Elevated percentage of HLA-DR⁺ and ICAM-1⁺ conjunctival epithelial cells in active Graves' orbitopathy.

BACKGROUND: To evaluate if conjunctival epithelial cells' expression of HLA-DR and ICAM-1 could be helpful as early topical markers of inflammation in Graves' orbitopathy (GO). METHODS: The ocular examination evaluated a clinical activity score (CAS) by assessment of clinical features, (e.g., eyelid or conjunctival inflammation, lid width, lid closure, proptosis, ocular motility). Conjunctival epithelial cell specimens for flow-cytometric evaluations of ICAM-I and HLADR expression were collected by impression cytology from ten eyes with active GO (CAS ≥ 4 and duration ≤ 12 months), from 15 eyes with Graves' disease (GD) without active GO (CAS 0-2) and from 15 normal specimens without any ocular disorders. RESULTS: The percentage of HLA-DR + conjunctival epithelial cells was significantly elevated in patients with active GO comparing to GD without active GO and healthy controls, 10.7 % (8.5-17.7) and 7.78 % (3.92-10.1) (p < 0.05) vs. control 4.89 % (3.5-5.5) (p < 0.005), respectively. The expression of ICAM - 1+ conjunctival epithelial cells was greater only in patients with GO vs. controls, 5.5 % (4.8-7.03) and 1.46 % (0.69-2.51) (p < 0.005), respectively. CONCLUSION: The percentage of HLA-DR⁺ and ICAM-1⁺ conjunctival epithelial cells in patients with the active GO may serve as a topical inflammation marker in Graves' orbitopathy.

Impression cytology of the conjunctival epithelial cells in patients with cystic fibrosis.

PURPOSE: Cystic fibrosis (CF) is the most frequent lethal autosomal recessive hereditary disorder. The disease affects all secretory epithelia, including the eye, and belongs to the group of ocular surface epithelial diseases, termed keratoconjunctivitis sicca or dry eye syndrome. The aim of this study was to evaluate goblet cell population and conjunctival epithelial morphology in patients with CF. METHODS: A total of 20 CF patients and 20 controls underwent conjunctival impression cytology. RESULTS: Impression cytology showed conjunctival squamous metaplasia and goblet cell loss in patients with CF. CONCLUSION: Reduced goblet cell numbers and squamous metaplasia may be indicative of a higher degree of epithelial damage of conjunctival epithelial cells in CF patients, and the presence of neutrophils is a strong sign for an inflammatory background of this disease.In view of the simple, noninvasive nature of impression cytology, this technique may prove to be an important tool for the diagnosis and monitoring of dry eye changes in CF patients.

Flow cytometric analysis of HLA-DR antigen in conjunctival epithelial cells of patients with cystic fibrosis.

PURPOSE: Cystic fibrosis (CF) is an autosomal-recessive genetic disorder. The disease affects all secretory epithelia including the eye and belongs to the group of ocular surface epithelial diseases, termed keratoconjunctivitis sicca that develop in dry eye. In the pathogenesis of dry eye, inflammation plays a crucial role. The aim of this study was to investigate the expression of HLA-DR on conjunctival epithelial cells from patients with CF. MATERIALS AND METHODS: Twenty-five patients with CF and 25 normal subjects underwent ocular examination. Tear film break-up time (TBUT), Schirmer test, lissamine green staining, and conjunctival impression cytology were carried out. Cells were processed for flow cytometry, by using monoclonal antibodies to HLA-DR. RESULTS: The Schirmer test and TBUT scores were significantly lower in CF patients compared with controls. A significant increase of HLA-DR expression on epithelial cells was found in patients with CF compared with normal eyes. The Schirmer and TBUT test were positively correlated with HLA-DR expression for the percentage of cells. CONCLUSION: These results suggest that conjunctival epithelial cells play an important proinflammatory role in ocular changes in CF patients. Our findings confirm the presence of an inflammatory background and the immune nature of this disease. HLA-DR measurement might be a useful method for monitoring of inflammatory processes in the conjunctiva and could be helpful in the use of anti-inflammatory drugs in the treatment of ocular findings in CF patients.

Ultrastructural changes in the trabecular meshwork of congenital glaucoma.

