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Results for “Uveitis, Anterior”

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At least 19 recordsLinked to original sources
PubMed1990

Serologic evidence of Yersinia infection in patients with anterior uveitis.

Anterior uveitis is a common inflammatory eye disease associated with the HLA-B27 phenotype. Bacteriologic cofactors have been implicated in the pathogenesis of several diseases associated with HLA-B27. Using a sensitive enzyme-linked immunosorbent assay, we examined the incidence of previous Yersinia infection in a group of 28 consecutive patients with anterior uveitis. Twelve patients had a significantly increased antibody response to Yersinia, 8 of whom were HLA-B27 positive. Eight patients had IgM antibodies, possibly indicative of recent infection. There were no positive Yersinia serologic findings in our control group of 28 subjects, 13 of whom were HLA-B27 positive. A strong association was found between previous Yersinia infection and the development of anterior uveitis in HLA-B27-positive and HLA-B27-negative patients.

Adult↗
PubMed1987

Anterior segment fluorophotometry in acute anterior uveitis.

Anterior segment fluorophotometry was used to assess the severity of blood-aqueous barrier disruption in 25 patients with acute anterior uveitis. The results indicated that HLA-B27-positive patients had a more severe inflammation than did HLA-B27-negative patients, which was not discernible when judged by clinical signs and symptoms. Follow-up studies showed that the blood-aqueous barrier was disturbed for longer than the clinical signs indicated, and sometimes a temporary subclinical relapse was demonstrated on early withdrawal of topical therapy. The blood-aqueous barrier appeared to be restored after each attack of acute anterior uveitis in the majority of patients, with no evidence of progressive damage from repeated attacks. Our results indicated that fluorophotometry provides an objective and sensitive method of assessing anterior uveitis.

Acute Disease↗
PubMed1987

Chemotactic activity in aqueous humor from patients with anterior uveitis.

Anterior uveitis, inflammation of the iris or ciliary body of the eye, may be associated with a variety of systemic diseases. Although a leukocytic infiltrate is characteristic of anterior uveitis, few studies have sought to detect factors in aqueous humor that could attract neutrophils or monocytes into the anterior chamber. Using modified Boyden chambers, we found that a 5% concentration of aqueous humor from patients with anterior uveal inflammation induced monocyte movement comparable to optimal or near-optimal concentrations of C (complement)5a or platelet-derived growth factor. Aqueous humor from patients with anterior uveitis induced significantly more monocyte migration than did aqueous humor from two sets of controls (either patients undergoing cataract extraction or patients with posterior uveitis). "Checkerboard" or gradient analysis indicated that a majority of inflammatory disease samples induced monocyte chemotaxis (directed migration) while the control aqueous humor consistently induced chemokinesis (stimulated random migration) (P less than 0.02). Despite their ability to induce monocyte migration, samples tended to induce minimal neutrophil migration with the exception of aqueous humor that was obtained from one patient with acute anterior disease. This sample induced marked chemokinesis. Identification of chemotactic activity may clarify the pathogenesis of uveitis and the characterization of leukocyte migration factors in aqueous humor may help define subsets of anterior uveal inflammation.

Aqueous Humor↗
PubMed1991

Medical management of anterior uveitis.

Anterior uveitis is frequently caused by systemic disease, and it is appropriate not only to diagnose the iritis but also to determine, if possible, the underlying condition. Although diagnosis of an anterior uveitis is usually straightforward, medical management occasionally is not. Satisfactory treatment may be achieved in many cases with cycloplegics and topical corticosteroid therapy, but the management protocol must be tailored to suit the patient. Frequent assessment of the patient is required during the 2- to 3-week period usually required for resolution of an anterior uveitis.

Administration, Topical↗
PubMed2005

Metastatic lung and pleural malignancy presenting as bilateral acute anterior uveitis.

