Immunopatbological characteristics of bovine serum albumin (BSA)-induced uveitis in rabbit was studied dynamically by enzyme bistochemical and immunohistoehemieal methods.The acid alpha;-naphthy acetate esterase(ANAE) positive cells in eboroid were found 7 days after intravenous injection of BSA. Then the number of the positive cells increased progressively and the retinal tissue was destroyed. Infihrated lymphocytes in ehoroidea were mostly positive ANAE cells when ehtssic granulomatous pathological change showed in retinae after 11 days. These results indicated that T lymphocyte may play an important role in patbologlc process of BSA-induced uveitis in rabbits and may be closely related to destruction of retinal tissue and formation of granulomas. Chin J Ocul Fundus Dis,1994,10:153-155）
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
ObjectiveTo study the distribution of pathogenic microorganisms in the ocular fluid of patients with acquired immunodeficiency syndrome (AIDS) and infectious uveitis.MethodsIt was a retrospective case analysis. From June 2018 to December 2019, 31 AIDS patients with infectious uveitis who were hospitalized or outpatient at Shanghai Public Health Clinical Center were included in the study. Among them, there were 30 males and 1 female; the average age was 38.51±11.17 years. There were 20 cases of panuveitis, 10 cases of posterior uveitis, and 1 case of infectious endophthalmitis. Serum CD4+T lymphocyte count (CD4+TC) were 0 - 239/μl during the same period. The second-generation gene sequencing technology was used to detect the collected intraocular fluid. Among 31 specimens, aqueous humor and vitreous humor were 27 and 4 respectively.ResultsAmong 31 specimens, 18 samples (58.1%, 18/31) of cytomegalovirus (CMV) were detected; varicella-zoster virus (VZV) were detected in 5 samples (16.1%, 5/31); Epstein-Barr virus were detected in 9 samples (29.0%, 9/31); human beta herpes virus type 6 (HHV6) were detected in 3 samples (9.7%, 3/31), human papillary molluscum virus (HPV), human polyoma virus, type G hepatitis virus were separately detected in 1 sample (3.2%, 1/31), all coexisting with other microorganisms. Parvovirus were detedcted in 8 samples (25.8%, 8/31); treponema pallidum were detedcted in 5 samples (16.1%, 5/31); toxoplasma gondii and Harmon coccidia were detedcted in 1 sample (3.2%, 1/31); synitelium Polycarpum were detedcted in 1 sample (3.2%, 1/31); mycobacterium tuberculosis complex, fungi, and microbacteria coexist were detedcted in 1 sample (3.2%, 1/31). Among the 18 CMV specimens, the number of gene sequences was more than 1059 (50.0%), and 104-1055 (27.7%). Among the 5 specimens of VZV, the number of gene sequences was＞1044 (80.0%). In one specimen, the mycobacterium tuberculosis complex, fungi, and microbacteria coexist, and the number of gene sequences were all＜100. The number of gene sequences of HHV6, HPV, human polyoma virus, type G virus, and parvovirus in all specimens was small. Among 31 specimens, 15 (48.4%) of pathogenic microorganisms were detected at least 2 species.ConclusionsCMV and VZV are the main pathogenic microorganisms of infective uveitis in patients with serum CD4+TC＜100/μl; treponema pallidum, toxoplasma gondii or other protozoa, mycobacterium tuberculosis, and fungi cause more infectious uveitis which are common in AIDS patients with serum CD4+TC＞100/μl. The coexistence of two or more microorganisms can be detected in the intraocular fluid of AIDS patients with infectious uveitis.