Trabeculectomy specimens from 10 patients with congenital glaucoma were studied by electron microscopy. In all cases proliferation of fibrous connective tissue was found from the inner wall of Schlemm's canal. Accumulation of collagen fibres, sometimes of varied thickness and irregular striation, and agglomerations of microfibrillar material with the structure of collagen microfibrils were observed. This material formed basement membrane-like structures and 'shaggy' or fingerprint-like patterns. The ultrastructural examination of the trabecular meshwork revealed no significant differences between the morphological picture of primary congenital glaucoma and that found in Axenfeld and Rieger anomalies. Ultrastructural pictures of glaucoma cases examined in the present study converged also with those of juvenile glaucoma cases reported in literature, which may indicate the existence of a pathogenic factor common to these forms of glaucoma.

Bcl-2 expression in primary uveal melanoma.

AIMS: Uveal malignant melanoma is the most common intraocular tumor. The aim of this study was the analysis of bcl-2 oncoprotein expression in this tumor type. The melanomas were evaluated according to tumor location and patient age and sex. The relationship between bcl-2 expression and histological type, clinicopathologic stage and the presence of a set of predetermined morphological parameters was analyzed. METHODS: The study involved 39 patients with ocular melanomas treated with surgery alone between 1983 and 1997. Formalin-fixed, paraffin-embedded tissues were treated with anti-bcl-2 antibody (Dako No M0887). Immunolocalization of the bcl-2 oncoprotein was performed using the labeled streptavidin biotin (LSAB) method. bcl-2 expression in neoplastic cells was evaluated in a semiquantitative manner: lack of reactivity was defined as bcl-2 negative, reactivity present in less than 30% of cells as low bcl-2, and reactivity in more than 30% of cells as high bcl-2. The percentage of cells with a positive reaction was assessed independently by two pathologists, and the results were subjected to statistical analysis using Fischer's exact test. RESULTS AND CONCLUSION: No statistically significant correlation was found between the expression of bcl-2 oncoprotein and the clinicopathologic features analyzed. However, the high percentage of tumors with positive expression of this oncoprotein suggests that it plays a significant role in the biology of uveal melanoma.

[Ocular manifestations of tuberous sclerosis]. / Objawy oczne w stwardnieniu guzowatym.

A case of tuberous sclerosis in a 5-year old boy with ocular manifestations and other organ abnormalities (dermatologic, neurologic, renal pathology) is presented. Ophthalmological changes (astrocytic hamartomas of the retina, gelatinous tumor, vascular sheathing) are described. Differential diagnosis is presented.

Expression of P53 protein in primary uveal melanoma.

Malignant melanomas are the commonest intraocular tumours. The aim of the present study was the immunohistochemical analysis of P53 protein expression in 39 primary ocular melanomas treated surgically in the years 1983-1997. Expression of P53 was estimated semiquantitatively with the use of a light microscope at a magnification of x 400. At least 200 neoplastic cells per sample were analysed. The expression of P53 in 3% of melanoma cells was considered the threshold of positive reaction. The results were subjected to statistical analysis with exact Fischer's test. No statistically significant correlations were found between P53 expression and anatomoclinical properties of tumours, although increased P53 expression was observed in epithelioid-cellular melanomas and in tumours growing in women. A lack of statistically significant relationship between P53 protein level and the parameters examined, and morphological specificity of ocular melanomas hindering immunohistochemical analysis, indicate the necessity for studies on a wider group of tumours or/and use of molecular biology techniques to establish possible relations between P53 gene mutation and ocular melanoma biology.

Cellular immunity in pediatric uveitis.

To evaluate cellular immunity in children with uveitis, we used the flow cytometry method to study the T lymphocyte subpopulation in peripheral blood. Cytometric analysis of peripheral blood lymphocytes using fluorochrome-marked monoclonal antibodies was carried out in 29 children aged 6-18 years with parasitic uveitis (group A) and with uveitis of another etiology (group B). The control group consisted of 28 healthy children aged 6-15 years. A substantially higher percentage of B lymphocytes (19.0 +/- 6.03) was observed in the children with parasitic uveitis than was observed in the healthy children. Moreover, the absolute values were higher in groups A (1.60 +/- 0.53) and B (1.81 +/- 0.40) than in controls (1.50 +/- 0.38). The lowest percentage of CD4+ lymphocytes (34.25 +/- 6.06) and the highest percentage of CD8+ lymphocytes (31.14 +/- 6.50) was found in children with parasitic uveitis. The lowest index CD4+/CD8+ (1.29 +/- 0.53) in the group of children with parasitic uveitis reflected severe disorders in response regulation. However, the percentage values of natural killer cells was lower in the two groups of patients than in controls. These results suggest that quantitative changes in the subpopulation of peripheral blood lymphocytes are more pronounced in parasitic uveitis.

