ABSTRACT
Toxoplasmosis is a frequent cause of retinochoroiditis. Although the diagnosis relies mainly on ophthalmological examination, biological approaches are particularly useful in patients with atypical lesions. In a prospective study to determine the value of immunoblotting and immune load calculation in the diagnosis of active toxoplasmic retinochoroiditis, aqueous humor samples from 21 patients with retinochoroiditis and 5 control patients with cataracts were tested. Immune load was calculated on the basis of intraocular antibody production. The immune load ratio between aqueous humor and serum (Goldmann-Witmer coefficient) was significant (i.e. >2) in 9 of the 17 (53%) patients with retrospectively documented toxoplasmic retinochoroiditis. Immunoblotting suggested local antibody production in 10 of 17 (59%) patients. The combination of the two techniques gave a sensitivity of 71% (12/17). Both techniques were negative in the four patients in whom the final diagnosis of toxoplasmic retinochoroiditis was negative and in the five patients with cataracts. These results confirm the value of combining these two techniques. Moreover, immunoblotting has the advantages of being easy to perform and of requiring a very small sample.
Subject(s)
Blotting, Western , Chorioretinitis/diagnosis , Toxoplasma/immunology , Toxoplasmosis, Ocular/diagnosis , Adult , Aged , Animals , Antibodies, Protozoan/analysis , Chorioretinitis/parasitology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/analysis , Male , Middle Aged , Prospective Studies , Sensitivity and Specificity , Severity of Illness Index , Toxoplasma/isolation & purificationABSTRACT
Posterior uveitis is the most severe manifestation of ocular Behçet's disease, as it can lead to residual permanent damage. However, a better use of corticosteroid and immunosuppressive therapy in a multidisciplinary context has dramatically improved the overall visual prognosis and bilateral blindness is now rare.
Subject(s)
Behcet Syndrome/diagnosis , Eye Diseases/etiology , Adrenal Cortex Hormones/therapeutic use , Behcet Syndrome/drug therapy , Behcet Syndrome/immunology , Colchicine/therapeutic use , Diagnosis, Differential , Eye Diseases/diagnosis , Female , Fluorescein Angiography , Gout Suppressants/therapeutic use , HLA-B Antigens/immunology , HLA-B51 Antigen , Humans , Immunosuppressive Agents/therapeutic use , Male , Prognosis , Recurrence , Uveitis, Anterior/diagnosis , Uveitis, Anterior/etiology , Uveitis, Posterior/diagnosis , Uveitis, Posterior/etiologyABSTRACT
Primary open-angle glaucoma (POAG) is a highly prevalent cause of irreversible blindness which associates cupping of the optic disc and alteration of the visual field, elevation of intraocular pressure being a major risk factor. Provided diagnosis is made at an early stage, treatments are available to prevent visual impairment. A locus, GLC1A, has been mapped on chromosome 1q23-q25 in several families affected with juvenile-onset POAG (JOAG) and also in some families affected with juvenile and middle-age onset POAG. Recently, three mutations of the TIGR (Trabecular meshwork-Induced Glucocorticoid Response) gene were shown to be responsible for the disease in several American families and in unrelated POAG patients. We now describe five new mutations in eight French families. All mutations known to date appear to concentrate in the evolutionarily conserved C-terminal domain of TIGR which bears homology to frog olfactomedin, an extracellular matrix glycoprotein of the olfactory epithelium, to rat and human neuronal olfactomedin-related proteins and to F11C3.2, a protein from Caenorhabditis elegans . Moreover, this conserved domain of TIGR is encoded by a single exon to which mutation screening could be limited. Surprisingly, the TIGR message, which is abundantly transcribed in the trabecular meshwork and also in the ciliary body and the sclera, is not expressed in the optic nerve whose degeneration is, however, the primary lesion of POAG.
