Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In nine patients suffering from multifocal chorioretinitis with panuveitis, we obtained no impressive therapeutic benefit from vitrectomy. Seven women and two men ranging in age from 63 to 86 years underwent pars plana vitrectomy at 3-28 months after the first signs of uveitis had appeared. Previous medical treatment had always been unsuccessful. Vitrectomy was performed in one eye of eight patients and in both eyes of one patient. In addition, in two patients a cataract was removed by phacoemulsification and an intraocular lens was implanted. A visual improvement of one or two lines was achieved postoperatively in most cases, but the visual acuity decreased to preoperative values or less within 6 months. The surgical treatment showed no obvious effect on the intensity or frequency of uveitis relapse. In all cases, vitrectomy specimens were serologically negative for herpes-group viruses. Histologically, no malignancy was detectable. Immunohistochemistry studies revealed that a large number of the vitreous cells bore T-lymphocyte markers (mostly CD2-, CD3-, and CD4-positive); about one-third of the vitreous cells were macrophages, and B-lymphocytes were only rarely detected. In conclusion, pars plana vitrectomy in multifocal chorioretinitis achieved no positive long-term result. There was no diagnostic hint as to whether the cause of the uveitis might have been of a viral, malignant, or autoimmune origin. Therefore, multifocal chorioretinitis remains poorly understood in terms of its etiology and adequate treatment.
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PMID:Vitrectomy in multifocal chorioretinitis. 843 52

Clinical and immunological studies in 170 patients with senile cataracts carried out before and during the first 7 days after cataract extraction with implantation of intraocular lenses helped define the risk factors for development of an early exudative reaction: patients' age under 60 years, clinical signs of secondary immune deficiency presenting as infection syndrome, increased levels of nonspecific immunity factors with deterioration of the phagocytic component, T-lymphopenia, CD4/CD8 imbalance, and increased levels of interleukin-1 beta and tumor necrosis factor in the serum and lacrimal fluid.
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PMID:[Clinical and immunological factors in predicting an early exudative reaction after extraction of senile cataracts with implantation of elastic IOL]. 1037 70

To identify the cellular immune processes underlying intra-ocular inflammation, aqueous humour was obtained at cataract surgery from 22 patients with clinically inactive uveitis and 24 patients with age-related cataract. mRNA expression for the cytokines IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-12, interferon-gamma (IFN-gamma), transforming growth factor-beta (TGF-beta); T cell subsets CD3, CD4, CD8; monocytes and macrophages (CD14); and B cells (CD19) was measured using reverse transcriptase-polymerase chain reaction (RT-PCR) and radiometric analysis. The majority of uveitis patients demonstrated a T cell-mediated inflammatory response, predominately involving a Th1-like cytokine profile with expression of IL-2 and IFN-gamma in 16/22 and 18/22 samples, respectively. These cytokines were present in only a small number of patients with age-related cataract. This Th1-like polarization was supported by an increased expression of CD8 in a number of patients. IL-1beta was expressed in only six uveitic eyes. Only four patients expressed either IL-4 or IL-10 and no patient expressed both. TGF-beta mRNA could be detected in 18/22 uveitis patients and 15/24 controls. IL-12, the paradigmatic Th1-inducing cytokine, was absent in all samples but CD14 was expressed in the majority of patients and controls. CD19 could not be detected in any sample. The cellular infiltrate in the uveitic eyes showed clear evidence of low IL-1 and absent IL-12 expression despite a Th1-like profile and high expression of macrophages. This strongly suggests that the systemic immunosuppressive therapy used prior to surgery in some patients and/or the chronicity of the uveitis had actively suppressed/switched off macrophage function, leading to resolution of T cell activity.
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PMID:Molecular analysis of resolving immune responses in uveitis. 1046 47

