THE DIAGNOSIS AND TREATMENT OF HUMAN UVEITIS

该项目的目标是开发改进的方法， 诊断和治疗人葡萄膜炎。 在诊断领域， 活检和病理学标本检查患者 葡萄膜炎和艾滋病，以开发更好的诊断测试， 了解炎症性眼病的病理生理学。 这 实验室已经表明，需要重复玻璃体切除术， 30%的病例诊断为眼内淋巴瘤， 通常可以通过检查脑脊液来诊断。 到 我们正在测试用于诊断眼部结节病的改进方法 泪腺和结膜活检是否存在 干扰素-γ; Kveim抗原;白细胞介素2、3、4、6和8;和 T细胞受体可能对这种疾病有特异性。 吲哚菁绿色 血管造影术用于研究脉络膜血流在患者 葡萄膜炎 促肾上腺皮质激素释放激素测试是在 葡萄膜炎患者，以确定是否有缺陷 下丘脑-垂体-肾上腺轴与风险增加相关 自身免疫性眼部炎性疾病 我们是第一个 证明视网膜和脉络膜与肺孢子虫合并感染 卡氏杆菌和鸟胞内分枝杆菌。 我们对内毒素诱导的葡萄膜炎动物的研究表明， 肥大细胞数量增加的动物品系， 前葡萄膜病变较严重。 我们记录 各种细胞因子在这种疾病中的作用。 在治疗方面，正在进行几项研究： 比较乙酰唑胺与 用于治疗葡萄膜炎性囊样黄斑水肿的安慰剂是 目前，已有26名患者入选。 (2)局部施用 FK 506正在被测试作为一种治疗急性前葡萄膜炎， 内毒素诱导的大鼠葡萄膜炎动物。 (3)Behet的 这种疾病可能导致严重的眼部炎症和失明。 我们 回顾性分析了19例重度Beh患者埃氏葡萄膜炎 用环孢霉素治疗 患者随访（平均50.9个月） 环孢素（初始剂量，2.7-10.9 mg/kg）的19例中有11例 患者（58%）视力稳定或改善， 每只眼睛。 由于环孢霉素的副作用， 3例患者因肾毒性、高血压和神经系统疾病 症状 环孢霉素是一种有效的治疗许多患者 与京能集团还有葡萄膜炎

The goal of this project is to develop improved methods for diagnosing and treating human uveitis. In the area of diagnosis, biopsy and pathology specimens are examined from patients with uveitis and AIDS to develop improved diagnostic tests for better understanding the pathophysiology of inflammatory eye disease. This laboratory has shown that repeat vitrectomies are required to make the diagnosis of intraocular lymphoma in 30% of cases, and lymphoma can often be diagnosed by examination of the cerebrospinal fluid. To improve methods for diagnosing ocular sarcoidosis, we are testing lacrimal gland and conjunctival biopsies for the presence of interferon-gamma; Kveim antigen; interleukins 2, 3, 4, 6, and 8; and T-cell receptors possibly specific for this disease. Indocyanine green angiography is used to study choroidal blood flow in patients with uveitis. Corticotropin-releasing hormone tests are performed on patients with uveitis to determine whether a defective hypothalamic-pituitary- adrenal axis is associated with increased risk for autoimmune ocular inflammatory disease. We are the first to demonstrate coinfection of the retina and choroid with Pneumocystis carinii and Mycobacteria avium-intracellulare in a patient with AIDS. Our studies of animals with endotoxin-induced uveitis have shown that animal strains with increased numbers of mast cells in the anterior uveal tract have more severe disease. We have documented the role of various cytokines in this disease. In the area of treatment, several studies are in progress: (1) A masked, randomized crossover study comparing acetazolamide to placebo for the treatment of uveitic cystoid macular edema is in progress, and 26 patients have been recruited. (2) Topically applied FK506 is being tested as a treatment for acute anterior uveitis using animals with endotoxin-induced uveitis in the rat. (3) Behet's disease may cause profound ocular inflammation and blindness. We retrospectively reviewed 19 patients with severe Behet's uveitis treated with cyclosporine. Followup (mean, 50.9 months) of patients on cyclosporine (initial doses, 2.7-10.9 mg/kg) showed 11 of 19 patients (58%) had stabilization or improvement of visual acuity in each eye. Cyclosporine was discontinued because of side effects in three patients due to renal toxicity, hypertension, and neurologic symptoms. Cyclosporine is an effective treatment for many patients with Behet's uveitis.