical entities of uveitis. Sera from patients with noninfectious uveitis contained IFN-gamma (mean, 45.0 pg/mL), but the other serum cytokines in both types of uveitis were low or under the detectable level. CONCLUSIONS: IFN-gamma is the most abundant cytokine in infectious and noninfectious uveitis, with a remarkable difference between the two groups. The data suggest that cytokines in AqH of infectious uveitis are locally produced, whereas in noninfectious uveitis, IFN-gamma is produced both in the eye and the peripheral blood.

Adult↗
PubMed1996

Uveitis as a presenting feature of chronic sarcoidosis.

Uveitis is often a manifestation of sarcoidosis. Less well-recognized, however, is the development of uveitis several years before the diagnosis of systemic sarcoidosis. The possibility that presentation of uveitis is a marker for the chronicity of sarcoidosis has never been investigated. The aim of this work was to evaluate, in a Caucasian population, the epidemiology of uveitis as the primary manifestation of sarcoidosis with long-term follow-up, and the relationship of uveitis to the chronicity of sarcoidosis. The records of 1,156 Caucasian patients with histologically proven sarcoidosis, first seen in the period 1976-1992, were reviewed. In patients in whom uveitis was the primary feature of sarcoidosis, the following parameters were identified: systemic manifestations; time interval between the diagnosis of uveitis and sarcoidosis; therapy; the evolution of chest radiographic image over time; chronicity; the relationship between sarcoidosis and uveitis; and, finally, status in October 1994. In nine patients, uveitis was the reason for seeking medical treatment, resulting in the discovery of systemic sarcoidosis, which was then found to be chronic in 7 out of 9 cases. In an additional eight patients, uveitis preceded the diagnosis of systemic sarcoidosis by 1-11 yrs, and yet most subjects had systemic manifestations that went unrecognized during this time period, with chest radiograph at the time of diagnosis suggesting a long-standing chronic disease. Thus, uveitis appeared to be the primary manifestation of sarcoidosis in 17 of the 1,156 patients studied (1.5%). In conclusion, any uveitis of unknown origin may be due to sarcoidosis, although its systemic manifestations may not occur for up to 11 yrs. Uveitis patients need a very long-term follow-up, including periodic diagnostic tests for systemic sarcoidosis. Furthermore, when uveitis precedes the systemic symptoms and diagnosis of sarcoidosis by more than one year, it may be regarded as a marker of the chronicity of sarcoidosis.

Adult↗
PubMed1997

[Clinical and biological markers of secondary uveitis: results of a discriminant analysis].

BACKGROUND: The association of uveitis and systemic disease is well known. Patients suffering from uveitis often undergo a extensive battery of tests in order to detect underlying disease, but the efficiency of such screening is uncertain. The aim of this study was to investigate useful clinical data for recognizing secondary uveitis. PATIENTS AND METHODS: We conducted a prospective analysis of 115 patients with uveitis of unknown etiology. All of them were included in an extensive protocol study. Four groups were considered: specific ocular disease (SOD), idiopathic uveitis, HLA-B27 associated uveitis without arthritis (HLA-B27-AU) and secondary uveitis. Groups were compared by analysis of variance for continuous variables, and chi 2 test or Student's t-test for discrete variables. A stepwise multiple discriminant analysis was performed for ranking the variables in order of their usefulness for distinguishing idiopathic and secondary uveitis. RESULTS: We diagnosed 11 SOD (9.6%), 54 idiopathic uveitis (47%), 6 HLA-B27-AU (5.2%) and 41 secondary uveitis (35.7%). The discriminant analysis showed that age, an elevated erythrocyte sedimentation rate, presence of cutaneous lesion, joint pain and genital ulcers are the strongest predictors of secondary uveitis. This model classification functions detected 92.5% of idiopathic uveitis and 72% of secondary uveitis. The global percentage of patients with a correct diagnosis was 84.6%. CONCLUSIONS: Anamnesis, physical examination and basic laboratory tests are sufficient tools for the diagnostic approach of the majority of patients with uveitis. Subsequent diagnostic procedures must be planned in each patient to confirm a specific disease.

Adolescent↗
PubMed2003

Factors related to severe uveitis at diagnosis in children with juvenile idiopathic arthritis in a screening program.

