Ocular manifestations of immunological and rheumatological inflammatory disorders.

Our understanding of ocular manifestations in immunological and rheumatological inflammatory disorders has continued to expand over the past year. A report on the characteristics of ocular disease in children with Behçet's disease is presented. Two reports of Vogt-Koyanagi-Harada syndrome in 4-year-old children are discussed, and the uncommon complication of macular edema in this syndrome is highlighted. An article reporting the presence of Epstein-Barr virus DNA in the vitreous of a patient with Vogt-Koyanagi-Harada syndrome is reviewed. Radiologic imaging patterns of orbital disease in Wegener's granulomatosis are presented. Unusual manifestations of sarcoidosis, systemic lupus erythematosus, and Wegener's granulomatosis are also reported.

In vivo evaluation of a collagen corneal allograft derived from rabbit dermis.

BACKGROUND: This study evaluates epithelialization, clarity, intraocular inflammation, and fibroblast ingrowth of a collagen corneal allograft derived from rabbit dermis. METHODS: Dermal collagen fibers were dispersed intact and chemically modified to make them soluble. The allografts consisted of a fibrous, opaque peripheral zone and a central clear area. Twelve New Zealand white rabbits underwent penetrating keratoplasty with implantation of an allograft. The grafts were evaluated daily for clarify, anterior segment inflammation, and extent of reepithelialization with a slit-lamp microscope. RESULTS: Epithelialization of the fibrous peripheral zone of the graft ranged from 0% to 90%. The central clear area did not epithelialize in any of the animals. Fibroblasts migrated into the peripheral zone in all eyes. Complications included ulceration of the central clear area in two eyes. There was no ulceration or leakage at the graft-host interface and no synechia, fibrous, or inflammatory retrocorneal membranes in any of the eyes. CONCLUSIONS: Our study is the first to describe the method of modifying dermal type I collagen into a clear corneal allograft. Survival of the corneal collagen allograft beyond 1 month may be limited by several factors including lack of epithelialization of the central clear area.

Ocular manifestations of immunological and rheumatological inflammatory disorders.

Further exploration of ocular manifestations in systemic immunologic and inflammatory disease continues to yield new information regarding the genetic associations, diagnosis, and treatment of these disorders. The use of color Doppler ultrasound to diagnose giant cell arteritis is reported to be of diagnostic promise. The prognosis of scleritis associated with systemic immunologic and inflammatory disease is recently highlighted in two articles. The treatment of scleritis and uveitis associated with inflammatory bowel disease is reviewed. Two reports of Vogt-Koyanagi-Harada syndrome in monozygotic twins provide further understanding of the genetic factors involved in this disease. Unusual presentations of sarcoidosis and Wegener's granulomatosis are also reported.