ESSENTIALS IN OPHTHALMOLOGY: Uveitis and Immunological Disorders.
U. Pleyer · B. Mondino (Eds.)
ESSENTIALS IN OPHTHALMOLOGY G. K. Krieglstein · R. N. Weinreb Series Editors
Glaucoma
Cataract and Refractive Surgery Uveitis and Immunological Disorders Vitreo-retinal Surgery
Medical Retina
Oculoplastics and Orbit Paediatric Ophthalmology, Neuro-ophthalmology, Genetics Cornea and External Eye Disease
Editors Uwe Pleyer
Bartly Mondino
With 73 Figures, Mostly in Colour, and 26 Tables
Uveitis and
Immunological Disorders
123
Series Editors
Günther K. Krieglstein,MD Professor and Chairman Department of Ophthalmology University of Cologne
Joseph-Stelzmann-Straße 9 50931 Cologne
Germany
Robert N. Weinreb, MD Professor and Director Hamilton Glaucoma Center
Department of Ophthalmology – 0946 University of California at San Diego 9500 Gilman Drive
La Jolla, CA 92093-0946 USA
ISBN 3-540-20045-2
Springer Verlag Berlin Heidelberg New York
Volume Editors Uwe Pleyer,MD
Professor of Ophthalmology Augenklinik Charité Campus Virchow Klinikum Augustenburger Platz 1 13353 Berlin
Germany
Bartly Mondino, MD Professor of Ophthalmology Jules Stein Eye Institute 100 Stein Plaza #2–142 Los Angeles, CA 90095-7000 USA
ISSN 1612-3212
Library of Congress Control Number: 2004106762
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Essentials in Ophthalmology is a new review se- ries covering all of ophthalmology categorized in eight subspecialties. It will be published quar- terly; thus each subspecialty will be reviewed biannually.
Given the multiplicity of medical publica- tions already available, why is a new series needed? Consider that the half-life of medical knowledge is estimated to be around 5 years.
Moreover, it can be as long as 8 years between the description of a medical innovation in a peer-reviewed scientific journal and publica- tion in a medical textbook.A series that narrows this time span between journal and textbook would provide a more rapid and efficient trans- fer of medical knowledge into clinical practice, and enhance care of our patients.
For the series, each subspecialty volume comprises 10–20 chapters selected by two dis- tinguished editors and written by international- ly renowned specialists. The selection of these contributions is based more on recent and note-
worthy advances in the subspecialty than on systematic completeness. Each article is struc- tured in a standardized format and length, with citations for additional reading and an appro- priate number of illustrations to enhance im- portant points. Since every subspecialty volume is issued in a recurring sequence during the 2-year cycle, the reader has the opportunity to focus on the progress in a particular subspecial- ty or to be updated on the whole field. The clin- ical relevance of all material presented will be well established, so application to clinical prac- tice can be made with confidence.
This new series will earn space on the book- shelves of those ophthalmologists who seek to maintain the timeliness and relevance of their clinical practice.
G. K. Krieglstein R. N. Weinreb Series Editors
Foreword
Essentials in Ophthalmology is a publication se- ries that includes eight volumes covering the following topics: Glaucoma, Cataract and Re- fractive Surgery, Uveitis and Immunological Disorders,Vitreo-Retinal Surgery, Medical Reti- na, Ocular Plastics and Orbit, Neuro-Ophthal- mology, Paediatric Ophthalmology, and Cornea and External Eye Disease. A volume on each topic will be published every 2 years with one being published each quarter. Every 2 years, each volume will be repeated in a new and up- dated version with different topics.
Each volume is designed to bridge the gap between primary research literature and daily practice. Although current and practical infor- mation is stressed in each volume, the latest in research information and directions is also highlighted. The series is designed to be user friendly with numerous tables and illustrations.
The target audience includes ophthalmologists and optometrists in practice and training as well as libraries.
The third volume in this series is entitled Uveitis and Immunological Disorders. Our knowl- edge and understanding of these diseases has increased exponentially over the past decade, especially in the areas of immunopathogenesis and immunogenetics. This volume will provide the practitioner with practical information on how to diagnose and treat these difficult and, in some cases, blinding disorders. In addition,
there are important discussions of mechanisms underlying these conditions that incorporate the most recent, up-to-date research material available. A “Summary for the Clinician” as well as “Core Messages” enhance the value of the chapters. These aids will help the reader to focus on the important messages in each chapter.
