2014-2015 Basic and Clinical Science Course (BCSC): Section by American Academy of Ophthalmology, Ramana S. Moorthy MD

By American Academy of Ophthalmology, Ramana S. Moorthy MD

Starts with an summary of immune-mediated eye ailment, summarizing easy immunologic ideas, ocular immune responses and unique themes in ocular immunology. Discusses the medical method of uveitis and stories noninfectious (autoimmune) and infectious different types of uveitis, with an elevated part on viral uveitis and new fabric on infectious and noninfectious scleritis.

Enhanced detection of infectious brokers by means of immunologic and genetic tools and biologic therapeutics are particular. additionally covers endophthalmitis, masquerade syndromes, problems of uveitis and ocular points of AIDS.

Upon finishing touch of part nine, readers might be capable to:

Identify basic and particular pathophysiologic strategies that have an effect on the constitution and serve as of the uvea, lens, intraocular cavities, retina, and different tissues in acute and protracted intraocular inflammation
Differentiate and establish infectious and noninfectious uveitic entities
Choose acceptable exam suggestions and appropriate ancillary reviews in keeping with no matter if an infectious or noninfectious reason is suspected

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Extra info for 2014-2015 Basic and Clinical Science Course (BCSC): Section 9: Intraocular Inflammation and Uvetis

Example text

Classically, resting monocytes are thought to be the principal noninflammatory scavenging phagocyte. 1, Upon exposure to low levels of interferon gamma (IFN-y) from T lymphocytes, monocytes become primed, up-regulating major histocompatibility complex (MHC) class II molecules and performing other functions . Primed macrophages function in antigen presentation. 2, Fully activated macrophages, after exposure to bacterial lipopolysaccharide and interferon, are tumoricidal and bactericidal and mediate severe inflammation .

Some of these components have been implicated in various models for arthritis and uveitis. In many cases, the molecular mechanisms are probably similar to LPS. Exotoxins and other secretory products of bacteria Various bacteria are known to secrete products such as exotoxins into the microenvironment in which they are growing. Many of these products are enzymes that, although not directly inflammatory, can cause tissue damage that subsequently results in inflammation and tissue destruction. Examples include • collagenases • hemolysins such as streptolysin 0, which can kill neutrophils by causing cytoplasmic and extracellular release of their granules • phospholipases such as the Clostridium perfringens a-toxins, which kill cells and cause necrosis by disrupting cell membranes For example, intravitreal injection of a purified hemolysin BL toxin derived from Bacillus cereus can cause direct necrosis of retinal cells and retinal detachment.

Med. 2001 ;344(14):1058-1066. Walport MT. Complement. Second of two parts. N Engl JMed. 2001 ;344(15):1140-1144. Fibrin and other plasma factors Fibrin is the fin al deposition product of another important plasma-derived enzyme system, and its deposition during inflammation promotes hemostasis, fibrosis, angiogenesis, and leukocyte adhesion. Fibrin is released from its circulating zymogen precursor,fibrinogen, upon cleavage by thrombin. In situ polymerization of smaller units gives rise to the characteristic fibrin plugs or clots.

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