Aim: to investigate the dynamics of the T-cell immune response in rabbits with experimental autoimmune uveitis (EAU) of varying severity. Materials and Methods: The experiment involved two groups of Chinchilla rabbits (15 rabbits in each group). The model of EAU was created. The clinical picture of intraocular inflammation of varying severity was assessed. The determination of the level of white blood cells (WBC), lymphocytes (Lymphs), CD3+, CD4+, CD8+, and CD16+ in the blood of rabbits was conducted. Results: Group I – moderate and severe uveitis, Group II – uveitis of mild severity. WBC, Lymphs, CD3+, CD4+, CD16+ were elevated and statistically significant in both groups of animals compared to control parameters on all days of the experiment (3, 7, 10, 14, 21 days) (p < 0.001). CD8+ level had a significantly lower count than the control one (p < 0.001). When comparing the two groups, the immune response was more active in Group I, and the number of immune cells did not return to normal by the end of the experiment. Conclusion: In the case of EAU, the immune response is characterized by the activation of the T-cell immune system, with the intensity of this response depending on the severity of the clinical presentation of uveitis. Various degrees of clinical severity in EAU were obtained using an experimental model employed in our study. A rapid response of the immune system helps to establish a diagnosis and predict the severity of autoimmune uveitis.

• Keywords
• autoimunitní uveitida,
• MeSH
• Autoimmune Diseases immunology   blood   MeSH
• Rabbits MeSH
• Disease Models, Animal MeSH
• T-Lymphocytes immunology   MeSH
• Uveitis * immunology   blood   MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Animals MeSH

Cíl: Cílem práce je shrnout poznatky o cytomegalovirové (CMV) přední uveitidě a na krátkých kazuistických sděleních představit pacienty léčené na pracovišti Oční kliniky 1. LF UK a VFN v Praze s touto klinickou jednotkou. Materiál a metody: Retrospektivní analýza souboru pacientů Centra pro diagnostiku a léčbu uveitid od roku 2003 do 2024. Prezentace vlastních zkušeností s CMV přední uveitidou verifikovanou pomocí polymerázové řetězové reakce (PCR) z předněkomorové tekutiny formou kazuistik. Výsledky: Ze souboru 3844 pacientů s uveitidou, bylo 343 s herpetickou přední uveitidou, z toho 3 pacienti s CMV uveitidou potvrzenou PCR analýzou předněkomorové tekutiny. U všech pacientů byl zaznamenán přechod z původně akutní rekurentní přední uveitidy do chronické formy s elevací nitroočního tlaku (NOT). I navzdory lokální protizánětlivé a antiglaukomové terapii docházelo při jejím snižování k častým relapsům. Pro přetrvávající elevaci NOT s nedostatečným efektem maximální lokální antiglaukomové terapie byla u všech pacientů provedena antiglaukomová operace, při které byl odebrán vzorek předněkomorové tekutiny k PCR analýze. Po zahájení lokální antivirové terapie ganciklovirem došlo u pacientů ke stabilizaci onemocnění s výrazným snížením počtu relapsů zánětu a progrese glaukomu s kompenzovaným NOT. Závěr: CMV přední uveitida je u nás vzácná a je nutno na ni pomýšlet v případě přední uveitidy s elevací NOT nedostatečně reagující na protizánětlivou terapii. Časná verifikace etiologického agens se zahájením správné antivirové terapie je klíčová vzhledem k další prognóze onemocnění a rozvoji komplikací. Nízké udržovací dávky lokálně aplikovaného gancikloviru po dobu několika měsíců zabraňují relapsům uveitidy a dekompenzaci NOT.

Aim: The aim of the article is to summarize observations on cytomegalovirus (CMV) anterior uveitis, and in short case reports present cases of patients treated at our Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague. Material and methods: Retrospective analysis of patients at the Centre for diagnosis and treatment of uveitis from 2003 to 2024. Presentation of our experiences with CMV anterior uveitis confirmed by polymerase chain reaction (PCR) in aqueous humor in case reports. Results: From a cohort of 3844 patients with uveitis, 3 patients were diagnosed with CMV anterior uveitis, confirmed by PCR in the aqueous humor. The clinical presentation was as acute recurrent hypertensive anterior uveitis in all patients, with a switch to chronic form with elevated intraocular pressure (IOP). Despite local anti-inflammatory and antiglaucomatous therapy, there was high recurrence of uveitis with decompensation of IOP when the medication was reduced. Patients underwent antiglaucoma surgery because of persistent high IOP despite maximal local antiglaucomatous therapy. An anterior chamber tap was taken for PCR analysis, with a CMV-positive result. After the initiation of antiviral therapy with local ganciclovir, patients manifested compensated IOP and a pronounced reduction of recurrences of uveitis and progression of glaucoma. Conclusions: CMV anterior uveitis is a rare pathology in our geographic region, but it is important to consider this etiology in cases of recurrent anterior hypertensive uveitis with a low response to local anti-inflammatory medication. Timely verification of the etiological agent with prompt diagnosis and treatment is essential in order to achieve a favorable prognosis. Long-term, low maintenance doses of antiviral therapy with local ganciclovir for several months reduce relapses of uveitis and lead to compensation of IOP.

