RESUMO
HISTORY: A 20-year-old patient from India was referred because visual acuity of the left eye had deteriorated four weeks ago. A left branch retinal vein occlusion (BRVO) had been diagnosed in an external eye clinic. INVESTIGATIONS: His best corrected visual acuity was 1,0 in the right eye but only 0.3 in the left. Intraocular pressure was normal. Fundoscopy of the left eye confirmed the finding of a left BRVO. Fluorescein angiography showed evidence of a retinal vasculitis resulting in an ischemic BRVO. Full blood count showed leucocytosis. Chest X-ray, thoracic CT and an Interferon-Gamma Release Assay (IGRA) were suggestive of systemic tuberculosis (TB). TREATMENT AND COURSE: Antituberculosis treatment with ethambutol, isoniazid, rifampicin and pyrazinamide was administered for 4 months followed by maintenace therapy of isoniazid and ethambutol for 6 months. 6 months after treatment visual acuity of the left eye had improved; the findings of lung TB had regressed. CONCLUSION: BRVO associated with ocular TB is a rare presentation of retinal vasculitis. This rare manifestation of a BRVO emphasizes the need of thorough systemic evaluation in young patients with BRVO.
Assuntos
Emigrantes e Imigrantes , Vasculite Retiniana/diagnóstico , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/etiologia , Tuberculose/diagnóstico , Diagnóstico Diferencial , Angiofluoresceinografia , Alemanha , Humanos , Índia/etnologia , Masculino , Oftalmoscópios , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Membranoproliferative glomerulonephritis (MPGN) type II is a rare disease characterized by electron dense deposits on the basement membrane in the glomeruli of the kidneys and also in Bruch's membrane of the eye. Although most patients have asymptomatic drusen of the retina choroidal neovascularization can sometimes develop, which can permanently affect visual acuity. We report an unusual case of choroidal neovascularization in a patient with MPGN type II that was successfully treated with a single intravitreal injection of bevacizumab. The 6 months follow-up showed no recurrence of choroidal neovascularization.
Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/patologia , Glomerulonefrite Membranoproliferativa/tratamento farmacológico , Glomerulonefrite Membranoproliferativa/patologia , Adulto , Inibidores da Angiogênese/administração & dosagem , Bevacizumab , Neovascularização de Coroide/etiologia , Glomerulonefrite Membranoproliferativa/complicações , Humanos , Injeções Intravítreas , Masculino , Resultado do TratamentoRESUMO
PURPOSE: In recent years many three-dimensional cornea models have been developed. However, they show poor collagen stability in the stroma. Transglutaminases (Tgases) are calcium-dependent proteins which play an important role in cross-linking of the corneal stroma. The purpose of this study was to find out whether it is possible to induce in vitro cross-linking of the stroma in an artificial hemicornea model with the help of Tgases. MATERIALS AND METHODS: For the construction of the hemicornea, human SV40 adenovector corneal epithelial cells (HCE) and human SV40 adenovector corneal keratocytes (HCK) were cultivated. Confluent HCK cells were treated for 24 h with transforming growth factor beta (TGFb) 1, 2 and 3 at different concentrations as well as with other growth factors and the treated cells were compared to untreated cultivated cells. The quantification of the expression of the Tgases by HCKs was examined with the use of real time PCR, Western blot imaging and immunochemistry. RESULTS: All concentrations of TGFbs used resulted in a significant increase of Tgase-mRNA, Tgase protein level and Tgase activity. The Tgases remained unaffected after treatment with other growth factors in comparison to untreated control cells. Treatment of the hemicornea with TGFb2 showed a very strong contraction and haze in comparison to the untreated hemicornea. CONCLUSION: It has been shown for the first time that TGFb induces a strong expression of Tgases in HCK cells. This effect caused an undesired contraction and haze of the human hemicornea model. Further research is necessary in order to find out whether the induction of Tgases in the HCK cells can be regulated without losing stability of the constructed hemicornea.