Objective To observe the clinical features, the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients (66 eyes) with intermediate uveitis were retrospectively analyzed，including the clinical features, fundus fluorescein angiography (FFA) features, complications，treatment effects and prognosis. The patients, 21 males and 15 females, aged from 8 to 70 years，with the mean age of 34.8 years. There were 30 cases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity, peripheral retinal venous lesions, optic disc edema, macular edema and posterior subcapsular cataract. The results of FFA showed that peripheral retinal venous lesions, optic disc hyperfluorescence, cystoid macular edema and retinal vein staining. After the treatment, the visual acuity of 31 cases（60 eyes，90.9%) were improved, 4 cases（5 eyes，7.6%) were stable and 1 case（1 eye，1.5%) was worsening. The main complications were cystoid macular edema, posterior subcapsular cataract and vitreous hemorrhage which leads to visual damage. Conclusions Intermediate uveitis was a common bilateral and chronic progressive intraocular inflammation，the anterior vitritis, pars plana and peripheral retinal vascular changes were mainly involved. Early diagnosis and proper treatment may prevent the permanent visual damage.
Noninfectious uveitis refers to a category of inflammatory diseases involving the uvea, with the exception of infectious factors or masquerade syndrome. The diagnosis and follow-up of noninfectious uveitis that involving retina or choroid require fundus imaging techniques. Fundus autofluorescence is a noninvasive imaging technique. Compared with fundus colorized photography, fundus fluorescein angiography and indocyanine green angiography, fundus autofluorescence indicates the functional status of retinal pigment epithelium and photoreceptor cells in a better way, thus playing a role in the pathophysiological mechanisms investigating, early diagnosis, disease progression monitoring and prognosis estimating of noninfectious uveitis, such as Vogt-Koyanagi-Harada disease, Behçet disease, multifocal choroiditis, punctate inner choroidopathy, birdshot chorioretinopathy, multiple evanescent white dot syndrome, acute zonal occult outer retinopathy, acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis.
Uveitis is a group of inflammatory diseases affecting the uveal tract, retina, retinal blood vessels and vitreous. Due to its complex etiology, various entities, diverse and lack of constancy in treatment, some patients can experience visual impairment and even loss. In view of the fact that blindness caused by uveitis is mostly incurable and occurs usually in young and middle-aged people, it accounts for an important part of blinding eye diseases and has attracted worldwide attention. With the continuous development of precision medicine, clinicians will face new problems and challenges in disease diagnosis, and further in-depth research is needed to explore more optimized and efficient diagnostic processes and examinations to improve the diagnosis of uveitis in China.
Objective To observe the expression of matrix metalloproteinase-9 (MMP-9), its tissue inhibitor of matrix metalloproteinase (TIMP-1), inducible nitric oxide synthase (iNOS) and contents of nitric oxide (NO) in the ocular tissues of Sprague-Dawley (SD) rats with endotoxin induced uveitis（EIU）. Methods Ninety SD rats were randomly divided into experimental (81 rats) and control group (9 rats). The model of EIU was induced in rats in experimental group by injecting with lipoplysaccharide (LPS) 200 μl into the hind feet pads, while the rats in the control group were not injected. Nine rats were executed 0, 6, 12, 18, 24, 48, 72, 96 hours and 7 days, respectively, after injecting with LPS; the NO content and concentration of protein in the aqueous humor in blood plasma, aqueous humor, and uveal tissues were detected. The expressions of MMP-9, TIMP-1 and iNOS in the ocular tissues were detected by immunohistochemistry, and the average absorbance (A) value was evaluated by computer medical image analysis system. Results iNOS, MMP-9 and TIMP-1 expressed in the epithelial cells of iris and ciliary body and exudated inflammatory cells of rats. The concentration of protein in the aqueous humor, the contents of NO in blood plasma, aqueous humor, and uveal tissues, and A value of MMP-9 had obvious relativity with the inflammatory extent, while no positive correlation was found between the inflammatory extent and the A value of iNOS and TIMP-1. Expression of iNOS was found 6 hours after injection, reached the peak after 12 hours, and then dropped gradually. The expression of TIMP-1 could be seen 24 hours after injection, and reached its peak after 72 hours. Conclusion The content of NO and expressions of iNOS, MMP-9 and TIMP-1 changes from the beginning and during the development of EIU, which suggests that NO, iNOS, MMP-9 and TIMP-1 are involved in the pathologic process of EIU. (Chin J Ocul Fundus Dis, 2005, 21: 371-374)
The etiology of uveitis is complex and the clinical manifestations are varied. Diagnosis and treatment are often very difficult. Detailed medical history, thorough ocular examination and laboratory examination are important basis for diagnosis. In recent years, with the appearance of microincision vitrectomy surgery, it has been applied widely in the diagnosis and treatment of uveitis. It can confirm diagnosis, manage the fundus complications of uveitis, and has certain therapeutic effects. But it is worth emphasizing that the indications of vitrectomy must be strictly controlled. Suitable indications and surgical timing are the key to the effective diagnosis and treatment of uveitis.