Objective To investigate the effects of gamma;-interferon (IFN-gamma; on the expression of costimulatory molecules B7-1 (CD80) and B7-2 (CD86) and Fas/FasL in human retina. Methods Nine human eyes were obtained from the eye-bank of Zhongshan Ophthalmic Center. Six eyes were used for making retinal wholemounts, and 12 retinal wholemounts from each eye were put into the 24-hole culture board which had 2ml DMEM/F12 culture medium in each hole. The wholemounts were divided into 3 groups whose concentration of IFN-gamma; was 0, 200, and 1000 U/ml respectively. After cultured in 37℃ culture box (95%O 2，5%CO 2) for 24 hours, the expressions of B7-1 (CD80), B7-2 (CD86), and Fas/FasL on these retinal wholemounts were detected by immunohistochemical method. The retinal wholemounts from 3 healthy people were detected by immunohistochemical method as the control. Results Expression of FasL but not B7-1, B7-2 or Fas was found in the control group, while the expression of B7-1, B7-2 and Fas and increased expression of FasL were found after cultured with IFN-gamma;. Conclusion IFN-gamma; may be involved in the occurrence of ocular immune response and induction of apoptosis via the stimulation of expression of costimulatory molecules and Fas/FasL, which plays an important role in the activation of T lymphocytes. (Chin J Ocul Fundus Dis, 2006, 22: 117-119)
ObjectiveTo observe the clinical efficacy of dexamethasone intravitreal implant (DEX) in the treatment of active non-infectious uveitis macular edema (NIU-ME).MethodsA retrospective observational study. From February 2018 to February 2019, 23 patients (26 eyes) were included in the study who were diagnosed with NIU-ME at the Department of Ophthalmology, Central Theater Command General Hospital and received intravitreal DEX treatment. Among 23 patients, there were 8 males (8 eyes) and 15 females (18 eyes); the average age was 46.9 years; the average course of disease was 9.2±2.4 months. All the affected eyes underwent BCVA and intraocular pressure examination; at the same time, OCT was used to measure the central retinal thickness (CMT) of the macula. Snellen visual acuity chart was used for visual inspection. The average BCVA of the affected eye was 0.281±0.191, the average intraocular pressure was 16.2±0.8 mmHg (1 mmHg=0.133 kPa), and the average CMT was 395.4±63.7 μm. Among the 23 patients, 8 patients had middle uveitis and 15 patients had posterior uveitis. Seven patients had received intravenous infusion of methylprednisolone, 5 patients had been treated with methylprednisolone combined with immunosuppressive agents, and 11 patients had not received any treatment. All the affected eyes were treated with DEX intravitreal injection. Patients received repeated visual acuity, intraocular pressure and OCT examination with follow-up after injection. During the follow-up period, patients with recurrence of edema or poor efficacy, systemic methylprednisolone and intravitreal reinjection of DEX, triamcinolone acetonide or methotrexate should be considered based on the patient's own conditions. We observed the changes of BCVA, intraocular pressure and CMT before and after injection in the affected eyes, and analyzed the variance of a single repeated measurement factor. At the same time, we observed the occurrence of ocular adverse reactions and systemic complications.ResultsAfter treatment 1.2±0.4, 3.3±0.3, 6.7±1.1, 9.2±1.1, 12.2±0.6 months, the BCVA of the affected eyes were 0.488±0.296, 0.484±0.266, 0.414± 0.247, 0.411±0.244 and 0.383±0.232; CMT was 280.2±42.7, 271.0±41.4, 292.5±42.9, 276.2±40.5, 268.4±26.6 μm, respectively. Compared with before treatment, the BCVA and CMT of the all eyes increased after treatment, and the difference was statistically significant (F=30.99, 5 196.92; P＜0.000). Among 23 eyes completed a 12-month follow-up, 13 eyes (56.5%) received 2 injections, 3 eyes (13.0%) received 3 injections, and other 7 eyes (30.4%) received only 1 injection. After treatment 1.2±0.4 months, 5 patients (6 eyes) with intraocular pressure＞25 mmHg gradually returned to normal after treatment with two eye drops for lowering intraocular pressure; 1 patient (2 eyes) with intraocular pressure＞40 mmHg, the intraocular pressure gradually returned to normal after 3 kinds of eye drops for lowering intraocular pressure.ConclusionIntravitreal injection of DEX in the treatment of NIU-ME can improve the visual acuity of the affected eye and reduce CMT.
