To report a patient with Crohn's disease and acute decreased vision in one eye secondary to m... more To report a patient with Crohn's disease and acute decreased vision in one eye secondary to multifocal choroiditis and serous retinal detachment. A complete ocular examination, including fluorescein angiography, was performed. Fundus biomicroscopy disclosed multifocal, deep, discretely elevated yellowish lesions at the posterior pole of the affected eye. Fluorescein angiographic study of these lesions revealed early hypofluorescence followed by late hyperfluorescence. Subtenonian injection of corticosteroids rapidly induced remission of the choroidal lesions. Chorioretinal involvement in patients with Crohn's disease may or may not be related to reactivation of this disorder. Therefore, even patients without gastrointestinal symptoms who present with posterior segment inflammation must be informed of this. The chorioretinal inflammatory lesions do seem to respond promptly to periocular injection of corticosteroids.
Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human... more Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human disease, is negatively regulated by the PI3K/Akt signaling pathway. As Akt is constitutively activated in a subset of breast cancer, we hypothesized that glycogen synthase kinase 3β is inappropriately inactivated in these cases. In this study, we aimed to assess (1) the overall frequency of glycogen synthase kinase 3β inactivation in breast cancer; (2) whether there is an association between Akt activation and glycogen synthase kinase 3β inactivation; and (3) whether there is a correlation between glycogen synthase kinase 3β inactivation and various pathologic and clinical parameters. The phosphorylated form of glycogen synthase kinase 3β (pGSK-3β) and Akt (pAkt) were used as surrogate markers for glycogen synthase kinase 3β inactivation and Akt activation, respectively. Immunohistochemistry applied to paraffin-embedded tissues was used to assess 72 consecutive invasive mammary carcinomas, of which 50 were estrogen receptor positive. Overall, pGSK-3β and pAkt were positive in 34 (47.2%) and 35 (48.6%) cases, respectively. These 2 markers were significantly correlated with each other in the overall group and in the estrogen receptor-positive subgroup (P = .01 and .003, Spearman, respectively). Importantly, pGSK-3β, but not pAkt, significantly correlated a worse clinical outcome in this cohort (P = .004, log rank). In summary, evidence of glycogen synthase kinase 3β inactivation was found in approximately half of the invasive mammary carcinomas. Our data suggest that this abnormality is likely attributed to Akt activation and that glycogen synthase kinase 3β inactivation confers a worse clinical outcome.
Transactions of the ophthalmological societies of the United Kingdom, 1986
Recent advances in cellular immunology have enabled us to delineate numerous lymphocyte subsets a... more Recent advances in cellular immunology have enabled us to delineate numerous lymphocyte subsets and activation stages using monoclonal antibody techniques. lymphocyte subsets and activation stages using monoclonal antibody techniques. We have used a fluorescence activated cell sorter (FACS) and newer monoclonal antibodies to study lymphocyte subpopulations and activation stages of T lymphocytes in intraocular fluids and peripheral blood of uveitis patients. T lymphocytes predominated in aqueous and vitreous. A statistically significant correlation was observed between the T lymphocyte subsets in aqueous and peripheral blood. No correlation was seen between the intravitreal lymphocyte subsets and peripheral blood. Many intraocular lymphocytes are present in the aqueous secondary to a blood ocular barrier breakdown. Using an anti-interleukin-2 (IL-2) receptor monoclonal antibody as a marker for T-cell activation, activated lymphocytes were found in intraocular and peripheral blood of ...
We retrospectively reviewed the cytology and immunohistochemistry of vitreous cells from 14 patie... more We retrospectively reviewed the cytology and immunohistochemistry of vitreous cells from 14 patients with benign or malignant intraocular diseases. Nine patients had intraocular lymphoma and five had benign forms of diffuse uveitis. The most useful cytologic criteria for lymphoma included an irregular nuclear outline, a coarse chromatin pattern and prominent nucleoli. In several cases, it was necessary to obtain more than one specimen to establish the diagnosis of lymphoma. When vitreous fluid was mixed with a balanced salt solution prior to processing, a resulting artifact interfered with interpretation of the specimen. A diagnosis of lymphoma was established by cytology in all nine patients; immunohistochemical techniques were less sensitive than was cytology.
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 1991
A 59-year-old man underwent total gastrectomy for diffuse, poorly differentiated gastric adenocar... more A 59-year-old man underwent total gastrectomy for diffuse, poorly differentiated gastric adenocarcinoma diagnosed as linitis plastica. Loss of vision in the right eye 5 months later due to extensive choroidal tumours was the first indication of metastatic disease. Radiologic studies showed multiple bony metastases. The blind, painful eye was enucleated. Pathological examination of the globe showed massive metastatic mucus-secreting adenocarcinoma of the choroid, with positive immunohistochemical staining for carcinoembryonic antigen (CEA) of the foci of the more highly differentiated neoplastic cells. The plasma CEA level had been normal. The patient died 3 months after enucleation from metastatic disease.