• MeSH
• Antiviral Agents therapeutic use   MeSH
• Cytomegalovirus Infections * diagnosis   drug therapy   complications   virology   MeSH
• Cytomegalovirus genetics   isolation & purification   MeSH
• Aqueous Humor MeSH
• Humans MeSH
• Uveitis, Anterior * diagnosis   drug therapy   virology   MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH

BACKGROUND: To our knowledge, limited information is available about the differences in the characteristics of rheumatoid factor (RF)-negative polyarticular juvenile idiopathic arthritis (JIA) throughout the world. This study was aimed to compare the demographic and clinical features of patients with RF-negative polyarthritis across the world. METHODS: Patients were part of a multinational sample included in a study aimed to investigate the prevalence of disease categories, treatment regimens, and disease status in patients from different geographical areas (EPOCA Study). All patients underwent a retrospective assessment, based on the review of clinical chart, and a cross-sectional evaluation, which included assessment of physician- and parent-reported outcomes and collection of ongoing medications. RESULTS: Among the 9081 patients enrolled in the EPOCA study, 2141 patients (23.6%) with RF-negative polyarthritis were included in the present analysis. The prevalence of RF-negative polyarthritis was highest in North America and lowest in Southeast Asia (12.7%). The age at disease onset was lower in Northern and Southern Europe, where the highest prevalence of uveitis was found. Uveitis was rare in Southeast Asia, Africa & Middle East and Latin America. Patients from Eastern Europe, Latin America and Africa and Middle East presented with the highest prevalence of active joints at the visit. The combination of early onset, ANA positivity, and uveitis was observed mainly in Southern Europe (39%). CONCLUSIONS: Our results confirm the wide heterogeneity of the clinical presentation and outcome of children with RF-negative polyarticular JIA throughout the world. In particular, relevant differences in the onset age were observed across geographic areas. The group of children with early onset polyarthritis, ANA positivity, and risk of uveitis is remarkably frequent in Southern Europe.

• MeSH
• Antirheumatic Agents therapeutic use   MeSH
• Global Health MeSH
• Child MeSH
• Arthritis, Juvenile * epidemiology   diagnosis   MeSH
• Humans MeSH
• Adolescent MeSH
• Child, Preschool MeSH
• Prevalence MeSH
• Cross-Sectional Studies MeSH
• Retrospective Studies MeSH
• Rheumatoid Factor * blood   MeSH
• Uveitis epidemiology   diagnosis   MeSH
• Age of Onset MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Geographicals
• Europe MeSH

• MeSH
• Acetazolamide therapeutic use   MeSH
• Biological Therapy methods   adverse effects   MeSH
• Adrenal Cortex Hormones therapeutic use   MeSH
• Antibodies, Monoclonal, Humanized administration & dosage   adverse effects   MeSH
• Arthritis, Juvenile * drug therapy   complications   MeSH
• Cataract drug therapy   complications   therapy   MeSH
• Humans MeSH
• Methotrexate adverse effects   therapeutic use   MeSH
• Therapeutic Occlusion methods   MeSH
• Child, Preschool MeSH
• Disease Progression MeSH
• Risk MeSH
• Uveitis * diagnosis   drug therapy   complications   pathology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Acyclovir administration & dosage   MeSH
• Anti-Bacterial Agents administration & dosage   MeSH
• Dexamethasone administration & dosage   MeSH
• Endophthalmitis * diagnostic imaging   etiology   pathology   therapy   MeSH
• Middle Aged MeSH
• Humans MeSH
• Ophthalmologic Surgical Procedures * adverse effects   MeSH
• Disease Progression MeSH
• Uveitis diagnosis   drug therapy   pathology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Capsulorhexis methods   MeSH
• Cataract Extraction * methods   MeSH
• Glucocorticoids administration & dosage   MeSH
• Lens Implantation, Intraocular methods   MeSH
• Cataract complications   therapy   MeSH
• Humans MeSH
• Uveitis, Anterior complications   MeSH
• Child, Preschool * MeSH
• Check Tag
• Humans MeSH
• Child, Preschool * MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Dexamethasone administration & dosage   MeSH
• Diagnosis, Differential MeSH
• Adult MeSH
• HLA-B27 Antigen * MeSH
• Humans MeSH
• Mydriatics therapeutic use   MeSH
• Uveitis, Anterior * drug therapy   pathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

