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This study aimed to conduct a comparative epidemiological survey of uveitis across various healthcare settings and elucidate the clinical characteristics. We conducted a retrospective cross-sectional study in the Ube-City medical region in Yamaguchi prefecture and recruited 268 patients from a university hospital (151 patients), municipal hospitals (51 patients), and private eye clinics (58 patients). Medical records of patients newly diagnosed with uveitis between January 2018 and December 2019 in the institutes were included, reviewed, and compared. The main outcomes included the number of uveitis causes, treatment methods, and visual acuity. Panuveitis, which is associated with systemic diseases, such as Vogt–Koyanagi–Harada disease and sarcoidosis, was more prominent in university hospital patients. Conversely, anterior uveitis, including traumatic iritis, was prominently detected in general hospitals and private eye clinics. The best-corrected visual acuity improved to 1.0 (logMAR = 0); an improvement of 74%, 61%, and 54% was observed in private eye clinic, general hospital, and university hospital patients, respectively. This study identified differences in uveitis presentation and treatment across diverse clinical settings. The results of this study provide valuable data for differentiating the causes of uveitis at university hospitals, general hospitals, and private eye clinics.

Purpose Lymphoproliferative disorders (LPDs) can develop in patients treated with methotrexate (MTX) and usually respond well to MTX withdrawal. Mucosa-associated lymphoid tissue (MALT) lymphoma is a relatively rare type of MTX-LPD. The development of MTX-LPD in the orbit has not been previously described. We here report a case of orbital MALT lymphoma that disappeared after MTX withdrawal in a patient treated with MTX for rheumatoid arthritis. Case A 78-year-old woman who complained of swelling of the left upper eyelid had been treated with MTX for >8 years for rheumatoid arthritis. Slit-lamp examination revealed a temporal subconjunctival mass, salmon pink in color, in the left eye. Fundus photographs also suggested the presence of a temporal tumor in the left orbit. [ 18 F]Fluorodeoxyglucose positron emission tomography-computed tomography revealed highly integrated lesions in the left inferotemporal orbit and a left external iliac lymph node, a left obturator lymph node, and an inguinal lymph node. Pathologic analysis of a tumor biopsy specimen showed small- and medium-sized lymphocytes positive for CD20, MIB-1, and bcl-2 and negative for CD10, CD3, bcl-1, IgG4, and EBV-ISH. On the basis of these findings, we diagnosed the tumor as MTX-induced MALT lymphoma. The subconjunctival and orbital masses disappeared gradually over 10 months after MTX withdrawal and did not recur within 2 years. Conclusion This case of orbital MTX-LPD suggests that the possibility of MTX-LPD should be considered even for ocular tumors in patients treated with MTX.

Purpose To report a case of melanoma-associated retinopathy (MAR) in a Japanese patient found to have autoantibodies to transient receptor potential cation channel, subfamily M, member 1 (TRPM1). Case An 82-year-old man presented with blurred vision OS as well as night blindness and photopsia OU. Fundus photography, fluorescein angiography, and spectral domain-optical coherence tomography findings were essentially normal. Goldmann perimetry revealed a relative central scotoma, including the blind spot in the right eye, as well as a relative scotoma around a blind spot OS. The full-field scotopic electroretinograms showed a “negative-type” pattern OU, suggestive of extensive bipolar cell dysfunction. Systemic examination revealed that the patient had malignant melanoma of the anus with lung metastasis. Autoantibodies to TRPM1 were detected in the serum of the patient by immunoblot analysis. Vitreous opacity developed during follow-up. The visual symptoms and vitreous opacity of the patient were markedly improved after oral prednisolone therapy. The patient died as a result of widespread metastasis of the melanoma at 11 months after his first visit. Conclusion The present case is the first reported instance of MAR positive for autoantibodies to TRPM1 in an Asian patient.

Background: The chemokine eotaxin is a potent and selective chemoattractant for eosinophils. The production of eotaxin by corneal fibroblasts likely contributes to eosinophil infiltration into the corneal stroma. The regulation of eotaxin synthesis in these cells was investigated by examining the effect of interferon-γ (IFN-γ), a T helper cell 1-derived cytokine, on eotaxin expression in cultured human corneal fibroblasts. Methods: The release of eotaxin from cultured corneal fibroblasts was measured by enzyme-linked immunosorbent assay, and the abundance of eotaxin mRNA in these cells was determined by reverse transcription combined with real-time polymerase chain reaction analysis. Results: IFN-γ inhibited in a dose-dependent manner the release of eotaxin induced by each of the proinflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin-1α (IL-1α) and IL-1β in corneal fibroblasts. IFN-γ also inhibited the increase in the abundance of eotaxin mRNA induced by each of these cytokines. The synergistic increases in eotaxin release and in eotaxin mRNA abundance induced by the combination of TNF-α and the T helper cell 2-derived cytokine IL-4 were also both markedly inhibited by the treatment of cells with IFN-γ. Conclusions: IFN-γ inhibited eotaxin expression at both the protein and mRNA levels in cultured human corneal fibroblasts. This effect of IFN-γ may contribute to the inhibition of eosinophil infiltration into the cornea. Exogenous IFN-γ thus represents a potential new therapeutic agent for the treatment of corneal disorders associated with inflammatory ocular diseases such as vernal keratoconjunctivitis.

Journal Article

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