Anterior uveitis is associated with a variety of underlying systemic diseases but the association between bilateral acute anterior uveitis (BAAU) and lung and pleural malignancy is not widely recognized. The case is described here of a 61-year-old woman presenting to an eye clinic with BAAU. A routine chest radiograph performed principally to exclude pulmonary sarcoidosis revealed an intrapulmonary mass and she was subsequently found to have widespread lung and pleural malignancies. Evidence is discussed that suggests a link and potential aetiology between BAAU and lung and pleural malignancies. The present case shows the virtue of requesting a chest radiograph in patients presenting with BAAU, even in the absence of other symptoms or clinical findings.

Acute Disease↗
PubMed2004

Soluble HLA class I and HLA-DR plasma levels in patients with anterior uveitis.

Anterior uveitis (AU) is an autoimmune disease frequently associated with HLA-B27 antigen. Because of the immune regulatory properties of soluble human leukocyte antigen (sHLA) molecules, we quantified sHLA class I (sHLA-I) and sHLA-DR plasma levels in HLA-typed AU patients (n = 60). Randomly selected healthy individuals (n = 128) and HLA-B27 antigen-positive individuals (n = 24) with HLA phenotype frequencies similar to the HLA-B27 antigen-positive AU patients served as control panels. As expected, HLA-B27 phenotype was significantly increased in AU patients (n = 60), compared to healthy controls. Mean sHLA-I levels in AU patients were slightly higher than in randomly selected healthy controls. Regarding AU subgroups, elevated sHLA-I levels were only found in HLA-B27 antigen-negative patients. Compared to controls, sHLA-DR levels were significantly increased in AU patients and the subgroups of HLA-B27 antigen-negative and -positive patients but not Fuchs' heterochromic cyclitis (FHC). AU patients negative for HLA-B27 antigen with a chronic course had higher sHLA-DR levels than those with an acute course. The presence of associated systemic diseases in AU patients was related to elevated sHLA-DR levels. Secretion of sHLA-DR in blood differs among the various forms of AU. Systemic immune activation was present in AU but not in FHC.

HLA-DR Antigens↗
PubMed1992

Leukemic infiltrate versus anterior uveitis.

Anterior segment leukemic infiltrate (ASLI) is rare; it is found in 0.5% to 2.5% of all leukemic relapses. Its clinical manifestations, at times, are similar to those of anterior uveitis (AU). We report the cases of three patients, all of whom had ASLI as their primary manifestation of relapse. We observed some major clinical differences between ASLI and AU that may help differentiate these two conditions without using anterior chamber paracentesis and/or iris biopsy. The development of resistance to leukemic therapy is the major factor in treatment failure.

Adolescent↗
PubMed1980

[HLA antigens in uveitis anterior (author's transl)].

From January 1977 to May 1978, 101 patients with anterior uveitis were typed for HLA antigens. All came from the southwestern area of Germany, and 75 of these patients exhibited no signs of associated systemic disease (21 under 20 years of age, 54 over 20). In this group of 75 patients without associated systemic disease, a B27 frequency of 33.3% (8.9% in a random population) and a Cwl frequency of 16.0% (5.8% in a random population) was found as well as a B27-Cwl linkage of 13.3% (1.9% in a random population). A significant association with HLA antigens was found in (1) the adult form of anterior uveitis (disease onset over 20 years of age), namely, B27 antigen 38.9%, Cwl antigen 18.5%, B27-Cwl linkage 16.7%; and (2) male patients with anterior uveitis but without associated systemic disease, namely, B27 antigen 46.2%, Cwl antigen 17.9%, and B27-Cwl linkage 17.9%. No significant association with HLA antigens was found in (1) the juvenile form of anterior uveitis (disease onset under 20 years of age) and (2) female patients with anterior uveitis but without associated systemic disease.

Adolescent↗
PubMed1992

High incidence of asymptomatic urogenital infection in patients with uveitis anterior.

Acute anterior uveitis (AAU) may be associated with systemic infectious or inflammatory disease. We examined 92 patients with the first attack of acute anterior uveitis; all patients were free of any extraocular symptoms. A thorough clinical examination did not reveal any systemic underlying disease. In the course of microbiological examination, however, a high incidence of asymptomatic infection of the urethra and/or cervix with ureaplasma urealyticum, chlamydia trachomatis and mycoplasma hominis was found. Infections with ureaplasma were significantly more frequent in patients with AAU when compared with a sex- and age-matched control group. There was no statistically valid association of these infections with the HLA-B27 phenotype in the patients. The higher rate of urogenital infections in patients with AAU may reflect a higher rate of sexual promiscuity. Transmission of infectious agents seems to be one possible factor in the pathogenesis of AAU.

