L-硝基精氨酸甲酯对实验性葡萄膜炎的影响

目的：观察一氧化氮（ＮＯ）含量含量在葡萄炎房东水及玻璃体中的变化及Ｌ－硝基精氨酸甲酯（Ｎ＾Ｇ－ｎｉｔｒｏ－Ｌ－ａｒｇｉｎｉｎｅ ｍｅｔｈｙｌ ｅａｒｔｅｒ,Ｌ－ＮＡＭＥ）的治疗效果。方法;采用兔眼玻璃２本内注射内毒素脂多糖（ＬＰＳ）制备葡萄膜炎模型,以检测房水蛋白浓度,结果：葡萄为房水及玻璃体及玻璃体中显著增高,即刻使用Ｌ ＮＡＭＥ;显著降低了ＮＯ水平,同时其蛋白浓度、细胞数目及组织炎症程度明显降     

Epidemiological characteristics of uveitis in Switzerland

Since January 1990, data from uveitis patients have been systematically stored in a computer data bank. During the period from January 1990 to March 1993, 435 new patients (185 female and 250 male, mean age 43 years; range 6–92) were seen at the Uveitis Clinic of the Hopital Jules Gonin. These 435 patients (630 eyes) were subdivided into anterior uveitis (268 patients — 62%), intermediate uveitis (47 patients — 11%), posterior uveitis (89 patients — 20%) and panuveitis (31 patients — 7%). The incidence of uveitis for the referral area considered was calculated to be 17 per 100,000 inhabitants per year. A specifie diagnosis was found in 312 cases (72%). The most frequently diagnosed entities were HLA-B27-associated acute anterior uveitis (67 cases — 15.4%), uveitis associated with acute herpes zoster ophthalmicus (40 cases — 9.2%), toxoplasmosis (39 cases — 9%), typical pars planitis (29 cases — 6.7%), sarcoidosis (29 cases — 6.7%), Fuchs' heterochromic cyclitis (27 cases — 6.2%), herpetic anterior uveitis (21 cases — 4.8%) and acute retinal necrosis (11 cases — 2.5%). Incidence and distribution of most disease entities correspond to those of other European series.     

Acute hypopyon uveitis in a patient with acquired immunodeficiency syndrome treated for systemic Mycobacterium avium complex (MAC) infection with rifabutin

Background: Hypopyon-uveitis has been identified as a dosage-dependent side effect in patients with acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex (MAC) infection with systemic rifabutin. Patients and methods: We report a 38-year-old female AIDS patient with bilateral hypopyon uveitis under therapy with rifabutin in combination with clarithromycin and indinavir. Results: At the time of presentation of the bilateral hypopyon uveitis the patient was treated with rifabutin (300 mg/day), clarithromycin (1000 mg/day) and ethambutol (1000 mg/day) for an M. avium complex infection. Also, the patient received the protease inhibitor indinavir. The rifabutin dose was reduced to 150 mg/day. Hypopyon and inflammation resolved under therapy with steroids. Conclusions: The concomitant use of rifabutin, clarithromycin, and protease inhibitors may lead to hypopyon uveitis. Reduction of dosage of rifabutin (150 mg/day) and treatment with topical steroids are required.      

通过前房相关免疫偏离阻止实验性自身免疫前葡萄膜炎

目的 实验性自身免疫性前葡萄膜炎（ＥＡＡＵ）是研究人前葡萄膜炎的有用模型。本研究旨在观察前房相关免疫偏离（ＡＣＡＩＤ）能否阻止ＥＡＡＵ发生。方法 将溶于磷酸盐缓冲液（ＰＢＳ）的牛黑色素蛋白（ＢＭＰ）注射于大鼠右眼前房;对照组动物仅注射ＰＢＳ。７d后使用且加完全福氏佐剂（ＣＦＡ）的ＢＭＰ和百日咳毒素免疫所有动物。通过临床 观察和组织病理学检测葡萄膜炎的严重程度和发病率。通过由注射ＢＭＰ刺激的足垫水肿反     

Prevention of experimental autoimmune anterior uveitis by anterior chamber-associated immune deviation