The scope of chapters ranges from diseases that are relatively common and usually require only topical therapy such as ocular allergy and dry eye to diseases that may result in blindness without systemic therapy such as ocular cicatri- cial pemphigoid, scleritis and some forms of uveitis. Two of the chapters, “Immune Mecha- nisms in Uveitis” and “Uveitis and Genetics”, provide the reader with the latest laboratory re- search in these areas.
This volume has information of interest to a wide range of ophthalmic subspecialists. For ex- ample, the anterior segment subspecialist will find an interest in subjects such as ocular aller- gy, dry eye, cicatricial pemphigoid, corneal trans- plantation, scleritis and herpes viruses. Retina and uveitis specialists will have a special interest in the chapters dealing with uveitis and its mechanisms and therapy, including medical and surgical. Lastly, the chapter covering uveitis in children provides important and useful in- formation for paediatric ophthalmologists.
Uwe Pleyer Bartly Mondino
Preface
Chapter 1
Targets in Ocular Allergy
Alessandra Micera, Sergio Bonini, Alessandro Lambiase, Roberto Sgrulletta, Stefano Bonini
1.1 Introduction . . . 1
1.2 Chronic Allergic Eye Diseases . . . 2
1.3 Effector Cells and Cytokine Release. 2 1.4 Chemokines and Adhesion Molecules . . . 3
1.5 Neuropeptide and Growth Factor Involvement . . . . 4
1.6 Tissue Remodelling and the Contribution of Fibroblasts 5 1.7 Metabolism of Extracellular Matrix . 6 1.8 Conclusions . . . 7
References . . . 8
Chapter 2 Dry Eye: Inflammation of the Lacrimal Functional Unit Stephen C. Pflugfelder, Michael E. Stern 2.1 Introduction . . . 11
2.1.1 Basics . . . 11
2.1.2 Lacrimal Functional Unit . . . 12
2.2 Specific Pathologies of the Lacrimal Functional Unit . . . . 14
2.2.1 Dysfunction of the Afferent System . 14 2.2.2 Dysfunction of the Efferent System . 15 2.2.3 Glandular Dysfunction . . . 15
2.3 Lacrimal Keratoconjunctivitis Inflammation . . . 16
2.3.1 Corneal Epithelial Disease . . . 17
2.3.2 Conjunctival Epithelial Disease . . . . 17
2.3.3 Inflammation . . . 18
2.4 Diagnosis . . . 19
2.5 Therapies . . . 21
References . . . 22
Chapter 3 Ocular Cicatricial Pemphigoid Ahmed Muna, C. Stephen Foster 3.1 Introduction . . . 25
3.2 Pathophysiology . . . 26
3.3 Epidemiology . . . 26
3.4 Clinical History . . . 26
3.5 Clinical Signs . . . 26
3.6 Staging . . . 27
3.7 Diagnosis . . . 28
3.7.1 Laboratory Tests . . . 28
3.7.2 Conjunctival Biopsy . . . 28
3.7.3 Histology . . . 29
3.8 Treatment . . . 29
3.8.1 Medical . . . 29
3.8.2 Surgery . . . 31
3.9 Collaborative Care . . . 33
3.10 Prognosis . . . 33
References . . . 34
Chapter 4 Immunomodulation for Corneal Transplantation Douglas J. Coster, Keryn A. Williams 4.1 Introduction . . . 35
4.2 Why Has Corneal Transplantation Fallen Behind Solid Organ Grafting? . . . 36
4.3 Immunomodulation for Corneal Transplantation . . . 36
4.4 Actuarial Survival Data on Corneal Transplantation . . . 37
4.5 Options for Immunomodulation . . . 38
4.6 Corneal Privilege . . . 38
4.7 Mechanisms of Corneal Allograft Rejection . . . 39
Contents
4.8 The Afferent Limb:
Sensitization to Corneal Alloantigens 39 4.9 The Efferent Limb:
Histological Correlates . . . 40
4.10 Current Approaches to Immunomodulation for Corneal Transplantation . . . 41
4.10.1 Anti-inflammatory Measures . . . 41
