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Mediators of Inflammation
Volume 2014 (2014), Article ID 971417, 10 pages
http://dx.doi.org/10.1155/2014/971417
Review Article

Immune Recovery Uveitis: Pathogenesis, Clinical Symptoms, and Treatment

1Department of Pediatric Ophthalmology and Strabismus, Medical University of Białystok, Białystok University Children’s Hospital, Waszyngtona Street 17, 15-274 Białystok, Poland
2Department of Pediatric Ophthalmology and Strabismus, Białystok University Children’s Hospital, Waszyngtona Street 17, 15-274 Białystok, Poland

Received 16 May 2014; Accepted 10 June 2014; Published 24 June 2014

Academic Editor: Francisco J. Ascaso

Copyright © 2014 Beata Urban et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. S. Sudharshan and J. Biswas, “Introduction and immunopathogenesis of acquired immune deficiency syndrome,” Indian Journal of Ophthalmology, vol. 56, no. 5, pp. 357–362, 2008. View at Publisher · View at Google Scholar · View at Scopus
  2. R. B. Nussenblatt and H. C. Lane, “Human immunodeficiency virus disease: changing patterns of intraocular inflammation,” The American Journal of Ophthalmology, vol. 125, no. 3, pp. 374–382, 1998. View at Publisher · View at Google Scholar · View at Scopus
  3. G. N. Holland, “AIDS and ophthalmology: the first quarter century,” The American Journal of Ophthalmology, vol. 145, no. 3, pp. 397.e1–408.e1, 2008. View at Publisher · View at Google Scholar · View at Scopus
  4. M. O. Westendorp, V. A. Shatrov, K. Schulze-Osthoff et al., “HIV-1 Tat potentiates TNF-induced NF-κB activation and cytotoxicity by altering the cellular redox state,” EMBO Journal, vol. 14, no. 3, pp. 546–554, 1995. View at Google Scholar · View at Scopus
  5. N. Chatterjee, S. Callen, G. M. Seigel, and S. J. Buch, “HIV-1 Tat-mediated neurotoxicity in retinal cells,” Journal of Neuroimmune Pharmacology, vol. 6, no. 3, pp. 399–408, 2011. View at Publisher · View at Google Scholar · View at Scopus
  6. X. Che, F. He, Y. Deng et al., “HIV-1 Tat-mediated apoptosis in human blood-retinal barrier-associated cells,” PLoS ONE, vol. 9, no. 4, Article ID e95420, 2014. View at Publisher · View at Google Scholar
  7. C. S. P. Tsang and L. P. Samaranayake, “Immune reconstitution inflammatory syndrome after highly active antiretroviral therapy: a review,” Oral Diseases, vol. 16, no. 3, pp. 248–256, 2010. View at Publisher · View at Google Scholar · View at Scopus
  8. S. A. Shelburne, F. Visnegarwala, J. Darcourt et al., “Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy,” AIDS, vol. 19, no. 4, pp. 399–406, 2005. View at Google Scholar · View at Scopus
  9. M. Müller, S. Wandel, R. Colebunders, S. Attia, H. Furrer, and M. Egger, “Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis,” The Lancet Infectious Diseases, vol. 10, no. 4, pp. 251–261, 2010. View at Publisher · View at Google Scholar · View at Scopus
  10. G. M. N. Behrens, D. Meyer, M. Stoll, and R. E. Schmidt, “Immune reconstitution syndromes in human immunodeficiency virus infection following effective antiretroviral therapy,” Immunobiology, vol. 202, no. 2, pp. 186–193, 2000. View at Google Scholar · View at Scopus
  11. P. M. Grant, L. Komarow, M. M. Lederman et al., “Elevated interleukin 8 and T-helper 1 and T-helper 17 cytokine levels prior to antiretroviral therapy in participants who developed immune reconstitution inflammatory syndrome during actg a5164,” Journal of Infectious Diseases, vol. 206, no. 11, pp. 1715–1723, 2012. View at Publisher · View at Google Scholar · View at Scopus
