DIAGNOSIS AND TREATMENT OF HUMAN UVEITIS AND AIDS-RELATED OCULAR DISEASE

该项目的目标是开发改进的诊断方法 以及治疗人类葡萄膜炎和艾滋病的眼部并发症。这 该项目包括评估新的诊断和治疗的临床试验 眼内炎性疾病的治疗方法 血液和组织的疾病、免疫学和组织学研究 取自眼部炎症患者的标本，以及天然的 各种形式葡萄膜炎患者的病史研究。 一些研究的重点是改进诊断测试，以 葡萄膜炎。结膜和泪腺活检标本 对结节病患者进行了反向分析 转录酶-聚合酶链式反应(RT-PCR)结果显示 某些Gammadelta T细胞受体克隆型的检测。这 信息将提供有价值的关于 这些患者的眼部炎症反应，可能有助于 将这种疾病与其他形式的葡萄膜炎区分开来。 临床科仍在参与一些设计的研究 提高葡萄膜炎和眼部恶性肿瘤的治疗水平。一个 前瞻性、双掩蔽、随机研究表明 乙酰唑胺治疗引起的有统计学意义但很小的 与安慰剂相比，黄斑囊样水肿有所减轻，尽管 视力没有实质性的变化。多中心、随机化 肝素表面修饰人工晶状体的临床研究 在葡萄膜炎患者中已经招募了12名患者，并自然 葡萄膜炎和视力良好患者的病史研究正在进行中。 最后，临床科参与了眼科的研究 与获得性免疫缺陷综合征(艾滋病)相关的并发症。我们 回顾600例眼科检查 提高艾滋病患者的诊断率。我们最近显示，大约有50 %的患者在诊断时没有眼部不适 巨细胞病毒(CMV)视网膜炎，建议定期筛查 需要眼科检查才能发现这种视网膜感染。 早期的国家。此外，我们还参与了新医学的研究 和巨细胞病毒视网膜炎的外科治疗，包括 更昔洛韦缓释植入剂。

The goal of this project is to develop improved methods for diagnosing and treating human uveitis and the ocular complications of AIDS. This project encompasses clinical trials evaluating new diagnostic and therapeutic approaches for patients with intraocular inflammatory disease, immunologic and histologic studies of blood and tissue specimens obtained from patients with ocular inflammation, and natural history studies of patients with various forms of uveitis. A number of studies have focused on improving diagnostic tests for uveitis. Conjunctival and lacrimal gland biopsy specimens from patients with sarcoidosis have been analyzed using reverse transcriptase-polymerase chain reaction (RT-PCR) and showed increased detection of certain gammadelta T-cell receptor clonotypes. This information will provide valuable information on the nature of the ocular inflammatory response in these patients and may help to differentiate this disease from other forms of uveitis. The Clinical Branch remains involved in a number of studies designed to improve the treatment of uveitis and ocular malignancy. A prospective, double-masked, randomized study demonstrated that acetazolamide therapy caused a statistically significant but small decrease in cystoid macular edema compared with placebo, although visual acuity did not substantially change. A multicenter, randomized clinical trial evaluating a heparin surface-modified intraocular lens in patients with uveitis has recruited 12 patients, and a natural history study of patients with uveitis and good vision is in progress. Finally, the Clinical Branch is involved in studies with ocular complications related to acquired immunodeficiency syndrome (AIDS). We are retrospectively reviewing the ophthalmologic examinations of 600 AIDS patients to improve diagnosis. We recently showed that about 50 percent of patients have no ocular complaints at the time of diagnosis of cytomegalovirus (CMV) retinitis, suggesting that regular screening eye examinations are needed to detect this retinal infection at an early state. In addition, we are involved in the study of new medical and surgical treatment for CMV retinitis, including a sustained-release ganciclovir implant.