Abstract:
Introduction: Uveitis is a disease that manifests with increased vascular
permeability and occlusion, with some ischemia and inflammatory
mediators. It is characterized by a wide range of pathological processes,
including inflammation, increased vascular permeability and occlusion, local
ischemia and cell alteration by inflammatory mediators, and is characterized
by the presence of complications.
Aim: To study the state of ocular hemodynamics by rheoophthalmography,
as well as the immune status in patients with idiopathic recurrent anterior
uveitis complicated by intraocular hypertension, Fuchs heterochromic
uveitis, Posner-Schlossman syndrome, during the relapse period.
Materials and methods: 93 patients with idiopathic recurrent anterior
uveitis were included in this study, 8 patients with Fuchs’ uveitis, and 6
patients with Posner-Schlossman syndrome. According to clinical signs,
relapse and remission were considered. The control group (healthy
volunteers of the same age) consisted of 27 people. In this regard, 5 groups
of subjects were formed. The mean age of the patients was (M ± SD) 39.2 ±
14.6 years. According to the Median (range), the duration of the disease in
patients was 2033 (350-3285) days, intraocular hypertension being
recorded at P0 > 20 mm Hg.
Statistical analysis was carried out in spreadsheets using STATISTICA 8.0
(StatSoft.Inc) program. Quantitative indicators were evaluated according to
the correspondence to the normal distribution and to the KolmogorovSmirnov criterion. With a normal distribution, arithmetic means (M) and
standard deviations (SD), limits of the 95% confidence interval (95% CI) and
Student’s t-test were calculated.
Results: The volumetric blood filling of the eye according to the
rheoophthalmographic indicator RQ during the period of remission of
uncomplicated and complicated by hypertension anterior uveitis was
reduced by 32.4%-40.5%, respectively, compared with the norm. During the
period of relapse, RQ was significantly higher by 28% (p<0.05) than in
remission, in the group of uncomplicated uveitis, and in the group of uveitis
with increased IOP, no significant differences between the periods of
remission and relapse were observed, which reflected the ischemic process
in the relapse period. Volumetric blood filling in Fuchs and PosnerSchlossman syndromes in the acute period did not differ from the norm.
Cellular immunity in the groups of uncomplicated and complicated by
intraocular hypertension idiopathic uveitis, as well as with Fuchs and Posner-Schlossman syndromes, had a higher level of CD4 helper
lymphocytes and a lower level of CD8 suppressor lymphocytes, which
reflected higher values of the immunoregulatory index. The increase in the
immunoregulatory index is most pronounced in Fuchs and PosnerSchlossman syndromes.
Discussion: In the presented study, the incidence of idiopathic recurrent
anterior uveitis complicated by intraocular hypertension was 9,9% among
all cases of idiopathic recurrent anterior uveitis in one-time period.
According to literature, this complicated form of uveitis occurs in 11,5%-
46,1% of cases. Most often (up to 92% of cases), the anterior chamber angle
was open.
Conclusions: Different activity of the mechanisms regulating the balance of
cellular and humoral immunity, sensitivity of T-cells to eye antigens in
idiopathic anterior uveitis, Fuchs and Posner-Schlossman syndromes was
assumed. Peculiarities of eye hemodynamics in these forms of uveitis were
also revealed.