PURPOSE: To identify factors associated with severe uveitis at diagnosis of eye disease in children with juvenile idiopathic arthritis (JIA) who were observed in a screening program, and to identify temporal changes in findings associated with screening during the period 1986 to 2000. DESIGN: Case control study. METHOD: Uveitis was defined as being severe at diagnosis if there were associated synechiae, cataracts, or retinal edema. Clinical factors for all patients undergoing screening for JIA-associated uveitis from 1986 to 2000 at one institution were studied retrospectively. Children with severe uveitis at diagnosis (cases) were compared with those with mild uveitis at diagnosis and those who never developed uveitis during follow-up in the screening program (controls). RESULTS: Severe uveitis was present at diagnosis in 22 (5.4%) of 409 patients. Male patients were more likely to have severe uveitis at diagnosis (odds ratio [OR] 3.7 [95% confidence interval 1.3 to 10.7], P =.014). A longer interval from the onset of arthritis symptoms to the diagnosis of uveitis was associated with a reduced risk of severe uveitis at diagnosis (OR 0.95 [0.91 to 1.0], P =.044). There was no difference in the frequency of severe uveitis at diagnosis between two screening periods: 1986 to 1993 (before American screening guidelines were published) and 1994 to 2000. CONCLUSIONS: Male children are more likely than female children to have severe uveitis at diagnosis. The proportion of children with severe uveitis at diagnosis has not changed since current screening guidelines have been widely publicized, suggesting the need for refinements in screening procedures to target high-risk children with increased surveillance.

Adolescent↗
PubMed1997

Scleritis-associated uveitis.

PURPOSE: Anterior uveitis may accompany scleritis. This study was undertaken to analyze the incidence, characteristics, and meaning of uveitis in the course of scleritis. METHODS: Patient characteristics, scleritis type, ocular complications, and specific systemic diseases were evaluated in patients with scleritis-associated uveitis; comparisons were made between patients with scleritis-associated uveitis and patients with scleritis without uveitis. RESULTS: Seventy three (42%) of 172 patients with scleritis had anterior uveitis. Scleritis-associated uveitis ranged from mild to moderate intensity and always was related to the presence of active scleritis. Patients with scleritis-associated uveitis had more necrotizing scleritis (37%, P = 0.0001), decrease in vision (49%, P = 0.0046), peripheral ulcerative keratitis (22%, P = 0.0095), and glaucoma (19%, P = 0.0313) than did patients with scleritis without uveitis. Patients with scleritis-associated uveitis did not have any specific associated systemic disease more often than did patients with scleritis without uveitis. CONCLUSION: Extension of scleral inflammation to the anterior uveal tract is a consequence of a more severe disease with possible ocular complications that may cause progressive visual loss. The occurrence of anterior uveitis in the course of scleritis entails a poor ocular prognosis. The authors believe, therefore, that the anterior uveal tract should be evaluated at every follow-up visit of a patient with scleritis, so that emergence of this important prognostic condition (anterior uveitis) may be detected promptly and systemic therapy instituted appropriately.

Adolescent↗
PubMed1999

The importance of specific IgG and IgE autoantibodies to retinal S antigen, total serum IgE, and sCD23 levels in autoimmune and infectious uveitis.

Autoimmunity plays an important role in the development of uveitis. The uveitis are linked to Th1 or Th2 lymphocyte activation. We studied 41 patients with uveitis, divided into autoimmune uveitis (n = 32) and infectious uveitis (n = 9), 30 normal controls, and 20 asthmatic atopic without ocular diseases. The infectious uveitis patients were separated into bacterial (n = 6) and toxoplasmic (n = 3) retinochoroiditis. We measured IgE and sCD23 serum levels and specific IgG and IgE to retinal S antigen by ELISA tests. The IgE levels were 500 +/- 325 kU/L in autoimmune uveitis, 57 +/- 35 kU/L in bacterial uveitis, 280 +/- 38 kU/L in toxoplasmic retinochoroiditis, 75 +/- 32 kU/L in the controls, and 557 +/- 243 kU/L in atopics (P < 0.0005). The sCD23 levels were 10.4 +/- 5.4 ng/ml in autoimmune uveitis, 3.7 +/- 1.17 ng/ml in bacterial uveitis, 6.76 +/- 1.36 ng/ml in toxoplasmic retinochoroiditis, 3.4 +/- 1 ng/ml in controls, and 8.35 +/- 2.2 ng/ml in atopic patients (P < 0.005). The specific IgG to retinal S antigen was positive in 27 of 32 cases, and the specific IgE to retinal S antigen was positive in 22 of 32 autoimmune uveitis. The bacterial uveitis patients as well as the controls were negative for both autoantibodies to retinal S antigen. The toxoplasmic retinochoroiditis patients presented specific IgG and IgE to retinal S antigen in two of three cases, respectively, one of them with overlap of both antibodies. These results suggest the importance of specific IgG and IgE to retinal S antigen in autoimmune uveitis, which, along with higher IgE and sCD23 levels, reveal Th2 activation.