[The vision organ evaluation in children with heparin modified intraocular lens implants]. / Ocena narzadu wzroku u dzieci z wszczepem sztucznej soczewki wewnatrzgalkowej heparynizowanej.

PURPOSE: The aim of the work was to estimate the vision organ state in children with IOLs-PMMA and heparin modified IOLs operated on different types of cataract. MATERIAL AND METHODS: Material comprised 65 eyes with congenital, traumatic and complicated cataract in patients aged from 3 months to 17 years. Visual acuity and anatomic state of eyes with IOLs were evaluated. CONCLUSIONS: Results indicate the suitability of heparin modified IOLs implantation in children with different types of cataract.

[Selected parameters of cellular immunity in uveitis in children]. / Wybrane parametry odpornosci komórkowej w zapaleniach blony naczyniowej u dzieci.

Evaluation of lymphocyte in children with uveitis basing on the study of T lymphocyte subpopulation in the peripheral blood using the flow cytometry method is presented. Cytometric analysis of peripheral blood lymphocytes using fluorochrome-marked monoclonal antibodies was carried out in 29 children, aged 6-18, with parasitic uveitis (group A) and with uveitis of another aetiology (group B). Control group consisted of 28 healthy children aged 6-15. The absolute values of T lymphocytes were higher in groups A (x = 1.60 +/- 0.53) and B (x = 1.81 +/- 0.40) compared to controls (x = 1.50 +/- 0.38). The lowest percentage of CD4+ lymphocytes (x = 34.25 +/- 6.06) and the highest percentage of CD8+ lymphocytes (x = 31.14 +/- 6.50) were revealed in children with parasitic uveitis. The lowest index CD4+/CD8+ (x = 1.29 +/- 0.53) in the group of children with parasitic uveitis reflects severe disorders in response regulation. However, the percentage values of NK cells were lower in the two groups of patients compared to controls. The results allow for the assumption that quantitative changes in the subpopulation of peripheral blood lymphocytes are more pronounced in parasitic uveitis.

[Selected markers of T cell activation in children with idiopathic uveitis]. / Wybrane markery aktywacji limfocytów T krwi obwodowej u dzieci z idiopatycznym zapaleniem blony naczyniowej.

The aim of our investigation was to assess T cell activation markers (CD69, HLA-DR, CD25, CD49a) in idiopathic uveitis. T cells from children aged 9-17 with idiopathic uveitis were studied. Monoclonal antibodies against chosen markers of T cell activation were used. Expression of the CD69, HLA-DR, CD25, CD49a were determined by flow-cytometry. HLA-DR and CD49a--marker of the late activation--were significantly increased.

[A case of 9-year old child with craniopharyngioma]. / Przypadek czaszkogardlaka u 9-letniego dziecka.

Craniopharyngiomas are slow-growing tumours arising from vestigal remnants of Rathke's pouch along the pituitary stalk. A case of 9-year old child with craniopharyngioma is presented. Immediate diagnostic and surgical treatment improved clinical condition.

[Ocular toxocariasis in 16-year old boy: a case report]. / Toksokaroza oczna u 16-letniego chlopca--opis przypadku.

The authors present a case of 16-year old boy with unilateral neurochorioretinitis induced by toxocariasis. Quick diagnosis and effective treatment allowed to obtain clinical improvement.

[A case of orbital foreign body in a 17-year old boy]. / Przypadek ciala obcego oczodolu u 17-letniego chlopca.

The authors describe a case of a 17-year-old boy who sustained orbital trauma. It is very interesting on account of the foreign body size, its location and successful treatment outcome.

[Fluorescein angiography in children and adolescents with type I diabetes mellitus]. / Angiografia fluoresceinowa u dzieci i mlodziezy z cukrzyca typu I.