目的实验性自身免疫性前葡萄膜炎（ＥＡＡＵ）是研究人前葡萄膜炎的有用模型。本研究旨在观察前房相关免疫偏离（ＡＣＡＩＤ）能否阻止ＥＡＡＵ发生。方法将溶于磷酸盐缓冲液（ＰＢＳ）的牛黑色素蛋白（ＢＭＰ）注射于大鼠右眼前房;对照组动物仅注射ＰＢＳ。７ｄ后,使用添加完全福氏佐剂（ＣＦＡ）的ＢＭＰ和百日咳毒素免疫所有动物。通过临床观察和组织病理学检测葡萄膜炎的严重程度和发病率。通过由注射ＢＭＰ刺激的足垫水肿反应评估迟发型超敏反应（ＤＴＨ）。结果与对照组相比,预先眼内注射ＢＭＰ的大鼠,其ＥＡＡＵ的严重程度和发病率减低,且ＤＴＨ反应受到显著抑制。结论这些资料提示ＡＣＡＩＤ可以用来阻止ＥＡＡＵ的发生。     

Effect of a selective inducible nitric oxide synthase inhibitor on intraocular nitric oxide production in endotoxin-induced uveitis rabbits: in vivo intraocular microdialysis study

Inducible nitric oxide (NO) synthase (iNOS) is believed to contribute to the pathogenesis of endotoxin-induced uveitis (EIU). In the present study, we investigated the inhibitory effects of N(G)-nitro-L-arginine methyl ester (L-NAME), a non-selective NOS inhibitor, and S,S'-1,4-phenylene-bis(1,2-ethanediyl)bis-isothiourea (PBITU), a potent and selective iNOS inhibitor, on intraocular NO production in EIU rabbits using an in vivo intraocular microdialysis technique. The flare level in the anterior chamber increased from 1h after the injection of 100 micro g/kg lipopolysaccharide (LPS), and continued to increase for 24h. Aqueous humor protein concentrations were significantly increased at 24h after LPS-injection. These changes were significantly reduced by L-NAME (10mg/kg) and PBITU (1mg/kg), but not by D-NAME (10mg/kg). The increase in NO(2)(-) and NO(3)(-) levels in the dialysate induced by LPS was significantly inhibited by L-NAME (10mg/kg) and PBITU (1mg/kg), but not by D-NAME (10mg/kg). These results suggest that activation of iNOS may play a key role in the development of EIU, and selective inhibitors of iNOS may have therapeutic applications in the treatment of EIU.     

人类白细胞抗原B27相关性前葡萄膜炎的诊断与治疗

综述了人类白细胞抗原B27相关性前葡萄膜炎的临床表现、发病机制、诊断特点和治疗原则.     

光学相干断层扫描在Vogt-小柳原田病中的应用

目的观察Vogt-小柳原田病患者光学相干断层扫描(optical coherence tomography,OCT)的图像特征.方法对8例Vogt-小柳原田病患者(16只眼)进行OCT检查.结果所有患眼均表现程度不等的神经上皮脱离,脱离范围平均4022μm;神经上皮脱离高度1O1μm～2765μm,平均294μm;神经上皮厚度129μm～264μm,平均190μm.有1只眼表现为神经上皮层间水肿.神经上皮层下积液有浓密不均的点状回声,2只眼表现为团状渗出点,1只眼表现囊腔形成.结论OCT对于Vogt-小柳原田病尤其不完全性Vogt-小柳原田病的早期诊断有其优越性.同时为疾病的病情追踪、疗效评价以及视力预测提供了客观定量的评价标准.     

地塞米松玻璃体植入剂应用进展

地塞米松玻璃体植入剂(DEX)是一种装载0.7mg地塞米松的可生物降解的缓释植入物,其适应证主要有视网膜静脉阻塞继发黄斑水肿(RVO-ME)、糖尿病黄斑水肿(DME)和非感染性葡萄膜炎(NIU)。DEX的应用中不良事件主要有眼压升高和白内障,也正因此DEX在RVO-ME、DME的治疗中属于二线用药,多在抗血管内皮生长因子(VEGF)治疗无应答时使用,但DEX在人工晶状体眼或不愿频繁注药的患者中能发挥出其特定的优势。近来很多研究证实了DEX治疗NIU的有效性和安全性,但其在NIU治疗中的地位尚不明确。本文综述了DEX相关的重大临床试验结果,分析其应用进展和安全性。