The Structural Basis of Altered Vascular Permeability Following Intraocular Inflammation

Howes, Edward L.; Cruse, V K

doi:10.1001/archopht.1978.03910060294024

Cited by 31 publications

(13 citation statements)

References 21 publications

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“…53 Increased vascular permeability in uveitis may fail to reverse after resolution of the inflammation, resulting in chronic elevation of aqueous protein, which manifest clinically as chronic flare. 54 …”

Section: Proteinssupporting

confidence: 44%

Uveitis and Glaucoma: A Critical Review

Mahajan¹,

Venkatesh²,

Garg³

2011

JOCGP

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Raised intraocular pressure is a frequently encountered complication of uveitis. Intraocular homeostasis, maintained by the impermeable blood-ocular barrier, is important to guarantee optimal visual function. During uveitis breakdown of the blood-ocular barrier occurs, allowing the influx of proteins as well as inflammatory and immunocompetent cells. The combination of action of inflammatory cells and the mediators they release; and the chronic corticosteroid therapy used to treat the uveitis can participate in the pathogenesis of uveitic glaucoma. These factors alter the normal anatomic structure of the anterior chamber and angle. Management of uveitic glaucoma may be difficult because of the numerous mechanisms involved in its pathogenesis and is guided by careful delineation of the pathophysiology involved in each individual case. This article reviews, in detail, the pathogenesis of uveitic glaucoma and its therapies, with emphasis on the recent developments in the subject.

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Section: Proteinssupporting

confidence: 44%

Uveitis and Glaucoma: A Critical Review

Mahajan¹,

Venkatesh²,

Garg³

2011

JOCGP

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“…4, 15, 23, 24 This is hypothesized to result from the release of inflammatory cytokines that disrupt the inner and outer blood-retinal-barrier in addition to other structural changes. 3, 24, 25 These changes occur even in anterior uveitis, presumably due to diffusion of inflammatory mediators in the vitreous. 3 The highly significant differences in capillary density and morphology that we detected in uveitic subjects shows that the effects of intraocular inflammation can be quantitatively measured even within a 3×3 mm 2 parafoveal window.…”

Section: Discussionmentioning

confidence: 99%

Quantifying Retinal Microvascular Changes in Uveitis Using Spectral-Domain Optical Coherence Tomography Angiography

Kim

Rodger

Shahidzadeh

et al. 2016

American Journal of Ophthalmology

158

133

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Purpose To quantify retinal capillary density and morphology in uveitis using SD-OCTA. Design Cross-sectional, observational study Methods Healthy and uveitic subjects were recruited from two tertiary care eye centers. Prototype SD-OCTA devices (Cirrus, Carl Zeiss Meditec, Inc., Dublin, CA) were used to generate 3×3 mm2 OCTA images centered on the fovea. Subjects were placed into 3 groups based on the type of optical microangiography (OMAG) algorithm used for image processing (intensity-and/or phase) and type of retinal segmentation (automatic or manual). A semi-automated method was used to calculate skeleton density (SD), vessel density (VD), fractal dimension (FD), and vessel diameter index (VDI). Retinal vasculature was assessed in the superficial retinal layer (SRL), deep retinal layer (DRL), and non-segmented retinal layer (NS-RL). A generalized estimating equations model was used to analyze associations between the OCTA measures and disease status within each retinal layer. A P value < 0.05 was accepted as significant. Reproducibility and repeatability were assessed using the Intraclass Correlation Coefficient (ICC). Results The SD, VD, and FD of the parafoveal capillaries were lower in uveitic eyes compared to healthy eyes in all retinal segments. In addition, SD and VD were significantly lower in the DRL of subjects with uveitic macular edema. There was no correlation in any capillary parameters and anatomic classification of uveitis. Conclusions Quantitative analysis of parafoveal capillary density and morphology in uveitis demonstrates significantly lower capillary density and complexity. SD-OCTA algorithms are robust enough to detect these changes and can provide a novel diagnostic index of disease for uveitis subjects.

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“…Protein can also be deposited in the outflow pathway (Peretz and Tomasi, 1961). Aqueous protein levels may be chronically elevated if vascular permeability does not revert to normal after the inflammation resolves, and this is manifest clinically as chronic flare (Howes and Cruse, 1978;McLaren et al, 1990). In children with chronic anterior uveitis, increased flare is a predictor of complications including raised IOP (Holland, 2007).…”

Section: Changes In Aqueous Compositionmentioning

confidence: 45%