Objective To observe the expression of matrix metalloproteinase-9 (MMP-9), its tissue inhibitor of matrix metalloproteinase (TIMP-1), inducible nitric oxide synthase (iNOS) and contents of nitric oxide (NO) in the ocular tissues of Sprague-Dawley (SD) rats with endotoxin induced uveitis（EIU）. Methods Ninety SD rats were randomly divided into experimental (81 rats) and control group (9 rats). The model of EIU was induced in rats in experimental group by injecting with lipoplysaccharide (LPS) 200 μl into the hind feet pads, while the rats in the control group were not injected. Nine rats were executed 0, 6, 12, 18, 24, 48, 72, 96 hours and 7 days, respectively, after injecting with LPS; the NO content and concentration of protein in the aqueous humor in blood plasma, aqueous humor, and uveal tissues were detected. The expressions of MMP-9, TIMP-1 and iNOS in the ocular tissues were detected by immunohistochemistry, and the average absorbance (A) value was evaluated by computer medical image analysis system. Results iNOS, MMP-9 and TIMP-1 expressed in the epithelial cells of iris and ciliary body and exudated inflammatory cells of rats. The concentration of protein in the aqueous humor, the contents of NO in blood plasma, aqueous humor, and uveal tissues, and A value of MMP-9 had obvious relativity with the inflammatory extent, while no positive correlation was found between the inflammatory extent and the A value of iNOS and TIMP-1. Expression of iNOS was found 6 hours after injection, reached the peak after 12 hours, and then dropped gradually. The expression of TIMP-1 could be seen 24 hours after injection, and reached its peak after 72 hours. Conclusion The content of NO and expressions of iNOS, MMP-9 and TIMP-1 changes from the beginning and during the development of EIU, which suggests that NO, iNOS, MMP-9 and TIMP-1 are involved in the pathologic process of EIU. (Chin J Ocul Fundus Dis, 2005, 21: 371-374)
The etiology of uveitis is complex and the clinical manifestations are varied. Diagnosis and treatment are often very difficult. Detailed medical history, thorough ocular examination and laboratory examination are important basis for diagnosis. In recent years, with the appearance of microincision vitrectomy surgery, it has been applied widely in the diagnosis and treatment of uveitis. It can confirm diagnosis, manage the fundus complications of uveitis, and has certain therapeutic effects. But it is worth emphasizing that the indications of vitrectomy must be strictly controlled. Suitable indications and surgical timing are the key to the effective diagnosis and treatment of uveitis.
ObjectiveTo observe and analyze the macular microvascular system changes in unilateral pediatric uveitis (PU) and healthy contralateral eyes. MethodsA cross-sectional case-control study. From January 2019 to July 2021, 21 eyes of 21 patients with PU diagnosed in one eye (PU group), 21 unaffected contralateral eyes (contralateral eye group), and 21 age-matched volunteers with 21 eyes (NC group) during the same period were examined in Peking Union Medical College Hospital. Optical coherence tomography angiography was used to scan the 6 mm × 6 mm fundus macular area in the three groups of selected eyes to measure the vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the retina, the area of the avascular zone (FAZ) in the fovea of the macula, the choroidal thickness under the fovea (SFCT), and the retinal thickness in the fovea of the macula (CRT). The device comes with a software choriocapillary flow measurement tool, which can obtain the macula's choriocapillary density (CCD) with the fovea as the center and the diameter of the annular area of 1.0 mm, 1.5 mm, and 3.0 mm, respectively. They were recorded as CCD-1.0, CCD-1.5, and CCD-3.0. The measurement data of multiple groups were compared by analysis of variance; if the variance of the three groups of data was not uniform, the Kruskal-Wallis test was used. Multiple linear regression analysis was used to evaluate the potentially related factors of CCD. ResultsCompared with the contralateral eye group and the NC group, the vessel density