OBJECTIVE: Granulomatosis with polyangiitis (GPA) is an ANCA-associated vasculitis. The 2022 ACR/EULAR-endorsed classification criteria for GPA was derived using data only from adult patients. We aimed to assess the performance of the ACR/EULAR classification criteria for GPA in paediatric patients and compare it with the EULAR/Pediatric Rheumatology International Trials Organization (PRINTO)/Pediatric Rheumatology European Society (PReS)-endorsed Ankara 2008 criteria for GPA. METHODS: Retrospective data of paediatric patients with GPA in 20 centres from 9 countries were evaluated. The diagnosis of GPA was made according to the expert opinion. The sensitivity, specificity, positive predictive value, and negative predictive value of the criteria sets were evaluated. RESULTS: The study included 77 patients with GPA and 108 controls [IgA vasculitis (n = 44), Takayasu's arteritis (n = 20), microscopic polyangiitis (n = 16), polyarteritis nodosa (n = 14), Behçet's disease (n = 12), eosinophilic granulomatosis with polyangiitis (n = 1) and Cogan's syndrome (n = 1)] with a median age of 17.8 and 15.2 years, respectively. Among patients with GPA, constitutional symptoms (85.7%) and ENT involvement (79.2%) were the most common presentations. In the GPA group, 73 patients fulfilled the Ankara 2008 criteria and 69 the ACR/EULAR classification criteria. Sensitivities of the Ankara 2008 criteria and the ACR/EULAR classification criteria were 94.8% and 89.6%, while specificities were 95.3% and 96.3%, respectively. No significant difference was found between sensitivities and specificities of both classification criteria (P = 0.229 and P = 0.733, respectively). CONCLUSION: In children, both the ACR/EULAR and EULAR/PRINTO/PReS Ankara 2008 classification criteria for GPA perform well and similarly.

• MeSH
• Behcet Syndrome classification   diagnosis   MeSH
• Churg-Strauss Syndrome diagnosis   classification   MeSH
• Child MeSH
• Granulomatosis with Polyangiitis * classification   diagnosis   MeSH
• IgA Vasculitis diagnosis   classification   MeSH
• Humans MeSH
• Microscopic Polyangiitis classification   diagnosis   MeSH
• Adolescent MeSH
• Polyarteritis Nodosa classification   diagnosis   MeSH
• Predictive Value of Tests MeSH
• Child, Preschool MeSH
• Retrospective Studies MeSH
• Rheumatology standards   MeSH
• Sensitivity and Specificity * MeSH
• Takayasu Arteritis * classification   diagnosis   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Comparative Study MeSH
• Geographicals
• Europe MeSH

Cíl: Upozornit na vyšší podíl případů Fuchsovy heterochromní iridocyklitidy (FHI) u pacientů s roztroušenou sklerózou (RS). Materiál a metody: Retrospektivní studie dat shromážděných v Centru pro diagnostiku a léčbu uveitid. Výsledky: Byla provedena analýza lékařských záznamů 3016 pacientů s uveitidou (v letech 2003–2020) se zaměřením na RS. Uveitida spojená s RS byla diagnostikována u 90 pacientů (3 %): přední uveitida (n = 7), intermediální uveitida (n = 23), retinální vaskulitida (n = 24) a panuvei tida (n = 36). Klinické vyšetření odhalilo známky FHI na předním segmentu v 11 z 90 případů (12 %). Mezi atypické projevy FHI patřil vyšší výskyt bilaterálního postižení (45 %), retinální vaskulitidy (27 %) a sněhových koulí ve sklivci (18 %). Diagnóza FHI předcházela diagnóze RS ve 4 případech. Medián doby latence byl 10,5 (rozmezí 8–15) let. U 4 pacientů byla diagnóza demyelinizačního onemocnění stanovena do jednoho roku od diagnózy FHI. Neurologické vyšetření jsme doporučili pro optickou neuritidu (n = 1), parestezie (n = 3), relaps motorického deficitu (n = 1), screening etiologie u případů s postižením zadního segmentu (n = 3). V dalších 3 případech předcházela diagnóza RS diagnó ze FHI, medián latence 13 (rozmezí 8–19) let. Závěry: Klinické příznaky FHI jsme odhalili u 12 % případů uveitidy spojených s RS, častěji u oboustranných projevů nitroočního zánětu. Podle našich zkušeností doporučujeme pátrat v anamnéze pacientů s FHI po projevech senzitivních, senzorických a motorických deficitů, a to zejména v bilaterálních případech.

