RESUMO
AIM: To determine whether intravitreal injection of tacrolimus suppresses ongoing experimental autoimmune uveoretinitis (EAU) in rats. METHODS: Rats were immunised with interphotoreceptor retinoid-binding protein peptide (R14) and given an intravitreal injection of tacrolimus on day 12 after immunisation. Intraocular inflammation was assessed by slit-lamp biomicroscopy and histopathological examination. Interferon gamma and tumour necrosis factor alpha protein levels in the ocular tissues were measured. Gene expression of chemokines was determined in ocular tissues by reverse transcription-polymerase chain reaction. To evaluate the systemic effect of intravitreal injection of tacrolimus, delayed-type hypersensitivity was measured by ear swelling. RESULTS: Clinical and pathological scores showed that ocular inflammation of tacrolimus-treated eyes was markedly less than that of vehicle-treated eyes. The amount of interferon gamma and tumour necrosis factor alpha was considerably inhibited in tacrolimus-treated eyes. The gene expression of monocyte chemattractant protein-1 (MCP-1) and regulated upon activation, normal T cell expressed and secreted (RANTES) was markedly reduced in tacrolimus-treated eyes. Delayed-type hypersensitivity responses were not impaired in tacrolimus-treated rats. CONCLUSIONS: Intravitreal injection of tacrolimus was highly effective in suppressing the ongoing process of EAU without any side effects on systemic cellular immunity. This treatment may be useful in the management of patients with severe uveitis.
Assuntos
Doenças Autoimunes/tratamento farmacológico , Imunossupressores/uso terapêutico , Retinite/tratamento farmacológico , Tacrolimo/uso terapêutico , Uveíte/tratamento farmacológico , Animais , Doenças Autoimunes/imunologia , Doenças Autoimunes/metabolismo , Células Cultivadas , Quimiocinas/biossíntese , Quimiocinas/genética , Olho/metabolismo , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Hipersensibilidade Tardia , Imunidade Celular/efeitos dos fármacos , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Injeções , Interferon gama/biossíntese , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , RNA Mensageiro/genética , Ratos , Ratos Endogâmicos Lew , Retinite/imunologia , Retinite/metabolismo , Tacrolimo/administração & dosagem , Tacrolimo/toxicidade , Resultado do Tratamento , Fator de Necrose Tumoral alfa/biossíntese , Uveíte/imunologia , Uveíte/metabolismo , Corpo VítreoRESUMO
PURPOSE: To report a case of intraocular lymphoma suspected of spontaneous regression based on ocular fundus findings, subretinal biopsy, and observation of clinical course. CASE: A 64-year-old woman presented at our clinic with multiple yellowish-white patchy lesions in the left fundus and focal atrophy of the retinal pigment epithelium in the right fundus. No inflammatory infiltrates were observed in either eye. Intraocular lymphoma was suspected based on the clinical manifestations including fluorescein angiography and optical coherence tomography. Vitrectomy and subretinal biopsy were subsequently performed for diagnostic purposes. Histological examination showed that the subretinal lesion was composed mostly of necrotic tissue derived from the lymphoid corpuscle and that there was no cellular component except the retinal pigment epithelium. Interleukin-10 in the vitreous humor was low at 9 pg/ml. No serious postoperative complications were observed after surgery and the residual retinal lesions gradually regressed spontaneously. Laboratory data and whole body evaluation including the central nervous system (CNS) showed no remarkable findings for 1 year after surgery. CONCLUSIONS: It is suggested that the present case was an intraocular lymphoma which regressed spontaneously. However, careful follow-up including the possible occurrence of CNS lesions is required in such cases.