THE DIAGNOSIS AND TREATMENT OF HUMAN UVEITIS

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。为了提高我们的诊断敏锐度，我们正在 慢性泪囊炎患者结膜和泪腺活检分析 眼内淋巴瘤患者玻璃体标本中的结节病 和痤疮丙酸杆菌眼内炎，并进行了血清学试验 白塞病和莱姆病患者。这项工作包括 几个方面： (1)由痤疮丙酸杆菌引起的眼内感染是 白内障手术后的持续性葡萄膜炎。我们已经将 这些患者的炎症反应，并显示T细胞缺乏 抑制物，这可能解释了这些患者的慢性炎症 病人。 (2)我们研究了玻璃体切除在眼内诊断中的作用。 淋巴瘤，并表明需要重复玻璃体切除才能使 30%的病例得到了诊断。 (3)25例中间型肝炎患者中有4例莱姆血清阳性。 葡萄膜炎似乎代表了假阳性检测。工作也在进行中 评价血清学试验在预测水平方面的应用进展 白塞病的活动性。 (4)一项掩蔽、随机交叉研究，比较乙酰唑胺和 治疗葡萄膜炎黄斑囊样水肿的安慰剂问世 进步。我们还检测了泪腺和结膜活检 对于干扰素-γ、Kveim抗原、白介素类的存在 2，3，4，6和8，以及被认为是特异性的T细胞受体 结节病。

The goal of this project is to develop improved methods for diagnosing and treating human uveitis. To improve our diagnostic acumen, we are analyzing conjunctival and lacrimal gland biopsies from patients with sarcoidosis, vitreous specimens from patients with intraocular lymphoma and Propionibacterium acnes endophthalmitis, and serological tests in patients with Behcet's disease and Lyme disease. The work includes several aspects: (1) Intraocular infection by Propionibacterium acnes is a cause of persistent uveitis following cataract surgery. We have characterized the inflammatory response in these patients, and demonstrated a lack of T suppressor, which may explain the chronic inflammation seen in these patients. (2) We have examined the role of vitrectomy in diagnosing intraocular lymphoma, and showed that repeat vitrectomies were required to make the diagnosis in 30% of cases. (3) Positive Lyme serologies found in 4 of 25 patients with intermediate uveitis appear to represent false-positive tests. Work is also in progress to evaluate the use of serologic tests in predicting the level of activity of Behcet's disease. (4) A masked, randomized crossover study comparing acetazolamide to placebo for the treatment of uveitic cystoid macular edema is in progress. We are also 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 that are felt to be specific for sarcoidosis.