Equine recurrent uveitis (ERU), a chronic, recurrent inflammation primarily of the anterior uveal tract, is the most common cause of blindness in horses. Recently, T-lymphocytes have been found to be the most numerous cell type to infiltrate the anterior uveal of horses with ERU. In the present study, we characterized the T-lymphocyte population in the anterior uveal tract of eyes of horses with chronic ERU by evaluating the microscopic appearance (histopathologic features), the T-lymphocyte subsets, and the relative levels and amounts of T-lymphocyte cytokine mRNA in the anterior uvea. Seven inflamed eyes (from six horses with chronic ERU) and 5 normal eyes (from five horses with nonocular problems) were studied. After clinical examination, the eyes were removed, ocular fluids were aspirated, and anterior uveal tissues (iris and ciliary body) were processed for histologic and molecular (RNA isolation) analyses. Histologic examination by hematoxylin and eosin (H and E) staining and immunohistochemistry evaluating T-lymphocyte subsets (anti-CD4, CD8, CD5) were performed for each sample. RNA samples were analyzed for levels of messenger (m) RNA specific for interleukin (IL)-2, 4, and interferon-gamma (IFNgamma) by quantitative reverse transcriptase polymerase chain reaction (QRT-PCR). Eyes with ERU exhibited characteristic clinical signs, including corneal edema, aqueous flare, posterior synechia, corpora nigra degeneration, and cataract formation. Histologically, infiltration of the uveal tract with lymphocytes, plasma cells, and macrophages was most evident in the ciliary body and base of the iris. Loss of tissue structure (destruction) was most evident in the ciliary processes. Infiltrating lymphocytes were predominantly CD4+ T-cells (e.g. 48% CD4+ and 18% CD8+ in the ciliary body stroma), as determined by immunohistochemistry. Few inflammatory cells were observed in the normal eyes. The QRT-PCR results revealed increased transcription of IL-2 and IFNgamma and low IL-4 mRNA expression in eyes with chronic ERU compared to normal eyes, demonstrating a Thelper (Th) 1-like inflammatory response in eyes with ERU.
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PMID:Characterization of T-lymphocytes in the anterior uvea of eyes with chronic equine recurrent uveitis. 1052 83

An immunological study was performed in 71 children aged 6-15 years old. Twenty seven of these 71 patients have undergone surgery for congenital cataract, 23 - for traumatic cataract aspiration-irrigation with a posterior chamber intraocular lens implantation and 21 - for secondary intraocular lens implantation. The number of peripheral blood active T lymphocytes, CD4(+), CD8(+), HLA DR(+) lymphocytes and antibody response to lens (alpha-crystalline) and retina (S-antigen) proteins were determined. Tissue specific antibodies were revealed in cases of both increased and decreased T-cellular immunity parameters. Sensibilization to S-antigen at the background of HLA DR(+) lymphocytes increase and a decrease in other parameters of immunity that may be regarded as the autoimmune status was the most unfavorable prognostic sign. In these cases even after atraumatic surgery the risk of postoperative inflammation was rather high with development of chronicity.
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PMID:Some Parameters of Immune Status in Children before and after Cataract Extraction with Intraocular Lens Implantation. 1268 98

CD4(+), CD8(+), immunoglobulin status and ocular lesions of some onchocerciasis-infected rural Nigerians as manifested by the presence of microfilariae in their skin snips and some chronic symptoms of the parasitic infestation were evaluated. The highest mean CD4(+) and mean microfilarial (mff) load of 560 +/- 20.46 unit cells/microl and 20 mff/mg were recorded among the individuals within the second decade of life, while the least mean CD4+ and mff load of 307.20 +/- 11.23 unit cell/microl and 6.5 mff/mg occurred among volunteers after 60 years of age. The highest mean CD8(+) of 388.00 +/- 23.71 unit cells/microl occurred at the third decade of life. The individuals above 60 years had the least mean CD8(+) of 350.25 +/- 11.90 unit cells/microl. The volunteers had mean CD4(+) of 372.45 +/- 109.02 unit cells/microl and mean CD8(+) of 359.42 +/- with an overall CD4(+):CD8(+) ratio of 1.04. The mean CD4(+) and mean CD8(+) had positive correlation with the mean microfilarial load (r = 0.52 and r = 0.40), respectively. The mean IgE, IgG, lgA, IgM, and IgD were 2,074.82 +/- 823.09, 19.36 +/- 2.49, 3.88 +/- 0.26, 3.59 +/- 0.38, and 0.29 +/- 0.19 mg/dl, and these immunoglobulins negatively correlated with the mean microfilarial load at r = -0.02, r = -0.15, r = -0.82, r = -0.37, and r = 0.26, respectively. Among these immunoglobulins evaluated, only mean IgE (2,074.82 +/- 823 ng/ml) was statistically different from the control subjects (0 mg/dl) at t = 3.39, P < 0.05. In all, the prevalence of the visual impairment and lesions were low. Among the six visual lesions, namely, cataract, choroidoretinitis, iridocyclitis, glaucoma, sclerosing keratitis, and optic atrophy encountered in Egoro-Eguare, only optic atrophy and sclerosing keratitis was reported among the children. The female adults had the highest prevalence of reduced vision 20(43.5%). Also, the prevalence of choroidoretinitis (2.2%) and iridocyclitis (2.2%) were the least prevalent ocular lesions reported among these female adults. The depletion of the CD4(+) contributed to the low prevalence of visual impairment and lesions in this locality. The depleted CD4(+), CD8(+), and the lower values of IgA, IgM, and IgG contributed in the maintenance of chronicity of onchocerciasis in Egoro-Eguare, Nigeria.
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PMID:CD4(+), CD8(+), immunoglobulin status and ocular lesions among some onchocerciasis-infected rural Nigerians. 1720 2