Adult↗
PubMed2000

Uveitis in children.

PURPOSE: To summarize the prevalence and patterns of uveitis in children. METHODS: Pertinent articles were reviewed. RESULTS: Children constitute 5-10% of the patients with uveitis seen at tertiary referral centers, and girls appear to develop uveitis slightly more frequently than boys. Among all children with intraocular inflammation, anterior uveitis accounts for 30-40%, posterior uveitis accounts for 40-50%, intermediate uveitis accounts for 10-20%, and diffuse uveitis accounts for 5-10%. The most common cause of anterior uveitis is juvenile idiopathic arthritis (JIA), whereas the most frequent type of posterior uveitis is toxoplasmic retinochoroiditis. Most cases of intermediate and diffuse uveitis are bilateral, chronic, and idiopathic. The most common causes of vision loss in children with uveitis are cataract, band keratopathy, glaucoma, and cystoid macular edema. Up to one-third of the children with uveitis are left with severely impaired vision as a result of these complications. CONCLUSIONS: Uveitis is an important cause of ocular morbidity in children. Prompt diagnosis and treatment is essential to minimize the risk of long-term vision loss.

Child↗
PubMed2005

Causes of uveitis in a referral hospital in Ankara, Turkey.

PURPOSE: To evaluate the etiology of uveitis and its associated systemic findings in a referral hospital in Ankara, Turkey. MATERIALS AND METHODS: Clinical records of patients in our uveitis department were reviewed retrospectively and 419 eyes of 300 consecutive patients were included in the study. Cases of uveitis due to postoperative endophthalmitis, perforating injuries, and foreign bodies were excluded from the study. The data, including sex, age, clinical presentation, disease course and outcome, ocular involvement, etiology, and associated systemic findings, were entered into a computer database. Pearson chi-square statistical analysis was performed to analyze the data whenever necessary. RESULTS: The study subjects consisted of 162 males and 138 females, with a female to male ratio of 1:1.17 and an average age of 35.7 years. Anterior uveitis was the most common form of uveitis with 43.6%, followed by posterior uveitis (26.6%), panuveitis (20.6%), and intermediate uveitis (9%). Idiopathic uveitis (28.3%) was the most frequent cause of uveitis diagnosed, followed by Behçet's disease (26%) and rheumatic diseases (9%). In 215 (71.7%) out of 300 patients, a specific cause of uveitis with associated systemic findings was identified. Uveitis was attributed to an infectious etiology in only 41 patients (13.6%) of the entire study population. COMMENTS: The etiology of uveitis and its associated systemic findings may vary depending on the geographic distribution of patients and local factors. These results represent those of patients with uveitis referred to hospitals in central Anatolia.

Adolescent↗
PubMed2004

The number of CD8+ T cells and NKT cells increases in the aqueous humor of patients with Behçet's uveitis.

To determine whether there are differences in the immunopathogenesis of different endogenous uveitis syndromes, the phenotypic characteristics of immune cells were analysed among patients with endogenous uveitis. The aetiology of the uveitis included idiopathic recurrent acute anterior uveitis (18 patients), idiopathic intermediate uveitis (13 patients), Behçet's uveitis (17 patients), Vogt-Koyanagi-Harada syndrome (7 patients), and so on. Flow cytometric analysis was performed using immune cells of the aqueous humor and the peripheral blood during the active phase of intraocular inflammation, and monoclonal antibodies to CD3, CD4, CD8, CD14, CD19, CD56, TCR gammadelta, pan TCR alphabeta and Valpha24. CD8+ T cells were predominant in the aqueous humor of the patients with Behçet's uveitis, whereas CD4+ T cells were mainly found in the aqueous humor of patients other than those with Behçet's uveitis. The number of NKT (CD3+CD56+) cells was significantly higher both in the aqueous humor and the peripheral blood of the patients with Behçet's uveitis compared with the other groups (P < 0.05). CD8+CD56+ cells were the predominant subtype of the increased NKT cells in patients with Behçet's uveitis. In addition, intraocular infiltration of CD14+ cells significantly differed among the uveitis patients (P < 0.05). These results suggest that the immunopathogenesis of endogenous uveitis can vary between syndromes, and that CD8+CD56+ NKT cells may play an important role in the immunopathogenesis of Behçet's uveitis.