Acute Disease↗
PubMed1993

Traumatic anterior uveitis.

Traumatic anterior uveitis is a common result of ocular contusion. Patients require careful evaluation to determine the degree of injury and the risk of further complications. This discussion updates the practitioner on the pathophysiology, diagnosis, and treatment of anterior uveitis secondary to a nonpenetrating ocular injury.

Eye Injuries↗
PubMed2002

An evaluation of baseline risk factors predicting severity in juvenile idiopathic arthritis associated uveitis and other chronic anterior uveitis in early childhood.

BACKGROUND/AIMS: The clinical course for childhood chronic anterior uveitis can vary from mild, self limiting disease to bilateral blindness. The purpose of this study was to identify those risk factors at onset that predict disease severity. METHODS: A retrospective case note review of all patients with painless anterior uveitis diagnosed from 1982 to 1998. Patients were divided into two cohorts based on route of referral, diagnosis, and compliance with treatment. The standard cohort consisted of only those diagnosed from routine screening of juvenile idiopathic arthritis. RESULTS: Complications-cataract surgery, ocular hypertension treatment, and visual acuity <6/24. Remission: inactive uveitis on no topical treatment for >6 months. Results-163 patients were included. 34 patients (21%) developed at least one complication. The most significant predictor of complications was severe disease at onset (p = 0.001). Other factors included uveitis at the first examination (p = 0.034), membership of the non-standard cohort (p = 0.0001), non-oligoarticular disease (p = 0.02), and late onset arthritis (p = 0.024). Male sex was associated with increased complications in the standard cohort (p = 0.001). Factors predisposing to remission included membership of the standard cohort (p = 0.003), onset after 1990 (p = 0.016), white race (p = 0.015), mild disease onset (p = 0.003), and a long gap between arthritis and uveitis onset (p = 0.015). CONCLUSIONS: It is possible to characterise the severity of those with childhood chronic anterior uveitis at the onset of disease. The majority of patients remit without visually disabling complications. It may be possible to reduce the complication rate by targeting aggressive immunosuppression on high risk patients before complications develop.

Adolescent↗
PubMed2002

Diagnosis and management of herpetic anterior uveitis.

Herpetic anterior uveitis is a relatively common condition. History of herpetic disease and the presence of characteristic findings on ocular examination suggest the diagnosis and help to differentiate between HSV and VZV as the cause of this condition. New diagnostic techniques have allowed a more specific diagnosis. Topical corticosteroids and oral antivirals have become the main standards for management.

Eye Infections, Viral↗
PubMed1985

The genetics of acute anterior uveitis.

Acute anterior uveitis (AAU), and the many diseases with which it is associated, may be inherited. The antigen HLA-B27, on the 6th chromosome, increases the risk of AAU twenty-fold. AAU is also associated with an unusual phenotype, MZ, on the 14th chromosome--particularly when the AAU is related to ankylosing spondylitis.

Acute Disease↗
PubMed1998

Basic pathogenic mechanisms operating in experimental models of acute anterior uveitis.

Acute anterior uveitis is a recurrent inflammatory disease of the eye that occurs commonly, is distressing for the patient, and may have potentially blinding sequelae. The pathogenesis of the disease is poorly understood, and anti-inflammatory treatment is consequently non-specific and may be associated with significant complications. Animal models are a possible key to a better understanding of this disease. In one model, rats and mice develop a relatively short-lived anterior uveal inflammation almost immediately after systemic injection of bacterial endotoxin. Accumulating evidence suggests that cytokine production by resident uveal macrophages initiates endotoxin-induced uveitis which is characterized by an infiltration of neutrophils and mononuclear cells. A second model displays features in keeping with a delayed-type hypersensitivity immune response. Experimental melanin-induced uveitis is an acute recurrent uveitis with delayed onset but extended duration, observed when rats are immunized with bovine ocular melanin. Both animal models have clinical features in common with acute anterior uveitis, although experimental melanin-induced uveitis appears to mimic the human disease more closely. Novel treatment options to target implicated inflammatory cells and molecules are currently under consideration.