4.10.2 Atraumatic Microsurgical Technique 41 4.10.3 Topical Corticosteroids . . . 41
4.10.4 HLA Matching for Class I and Class II Antigens . . . 41
4.10.5 Systemic Immunosuppression . . . 42
4.10.6 Systemic Corticosteroids . . . 42
4.10.7 Antiproliferative Agents . . . 43
4.10.8 Calcineurin Blockers . . . 43
4.10.9 Combination Therapy . . . 44
4.10.10Side Effects of Systemic Immunosuppression . . . 44
4.11 Novel Approaches to Immunomodulation . . . 45
4.11.1 Monoclonal Antibody Fragments . . 45
4.11.2 Gene Therapy . . . 45
4.12 Conclusion . . . 46
References . . . 46
Chapter 5 Scleritis Alisa Kim, Sean Dumars, Samir Shah, Bartly Mondino 5.1 Introduction . . . 52
5.1.1 Classification . . . 52
5.1.2 Anatomy . . . 55
5.1.3 Pathogenesis . . . 55
5.1.4 Histopathology . . . 56
5.2 Clinical Presentation . . . 57
5.2.1 History: Ocular Symptoms . . . 57
5.2.2 Physical Examination: Ocular Signs . . . 58
5.2.3 Associated Ocular Manifestations . . 60
5.2.4 Systemic Diseases: Clinical Evaluation . . . 61
5.3 Diagnostic Tools . . . 62
5.4 Medical Management . . . 63
5.5 Surgical Management . . . 64
References . . . 65
Chapter 6 Clinical Aspects of MALT Erich Knop, Nadja Knop, Uwe Pleyer 6.1 Introduction . . . 67
6.2 Structure and Function of MALT . . . 68
6.2.1 Structure of MALT . . . 68
6.2.2 Eye-Associated Lymphoid Tissue (EALT) . . . 71
6.2.3 Basic Functions of MALT . . . 74
6.3 Dry Eye Disease . . . 76
6.3.1 Introduction . . . 75
6.3.2 Epidemiology, Definition and Characteristics of Dry Eye . . . 76
6.3.3 Novel Therapeutic Approaches to Dry Eye Disease . . . 80
6.4 Ocular Allergy . . . 81
6.4.1 Introduction . . . 81
6.4.2 Epidemiology, Definition and Characteristics of Allergic Eye Disease . . . 81
6.4.3 Course and Therapy Options in Allergic Ocular Disease . . . 84
6.5 Keratoplasty . . . 84
6.5.1 Introduction . . . 84
6.5.2 Immunological Characteristics of Keratoplasty . . . 85
References . . . 87
Chapter 7 Immunogenetics of Ocular Inflammatory Disease Ralph D. Levinson 7.1 Introduction . . . 91
7.2 Human Leukocyte Antigens . . . 93
7.2.1 HLA Nomenclature . . . 94
7.2.2 Class I HLA . . . 94
7.2.3 Class II HLA . . . 95
7.2.4 HLA Haplotypes and Linkage Disequilibrium . . . 95
7.2.5 HLA and Disease Pathogenesis . . . . 95 7.3 HLA Associations
with Ocular Inflammatory Disease . 96 7.3.1 Class I HLA Associations
with Ocular Inflammatory Disease . 96 7.3.2 Class II HLA Associations
with Ocular Inflammatory Disease . 98 X Contents
7.3.3 HLA Associations
with Ocular Infections . . . 100
7.3.4 HLA Associations with External Ocular Inflammation. 100 7.3.5 HLA Associations with Extraocular Disease . . . 100
7.4 Non-HLA Genes Associated with Ocular Inflammatory Disease . 101 7.5 Other Ocular Diseases . . . 102
7.6 Conclusion . . . 102
References . . . 102
Chapter 8 Immune Mechanisms in Uveitis Ling Chen, Lynn K. Gordon 8.1 Introduction . . . 109
8.2 Animal Uveitis Models . . . 110
8.2.1 Experimental Autoimmune Uveitis (EAU). . . 110
8.2.2 Endotoxin-Induced Uveitis (EIU) . . 116
8.2.3 Experimental Melanin-Protein- Induced Uveitis (EMIU) . . . 116
8.2.4 Experimental Autoimmune Pigment Epithelial Membrane Protein- Induced Uveitis (EAPU). . . 117
8.3 Immune Mechanisms in Human Uveitis . . . 117
8.3.1 HLA-Associated Human Uveitis . . . 117
8.3.2 Behçet’s Disease . . . 119
8.3.3 Vogt-Koyanagi-Harada Syndrome . . 120
