PURPOSE: To investigate the influence of transforming growth factor-beta
(TGF-beta;) on endotoxin-induced uveitis (EIU).
METHODS: TGF- beta; was abstracted from humam platelets using Bio-gel P-60 chromatography. It was introduced either topically(drops) or intraperitoneally into the SD rats after footpad injection of lipopolysaccbaride(LPS). The inflammation in the anterior uvea was clinically evaluated with slitlamp every day.
RESULTS :TGF-beta; obtained from Biogel P-60 chromatography displayed single band on SDS-PAGE,showing a molecular weight of 12 500 EIU occurs significantly earlier and more severe in the rats which only received LPS injection than in the TGF-beta; treated rats. The duration of the inflammation was also much longer in the untreated rats than in the treated rats (P＜0. 001). CONCLUSION: TGF-beta; purified from human platelets may partly prevent the development of EIU and effectively reduce the severity of the inflammation induced by LPS injection.
（Chin J Ocul Fundus Dis,1996,12: 101-104)
Noninfectious uveitis refers to a category of inflammatory diseases involving the uvea, with the exception of infectious factors or masquerade syndrome. The diagnosis and follow-up of noninfectious uveitis that involving retina or choroid require fundus imaging techniques. Fundus autofluorescence is a noninvasive imaging technique. Compared with fundus colorized photography, fundus fluorescein angiography and indocyanine green angiography, fundus autofluorescence indicates the functional status of retinal pigment epithelium and photoreceptor cells in a better way, thus playing a role in the pathophysiological mechanisms investigating, early diagnosis, disease progression monitoring and prognosis estimating of noninfectious uveitis, such as Vogt-Koyanagi-Harada disease, Beh?et disease, multifocal choroiditis, punctate inner choroidopathy, birdshot chorioretinopathy, multiple evanescent white dot syndrome, acute zonal occult outer retinopathy, acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis.
ObjectiveTo preliminarily investigate the mechanism of MMP-9 blocking CD73 detachment from RPE cells surface and preventing and treating experimental autoimmune pigment membranitis (EAU).MethodsRPE cells isolated from wild-type C57BL/6 and CD73 gene knockout (CD73-/-) mice were cultured in vitro, and treated with lipopolysaccharide and TNF-α to induce CD73 detachment from RPE surface. According to whether MMP-9 inhibitor CTK8G1150 was added at the same time (the final concentration was 5.0 mol/L) or not, RPE cells cultured in the two types of mice were respectively set as MMP-9 inhibitor intervention group and non-intervention control group. The cells in each group were treated with the intervention of a solvent, 1 μmol/L adenosine monophosphate (AMP), 1 μmol/L AMP, and 3 μmol/L 5' -α,β-methylene adenosine diphosphate (APCP) (AMP+APCP). The stimulating effect of RPE cells in different groups on CD4+ T cell proliferation was detected by tritiated thymidine incorporation. Adoptive immune induced EAU in wild-type B6 mice and CD73-/- mice, respectively. The receptor mice were randomly divided into the MMP-9 inhibitor intervention group and the non-intervention control group, and CTK8G1150 or the solvent were injected into the subretinal cavity 4, 7 and 10 days after adoptive immunity. CD73 mRNA and protein expression in RPE cells of recipient mice were detected by real-time quantitative PCR (RT-PCR) and Western blot. One-way ANOVA was used to analyze all experimental data.ResultsWhen the stimulation mode was AMP, the proliferation of CD4+ T cells in the C57BL/6 MMP-9 inhibitor intervention group decreased significantly compared with the non-intervention group (F=13.28, P＜0.01). When the stimulation mode was solvent and AMP+APCP, there was no statistically significant difference in the proliferation capacity of CD4+ T cells between the two groups (F=7.78, 6.58; P＞0.05). There was no statistically significant difference in the proliferation capacity of CD4+ T cells between the CD73-/- MMP-9 inhibitor intervention group and the non-intervention group (F=5.24, 6.12, 7.04; P＞0.05). RT-PCR results showed that there was no statistically significant difference in the relative expression of CD73 mRNA in RPE cells between the MMP-9 inhibitor group and the non-intervention control group (F=6.54, P>0.05). Western blot results showed that the expression of CD73 protein in RPE cells in the MMP-9 inhibitor group of B6 receptor mice was significantly increased compared with the control group (F=15.24, P＜0.01).ConclusionMMP-9 inhibitor blocks CD73 detachment from RPE cells surface and has a protective effect on EAU.
Objective
To explore the consistency and significance of optical coherence tomography (OCT) and clinical and histopathological findings in adoptively transferred uveitis in mice.