  12. M. P. Karavellas, M. Song, J. C. MacDonald, and W. R. Freeman, “Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis,” The American Journal of Ophthalmology, vol. 130, no. 1, pp. 57–64, 2000. View at Publisher · View at Google Scholar · View at Scopus
  13. Q. D. Nguyen, J. H. Kempen, S. G. Bolton, J. P. Dunn, and D. A. Jabs, “Immune recovery uveitis in patients with AIDS and cytomegalovirus retinitis after highly active antiretroviral therapy,” The American Journal of Ophthalmology, vol. 129, no. 5, pp. 634–639, 2000. View at Publisher · View at Google Scholar · View at Scopus
  14. H. W. A. Henderson and S. M. Mitchell, “Treatment of immune recovery vitritis with local steroids,” The British Journal of Ophthalmology, vol. 83, no. 5, pp. 540–545, 1999. View at Google Scholar · View at Scopus
  15. M. E. Zegans, R. C. Walton, G. N. Holland, J. J. O'Donnell, M. A. Jacobson, and T. P. Margolis, “Transient vitreous inflammatory reactions associated with combination antiretroviral therapy in patients with AIDS and cytomegalovirus retinitis,” The American Journal of Ophthalmology, vol. 125, no. 3, pp. 292–300, 1998. View at Publisher · View at Google Scholar · View at Scopus
  16. J. V. Iyer, J. Connolly, R. Agrawal et al., “Cytokine analysis of aqueous humor in HIV patients with cytomegalovirus retinitis,” Cytokine, vol. 64, no. 2, pp. 541–547, 2013. View at Publisher · View at Google Scholar · View at Scopus
  17. J. P. Dunn, “Immune recovery vitritis in HIV infection: commentary,” The Journal of the American Medical Association, vol. 280, no. 2, pp. 185–186, 1998. View at Publisher · View at Google Scholar · View at Scopus
  18. J. C. Macdonald, M. P. Karavellas, F. J. Torriani et al., “Highly active antiretroviral therapy-related immune recovery in AIDS patients with cytomegalovirus retinitis,” Ophthalmology, vol. 107, no. 5, pp. 877–881, 2000. View at Publisher · View at Google Scholar · View at Scopus
  19. M. R. Robinson, G. Reed, K. G. Csaky, M. A. Polis, and S. M. Whitcup, “Immune-recovery uveitis in patients with cytomegalovirus retinitis taking highly active antiretroviral therapy,” The American Journal of Ophthalmology, vol. 130, no. 1, pp. 49–56, 2000. View at Publisher · View at Google Scholar · View at Scopus
  20. N. G. Pakker, D. W. Notermans, R. J. de Boer et al., “Biphasic kinetics of peripheral blood T cells after triple combination therapy in HIV-1 infection: a composite of redistribution and proliferation,” Nature Medicine, vol. 4, no. 2, pp. 208–214, 1998. View at Publisher · View at Google Scholar · View at Scopus
  21. D. A. Jabs, A. Ahuja, M. van Natta, A. Lyon, S. Srivastava, and S. Gangaputra, “Course of cytomegalovirus retinitis in the era of highly active antiretroviral therapy: five-year outcomes,” Ophthalmology, vol. 117, no. 11, pp. 2152.e2–2161.e2, 2010. View at Publisher · View at Google Scholar · View at Scopus
  22. M. P. Karavellas, C. Y. Lowder, J. C. Macdonald, C. P. Avila Jr., and W. R. Freeman, “Immune recovery vitritis associated with inactive cytomegalovirus retinitis: a new syndrome,” Archives of Ophthalmology, vol. 116, no. 2, pp. 169–175, 1998. View at Google Scholar · View at Scopus
  23. S. Leeamornsiri, P. Choopong, and N. Tesavibul, “Frosted branch angiitis as a result of immune recovery uveitis in a patient with cytomegalovirus retinitis,” Journal of Ophthalmic Inflammation and Infection, vol. 3, no. 1, article 52, 2013. View at Publisher · View at Google Scholar
  24. G. N. Holland, “Immune recovery uveitis,” Ocular Immunology and Inflammation, vol. 7, no. 3-4, pp. 215–221, 1999. View at Google Scholar · View at Scopus