References . . . 121
Chapter 9 The Tip of the Iceberg: Current Knowledge of Uveitis in Juvenile Arthritis Uwe Pleyer, Claudia Sengler, Natasa Orlic, Rolf Keitzer 9.1 Introduction . . . 125
9.2 Classification of Arthritis . . . 126
9.3 Epidemiology . . . 126
9.4 Pathogenesis . . . 127
9.5 Risk Factors for the Development of Uveitis in JRA . . . 128
9.6 Clinical Features of Uveitis in JCA . . 128
9.7 Complications of Uveitis in JCA . . . . 129
9.7.1 Macula Edema . . . 130
9.8 Differential Diagnosis . . . 130
9.9 Prognostic Factors for Uveitis. . . 131
9.9.1 Gender . . . 132
9.9.2 Type of Arthritis . . . 132
9.9.3 Onset of Arthritis . . . 132
9.9.4 Severity of Uveitis at Onset . . . 132
9.10 Correlation of Uveitis and Arthritis Activity . . . 133
9.11 Treatment of Uveitis in JCA. . . 133
9.11.1 Topical Steroid Treatment . . . 133
9.11.2 Nonsteroidal Anti-inflammatory Drugs (NSAID) . . . 134
9.11.3 Systemic Immunomodulatory Agents . . . 134
9.12 Recommendations for Ocular Screening in JCA . . . 136
References . . . 136
Chapter 10 Herpes Viruses in Ocular Inflammation Bahram Bodaghi, Phuc LeHoang 10.1 Introduction . . . 141
10.2 Fundamental Virology . . . 143
10.3 Epidemiology . . . 143
10.4 Pathophysiology . . . 144
10.4.1 Experimental Viral Uveitis . . . 144
10.4.2 Experimental Models to Study Viral Retinitis . . . 145
10.5 Clinical Features . . . 145
10.5.1 Anterior Uveitis . . . 145
10.5.2 Viral Retinopathies . . . 147
10.5.3 Differential Diagnosis . . . 149
10.5.4 Putative Viral-Associated Uveitis . . . 150
10.6 Diagnosis . . . 150
10.6.1 Obtention of Ocular Fluids . . . 151
10.6.2 Herpes Viruses . . . 151
10.6.3 Search for Antiviral Antibodies . . . . 152
10.7 Treatment . . . 153
10.7.1 Anterior Uveitis . . . 153
10.7.2 Viral Retinopathies . . . 154
References . . . 157
Chapter 11 Cytomegalovirus and the Eye Marc D. de Smet 11.1 Introduction . . . 161
11.2 Populations at Risk . . . 161 Contents XI
11.2.1 HIV Associated
Immunosuppression . . . 161
11.2.2 Immunosuppression in Non-HIV Settings . . . 162
11.3 Appearance and Course . . . 163
11.3.1 Manifestation Prior to Initial Treatment . . . 163
11.3.2 Manifestations Under Therapy . . . 164
11.3.3 Differential Diagnosis . . . 165
11.3.4 Investigations . . . 166
11.4 Therapeutic Agents . . . 166
11.4.1 Ganciclovir. . . 166
11.4.2 Valganciclovir . . . 167
11.4.3 Foscarnet . . . 167
11.4.4 Other Agents . . . 167
11.5 Screening and Treatment Algorithms . . . 167
11.5.1 CMV in HIV Infected Patients . . . 168
11.5.2 CMV in Other Immunosuppressive States . . . 168
11.6 Management of Complications . . . 168
11.6.1 Immune Recovery . . . 168
11.6.2 Retinal Detachment . . . 168
References . . . 169
Chapter 12 Behçet’s Disease Manfred Zierhut, Nicole Stübiger, Christoph Deuter, Ina Kötter 12.1 Introduction . . . 173
12.2 Definition and Epidemiology of BD 174 12.2.1 Definition . . . 174
12.2.2 History . . . 174
12.2.3 Epidemiology . . . 174
12.3 Genetics of BD . . . 178
12.4 Immunology . . . 182
12.4.1 T Cells . . . 182
12.4.2 NK Cells . . . 183
12.4.3 Neutrophils . . . 183
12.4.4 Endothelial Dysfunction . . . 183
12.4.5 Coagulation and Fibrinolytic Pathway Abnormalities . . . 184
12.5 General (Extraocular) Manifestations of BD . . . 184
12.5.1 Oral Aphthous Ulcerations . . . 184
12.5.2 Genital Ulcerations . . . 185
12.5.3 Skin Lesions . . . 185