Methods
The adoptively transferred experimental autoimmune uveitis (EAU) model was established by intraperitoneal injection of antigen-specific T cells in C57BL/6 mice. Since 9 days after transferred, inflammation of eyes was observed by indirect ophthalmoscope with +90D lens and record clinical scores every 3 days. The disease was divided into 6 phases including onset phase, early phase, pre-peak phase, peak phase, resolution phase and late phase of EAU, which respectively corresponding to clinical score 0.5, 1.0, 1.5 - 2.0, 2.5 - 3.0, 1.0 - 2.0 and less than 1.0. Since 9 days after transferred, the retina and retinal thickness (RT) was measured by spectralis OCT about 1 disc from the disc edge in 10 time points including 9, 11, 16, 21, 25, 30, 35, 40, 50 and 60 days after transferred. The OCT score was recorded as from 0.0 to 4.0. After transferred 9, 21 and 60 days, the mice were killed and eye balls were examined in histology. OCT score, clinical score and histology in the mouse were compared and analyzed.
Results
The disease was divided into onset phase, early phase, pre-peak phase and peak phase of EAU, which respectively corresponding to 9, 16, 21 and 26 days after transferred. In four phases, OCT score were 0.5, 1.0, 2.0 and 4.0 respectively. After transferred 30 days, which was in resolution phase of EAU, the inflammation cells in vitreous were decreased and OCT score was 3.0. After transferred 60 days, which was in late phase of EAU, inflammation cells in vitreous were disappeared and retina was atrophic topically. The histology showed the vitreous has slight inflammation cells and retinal structure was normal at onset of EAU. The vitreous has massive inflammation cells and retina structure was disorder at pre-peak of EAU. And in resolution phase of EAU, the inflammation cells in vitreous were slightly and retina was atrophic and thinned. The data in this study demonstrated that OCT score was well correlated with clinical score in EAU (r=0.957 9, P < 0.000 1).
Conclusion
OCT and clinical and histopathological findings in adoptively transferred uveitis in mice were consistency and OCT is contribute to evaluate the disease dynamically and quantifiably.
Objective
To detect the prognosis of visual acuity, operation timing and medical management of peri-operation in patients who had undergone pars plana vitrectomy for uveitis associated with tractive retinal detachment.
Methods
The clinical data of 15 eyes (13 patients) with tractive retinal detachment associated with uveitis who had undergone pars plana vitrectomy from our Department were retrospectively analyzed. The patients, 6 males and 7 females, aged from 19.0 to 70.0 years, with the average of 42.8 years. The duration of the disease history was 3-15 years with the average of 7 years. In the 15 affected eyes, the visual acuity was le;hand moving before the eye in 7 eyes, 0.01-0.1 in 7, and 0.2 in 1. Vitreous opacity, proliferative vitreoretinopathy, and tractive retinal detachment were found in all of the affected eyes. All the patients had been treated with oral and topical steroid. In addition, 3 of them received oral azathioprine meanwhile. Eye drops of 1% prednisolone acetate, 1% atropine, and tropicamide were used. The inactive duration of inflammation of uveitis was 0.5-4.5 months with the average of 2.0 months. After the inflammation became inactive, pars plana vitrectomy with membrane peeling, intraocular photocoagulati,filling with C3F8 or silicon oil were performed, including 7 eyes underwent lens excision. Glucocorticoid was given to the patients orally before the operation, and systemic and ocular medication of glucocorticoid were given continuously after the operation, in whom 3 were treated with oral azathioprine meanwhile. The postoperative follow-up duration ranged from 3 to 146 months with the average of 26 months.
Results
No recrudescence of uveitis, inflammation of ocular anterior segment, or vitreous inflammation was fund in the 15 eyes. The retina reattached successfully and the visual acuity improvement in 13 eyes (86.7%), inluding 2 eyes achieved the visual acuity increased from 0.2 to 0.8 and 0.03 to 0.6, 1 eye had unchanged visual acuity (6.7%)，and 1 eye decreased from hand moving to light perception (6.7%). In the follow-up duration, 4 eyes had cataract formation and underwent cataract extraction and intraocular lens (IOL) implantation, and the visual acuity improved after the operation. Iris neovascularization and secondary hyphema were found in 1 eye. Organization membrane on the surface of rtina and tractive retinal detachment recurred in another eye.
Conclusion
Pars plana vitrectomy is effective on uveitis associated with tractive retinal detachment. Operation timing and perioperational reasonable glucocorticoid application are essential for surgery success.
(Chin J Ocul Fundus Dis, 2007, 23: 108-111)
ObjectiveTo analyze the clinical character of uveitis in second hospital of Jilin university.
MethodsRetrospectively analyze the clinical data of uveitis patients referred to from Second Hospital of Jilin University from September 2009 to September 2014. According to anatomical location, the manifestation of these uveitis patients were divided into anterior uveitis, panuveitis, intermediate uveitis and posterior uveitis. To discuss the possible causes of these patients according to the general information and relevant clinical laboratory examinations results.
ResultsThere were 1215 cases in this study, which included 587 male, accounting for 48.31%; and 628 female, accounting for 51.69%. The ratio of male-to-female was 0.93:1. The range of the age of these patients was from 4 to 91 years old. The mean age of these patients at the onset of these disease was (41.43±14.20) years. Of the 1215 cases, 40 male and 43 female were younger than 20 years. The ratio of male-to-female was 0.93:1; 412 male and 396 female were between 21 and 50 years old. The ratio of male-to-female was 1.04:1; 135 male 189 female were older than 50 years. The ratio of male-to-female was 0.71:1. There were 572 cases of anterior uveitis, accounting for 47.08%; 527 cases of panuveitis, accounting for 43.37%; 52 cases of intermediate uveitis, accounting for 4.28%; 64 cases of posterior uveitis, accounting for 5.27%. 703 cases had etiological diagnosis according to the clinical character and the auxiliary results, accounting for 57.68%. Vogt-koyanagi Haradal (VKH) syndrome, ankylosing spondylitis associated with uveitis and Beh?et's disease were the common entity, accounting for 30.44%, 19.77% and 14.22% respectively.
ConclusionsThe mean age of these patients in this study was older, compared to other reports. Female patients were more than male, especially in these patients older than 50 years. VKH syndrome, ankylosing spondylitis associated with uveitis and Beh?et's disease were the common entities.
Objective To analyze the onset, clinical manifestation, causation, complications of pediatric uveitis. Methods One hundred and two patients with uveitis under 16 year-old were retrospectively studied. They visited the clinic in Peking University First Hospital from November 1979 to December 2008. Their age ranged from 2.5 to 16 years old, with a mean of 11.9 years. Routine exam was carried out, including visual acuity, slit lamp, fundus, and laboratory workup. The diagnosis and classification were made by the anatomic location according to the standard of The International Uveitis Working Group. The data of disease history, age of onset, manifestation, recurrence, causation, systemic diseases, complications, and lab examination were analyzed.Results A total of 102 patients (170 eyes) with pediatric uveitis were included in this study, 68 patients (66.6%) were bilateral cases. Anterior uveitis represented in 38 patients (37.3%), intermediate uveitis in 19 (18.6%), posterior uveitis in 10 (9.8%), and panuveitis in 35 (34.3%). The disease duration was from five days to 2.4 years, with a mean of 3.6 months. The follow-up time was two weeks to more than ten years. The first three causes of pediatric uveitis were juvenile idiopathic arthritis, Vogt-Koyanagi-Harada disease, and Behccedil;etprime;s disease. 36 patients were found with complications, and among them 19 had complicated cataract, seven had secondary glaucoma, five had corneal band dystrophy, 12 had iris synechia (both anterior and posterior), one had retinal detachment, two had eye atrophy, and one patient with juvenile idiopathic arthritis had bilateral femoral head necrosis because of the use of steroid and hip joint was replaced. There were ten children suffering more than two complications. Conclusions Pediatric uveitis is a possible blindness disease with variety of etiology and manifestations,and tends to cause complications. Early and special attention must be taken to avoid serious consequences.
Acquired syphilis uveitis, due to lack of the characteristic features, presents with various types. The most common type is posterior uveitis and panuveitis, including chorioretinitis, retinal vasculitis, optic nerve retinitis. The diagnosis and assessment of response to treatment depends mainly on the serological diagnostic tests, including nontreponemal and treponemal test. Acquired syphilis uveitis often presents with manifestations similar to various types of uveitis, especially to autoimmune uveitis and other infectious uveitis, so differential diagnosis is important. The gold standard treatment for active syphilitic uveitis is penicillin G, or doxycycline if patient is allergy to penicillin. Clinically misdiagnosis and delayed treatment may result in irreversible visual impairment and severe systemic and eye complications. However such timely treatment always has a good prognosis.
Among 21 cases (27 eyes)of complicated cataract of uveitis that underwent surgery of cataract extraction, 22 eyes (81%) attained the visual acuity of 0.1 or better without apparent side-effect. The results indicated that cataract extraction is recommendable to improve visual acuity and alleviate intraocular inflammation in some eases of complicated cataract of uveltis accompanied with relatively high doage of cortical steroid therapy before and after operation,and the operation could be performed even flare and cells in aqueous humor or keratic precipitates were observed.
（Chin J Ocul Fundus Dis,1994,10:162-164）
Glucocorticoids (GCS) are the main treatment for non-infectious uveitis (NIU). However, long-term GCS treatment may induce systemic side effects including hypertension, hyperlipidemia and diabetes. Patients may develop cataract, ocular hypertension or glaucoma because of topical application of GCS. Rapamycin (RAPA) exhibits immunosuppressive, antiangiogenic and antiproliferative effects. Animal experiments and clinical trials have shown that RAPA has therapeutic potential for NIU, especially the treatment of intravitreal injection. In particular, intravitreal injection of RAPA can result in minimal systemic exposure and reduce adverse events. Meanwhile, systemic unwanted effects should be concerned about. In recent years, some studies have attempted to employ nanostructured carriers to improve penetrating abilities of RAPA and efficacy of treatment for ocular posterior segment diseases. These carriers include micelles, liposomes, nanocrystals, polymeric nanoparticles, magnetic nanoparticles and so on. Whether they can load RAPA for treating NIU deserves further study and exploration.
