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UVEITIS Th1 and Th2 responses on the ocular surface in uveitis identified by CCR4 and CCR5 conjunctival expression. Trinh L, Brignole-Baudouin F, Raphaël M, Dupont-Monod S, Cassoux N, Lehoang P, Baudouin C. Am J Ophthalmol. 2007 Oct;144(4):580-5. Epub 2007 Aug 8 PURPOSE: To investigate CC chemokine receptor 4 (CCR4) and CC chemokine receptor 5 (CCR5) expression, known to be related to the Th2 and Th1 inflammatory pathways, respectively, and human leukocyte antigen-D related (HLA-DR) antigens as hallmarks for ocular surface inflammation in patients with uveitis using conjunctival impression cytologic specimens. DESIGN: Case-controlled study. METHODS: Conjunctival impression cytologic specimens were obtained from patients with anterior uveitis (n = 26), and their inflammatory profile was compared with those of patients with vernal keratoconjunctivitis (VKC; n = 24), keratoconjunctivitis sicca (KCS; n = 17), and normal subjects (n = 17). Expressions of CCR4, CCR5, and HLA-DR were analyzed using flow cytometry and were expressed by determining the percentage of cells expressing the markers in the conjunctival epithelium. RESULTS: CCR4 was overexpressed in the uveitis group (mean, 19.8% +/- 19.7% of positive cells) and in the VKC group (24.7% +/- 20.1%). CCR5 was expressed only weakly in uveitis patients (6.4% +/- 13.1%) and in the normal subjects (2.4% +/- 2.4%). HLA-DR expression by conjunctival cells was increased in the uveitis patients (57.4% +/- 21.1%) and in the KCS group (52.4% +/- 12.1%) compared with the VKC group (23.9% +/- 26.8%; P < .001) and normal subjects (22.1% +/- 19.1%; P < .001). CONCLUSIONS: CCR4, classically related to the Th2 system, and HLA-DR both were overexpressed by the conjunctival epithelium in uveitis patients, whereas CCR5, related to the Th1 system, was expressed weakly in uveitis patients. These preliminary results seem to suggest an involvement of the Th2 system on the ocular surface in uveitis. Exploration of the ocular surface in uveitis may represent a new way to understand better the immune pathways involved in this complex disease. Pars Planitis in Children: Epidemiologic, Clinical and Theraputic Characteristics. JPOS 2007; 44:288-293. Pars planitis is an idiopathic form of intermediate uveitis characterized by minimal anterior chamber involvement, anterior vitreous cells, vitreous condensations, and 78
peripheral retinal vasculitis. The etiology is unknown. 30 eyes in 16 patients diagnosed between 1995 and 2005 in the Department of Pediatric Ophthalmology at Hospital Universitario La Paz, Madrid, Spain were reviewed retrospectively. Pars planitis was bilateral in 87.5% and more frequent in males (68.8%). Average age of onset was 9.2 years. Cataract formation was the most prevalent complication (36.7%). Decreased vision was the most frequent initial symptom in this group. Periocular steroids were used in 33.3% of cases and cryotherapy or laser photocoagulation in 16.7%. With adequate medical and surgical treatment, pars planitis has a good prognosis in most cases. Infliximab to treat chronic noninfectious uveitis in children: retrospective case series with long-term follow-up. Ardoin SP, Kredich D, Rabinovich E, Schanberg LE, Jaffe GJ. Am J Ophthalmol. 2007 Dec;144(6):844-849. Epub 2007 Oct 22. PURPOSE: To assess a response to infliximab therapy in childhood uveitis. DESIGN: Retrospective case series. METHODS: We reviewed the course of 16 children with noninfectious uveitis treated with infliximab at an academic medical center. Outcome measures included incidence of uveitis recurrences, proportion of patients achieving zero or two-step decline in ocular inflammation, visual acuity, and proportion discontinuing topical glucocorticoids at zero, three, six, nine, and 12 months of therapy. RESULTS: Of sixteen children (29 affected eyes) with median age 11 years, six had associated extraocular inflammatory conditions. Fifteen of 16 were treated with concomitant methotrexate. Median follow-up was 26 months and median maintenance infliximab dose was 8.2 mg/kg. The median interval