Purpose: To draw attention to the higher proportion of Fuchs heterochromic iridocyclitis (FHI) cases in patients with multiple sclerosis (MS). Materials and Methods: Retrospective study of data collected at the Center for the Diagnosis and Treatment of Uveitis. Results: An analysis of the medical records of 3016 patients with uveitis (in the years 2003–2020) was performed with a focus on MS. MS-associated uveitis was diagnosed in 90 patients (3%): anterior uveitis (n = 7), intermediate uveitis (n = 23), retinal vasculitis (n = 24), and panuveitis (n = 36). A clinical examination revealed signs of FHI in the anterior segment in 11 out of 90 cases (12%). Atypical manifestations of FHI included a higher incidence of bilateral involvement (45%), retinal vasculitis (27%), and vitreous snowballs (18%). The diagnosis of FHI preceded the diagnosis of MS in 4 cases. The median latency was 10.5 (range 8–15) years. In 4 patients, the diagnosis of demyelinating disease was established within one year of the diagnosis of FHI. We recommended a neurological examination for optic neuritis (n = 1), paresthesia (n = 3), relapse of motor deficit (n = 1), and screening of etiology in cases with involvement of the posterior segment (n = 3). In the other 3 cases, the diagnosis of MS preceded the diagnosis of FHI, with a median latency of 13 (range 8–19) years. Conclusion: We detected clinical symptoms of FHI in 12% of uveitis cases associated with MS, more often in bilateral manifestations of intraocular inflammation. Based on our experience, we recommend an investigation of the medical history of patients with FHI for manifestations of sensitive, sensory and motor deficits, especially in bilateral cases.

• Keywords
• Fuchsova heterochromní iridocyklitida,
• MeSH
• Diagnostic Techniques, Ophthalmological classification   MeSH
• Iridocyclitis * diagnostic imaging   diagnosis   classification   MeSH
• Humans MeSH
• Retrospective Studies MeSH
• Multiple Sclerosis * diagnosis   immunology   pathology   MeSH
• Uveitis diagnosis   classification   MeSH
• Check Tag
• Humans MeSH

AIMS: To investigate the therapeutic potential of visual stimulation (VS) and BDNF in murine experimental autoimmune uveoretinitis (EAU). MAIN METHODS: Mice were immunized by subcutaneous injection of interphotoreceptor retinoid-binding protein in Freund's complete adjuvant and intravenous injection of pertussis toxin, and were then exposed to high-contrast VS 12 h/day (days 1-14 post-immunization). EAU severity was assessed by examining clinical score, visual acuity, inflammatory markers, and immune cells in the retina. The transcriptome of activated retinal cells was determined by RNA-seq using RNA immunoprecipitated in complex with phosphorylated ribosomal protein S6. The retinal levels of protein products of relevant upregulated genes were quantified. The effect of BDNF on EAU was tested in unstimulated mice by its daily topical ocular administration (days 8-14 post-immunization). KEY FINDINGS: VS attenuated EAU development and decreased the expression of pro-inflammatory cytokines/chemokines and numbers of immune cells in the retina (n = 10-20 eyes/group for each analysis). In activated retinal cells of control mice (n = 30 eyes/group), VS upregulated genes encoding immunomodulatory neuropeptides, of which BDNF and vasoactive intestinal peptide (VIP) also showed increased mRNA and protein levels in the retina of VS-treated EAU mice (n = 6-10 eyes/group for each analysis). In unstimulated EAU mice, BDNF treatment mimicked the protective effects of VS by modulating the inflammatory and stem cell properties of Müller cells (n = 5 eyes/group for each analysis). SIGNIFICANCE: VS effectively suppresses EAU, at least through enhancing retinal levels of anti-inflammatory and neuroprotective factors, VIP and BDNF. Our findings also suggest BDNF as a promising therapeutic agent for uveitis treatment.

• MeSH
• Autoimmune Diseases * immunology   metabolism   MeSH
• Cytokines metabolism   MeSH
• Disease Models, Animal MeSH
• Brain-Derived Neurotrophic Factor * metabolism   MeSH
• Mice, Inbred C57BL MeSH
• Mice MeSH
• Retina metabolism   drug effects   MeSH
• Retinitis * drug therapy   prevention & control   immunology   MeSH
• Uveitis * metabolism   drug therapy   immunology   MeSH
• Vasoactive Intestinal Peptide pharmacology   MeSH
• Animals MeSH
• Check Tag
• Mice MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH