Juvenile idiopathic arthritis-associated uveitis: a retrospective analysis from a centre of South Italy.

PURPOSE: To investigate the clinical and laboratory characteristics of the children affected by juvenile idiopathic arthritis (JIA) who developed uveitis. METHODS: In this retrospective study, we have examined data of 109 patients aged from 3 to 16 years, affected by JIA and followed at Paediatrics Rheumatology Clinic and Ophthalmology Clinic of University Hospital of Messina in the period from 2007 to 2017. The main outcome measures were clinical and laboratory findings related to JIA and ocular involvement. The prevalence of ocular signs and symptoms was determined and correlated with age. RESULTS: Twenty-one (19.3%) subjects developed uveitis. Two different peaks of age with ocular involvement were registered. The first occurred between 4 and 6 years and the second between 10 and 12 years. All subjects in the first group resulted to be female, presented oligoarticular arthritis and chronic anterior uveitis. In the second group, the 84% of patients were male with different types of JIA and acute anterior uveitis. The prevalence of ocular complications was higher in the first group. CONCLUSIONS: Two peaks of age emerged and were characterized by different clinical outcomes of arthritis and ocular involvement. The first occurred between 4 and 6 years and interested females affected by oligoarticular JIA who develop chronic anterior uveitis. The second appeared at 10-12 years and interested older males affected by different types of JIA with acute anterior uveitis. Early diagnosis and cooperation between paediatric rheumatologist and ophthalmologist are of great importance in the proper management of JIA children with uveitis.

The eye in cystic fibrosis.

PURPOSE: To investigate modifications of ocular surface and lens transparency in patients with cystic fibrosis in relation to the stage of digestive insufficiency. METHODS: Forty consecutive patients with cystic fibrosis and 24 age- and sex-matched healthy volunteers were examined. The tear tests (Schirmer's basic test, tear film break-up time) and conjunctival exfoliative cytology (CC) were used to study the ocular surface. The lens transparency was measured with the Opacity Lens Meter 701 (OLM 701, Interzeag AG, Switzerland). Digestive insufficiency was evaluated by the steatocrit method. RESULTS: Significant changes in conjunctival cytology and lens opacity, and abnormal tear tests were detected in CF patients; the alterations were more pronounced in patients with severe digestive insufficiency. CONCLUSIONS: Cystic fibrosis patients present ocular surface abnormalities and lens transparency modifications and their severity is related to the digestive insufficiency. Simple, rapid and non-invasive tear tests and cytological procedures might be used as additional tests for assessing the severity of cystic fibrosis.

Cystic fibrosis and lens opacity.

Cystic fibrosis (CF) is a fairly common lethal genetic disease in whites, inherited via an autosomal recessive pattern. Several clinically evident anomalies of the eye such as xerophthalmia, papilledema, retinal alterations and optic neuropathy have been described. In the present study we investigated lens changes in 40 patients affected by CF, to relate the results to the stage of digestive insufficiency. Each patient underwent an accurate ocular examination including visual acuity, slit-lamp examination, and measurement of lens transparency with the Opacity Lens Meter 701. The results were compared with those of an age- and sex-matched control group. The comparison between the lens opacity values obtained in the CF patients and those measured in the control group showed a statistically significant difference; moreover, lens transparency was more decreased in patients with severe digestive insufficiency.

The role of class I and class II HLA antigens in primary open angle glaucoma (POAG).

Several clinical and epidemiological studies have shown the role of genetic factors in the pathogenesis of primary open angle glaucoma (POAG). In this study, 30 patients affected by this disease were tissue-typed for HLA Class I and Class II antigens. The results pointed up an increased incidence of some antigens and, particularly, a statistically significant association with DQ1 and DR11 alleles.

HLA typing and retinitis pigmentosa.

Retinitis pigmentosa is a disease whose pathogenesis remains largely obscure. A lot of evidences support the hypothesis that auto-immunity is involved, but no HLA antigen has ever been associated with retinitis pigmentosa. Ten patients with autosomal recessive retinitis pigmentosa were tissue typed for class I and II HLA antigens. The results of the study show a significant increase in the frequency of the antigens Cw4, Cw6 and DR11. High values of relative risk were found also for some class I antigens, but the size of the group of patients with these loci precluded a meaningful statistical analysis.

Anterior uveitis and diabetes mellitus: immunological study.

The association between anterior uveitis (AU) and diabetes mellitus (DM) has always been known. The purpose of this study was to estimate the incidence of this association and to consider a possible role of the cell-mediated immune system. During the years 1989-1992, 196 diabetics (66 patients affected by type I DM and 130 by type II DM) were studied. The study of the lymphocytic subsets and the measurement of the circulating immunocomplexes and autoantibodies (ANA, AMA, ADNA, ASMA, APCA) were carried out, and the results were compared with those of a control group. The results underline the correlation between AU and type I DM. Many immunological reactions could play a crucial role: the high levels of CD8 subsets found could be an expression of the unstable lymphocytic equilibrium.

Effects of calcium antagonists in the treatment of ophthalmic postherpetic neuralgia.

Postherpetic neuralgia is one of the most common, but also one of the most difficult conditions to treat. This condition mainly involves trigeminal, intercostal and sciatic nerves and the brachial plexus area. It mostly appears in patients older than 60 years. Although pain is a transient condition, the pain of postherpeutic neuralgia may become intractable, disabling an may decrease the quality of the patient's life. We studied 30 patients affected by ophthalmic postherpetic neuralgia, appearing, some months after fronto-orbital cutaneous eruption. All patients received nicardipine retard, decreasing gradually, 40 mg/day for 2 weeks. The monitoring of pain was performed using the visual analogue score of Scott-Huskissonn. The results show an improvement in 'pain relief'.

Optic nerve granuloma as first sign of systemic sarcoidosis.

We report a rare casse of optic nerve involvement as the first sign of systemic sarcoidosis. A 43-year-old white woman presented with visual loss in her right eye, and the clinical appearance of optic nerve head swelling. Visual acuity was reduced to 20/200, and the only clinical signs were the presence of an enlarged optic nerve head, with engorged retinal veins and flame-shaped haemorrhages. Computed tomography scans showed an enlarged orbital portion of the right optic nerve, which was confirmed by magnetic resonance imaging. With a diagnosis of optic nerve tumour (possibly glioma) a surgical resection of the tumour was performed. Histopathology showed multiple nodular granulomas with epithelioid cells, consisted with the diagnosis of sarcoidosis. This was confirmed by systemic involvement of the parotids and liver. We review the literature and consider all possible involvement of the optic nerve in sarcoidosis. The rarity of systemic sarcoidosis with a first manifestation as papilloedema is discussed.

Influence of pseudoexfoliation syndrome on human lens transparency.

The possibility of a relationship between pseudoexfoliation syndrome (PEX) and lens opacity was studied. For this research, we used an opacity lens meter, the function of which is based on a back light scattering quantitation system. This instrument gives us an objective, reproducible, and numerically quantifiable measurement of the opacity of the lens. The lens opacity values measured in 91 PEX-positive eyes were compared with those measured in a control group of 100 normal eyes. This comparison showed that PEX-positive eyes always had higher lens opacity values than did normal ones, and this result was statistically significant (P = .01).