The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie médicale / AMMI Canada, 2004
The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significan... more The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significantly with the availability of highly active antiretroviral therapy (HAART). These updated guidelines are intended to provide practical help to physicians managing HIV-positive patients with or at risk for CMV disease. The 10 members of the Canadian CMV Disease in HIV/AIDS Consensus Group were infectious disease specialists, a primary care physician and ophthalmologists with expertise in HIV and CMV infection. Financial support by Hoffmann-La Roche Canada Ltd was unrestricted, and was limited to travel expenses and honoraria. The consensus group met in June and October 2002. Key areas to be considered were identified, and group members selected, reviewed and presented relevant recent literature for their assigned section for the group's consideration. Evidence was assessed based on established criteria, which were expert opinions of the members. Draft documents were circulated to the e...
Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human... more Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human disease, is negatively regulated by the PI3K/Akt signaling pathway. As Akt is constitutively activated in a subset of breast cancer, we hypothesized that glycogen synthase kinase 3β is inappropriately inactivated in these cases. In this study, we aimed to assess (1) the overall frequency of glycogen synthase kinase 3β inactivation in breast cancer; (2) whether there is an association between Akt activation and glycogen synthase kinase 3β inactivation; and (3) whether there is a correlation between glycogen synthase kinase 3β inactivation and various pathologic and clinical parameters. The phosphorylated form of glycogen synthase kinase 3β (pGSK-3β) and Akt (pAkt) were used as surrogate markers for glycogen synthase kinase 3β inactivation and Akt activation, respectively. Immunohistochemistry applied to paraffin-embedded tissues was used to assess 72 consecutive invasive mammary carcinomas, of which 50 were estrogen receptor positive. Overall, pGSK-3β and pAkt were positive in 34 (47.2%) and 35 (48.6%) cases, respectively. These 2 markers were significantly correlated with each other in the overall group and in the estrogen receptor-positive subgroup (P = .01 and .003, Spearman, respectively). Importantly, pGSK-3β, but not pAkt, significantly correlated a worse clinical outcome in this cohort (P = .004, log rank). In summary, evidence of glycogen synthase kinase 3β inactivation was found in approximately half of the invasive mammary carcinomas. Our data suggest that this abnormality is likely attributed to Akt activation and that glycogen synthase kinase 3β inactivation confers a worse clinical outcome.
Selecting the appropriate treatment for breast cancer requires accurately determining the estroge... more Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER) status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions.
International Journal of Radiation Oncology*Biology*Physics, 2011
To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in ... more To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.
Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Des... more Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Deschê nes
We performed a phase I study to assess the therapeutic efficacy of an anti-T cell monoclonal anti... more We performed a phase I study to assess the therapeutic efficacy of an anti-T cell monoclonal antibody conjugated with ricin A-chain in a corneal graft rejection model. Corneal allografts were exchanged between Dutch and New Zealand rabbits. Rejections occurred within 16-22 days in untreated animals. Graft rejection was delayed by topical or retrobulbar cyclosporine, but not by subconjunctival injections of a murine anti-rabbit T cell monoclonal antibody, nor by either subconjunctival or intravenous F(ab')2-ricin conjugate.
We retrospectively reviewed the cytology and immunohistology of vitreous specimens from nine pati... more We retrospectively reviewed the cytology and immunohistology of vitreous specimens from nine patients with intraocular lymphoma (ocular reticulum cell sarcoma). A single vitreous biopsy specimen was not always adequate to establish the diagnosis in this condition. Cytological evaluation was more accurate than lymphocyte surface marker analysis to differentiate lymphoma from uveitis. The immunological features of these tumours indicate a heterogeneous group of intraocular lymphomas.
Two colour flow cytometry techniques were used to assess the activation stages of peripheral and ... more 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.
To report a patient with Crohn's disease and acute decreased vision in one eye secondary to m... more To report a patient with Crohn's disease and acute decreased vision in one eye secondary to multifocal choroiditis and serous retinal detachment. A complete ocular examination, including fluorescein angiography, was performed. Fundus biomicroscopy disclosed multifocal, deep, discretely elevated yellowish lesions at the posterior pole of the affected eye. Fluorescein angiographic study of these lesions revealed early hypofluorescence followed by late hyperfluorescence. Subtenonian injection of corticosteroids rapidly induced remission of the choroidal lesions. Chorioretinal involvement in patients with Crohn's disease may or may not be related to reactivation of this disorder. Therefore, even patients without gastrointestinal symptoms who present with posterior segment inflammation must be informed of this. The chorioretinal inflammatory lesions do seem to respond promptly to periocular injection of corticosteroids.
Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human... more Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human disease, is negatively regulated by the PI3K/Akt signaling pathway. As Akt is constitutively activated in a subset of breast cancer, we hypothesized that glycogen synthase kinase 3β is inappropriately inactivated in these cases. In this study, we aimed to assess (1) the overall frequency of glycogen synthase kinase 3β inactivation in breast cancer; (2) whether there is an association between Akt activation and glycogen synthase kinase 3β inactivation; and (3) whether there is a correlation between glycogen synthase kinase 3β inactivation and various pathologic and clinical parameters. The phosphorylated form of glycogen synthase kinase 3β (pGSK-3β) and Akt (pAkt) were used as surrogate markers for glycogen synthase kinase 3β inactivation and Akt activation, respectively. Immunohistochemistry applied to paraffin-embedded tissues was used to assess 72 consecutive invasive mammary carcinomas, of which 50 were estrogen receptor positive. Overall, pGSK-3β and pAkt were positive in 34 (47.2%) and 35 (48.6%) cases, respectively. These 2 markers were significantly correlated with each other in the overall group and in the estrogen receptor-positive subgroup (P = .01 and .003, Spearman, respectively). Importantly, pGSK-3β, but not pAkt, significantly correlated a worse clinical outcome in this cohort (P = .004, log rank). In summary, evidence of glycogen synthase kinase 3β inactivation was found in approximately half of the invasive mammary carcinomas. Our data suggest that this abnormality is likely attributed to Akt activation and that glycogen synthase kinase 3β inactivation confers a worse clinical outcome.
Transactions of the ophthalmological societies of the United Kingdom, 1986
Recent advances in cellular immunology have enabled us to delineate numerous lymphocyte subsets a... more Recent advances in cellular immunology have enabled us to delineate numerous lymphocyte subsets and activation stages using monoclonal antibody techniques. lymphocyte subsets and activation stages using monoclonal antibody techniques. We have used a fluorescence activated cell sorter (FACS) and newer monoclonal antibodies to study lymphocyte subpopulations and activation stages of T lymphocytes in intraocular fluids and peripheral blood of uveitis patients. T lymphocytes predominated in aqueous and vitreous. A statistically significant correlation was observed between the T lymphocyte subsets in aqueous and peripheral blood. No correlation was seen between the intravitreal lymphocyte subsets and peripheral blood. Many intraocular lymphocytes are present in the aqueous secondary to a blood ocular barrier breakdown. Using an anti-interleukin-2 (IL-2) receptor monoclonal antibody as a marker for T-cell activation, activated lymphocytes were found in intraocular and peripheral blood of ...
We retrospectively reviewed the cytology and immunohistochemistry of vitreous cells from 14 patie... more We retrospectively reviewed the cytology and immunohistochemistry of vitreous cells from 14 patients with benign or malignant intraocular diseases. Nine patients had intraocular lymphoma and five had benign forms of diffuse uveitis. The most useful cytologic criteria for lymphoma included an irregular nuclear outline, a coarse chromatin pattern and prominent nucleoli. In several cases, it was necessary to obtain more than one specimen to establish the diagnosis of lymphoma. When vitreous fluid was mixed with a balanced salt solution prior to processing, a resulting artifact interfered with interpretation of the specimen. A diagnosis of lymphoma was established by cytology in all nine patients; immunohistochemical techniques were less sensitive than was cytology.
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 1991
A 59-year-old man underwent total gastrectomy for diffuse, poorly differentiated gastric adenocar... more A 59-year-old man underwent total gastrectomy for diffuse, poorly differentiated gastric adenocarcinoma diagnosed as linitis plastica. Loss of vision in the right eye 5 months later due to extensive choroidal tumours was the first indication of metastatic disease. Radiologic studies showed multiple bony metastases. The blind, painful eye was enucleated. Pathological examination of the globe showed massive metastatic mucus-secreting adenocarcinoma of the choroid, with positive immunohistochemical staining for carcinoembryonic antigen (CEA) of the foci of the more highly differentiated neoplastic cells. The plasma CEA level had been normal. The patient died 3 months after enucleation from metastatic disease.
The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie médicale / AMMI Canada, 2004
The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significan... more The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significantly with the availability of highly active antiretroviral therapy (HAART). These updated guidelines are intended to provide practical help to physicians managing HIV-positive patients with or at risk for CMV disease. The 10 members of the Canadian CMV Disease in HIV/AIDS Consensus Group were infectious disease specialists, a primary care physician and ophthalmologists with expertise in HIV and CMV infection. Financial support by Hoffmann-La Roche Canada Ltd was unrestricted, and was limited to travel expenses and honoraria. The consensus group met in June and October 2002. Key areas to be considered were identified, and group members selected, reviewed and presented relevant recent literature for their assigned section for the group's consideration. Evidence was assessed based on established criteria, which were expert opinions of the members. Draft documents were circulated to the e...
Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human... more Glycogen synthase kinase 3β, recently found to be functionally abnormal in various types of human disease, is negatively regulated by the PI3K/Akt signaling pathway. As Akt is constitutively activated in a subset of breast cancer, we hypothesized that glycogen synthase kinase 3β is inappropriately inactivated in these cases. In this study, we aimed to assess (1) the overall frequency of glycogen synthase kinase 3β inactivation in breast cancer; (2) whether there is an association between Akt activation and glycogen synthase kinase 3β inactivation; and (3) whether there is a correlation between glycogen synthase kinase 3β inactivation and various pathologic and clinical parameters. The phosphorylated form of glycogen synthase kinase 3β (pGSK-3β) and Akt (pAkt) were used as surrogate markers for glycogen synthase kinase 3β inactivation and Akt activation, respectively. Immunohistochemistry applied to paraffin-embedded tissues was used to assess 72 consecutive invasive mammary carcinomas, of which 50 were estrogen receptor positive. Overall, pGSK-3β and pAkt were positive in 34 (47.2%) and 35 (48.6%) cases, respectively. These 2 markers were significantly correlated with each other in the overall group and in the estrogen receptor-positive subgroup (P = .01 and .003, Spearman, respectively). Importantly, pGSK-3β, but not pAkt, significantly correlated a worse clinical outcome in this cohort (P = .004, log rank). In summary, evidence of glycogen synthase kinase 3β inactivation was found in approximately half of the invasive mammary carcinomas. Our data suggest that this abnormality is likely attributed to Akt activation and that glycogen synthase kinase 3β inactivation confers a worse clinical outcome.
Selecting the appropriate treatment for breast cancer requires accurately determining the estroge... more Selecting the appropriate treatment for breast cancer requires accurately determining the estrogen receptor (ER) status of the tumor. However, the standard for determining this status, immunohistochemical analysis of formalin-fixed paraffin embedded samples, suffers from numerous technical and reproducibility issues. Assessment of ER-status based on RNA expression can provide more objective, quantitative and reproducible test results. To learn a parsimonious RNA-based classifier of hormone receptor status, we applied a machine learning tool to a training dataset of gene expression microarray data obtained from 176 frozen breast tumors, whose ER-status was determined by applying ASCO-CAP guidelines to standardized immunohistochemical testing of formalin fixed tumor. This produced a three-gene classifier that can predict the ER-status of a novel tumor, with a cross-validation accuracy of 93.17±2.44%. When applied to an independent validation set and to four other public databases, some on different platforms, this classifier obtained over 90% accuracy in each. In addition, we found that this prediction rule separated the patients' recurrence-free survival curves with a hazard ratio lower than the one based on the IHC analysis of ER-status. Our efficient and parsimonious classifier lends itself to high throughput, highly accurate and low-cost RNA-based assessments of ER-status, suitable for routine high-throughput clinical use. This analytic method provides a proof-of-principle that may be applicable to developing effective RNA-based tests for other biomarkers and conditions.
International Journal of Radiation Oncology*Biology*Physics, 2011
To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in ... more To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.
Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Des... more Ahmed valve implantation in glaucoma secondary to chronic uveitis PÇ Ö zdal, RNG Vianna and J Deschê nes
We performed a phase I study to assess the therapeutic efficacy of an anti-T cell monoclonal anti... more We performed a phase I study to assess the therapeutic efficacy of an anti-T cell monoclonal antibody conjugated with ricin A-chain in a corneal graft rejection model. Corneal allografts were exchanged between Dutch and New Zealand rabbits. Rejections occurred within 16-22 days in untreated animals. Graft rejection was delayed by topical or retrobulbar cyclosporine, but not by subconjunctival injections of a murine anti-rabbit T cell monoclonal antibody, nor by either subconjunctival or intravenous F(ab')2-ricin conjugate.
We retrospectively reviewed the cytology and immunohistology of vitreous specimens from nine pati... more We retrospectively reviewed the cytology and immunohistology of vitreous specimens from nine patients with intraocular lymphoma (ocular reticulum cell sarcoma). A single vitreous biopsy specimen was not always adequate to establish the diagnosis in this condition. Cytological evaluation was more accurate than lymphocyte surface marker analysis to differentiate lymphoma from uveitis. The immunological features of these tumours indicate a heterogeneous group of intraocular lymphomas.
Two colour flow cytometry techniques were used to assess the activation stages of peripheral and ... more 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.
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Papers by Jean Deschenes