Clinical significance of detecting organ-specificsensitization in patients with long-term chronic posttraumatic uveitis

Abstract

Purpose: to assess the clinical significance of detecting organ-specific sensitization in chronic posttraumatic uveitis (CPTU) based on a comparative analysis of data from the leukocyte migration inhibition test (LMIT) and histological examination.Materials and methods. We examined 54 patients aged 17-82 with CPTU who underwent surgical removal of the eyeball (by enucleation/evisceration). To detect organ-specific sensitization, the LMIT in whole blood with extracts of corneal, lens, and uvearetinal tissue antigens was used. The eyes were subjected to histological examination after removal.Results. A positive response in LMIT was detected in 35.2 % of patients with CPTU. Pathomorphological signs of immune inflammation were found in 55.5 % of cases (30 eyes). In 23 eyes (42.6 %), the morphological picture was characterized by atrophic, fibrous and dystrophic changes in tissues. Based on the data from a comparative analysis of LMIT results and histological studies, we showed that in 16 cases out of 30 (53.3 %), morphologically confirmed immune inflammation was accompanied by sensitization to antigens of eye shells.Conclusions. In half of the cases, a productive inflammation, detected in CPTU during histological examination, was associated with the development of specific sensitization to eye tissue antigens. This result is important and should be considered when choosing how the patient should be managed, including targeted diagnostics and immunotropic therapy. The negative organ-specific response of LMIT in patients with chronic CPTU and intraocular inflammation confirmed by pathomorphological signs suggests a possible involvement of additional mechanisms of the inflammatory process, which requires further research.

Keywords

• trauma
• inflammation
• post-traumatic uveitis
• sympathetic ophthalmia
• sensitization