CD8 deficiency is a rare primary immunodeficiency with low or absent peripheral CD8 cells which results from TAP deficiency, Zap 70 deficiency and CD8 alpha gene mutation.We report a 14 year old female who presented with a history of recurrent pneumonia, bronchiectasis, otitis, severe varicella, herpetic lesions of mouth, bilateral uveitis, and cataract formation since the age of 8 years.She had growth failure, a huge spleen and moderate clubbing. In immunologic workup, humoral and phagocytic systems were normal. DTH response to candida, PPD and DT were negative but LTT response to PHA mitogen was normal. HLA typing showed normal class I expression. Flowcytometry of peripheral blood showed CD8: 0 to 2% (absolute count, 0-60 cells/mm3) with increased CD4/CD8 ratio on several occasions.Diagnosis of this patient cannot be HLA class I deficiency (TAP1 or TAP2), because class I expression had been normal. It is possible to be Zap -70 deficiency or CD8 alpha gene mutation. Bilateral uveitis in our patient was a unique presentation which might have resulted because of immune dysregulation in CID.
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PMID:Recurrent infections and bilateral uveitis in a patient with CD8 deficiency. 1730 23

As biopsies are not taken at the time of human corneal allograft rejection, most information on the early cellular changes in rejection is from animal models. We examined the phenotype of alloreactive cells present in the human anterior chamber during corneal graft rejection by flow cytometry and quantified aqueous humor levels of cytokines and chemokines using cytometric bead array. Aqueous and peripheral blood samples were taken from patients with graft endothelial rejection (n = 11) and from control patients undergoing cataract surgery (n = 8). CD45(+)CD4(+), CD45(+)CD8(+) and CD45(+)CD14(+) cells were found in aqueous during rejection; no CD45(+) cells were seen in control samples. Higher proportions of CD45(+) cells found in aqueous during rejection were CD14(+), denoting monocyte/macrophage lineage, than were CD4(+) or CD8(+). Large elevations were seen in aqueous levels of IL-6, MCP-1 and IP-10 during rejection compared with controls; smaller but still statistically significant increases were seen in MIP-1alpha and eotaxin. The role of CD14(+) cells in allorejection is unclear as is the potential of these chemokines and their receptors as therapeutic targets. Aqueous humor samples offer a unique opportunity to analyze components of the allogeneic response in direct contact with donor tissue but without artifacts inherent in examination of tissue.
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PMID:Aqueous humor alloreactive cell phenotypes, cytokines and chemokines in corneal allograft rejection. 1855 41

Vogt-Koyanagi-Harada (VKH), a multisystem autoimmune bilateral panuveitis with systemic manifestations, is uncommon in immunocompromised patients such as human immunodeficiency virus (HIV)/acquired immunodeficiency disease syndrome (AIDS). We report a rare presentation of VKH in a 45-year-old HIV-positive female on highly active antiretroviral therapy (HAART) who presented with a history of recurrent panuveitis. A diagnosis of probable VKH was made based on ocular and systemic signs and symptoms. She was treated with topical and systemic steroids with close monitoring of CD4 counts and viral loads. After inflammation control, complicated cataract was managed surgically under perioperative steroid cover. VKH in HIV/AIDS has not been reported earlier. This case shows that significant inflammation can be seen even in HIV/AIDS patients on HAART with VKH in spite of moderate CD4 counts. Management is a challenge considering the systemic risks with long-term use of steroids.
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PMID:Management of a rare presentation of Vogt-Koyanagi-Harada disease in human immunodeficiency virus/acquired immunodeficiency disease syndrome patient. 2857 2

A retired woman with left ophthalmic shingles of over 2 years' duration attended with bilateral vision loss and systemic upset. Acute retinal necrosis with detachment was detected on right fundus examination. Cataract in left eye precluded funduscopy. Ocular ultrasonography revealed fibrotic retinal detachment in the left eye. MRI brain and orbits also showed signals of retinal detachment. No abnormal MRI signal within the optic nerve or brain was found. Varicella zoster virus was detected in ocular aqueous and blood samples. High-dose intravenous acyclovir was administered. HIV test was positive with a very low CD4 count. Antiretroviral medications were prescribed. There was no recovery of vision. She was certified as blind, and social services were involved in seeking to provide alterations to her home in view of her severe disability. This case highlights the importance of suspecting HIV in patients with severe or chronic ophthalmic shingles. Images and implications for clinical practice are presented.
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PMID:Sequential retinal necrosis secondary to varicella zoster in unrecognised long-standing HIV infection: patient safety report. 2956 25


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