12.5.4 Pathergy Phenomenon . . . 185
12.5.5 Skeletal System . . . 185
12.5.6 Gastrointestinal Manifestations . . . . 186
12.5.7 Neurological Manifestations . . . 186
12.5.8 Vascular Manifestations . . . 186
12.5.9 Rare Manifestations . . . 187
12.5.10 Life Expectancy . . . 187
12.6 Ocular Involvement . . . 187
12.6.1 Anterior Segment Changes . . . 188
12.6.2 Posterior Segment Changes . . . 188
12.6.3 Complications . . . 189
12.6.4 Diagnosis . . . 190
12.7 Therapy . . . 190
12.7.1 Local Treatment . . . 191
12.7.2 Systemic Treatment. . . 191
12.7.3 Surgical Treatment . . . 194
12.7.4 Practical Treatment Recommendations . . . 194
References . . . 195
Chapter 13 Choroiditis: General Considerations and Classification Carl P. Herbort 13.1 Introduction . . . 202
13.2 Indocyanine Green Angiography (ICGA) . . . 202
13.2.1 Physicochemical Properties of Indocyanine Green (ICG) . . . 202
13.2.2 Standard ICG Angiographic Protocol for Inflammatory Diseases . . . 204
13.2.3 Principles for the Interpretation of ICGA [9, 10] . . . 204
13.2.4 Differences Between Fluorescein and Indocyanine Green Angiography . . . 205
13.2.5 Clinico-pathologic-angiographic Correlations . . . 205
13.2.6 Relevance of ICGA in Ocular Inflammatory Diseases . . . 205
13.3 The Concepts of Inflammatory Choriocapillaropathy and Stromal Choroiditis [12] . . . 206
13.3.1 Primary Inflammatory Choriocapillaropathy (PICCP) . . . 206
13.3.2 Stromal Choroiditis . . . 207
13.3.3 Secondary Inflammatory Choriocapillaropathy . . . 207
References . . . 207 XII Contents
Chapter 14
Primary Inflammatory Choriocapillaropathies Luca Cimino, Alessandro Mantovani, Carl. P. Herbort
14.1 Introduction . . . 210
14.2 Angiographic Signs in Inflammatory Choriocapillaropathies . . . 211
14.2.1 Angiographic Signs in Inflammatory Choriocapillaropathies . . . 213
14.3 Patient History, Systemic and Ocular Symptoms and Signs in Primary Inflammatory Choriocapillaropathies . . . 213
14.4 Practical Attitude in Primary Inflammatory Choriocapillaropathies (PICCP) . . . 214
14.5 Specific Entities . . . 215
14.5.1 Multiple Evanescent White Dot Syndrome (MEWDS) . . . 215
14.5.2 Acute Idiopathic Blind Spot Enlargement (AIBSE) . . . 216
14.5.3 Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) or Acute Multifocal Ischaemic Choriocapillaropathy (AMIC) . . . 217
14.5.4 Multifocal Choroiditis (MFC), Including Punctate Inner Choroiditis (PIC), Diffuse Subretinal Fibrosis and Presumed Ocular Histoplasmosis Syndrome (POHS) . . . 219
14.5.5 Serpiginous Choroiditis . . . 222
14.6 Rare Entities . . . 224
14.6.1 Acute Zonal Occult Outer Retinopathy (AZOOR) and Acute Annular Outer Retinopathy (AAOR) . . . 224
14.6.2 Acute Macular Neuroretinopathy (AMN) . . . 225
14.7 Overlapping Clinical Pictures in PICCPs: The Choriocapillaris as the Common Denominator of PICCPs . . . 226
14.7.1 Association of Different PICCPs in the Same Patient . . . 226
14.7.2 Intermediary Forms of PICCP . . . 226
14.7.3 Unclassifiable Primary Inflammatory Choriocapillaropathies . . . 227
14.8 Conclusion . . . 228
References . . . 228
Chapter 15 Stromal Choroiditis Nadia Bouchenaki, Carl O. Herbort 15.1 Introduction . . . 233
15.2 Specific Entities . . . 234
15.2.1 Primary Stromal Choroiditis . . . 234
15.2.2 Stromal Choroiditis as a Random Involvement of a Systemic Disease . 243 15.2.3 Other Infectious Choroiditides . . . . 249