Acute Disease↗
PubMed1992

Morphologic correlations with fluorophotometric data from monkey eyes with anterior uveitis.

Acute anterior uveitis was induced in monkeys by unilateral intravitreal injection of 1.0 ng of Escherichia coli endotoxin. Twenty-four hours later, each animal received an intravenous injection of 250 mg/kg body weight of fluoresceinated horseradish peroxidase (F-HRP), and fluorophotometric measurements were taken for 90 min. The animals were killed, and both eyes were processed for HRP demonstration. In the anterior chamber aqueous humor of normal control eyes, F-HRP concentrations were less than 0.002 mg/ml at 90 min. The F-HRP concentration was elevated consistently in the endotoxin-injected eyes; however, the magnitude of the effect varied. By fluorophotometry, inflamed eyes fell into two distinct groups. At 90 min, most had an anterior chamber F-HRP concentration of 0.014-0.06 mg/ml, although others had 0.39 mg/ml. In the latter group, an appreciably shorter latency was observed between the time of tracer injection and its detection in the anterior chamber. Aqueous humor protein concentrations, although highest in the most F-HRP-permeable eyes, followed more of a continuum in their distribution and identified less clearly the subpopulations seen by fluorophotometry. Normal eyes had no tracer leakage across either the ciliary epithelial or iris vascular endothelial barriers. All inflamed eyes had HRP leakage across the ciliary epithelium, but the subpopulation of eyes with shorter latencies and higher F-HRP concentrations by fluorophotometry also had iris vascular leakage.

Animals↗
PubMed2006

Anterior uveitis investigation by Canadian ophthalmologists: insights from the Canadian National Uveitis Survey.

BACKGROUND: Anterior uveitis can be the result of a number of underlying etiologies and is commonly seen in ophthalmology practice. The clinician must choose from a battery of potential investigations. A nonselective approach to testing is costly and inefficient and can lead to misinterpretation of false positive results. The purpose of this study was to identify investigation patterns of ophthalmologists in Canada for anterior uveitis and to make evidence-based recommendations for appropriate tests that could lead to improved patient care and more cost-effective use of health care resources. METHODS: A cross-sectional survey of practicing ophthalmologists, fellows, and residents in Canada was conducted in September 2004. The survey instrument was an 11-item questionnaire mailed to 1196 physicians in Canada. RESULTS: A total of 498 (42%) physicians responded to the survey. A wide range of tests were chosen when respondents were presented with 5 scenarios for anterior uveitis and asked what investigations they would order. Many of these tests have low diagnostic yields because they lack the sensitivity and specificity to be used as routine investigations in the setting of anterior uveitis. INTERPRETATION: Increased education and awareness could lead to more cost-effective and efficient investigations in the setting of anterior uveitis. On the basis of evidence from a review of the literature, we make recommendations for investigations that should be considered in patients with anterior uveitis.

Canada↗
PubMed1982

HLA-B27, Klebsiella pneumoniae, and the relation to acute anterior uveitis.

Acute anterior uveitis (AAU) is a disease of unknown etiology, although it is frequently associated with various autoimmune diseases. It has recently been shown in patients with ankylosing spondylitis (AS), a disease often associated with AAU, that antiserum raised against a particular isolate of Klebsiella pneumoniae would cross-react with lymphocytes possessing HLA-B27. The present study was performed to evaluate the response of lymphocytes of patients to K. pneumoniae and to determine the correlation with HLA-B27. The circulating immune complex levels in the serum of the patients were also determined for correlation with the presence of HLA-B27 antigen. We were able to demonstrate this cross-reactivity in the samples of AAU patients; however, we did find an increased immune complex level that was independent of HLA-B27 antigen. From our results, we conclude that although AAU is clinically associated with AS, the role of K. pneumoniae in these disease states remains unclear.

Antigen-Antibody Complex↗