  25. L. Figueiredo, R. Rothwell, M. Bilhoto, R. Varandas, and S. Fonseca, “Immune recovery uveitis masked as an endogenous endophthalmitis in a patient with active CMV retinitis,” Case Reports in Ophthalmological Medicine, vol. 2013, Article ID 462968, 4 pages, 2013. View at Publisher · View at Google Scholar
  26. J. H. Kempen, Y. Min, W. R. Freeman et al., “Risk of immune recovery uveitis in patients with AIDS and cytomegalovirus retinitis,” Ophthalmology, vol. 113, no. 4, pp. 684–694, 2006. View at Publisher · View at Google Scholar · View at Scopus
  27. M. P. Karavellas, D. J. Plummer, J. C. Macdonald et al., “Incidence of immune recovery vitritis in cytomegalovirus retinitis patients following institution of successful highly active antiretroviral therapy,” Journal of Infectious Diseases, vol. 179, no. 3, pp. 697–700, 1999. View at Publisher · View at Google Scholar · View at Scopus
  28. R. D. Schrier, M. K. Song, I. L. Smith et al., “Intraocular viral and immune pathogenesis of immune recovery uveitis in patients with healed cytomegalovirus retinitis,” Retina, vol. 26, no. 2, pp. 165–169, 2006. View at Publisher · View at Google Scholar · View at Scopus
  29. B. R. Kosobucki, D. E. Goldberg, K. Bessho et al., “Valganciclovir therapy for immune recovery uveitis complicated by macular edema,” The American Journal of Ophthalmology, vol. 137, no. 4, pp. 636–638, 2004. View at Publisher · View at Google Scholar · View at Scopus
  30. B. D. Kuppermann and G. N. Holland, “Immune recovery uveitis,” The American Journal of Ophthalmology, vol. 130, no. 1, pp. 103–106, 2000. View at Publisher · View at Google Scholar · View at Scopus
  31. D. J. Hartigan-O'Connor, M. A. Jacobson, Q. X. Tan, and E. Sinclair, “Development of cytomegalovirus (CMV) immune recovery uveitis is associated with Th17 cell depletion and poor systemic CMV-specific T cell responses,” Clinical Infectious Diseases, vol. 52, no. 3, pp. 409–417, 2011. View at Publisher · View at Google Scholar · View at Scopus
  32. S. K. Sharma and M. Soneja, “HIV & immune reconstitution inflammatory syndrome (IRIS),” Indian Journal of Medical Research, vol. 134, no. 12, pp. 866–877, 2011. View at Google Scholar · View at Scopus
  33. L. S. Rios, A. L. Vallochi, C. Muccioli, M. A. Campos-Machado, R. Belfort Jr., and L. V. Rizzo, “Cytokine profile in response to Cytomegalovirus associated with immune recovery syndrome after highly active antiretroviral therapy,” Canadian Journal of Ophthalmology, vol. 40, no. 6, pp. 711–720, 2005. View at Google Scholar · View at Scopus
  34. G. Modorati, E. Miserocchi, and R. Brancato, “Immune recovery uveitis and human leukocyte antigen typing: a report on four patients,” European Journal of Ophthalmology, vol. 15, no. 5, pp. 607–609, 2005. View at Google Scholar · View at Scopus
  35. S. Sudharshan, S. Kaleemunnisha, A. A. Banu et al., “Ocular lesions in 1,000 consecutive HIV-positive patients in India: a long-term study,” Journal of Ophthalmic Inflammation and Infection, vol. 3, no. 1, article 2, 2013. View at Publisher · View at Google Scholar · View at Scopus
  36. A. S. Banker and A. Patel, “Effect of combination antiretroviral therapy on cytomegalovirus retinitis,” Indian Journal of Ophthalmology, vol. 50, no. 1, pp. 29–33, 2002. View at Google Scholar · View at Scopus
  37. J. F. Arevalo, A. J. Mendoza, and Y. Ferretti, “Immune recovery uveitis in AIDS patients with cytomegalovirus retinitis treated with highly active antiretroviral therapy in Venezuela,” Retina, vol. 23, no. 4, pp. 495–502, 2003. View at Publisher · View at Google Scholar · View at Scopus
