A simplified clinical classification system of uveitis has been proposed by the International Uveitis Study Group. Its aim is to assist in the diagnosis and evaluation of patients with uveitis. Used in conjunction with other recognized classification systems it will also enable enrollment of patients for clinical trials, and contribute to clinical guidelines.

Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Deschê nes AbstractPurpose To evaluate the efficacy of Ahmed valve (AV) implantation in patients with uveitic glaucoma. Methods In total, 18 patients (19 eyes) with glaucoma secondary to chronic uveitis, who underwent AV implantation were retrospectively reviewed. Visual acuity, intraocular pressure (IOP), and glaucoma medications at the most recent examination prior to surgery, were compared with those of last postoperative examination. The surgical success was defined as IOP less than 21 mmHg and greater than 4 mmHg without loss of light perception and visually devastating complications at the last postoperative examination. Decrease in the number of glaucoma medications was also a criterion for surgical success. Results The mean follow-up period was 2679.7 months. The mean preoperative and postoperative IOPs were 33.379.7 (range, 20-57) mmHg and 17.3710.8 (range, 6-40) mmHg respectively (Po0.0001). The mean number of antiglaucoma medications was 3.570.8 (range, 2-5) preoperatively and 1.471.3 (range, 0-4) postoperatively (Po0.0001). Valve occlusion (five eyes, 26.3%) was the most commonly observed complication. Surgical success was achieved in 13 eyes (68.4%). The cumulative probability of success was 94.4% at 1 year and 60% at 2 years. Five eyes (26.3%) with IOP greater than 21 mmHg and one (5.3%) with corneal decompensation requiring penetrating keratoplasty were considered as failures. Conclusions The implantation of AV is an effective surgical procedure for the management of uveitic glaucoma. The inflammatory background might contribute to the occurrence of valve occlusion, which is the most common complication. Prevention of this complication is an essential factor for improving the surgical outcome.

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Purpose To review causes for performing an ultrasound biomicroscopic (UBM) examination in traumatized eyes, to present common UBM findings of 109 eyes with a history of ocular trauma and to compare these findings according to the type of the trauma. Materials and methods A total of 109 eyes with a history of mechanical ocular trauma, which underwent an UBM examination between December 1996 and April 2002, were evaluated retrospectively. All cases were classified according to the criteria of the Ocular Trauma Classification Group and UBM findings were reviewed. For statistical analyses, v 2 test and Fisher's exact test were used. Results UBM examinations were performed for the evaluation of the zonules before cataract surgery (49.5%), examination of the anterior segment in the presence of media opacities (32.1%), detection of suspected ocular foreign bodies (10.1%) and the evaluation of ocular hypotony (8.3%). In all, 67 eyes (61.5%) had a closed-globe injury, whereas 42 (38.5%) had an open-globe injury. The most common UBM findings in a closed-globe injury were zonular deficiency (64.2%), angle recession (43.3%), iridodialysis (17.9%), and dislocated lens (16.4%). The most common UBM findings in an open-globe injury were zonular deficiency (54.8%), iridodialysis (26.2%), peripheral anterior synechiae (PAS) (26.2%), and iridocorneal adhesion (19%). Among the common UBM findings, the angle recession was significantly higher (Po0.001) in closedglobe injury group and PAS formation was significantly higher (Po0.05) in open-globe injury group. Conclusions UBM is particularly superior to other methods in the evaluation of the zonular status, angle recession, cyclodialysis, and the detection of small superficial and intraocular foreign bodies.

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SUMMARY Two colour flow cytometry techniques were used to assess the activation stages of peripheral and intraocular T lymphocytes in uveitis. Increased numbers of T lymphocytes bearing the interleukin-2 (IL-2) receptors were found in intraocular fluids or peripheral blood or both of 35/ 51 patients with uveitis. This increased expression of IL-2 receptors on lymphocytes correlated with increased expression of other early T lymphocyte activation markers, HLA-DR and L-35. Both T helper cells (Leu-3A+) and suppressor cells (Leu 2A+) were activated in vivo. A positive correlation was seen between lymphocyte activation and clinical uveitis activity. In idiopathic uveitis activation of Leu-3A lymphocytes (helper/inducer) was significantly increased, and intraocular activation of the Leu-2A lymphocytes (cytotoxic/suppressor) was significantly decreased. These data show that some patients with idiopathic uveitis have a perturbation of T helper cells. Twenty-two of 31 patients with idiopathic uveitis, not associated with systemic disease, had increased peripheral T lymphocyte activation. This finding indicates that in some inflammations believed to be restricted to the eye an abnormal systemic immune activation exists.Immunological abnormalities important in the pathogenesis and pathophysiology of uveitis are poorly defined.' We and others have used flow cytometry to characterise the nature of intraocular lymphocyte subpopulations in uveitis patients.2' The role of intraocular lymphocytes in uveitis is not clear.

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