between infliximab infusions was 5.6 weeks. At one year, 64% achieved zero ocular inflammation, and 79% had zero inflammation or a two-step decline in inflammation. Topical glucocorticoids were discontinued in 69%, and 58% remained free of uveitis recurrence at one year. Visual acuity remained stable. Infliximab was discontinued in two children, one because of inefficacy and the other because of parental concern about potential side effects. No adverse events occurred. CONCLUSIONS: Sixteen children with chronic, noninfectious uveitis tolerated chronic methotrexate and infliximab therapy. Visual acuity remained stable, control of ocular inflammation improved, and reliance on topical glucocorticoids decreased. High infliximab doses and frequent dosing intervals were necessary to control uveitis. 79
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What’s New and Important in Pedia
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ROP Retinopathy of Prematurity: the
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same diagnosis in 4 of 34 images (1
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PREMATURITY Perinatal care in the t
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STRABISMUS Causes and outcomes for
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METHODS: The medical records of all
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initial positive response to medica
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deviation as an intermittent exodev
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STRABISMUS SURGERY Unilateral reces
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The effect of topical tetracaine ey
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+/-0.08 and 0.34 +/-0.07 mm, for th
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THYROID Cigarette smoking and thyro
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excluding from the cataract group t
Page 27 and 28: Long-Term Results of Lensectomy in
Page 29 and 30: CATARACT SURGERY Pediatric anterior
Page 31 and 32: Suture-related complications after
Page 33 and 34: included vitrectomy, capsulotomy, c
Page 35 and 36: medication. At the last follow-up,
Page 37 and 38: REFRACTIVE ERROR / REFRACTIVE SURGE
Page 39 and 40: demonstrated a positive effect on t
Page 41 and 42: ANTERIOR SEGMENT Conjunctival Melan
Page 43 and 44: RESULTS: Directly after birth, corn
Page 45 and 46: and photophobia (80%). The children
Page 47 and 48: Validity and reliability of the Chi
Page 49 and 50: outcomes achieved at cessation of t
Page 51 and 52: METHODS: One hundred and thirteen c
Page 53 and 54: Verisyse intraocular lens implantat
Page 55 and 56: GENETICS Marfan syndrome: from mole
Page 57 and 58: Visual outcome of a cohort of child
Page 59 and 60: primarily affect the photoreceptors
Page 61 and 62: single morphogenetic anomaly in dev
Page 63 and 64: Three genome-wide association studi
Page 65 and 66: • Cafe-au-lait macules • Freckl
Page 67 and 68: Laryngeal and tracheal anomalies Po
Page 69 and 70: Treatment of retinoblastoma: Curren
Page 71 and 72: Secondary acute myeloid leukemia af
Page 73 and 74: one. Patients treated with radiatio
Page 75 and 76: Neuro-ophthalmological management o
Page 77: CONCLUSION: Canalicular involvement
Page 81 and 82: This article describes a 7-month-ol
Page 83 and 84: eference eyes. Photopic flash ERGs
Page 85 and 86: RESULTS: In models that adjusted fo
Page 87 and 88: ORBIT Porous orbital implants, wrap
Page 89 and 90: PLASTICS Conjunctival epithelial ch
Page 91 and 92: The authors conclude that lash ptos
Page 93 and 94: .03). SBP and DBP were significantl
Page 95 and 96: CONGENITAL INFECTION Congenital lym
Page 97 and 98: PEDIATRICS Visual Manifestations of
Page 99 and 100: controversial, ranging from one to
Page 101 and 102: SYSTEMIC Visual function and ocular
Page 103 and 104: Toxocara infection. Toxocara GWC an
Page 105 and 106: congenital cataracts. The retina wa
Page 107 and 108: Childhood blindness: a UK epidemiol
Page 109: safe and efficient procedure to cor
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