  38. G. Ortega-Larrocea, E. Espinosa, and G. Reyes-Terán, “Lower incidence and severity of cytomegalovirus-associated immune recovery uveitis in HIV-infected patients with delayed highly active antiretroviral therapy,” AIDS, vol. 19, no. 7, pp. 735–738, 2005. View at Google Scholar · View at Scopus
  39. A. Uemura, S. Yashiro, N. Takeda, and S. Oka, “Ocular complications in patients with human immunodeficiency virus infection,” Nippon Ganka Gakkai Zasshi, vol. 110, no. 9, pp. 698–702, 2006. View at Google Scholar · View at Scopus
  40. M. Dujić and D. Jevtović, “Immune recovery vitritis,” Srpski Arhiv za Celokupno Lekarstvo, vol. 135, no. 9-10, pp. 513–515, 2007. View at Google Scholar
  41. Y. C. Lin, C. H. Yang, C. P. Lin et al., “Cytomegalovirus retinitis and immune recovery uveitis in AIDS patients treated with highly active antiretroviral therapy in Taiwanese,” Ocular Immunology and Inflammation, vol. 16, no. 3, pp. 83–87, 2008. View at Publisher · View at Google Scholar · View at Scopus
  42. S. Gharai, P. Venkatesh, S. Garg, S. K. Sharma, and R. Vohra, “Ophthalmic manifestations of HIV infections in India in the era of HAART: analysis of 100 consecutive patients evaluated at a tertiary eye care center in India,” Ophthalmic Epidemiology, vol. 15, no. 4, pp. 264–271, 2008. View at Publisher · View at Google Scholar · View at Scopus
  43. S. U. Shah, S. P. Kerkar, and A. R. Pazare, “Evaluation of ocular manifestations and blindness in HIV/AIDS patients on HAART in a tertiary care hospital in western India,” The British Journal of Ophthalmology, vol. 93, no. 1, pp. 88–90, 2009. View at Publisher · View at Google Scholar · View at Scopus
  44. A. Hamamotoo, M. Tatebayashi, A. Uehira et al., “Retrospective study of ocular complications in patients with human immunodeficiency virus infection before and after HAART,” Nippon Ganka Gakkai Zasshi, vol. 116, no. 8, pp. 721–729, 2012. View at Google Scholar · View at Scopus
  45. A. Agarwal, N. Kumari, A. Trehan et al., “Outcome of cytomegalovirus retinitis in immunocompromised patients without human immunodeficiency virus treated with intravitreal ganciclovir injection,” Graefe's Archive for Clinical and Experimental Ophthalmology, 2014. View at Publisher · View at Google Scholar
  46. M. P. Karavellas, S. P. Azen, J. C. MacDonald et al., “Immune recovery vitritis and uveitis in aids: clinical predictors, sequelae, and treatment outcomes,” Retina, vol. 21, no. 1, pp. 1–9, 2001. View at Google Scholar · View at Scopus
  47. J. C. Canzano, J. B. Reed, and L. S. Morse, “Vitreomacular traction syndrome following highly active antiretroviral therapy in AIDS patients with cytomegalovirus retinitis,” Retina, vol. 18, no. 5, pp. 443–447, 1998. View at Google Scholar · View at Scopus
  48. R. Guzak, J. Rodman, and J. Pizzimenti, “Cystoid macular edema as a result of immune-recovery uveitis,” Optometry and Vision Science, vol. 88, no. 2, pp. E344–E351, 2011. View at Publisher · View at Google Scholar · View at Scopus
  49. K. Yoganathan, “Cystoid macular edema secondary to immune recovery uveitis in a man with cytomegalovirus retinitis and AIDS,” Clinical Ophthalmology, vol. 4, no. 1, pp. 1065–1067, 2010. View at Publisher · View at Google Scholar · View at Scopus
  50. J. Biswas, S. Raizada, L. Gopal, N. Kumarasamy, and S. Solomon, “Bilateral frosted branch angiitis and cytomegalovirus retinitis in acquired immunodeficiency syndrome,” Indian Journal of Ophthalmology, vol. 47, no. 3, pp. 195–197, 1999. View at Google Scholar · View at Scopus