References . . . 251
Chapter 16 Immunomodulatory Therapy in Uveitis Stephan R. Thurau, Gerhild Wildner 16.1 Introduction . . . 255
16.2 Cytotoxic Drugs . . . 257
16.2.1 Azathioprine . . . 258
16.2.2 Methotrexate . . . 258
16.2.3 Mycophenolate Mofetil . . . 259
16.2.4 Leflunomide . . . 259
16.2.5 Cyclophosphamide . . . 259
16.2.6 Chlorambucil . . . 260
16.3 Antibiotics . . . 261
16.3.1 Sulphasalazine . . . 261
16.4 Calcineurin Inhibitors . . . 261
16.4.1 Cyclosporine A (CsA) . . . 261
16.4.2 Tacrolimus (FK506) . . . 262
16.4.3 Sirolimus (Rapamycin) . . . 262
16.5 Immunomodulatory Substances . . . 262
16.5.1 Thalidomide . . . 262
16.5.2 Anti-TNF-a Treatment. . . 263
16.5.3 Interferon-a . . . 265
16.5.4 Daclizumab . . . 266
16.6 Oral Tolerance Induction . . . 266
16.6.1 Retinal Autoantigens as Tolerogens . 266 16.6.2 HLA-peptide B27PD as Oral Tolerogen . . . 267
References . . . 268 Contents XIII
Chapter 17
Vitrectomy in Uveitis
Matthias D. Becker, Arnd Heiligenhaus, Marc de Smet, Janet Davis
17.1 Introduction . . . 273
17.2 General Approach to PPV in Uveitis 273 17.2.1 Patient Selection . . . 273
17.2.2 Timing of Surgery . . . 273
17.2.3 Technical Considerations. . . 274
17.2.4 Diagnostic Procedures . . . 274
17.3 Perioperative Management . . . 274
17.3.1 Assessment of Other Ocular Disease 274 17.3.2 Concomitant Medical Management . 275 17.4 Combined Surgery . . . 277
17.4.1 Cataract Surgery . . . 277
17.4.2 Membrane Peeling . . . 278
17.4.3 Cryotherapy . . . 278
17.4.4 Diagnostic PPV . . . 278
17.5 Postoperative Complications . . . 279
17.5.1 Hypotony . . . 279
17.5.2 Retinal Detachment . . . 279
17.5.3 Vitreous Haemorrhage . . . 280
17.5.4 Uveitis Recurrence . . . 280
17.6 PPV in Specific Diseases . . . 280
17.6.1 Fuchs Uveitis Syndrome . . . 280
17.6.2 Behçet’s Disease . . . 280
17.6.3 Intermediate Uveitis . . . 280
17.6.4 Childhood Uveitis . . . 281
17.6.5 Infectious Uveitis . . . 281
References . . . 283
Subject Index . . . 285 XIV Contents
Becker, Matthias,Prof. Dr.
Interdisciplinary Uveitis Center, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Bodaghi, Bahram,MD, PhD Professor of Ophthalmology Department of Ophthalmology, Pitié-Salpêtrière Hospital, 47 Bd. de l-Hôpital, Paris 75013, France
Bonini, Sergio,MD Professor of Ophthalmology University of Rome Tor Vergata, Via Cassia Antica 35,
Rome 191, Italy
Bonini, Stefano,MD Professor of Ophthalmology Interdisciplinary Centre
for Biomedical Research (CIR), Laboratory of Ophthalmology,“Campus Bio-Medico”, University of Rome, Rome, Italy
Bouchenaki, Nadia,MD Inflammatory Eye Diseases Unit, Fondation A de Rothschild, Clinique Générale Beaulieu, Geneva, Switzerland
Chen, Ling,MD, MS Jules Stein Eye Institute, 100 Stein Plaza,
Los Angeles, CA 90095, USA
Cimino, Luca,MD Ocular Immunology Unit, Division of Ophthalmology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
Coster, Douglas J.,MD Professor of Ophthalmology Department of Ophthalmology, Flinders University of South Australia, Flinders Medical Centre,
Bedford Park, SA 5042, Australia
Davis, Janet,MD University of Miami,
Bascom Palmer, 900 NW 17th Street, Miami, FL 33136, USA
de Smet, Marc,MD Professor of Ophthalmology Department of Ophthalmology, Academic Medical Centre,
University of Amsterdam, Meibergdreef 9, Amsterdam AZ 1105, The Netherlands
Deuter, Christoph,Dr.