PURPOSE: The evaluation of changes in ophthalmoscopic examination and fluorescein angiography in children and adolescents with insulin dependent diabetes mellitus. MATERIAL AND METHODS: 100 patients with type I diabetes mellitus aged 9.3-21.5 years (15.76 +/- 2.69), with diabetes duration of 1-13.5 years (6.57 +/- 2.52) were examined. RESULTS: Retinal changes in ophthalmoscopic examination were observed in 12 cases. Fluorescein angiography allowed to detect diabetic retinopathy in 29 patients. There was no correlation between the incidence of retinopathy and the age of patients. Vascular abnormalities were related to the duration of diabetes. Retinopathy was not found in children < 10 years of age.

[Sub-retinal fluid interleukin-10 (Il-10) and interleukin-13 (Il-13) concentration in patients with retinal detachment]. / Stezenie interleukiny 10 (IL-10) i interleukiny 13 (IL-13) w plynie podsiatkówkowym u chorych z odwarstwieniem siatkówki.

PURPOSE: To evaluate the presence of IL-10 and IL-13 in subretinal fluid of patients with rhegmatogenous retinal detachment. MATERIAL AND METHOD: The studies comprised 14 patients on with retinal detachment operated. The presence of cytokines was evaluated using immunoenzymatic assay. RESULTS: IL-10 and IL-13 were found in all subretinal fluid samples. Our results suggest that the presence of IL-10 and IL-13 has the influence on suppression of inflammatory agent release and activity during retinal detachment.

[The evaluation of contrast sensitivity in children and adolescents with insulin-dependent diabetes mellitus]. / Ocena wrazliwosci na kontrast u dzieci i mlodziezy z cukrzyca insulinozalezna.

PURPOSE: The evaluation of contrast sensitivity in children and adolescents with type I diabetes mellitus with and without retinopathy, taking into account metabolic control. MATERIAL AND METHODS: We examined 100 young patients (71 without retinopathy and 29 with background retinopathy on fluorescein angiography) and 60 control non-diabetic subjects matched for age and sex, without visual or systemic symptoms. Contrast sensitivity was measured in spatial frequency of 3, 6, 12 and 18 cycles/degree (c/d). RESULTS: Contrast sensitivity was significantly lower (p < 0.001) in four spatial frequencies in all diabetic patients and in IDDM patients without retinopathy than in control group. Patients with IDDM and retinopathy had abnormal contrast sensitivity at spatial frequency 18 c/d when compared with patients without retinopathy. There was no correlation between contrast sensitivity and HbA1c values. CONCLUSIONS: Contrast sensitivity measurement in children and adolescents with type I diabetes is useful in the evaluation of the nature of early abnormalities in retinal function of diabetics.

[Morning glory syndrome: a case report]. / Zespól kwiatu powoju--opis przypadku.

The case of morning glory syndrome in two years old patient is presented.

Comparative studies of morphological changes and interleukin concentration in subretinal fluid of patients with retinal detachment.

Morphological evaluation was performed with the light and scanning electron microscope of subretinal fluids (SRF) collected during operations from 36 patients with rhegmatogenous retinal detachment. Duration of the disease was 3 weeks, 5-8 weeks, 10 weeks and 6 months. The immunoenzymatic method was used to establish the presence of interleukins IL-1beta, IL-2, IL-4 and IL-6 in SRF. It was revealed that the differentiation of the morphological picture of SRF depended on the duration of detachment. Most cell-rich SRF came from the 3-week detachment. Mononuclear cells were predominant in that period (macrophages, lymphocytes). In the later period (over 8 weeks) a decrease in the number of cells and a change in cellular composition were noted in the fluids examined, while after six months of detachment normal cellular elements were absent. In all time intervals analyzed, no significant increase in IL-1beta, IL-2 and IL-4 was noted in SRF. However, a significant quantity of IL-6 was found, particularly in the 5- to 8-week detachment. The authors assume that the presence of a large number of inflow cells in 'fresh' detachment can trigger a variety of inflammation-based immunological processes which stimulate the development of vitreoretinal proliferation.

[Helicobacter pylori as supposed factor of uveitis in children: a case report]. / Helicobacter pylori jako domniemany czynnik zapalen blony naczyniowej u dzieci--opis przypadku.

MATERIAL: A case of a 14-year-old boy with recurrent idiopathic bilateral uveitis. METHODS: Detection of Helicobacter pylori infection basing on endoscopic examination of upper alimentary tract and eradication of this factor using specific therapy leading to extinction of active uveitis in both eyes. RESULTS: Helicobacter pylori may be the etiological agent of uveitis in children with unknown reason of the disease.