  51. M. N. Alp, N. Baykam, and G. Kural, “Immune recovery uveitis associated with highly active antiretroviral therapy in a patient with CMV retinitis and AIDS despite a low CD4+ T cell count: case report and a review of the literature,” International Ophthalmology, vol. 30, no. 2, pp. 183–189, 2010. View at Publisher · View at Google Scholar · View at Scopus
  52. S. R. Sanislo, C. Y. Lowder, and P. K. Kaiser, “Optic nerve head neovascularization in a patient with inactive cytomegalovirus retinitis and immune recovery,” The American Journal of Ophthalmology, vol. 126, no. 2, pp. 318–320, 1998. View at Publisher · View at Google Scholar · View at Scopus
  53. M. E. Wright, D. L. Suzman, K. G. Csaky, H. Masur, M. A. Polis, and M. R. Robinson, “Extensive retinal neovascularization as a late finding in human immunodeficiency virus-infected patients with immune recovery uveitis,” Clinical Infectious Diseases, vol. 36, no. 8, pp. 1063–1066, 2003. View at Publisher · View at Google Scholar · View at Scopus
  54. J. Biswas, S. Choudhry, and S. Solomon, “Immune recovery vitritis presenting as panuveitis following therapy with protease inhibitors,” Indian Journal of Ophthalmology, vol. 48, no. 4, pp. 313–315, 2000. View at Google Scholar · View at Scopus
  55. M. Ruiz-Cruz, C. A. Barrera, Y. Ablanedo-Terrazas, and G. Reyes-Terán :, “Proposed clinical case definition for cytomegalovirus-immune recovery retinitis,” Clinical Infectious Diseases, 2014. View at Publisher · View at Google Scholar
  56. M. K. Song, S. P. Azen, A. Buley et al., “Effect of anti-cytomegalovirus therapy on the incidence of immune recovery uveitis in AIDS patients with healed cytomegalovirus retinitis,” The American Journal of Ophthalmology, vol. 136, no. 4, pp. 696–702, 2003. View at Publisher · View at Google Scholar · View at Scopus
  57. M. H. El-Bradey, L. Cheng, M. Song, F. J. Torriani, and W. R. Freeman, “Long-term results of treatment of macular complications in eyes with immune recovery uveitis using a graded treatment approach,” Retina, vol. 24, no. 3, pp. 376–382, 2004. View at Publisher · View at Google Scholar · View at Scopus
  58. D. A. Jabs, “Cytomegalovirus retinitis and the acquired immunodeficiency syndrome-bench to bedside: LXVII Edward Jackson memorial lecture,” The American Journal of Ophthalmology, vol. 151, no. 2, pp. 198.e1–216.e1, 2011. View at Publisher · View at Google Scholar · View at Scopus
  59. V. L. Morrison, I. Kozak, L. D. LaBree, S. P. Azen, O. O. Kayicioglu, and W. R. Freeman, “Intravitreal triamcinolone acetonide for the treatment of immune recovery uveitis macular edema,” Ophthalmology, vol. 114, no. 2, pp. 334–339, 2007. View at Publisher · View at Google Scholar · View at Scopus
  60. G. Modorati and E. Miserocchi, “Intravitreal injection therapy in the treatment of noninfectious uveitis,” Developments in Ophthalmology, vol. 51, pp. 110–121, 2012. View at Publisher · View at Google Scholar · View at Scopus
  61. J. Hu, M. Coassin, and J. M. Stewart, “Fluocinolone acetonide implant (Retisert) for chronic cystoid macular edema in two patients with AIDS and a history of cytomegalovirus retinitis,” Ocular Immunology and Inflammation, vol. 19, no. 3, pp. 206–209, 2011. View at Publisher · View at Google Scholar · View at Scopus
  62. G. Krishnan and N. Chatterjee, “Endocannabinoids affect innate immunity of Muller glia during HIV-1 Tat cytotoxicity,” Molecular and Cellular Neuroscience, vol. 59, pp. 10–23, 2014. View at Publisher · View at Google Scholar
  63. A. Rothova, “Inflammatory cystoid macular edema,” Current Opinion in Ophthalmology, vol. 18, no. 6, pp. 487–492, 2007. View at Publisher · View at Google Scholar · View at Scopus