of SCP (H=－13.857, －25.500; P=0.043, P<0.001), DCP (H=－15.333, －31.595; P=0.007, P<0.001) and CCD-1.0 (H=－14.000, －16.214; P=0.040, 0.012) of the clinically quiescent PU group were significantly decreased. CRT and FAZ were not statistically different between PU and NC groups (F=0.955; P=1.000, 0.661). Compared with the NC group, the mean vessel density of SCP and DCP in the contralateral eye group decreased, and the difference in DCP vessel density was statistically significant (H=－16.262, P=0.004). There was no statistically significant difference between the CCD of two groups (P=1.000). The SFCT of the PU group was significantly thicker than that of the NC group (F=5.552, P=0.004), however, difference was not statistically significant from the fellow eye group (F=5.552, P=0.270). The results of multiple linear regression analysis revealed that the CCD-1.0, CCD-1.5, and CCD-3.0 showed a linear correlation with the area of FAZ (β=－0.494, －0.527, －0.566; P=0.015, 0.009, 0.010) and CRT (β=－0.322, －0.466, －0.342; P=0.026, 0.002, 0.028). CCD-1.0 and CCD-1.5 showed a linear correlation with the vessel density of DCP (β=0.277, 0.275; P=0.047, 0.045). ConclusionBoth retinal and choroidal microvasculature are abnormal in resting eyes with PU, and macular circulation disorders may be present in the unaffected fellow eye.
Objective To investigate the features and main reasons of blindness induced by uveitis in China. Methods A retrospective analysis was performed on the data from 1214 patients with uveitis, referring to Zhongshan Ophthalmic Center, with special respect to the incidence of blindness in different uveitis entities, the characteristics of blindness, and possible causes for the blindness. Results In the affected 1892 eyes of 1214 patients with uveitis, 355 eyes (18.83%) were blind. The mean age at the onset of blindness was 34.38 years and the gender ratio of male to female was 1.52:1. The blindness led by panuveitis was found in 248 eyes (26.27%), including 128 (51.61%) and 73 (29.44%) blind eyes caused by Behcet’s disease and Vogt-Koyanagi-Harada syndrome. Complicated cataract, vitreous opacity and secondary glaucoma were responsible for the blindness of the patients with panuveitis［89(35.89%), 53 (21.37%), and 30 eyes (12.10%), respectively］. Blindness caused by anterior uveitis was noted in 79 eyes (10.73%) with the main reasons of complicated cataract ［56 eyes (70.89%)］and secondary glaucoma［16 eyes (20.25%)］, posterior uveitis in 15 eyes (15.63%) with the main reason of vitreous opacity ［9 eyes (60.00%)］, macular diseases in 3 eyes (20.00%), intermediate uveitis in 13 eyes (11.21%) with the main reasons of vitreous opacity［8 eyes (61.54%)］, and complicated cataract in 5 eyes (38.46%). Conclusions Uveitis is one of the important causes leading to blindness, especially in the young adults. Panuveitis, especially Behcet’s disease and Vogt-Koyanagi-Harada syndrome, are the most common entities responsible for blindness in patients with uveitis. Complicated cataract and secondary glaucoma are the main causes of blindness in uveitis. (Chin J O cul Fundus Dis, 2005, 21: 350-352)
Beh?et uveitis (BU), one of the common manifestations of Beh?et syndrome, has a poor prognosis, high blinding rate, and severely impairs the quality of patients’ life. The current treatment principle mainly induce and maintain inflammation remission by suppressing the immune response. The glucocorticoid combined with immunosuppressive therapy for the treatment of BU has disadvantages such as long medication time, severe adverse effects, and poor long-term prognosis, whereas biologics have gradually attracted attention about the treatment of BU because of their high efficacy, low toxicity, and good long-term prognosis. The biologics used to treat BU include tumor necrosis factor-α inhibitors, interferon-α, interleukin blockers, and lymphocyte targeting preparations. It is believed that with the progress of various studies and clinical trials, the stepwise application of biologics is promising, and it is hopeful to provide more accurate and effective treatment for patients with BU in the future.