Adolescent↗
PubMedDate not supplied

Uveitis as a marker of active arthritis in 372 patients with juvenile idiopathic seronegative oligoarthritis or polyarthritis.

OBJECTIVE: To compare the activity of arthritis in children with recently diagnosed seronegative oligoarthritis or polyarthritis with or without uveitis. METHODS: The study covered 372 JIA children with recently diagnosed seronegative oligoarthritis or polyarthritis. The mean prospective follow-up period was 4.5 years. Asymptomatic anterior uveitis was found in 96 cases. The activity of arthritis in all 372 patients was assessed clinically and by laboratory parameters. RESULTS: The erythrocyte sedimentation rate was significantly higher (p = 0.001) at the diagnosis of arthritis and at the end of the follow-up (p = 0.02) in the 96 JIA patients with uveitis than in the 276 JIA patients without uveitis. The hemoglobin value was significantly lower (p = 0.008) at the diagnosis of arthritis in patients with uveitis, but not at the end of the follow-up. The number of inflamed joints was significantly greater at the end of the follow-up in patients with persistent polyarthritis and uveitis (p = 0.01) compared to those polyarthritis patients without uveitis. Patients with uveitis were significantly more often treated with oral prednisolone (p < 0.001), glucocorticoid joint injections (p < 0.001), and with methotrexate (p = 0.003) compared to patients without uveitis. Clinical remission of arthritis was achieved significantly less frequently in patients with uveitis than in patients without uveitis (21% versus 42%, p<0.001). CONCLUSION: The inflammatory activity of arthritis seems to be increased in patients with seronegative oligo- or polyarthritis and uveitis compared to those without uveitis.

Arthritis↗
PubMed1994

Experimental arthritis and uveitis in rats associated with Mycobacterium butyricum.

OBJECTIVE: To determine if the anterior uveitis associated with adjuvant arthritis (AA) in the rat can be passively transferred with arthritis to syngeneic recipients using spleen cells or T cell lines prepared from animals given complete Freund's adjuvant (CFA) and Mycobacterium butyricum (M. butyricum) in incomplete Freund's adjuvant (IFA). METHODS: Spleen cells from Lewis or Lewis SsN rats given IFA, CFA, type I collagen in IFA (CI-IFA), or type II collagen in IFA (CII-IFA) were administered to naive rats or rats treated with pertussis toxin or bacterial endotoxin. Three CD4+ T cell lines, propagated from CFA injected rats and maintained in vitro with M. butyricum (M-1), bovine proteoglycan (PR-1) or an extract of M. butyricum (MBE-1) were administered to naive or immunosuppressed rats. The arthritogenic and uveitogenic properties of these cell preparations and intradermal MBE-IFA, CII-IFA and intraperitoneal (ip) M. butyricum without adjuvant were evaluated. RESULTS: Uveitis was observed in 15/69 (22%) arthritic rats given CFA. Spleen cells prepared from CFA injected rats caused arthritis in 55 (82%) and uveitis in 2 (3%) of 67 cell recipients. Uveitis occurred in 2/6 cell recipients pretreated with bacterial endotoxin. Neither uveitis nor arthritis was observed in rats given IFA (0/6) or spleen cells prepared from rats given IFA (0/27), CI-IFA (0/6), or CII-IFA (0/28). CII-IFA produced polyarthritis in 5/6 rats, but no uveitis. CII-IFA induced arthritis associated uveitis in 1/15 animals receiving spleen cells from rats given CII-IFA, but not those given CI-IFA (0/3) or IFA (0/13). Uveitis was observed in one recipient of the M-1 T cell line and in 2 recipients of the PR-1 T cell line. Immunization with 400 micrograms of MBE-IFA induced uveitis but not arthritis in 3/11 animals. The MBE specific T cell line was neither arthritogenic nor uveitogenic. A high frequency (5/6) of uveitis accompanied arthritis in male Lewis rats given ip M. butyricum. Arthritis occurred in 4/10 female Lewis rats given ip M. butyricum and 2 arthritic animals also developed uveitis. CONCLUSION: Uveitis occurs infrequently in arthritic rats given spleen cells from CFA injected animals. The ip administration of M. butyricum constitutes a novel disease model in which the immunopathological relationships between arthritis and uveitis may be more reliably studied.

