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Vogt-Koyanagi-Harada Disease (vogt-koyanagi-harada + disease)
Selected AbstractsVogt-Koyanagi-Harada disease associated with interferon alpha-2b/ribavirin combination therapyJOURNAL OF VIRAL HEPATITIS, Issue 6 2003D. L. Sylvestre Summary. The complex immunological effects of interferon and ribavirin therapy (IFN/R) in hepatitis C virus (HCV) may also exacerbate or trigger the de novo development of autoimmunity. We report the first case of IFN/R therapy associated with Vogt-Koyanagi-Harada disease, a T-cell-mediated autoimmune response to melanocytes. This condition, which has characteristic ocular, neurological and integumentary findings, elicits a systemic prodrome that may mimic side-effect profile and delay of IFN or mask its recognition. We discuss this disease in the context of the known immunomodulatory effects of IFN-alpha and ribavirin and suggest potential mechanistic explanations for the association. [source] 4151: Epidemiology of uveitis in the Middle East and North AfricaACTA OPHTHALMOLOGICA, Issue 2010M KHAIRALLAH Purpose Numerous studies have examined the pattern of uveitis around the world. Most of them are from western countries, including the USA and countries in Europe, and Eastern Asia. The aim of this presentation is to review the epidemiological characteristics of uveitis in the the Middle East and North Africa. Methods The epidemiologic data on uveitis available from the Middle East and North Africa were reviewed. Results Several recent studies addressed the pattern of uveitis in different countries, including Iran, Saudi Arabia, Turkey, and Tunisia. Uveitis was most often seen in adults with a peak age at presentation in the third and fourth decades. There was no dramatic difference in gender distribution. Anterior uveitis was the most common anatomic form of uveitis, but a high rate of posterior uveitis and panuveitis was reported. A definitive or presumed specific diagnosis could be established for 57-87% of patients. The most common infectious entities were herpetic anterior uveitis, toxoplasmosis, and tuberculosis (Saudi Arabia). The most common identifiable non-infectious entities included Behçet's disease and Vogt-Koyanagi-Harada disease. Conclusion Herpetic infection, toxoplasmosis, and tuberculosis are the most common infectious causes of uveitis in the Middle East and North Africa. Behçet's diease and Vogt-Koyanagi-Harada disease are the most common non-infectious uveitic entities.HLA-B27 acute anterior uveitis, ocular sarcoidosis, and juvenile idiopathic arthritis associated uveitis are less common than in western countries. [source] 4153: Vogt-Koyanagi-Harada diseaseACTA OPHTHALMOLOGICA, Issue 2010A ABU EL ASRAR [source] 4156: Inflammatory mediators in the aqueous humor from patients with uveitis associated with Behçet's disease and Vogt-Koyanagi-Harada diseaseACTA OPHTHALMOLOGICA, Issue 2010A ABU EL ASRAR Purpose We studied interphotoreceptor retinoid-binding protein (IRBP), a dominant autoimmune antigen in the eye. Methods Aqueous humour samples from 28 patients with active uveitis were analysed for immunoglobulin G (IgG) content as a marker for blood-ocular barrier breakdown and by gelatinase B zymography for the detection of inflammation. The data were correlated with the presence of intact IRBP (approximately 140 kD) as determined by Western blot analysis and with the clinical disease activity. Results Aqueous humour samples from control eyes and eyes with low disease activity showed positive immunoreactivity for intact IRBP. The IRBP signal weakened or disappeared with higher disease activity. Significant positive correlations were observed between disease activity and levels of gelatinase B/matrix metalloproteinase-9 (MMP-9) (rs=0.713; P<0.001) and IgG (rs=0.580; P=0.001). Significant negative correlations were found between levels of IRBP and disease activity (rs=-0.520; P=0.005) and levels of MMP-9 (rs=-0.727; P<0.001) and of IgG (rs=-0.834; P<0.001). Whereas neutrophil elastase converted intact IRBP into an immunoreactive 55 kD peptide in vitro, the conversion by neutrophil degranulates resembled more the in vivo context with a complete degradation of IRBP. Reversal of inflammation with immunosuppressive therapy was accompanied with reappearance of intact IRBP and disappearance of IgG and MMP-9. Conclusion The analysis of IRBP proteolysis is useful as a biomarker for uveitis and suggests that inhibition of proteinases might become a therapeutic strategy in an inflammatory context of a damaged blood-ocular barrier. [source] Vitreous surgery for macular hole in patients with Vogt-Koyanagi-Harada diseaseCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 9 2008Izumi Kobayashi MD Abstract We describe two patients with Vogt-Koyanagi-Harada (VKH) disease, both in the convalescent stage, who presented with unilateral macular holes together with clinically significant epi-retinal membranes. Vitreo-retinal surgery was performed on the affected eyes and the surgical technique involved a standard three-port vitrectomy, peeling of the epi-retinal and internal limiting membrane (ILM). In both cases the retinae were tamponaded with air resulting in anatomical closure of the macular holes. The histology of the excised membrane was available in one case and this revealed multiple layers of presumed retinal pigment epithelial cells with cytoplasmic processes and intercellular junctions forming a basal lamina attached to the smooth surface of the ILM. Our findings demonstrate that macular holes can develop in patients with VKH but that the hole can be successfully closed with vitreo-retinal surgery. The convalescent stage tends to occur several weeks after the acute stage when the uveitic process has subsided and is characterized by choroidal depigmentation, producing a sunset glow appearance to the ocular fundus. Patients may also demonstrate varying degrees of cutaneous hypopigmentation, poliosis and/or alopecia. Macular holes have also been reported previously in patients during the convalescent stage of VKH and this communication describes the outcome of two patients who underwent vitreo-retinal surgery for this problem. [source] | ||||||||||