Universitäts-Augenklinik, Schleichstraße 12, 72076 Tübingen, Germany
Dumars, Sean,MD Jules Stein Eye Institute,
100 Stein Plaza, Los Angeles, CA 90095, USA
Contributors
Foster, C. Stephen,MD Professor of Ophthalmology Massachusetts Eye & Ear Infirmary, Harvard Medical School,
243 Charles Street,
Boston, MA 02114-3069, USA Gordon, Lynn K.,MD, PhD Jules Stein Eye Institute, 100 Stein Plaza,
Los Angeles, CA 90095, USA Heiligenhaus, Arnd,Prof. Dr.
St. Franziskus Hospital, Hohenzollernring 74, 48145 Münster, Germany Herbort, Carl P.,MD, PD, MER Professor of Ophthalmology Department of Ophthalmology, University of Lausanne, La Source Eye Centre, 2 Ave. des bergieres, Lausanne 1004, Switzerland
Keitzer, Rolf,Dr.
Otto Heubner Center for Paediatric and Adolescent Medicine,
Augustenburger Platz 1, 13353 Berlin, Germany
Kim, Alisa,MD Jules Stein Eye Institute, 100 Stein Plaza,
Los Angeles, CA 90095, USA
Knop, Erich,Prof. Dr.
Augenklinik Charité, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
Knop, Nadja, Dr.
Augenklinik Charité, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
Kötter, Ina,Dr.
Universitäts-Augenklinik, Schleichstraße 12, 72076 Tübingen, Germany Lambiase, Alessandro,MD Laboratory of Ophthalmology, Interdisciplinary Centre for Biomedical Research (CIR),
“Campus Bio-Medico”, University of Rome, Rome, Italy
LeHoang, Phuc,MD, PhD Professor of Ophthalmology Department of Ophthalmology, Pitié-Salpêtrière Hospital,
47 Bd. de l-Hôpital, Paris 75013, France Levinson, Ralph D.,MD
Assistant Professor of Ophthalmology Jules Stein Eye Institute,
100 Stein Plaza, UCLA, Los Angeles, CA 90095, USA
Mantovani, Alessandro,MD Division of Ophthalmology, Ospedale Valduce, Como, Italy
Micera, Alessandra,MD Interdisciplinary Centre
for Biomedical Research (CIR), Laboratory of Ophthalmology,“Campus Bio-Medico”, University of Rome, Rome, Italy
Mondino, Bartly,MD Professor of Ophthalmology Jules Stein Eye Institute, 100 Stein Plaza,
Los Angeles, CA 90095, USA
Muna, Ahmed,MD
Ocular Immunology and Uveitis Service, Department of Ophthalmology,
Harvard Medical School,
243 Charles Street, Boston, MA 02114, USA
Pflugfelder, Stephen C.,MD Biological Sciences, Allergan Inc., 2525 Dupont Drive, Irvine, CA 92612, USA XVI Contributors
Pleyer, Uwe,Prof. Dr.
Augenklinik Charité, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany Orlic, Natasa,Dr.
Augenklinik Charité, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany Sengler, Claudia,Dr.
Otto Heubner Center for Paediatric and Adolescent Medicine,
Augustenburger Platz 1, 13353 Berlin, Germany Sgrulletta, Roberto,MD Laboratory of Ophthalmology, Interdisciplinary Centre for Biomedical Research (CIR),
“Campus Bio-Medico”, University of Rome, Rome, Italy
Shah, Samir,MD Jules Stein Eye Institute, 100 Stein Plaza, Rm, Los Angeles, CA 90095, USA
Stern, Michael E.,MD Professor of Ophthalmology Biological Sciences,
Allergan Inc., 2525 Dupont Drive, Irvine, CA 92612, USA
Stübiger, Nicole,Dr.
Universitäts-Augenklinik, Schleichstraße 12, 72076 Tübingen, Germany Thurau, Stephan R.,Prof. Dr.
Section of Immunobiology, Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstraße 8,
80336 Munich, Germany Gerhild, Wildner,Dr.
Section of Immunobiology, Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstraße 8,
80336 Munich, Germany Williams, Keryn A.,MD Department of Ophthalmology, Flinders University of South Australia, Flinders Medical Centre,
Bedford Park, SA 5042, Australia
Zierhut, Manfred,Prof. Dr.
Universitäts-Augenklinik, Schleichstraße 12, 72076 Tübingen, Germany
Contributors XVII