Animals↗
PubMed1994

Evaluation of laser flare-cell photometry in the appraisal and management of intraocular inflammation in uveitis.

BACKGROUND: Laser flare-cell photometry enables objective and quantitative measurement of anterior chamber inflammation. Systematic data currently are used mainly for clinical research; few are yet available in uveitis. The authors prospectively studied the amount, duration, and pattern of inflammation for well-defined uveitic conditions and evaluated the potential usefulness of laser flare-cell photometry in uveitis. METHODS: Mean initial flare was calculated in HLA-B27-positive acute anterior uveitis, acute herpes zoster uveitis, acute retinal necrosis (ARN), Fuchs heterochromic cyclitis, intermediate uveitis (pars planitis-type), posterior sarcoidosis, posterior pole toxoplasmosis, and birdshot chorioretinopathy. Evolution of aqueous flare and cells was analyzed for acute anterior uveitis, ARN, and pars planitis treated for cystoid macular edema (CME), all of which received a standardized therapy. RESULTS: Blood-aqueous barrier disruption was very pronounced in acute anterior uveitis (170.2 +/- 33 photons/msecond), ARN (177.4 +/- 88 photons/msecond), moderate in posterior sarcoidosis (38.1 +/- 11 photons/msecond), acute zoster uveitis (25.8 +/- 6.1 photons/msecond), and pars planitis (19.1 +/- 2.9 photons/msecond) but only minimal in Fuchs heterochromic cyclitis (10.2 +/- 3.5 photons/msecond), toxoplasmosis (9.0 +/- 1.2 photons/msecond) and birdshot chorioretinopathy (5.7 +/- 1.1 photons/msecond). For acute anterior uveitis, ARN, and pars planitis with CME, the inflammatory patterns were determined. The potential of laser flare-cell photometry for precise follow-up and adjustment of therapy was illustrated in cases of anterior and posterior uveitis. CONCLUSION: The authors' findings show that laser flare-cell photometry allows quantitative assessment of inflammation in uveitis and contributes to improved management of patients with uveitis.

Adolescent↗
PubMed2002

Causes of uveitis in dogs: 102 cases (1989-2000).

Uveitis is one of the most common ocular diseases and one of the most common causes of blindness in dogs. The purpose of this retrospective study was to correlate the signalment, history, clinical signs and ophthalmic findings of dogs with uveitis with the underlying etiology. We conducted a retrospective study of 102 dogs presented to the NCSU-VTH from 1989 to 2000 with clinical signs of uveitis. Medical records of dogs presented for uveitis were reviewed. Dogs were included in the study only if a complete diagnostic work-up database was collected, if sufficient follow-up was documented, and if the uveitis was not secondary to trauma or a hypermature cataract. The mean age +/- SD of all dogs in this study was 6.2 +/- 3.6 years. There were 33 intact and 16 castrated males, and 14 intact and 27 neutered females. Fourteen breeds were represented, with the Golden Retriever (n = 14) most common. Fifty-nine dogs (58%) were diagnosed with idiopathic/immune-mediated uveitis, neoplasia was diagnosed in 25 dogs (24.5%) and 18 dogs (17.6%) were diagnosed with infectious causes of uveitis. Aqueous flare was the most common clinical sign, occurring in 88 dogs (86%). The most common infectious organisms associated with uveitis in the dogs of this study were Ehrlichia canis (n = 7). Lymphosarcoma (n = 17) was the most common neoplasm. In approximately 60% of dogs presenting for uveitis an underlying cause was not found, and a diagnosis of immune-mediated or idiopathic uveitis was made. However, approximately 25% of dogs had ocular and/or systemic neoplasia (with 17% of cases having lymphosarcoma) and 18% with an underlying infectious cause for uveitis. Because of the high percentage of systemic disease associated with uveitis in dogs, extensive diagnostic testing is recommended before instituting symptomatic anti-inflammatory therapy.

Animals↗