Index

A

ABD. See Adamantiades–Behçet’s disease (ABD)

Acanthamoeba, 266–268 Actinomycetic scleritis, 254–255 Acute pneumonitis, 191 Adamantiades–Behçet’s disease (ABD)

diagnosis, 219–220 epidemiology, 218 laboratory findings, 219 medical treatment, 304 ocular manifestations

episcleritis, 219 scleritis, 219

systemic manifestations, 218 Adaptive immune response

components, 32 afferent arc, 32

central processing, 32 efferent arc, 32

lymphocytes, 34–36 monocytes/macrophages, 36–37 platelets, 38–39

polymorphonuclear granulocytes, 37–38

ADCC. See Antibody-dependent cell-mediated cytotoxicity (ADCC)

Afferent arc, adaptive immune response, 32

AION. See Anterior ischemic optic neuropathy (AION) Alfonso, M.E., 244

Alkaptonuria, 280

Allergic granulomatous angiitis. See Churg–Strauss syndrome

American Rheumatism Association, 188, 194, 195 Amyloidosis, 182, 280

ANAs. See Antinuclear antibodies (ANAs) ANCAs. See Anti-neutrophil cytoplasmic antibodies

(ANCAs) Ancillary therapy, 304 Anergy, 80

Angiopathic neuropathy, 180 Angle-closure glaucoma, 130 Ankylosing spondylitis (AS)

diagnosis, 199 epidemiology, 196

laboratory findings and radiologic evaluation, 198–199

ocular manifestations anterior uveitis, 197–198 episcleritis, 198 scleritis, 198

spondyloarthropaties, 194, 195 systemic manifestations

articular involvement, 196–197 extraarticular systemic manifestations, 197

Annular ciliochoroidal detachment, 115, 124–125 Anterior chamber polymerase chain reaction testing, 79 Anterior ischemic optic neuropathy (AION), 221 Anterior scleral foramen, 10–11

Anterior scleritis, 105

Anterior segment fluorescein angiography, 80–84.

See also Normal anterior segment fluorescein angiography

Anterior segment indocyanine green angiography, 84–85

Anterior uveitis, 184–185

Antibodies to cyclic citrullinated polypeptides (Anti-CCPs), 186–187

Antibody-dependent cell-mediated cytotoxicity (ADCC), 35–36

Antibody titers against infectious organisms, 78 Anti-CCPs. See Antibodies to cyclic citrullinated polypeptides (Anti-CCPs)

Anticyclic citrullinated peptide antibodies, 73 Antigen

and antibody valences, 42 blocking mechanism, 40 mimicry, 44

Antigen-presenting cells, 36–37 Anti-neutrophil cytoplasmic antibodies

(ANCAs), 75–76, 153, 154, 165 Antinuclear antibodies (ANAs), 73–75, 187, 188 Antiphospholipid (aPL), 193

Aortitis, 209 Arthus reaction, 43

AS. See Ankylosing spondylitis (AS) A-scan ultrasonography, 85

Aspergillus fumigatus, 163

Asymmetric multiple mononeuropathy, 181 Atopy, 223–224

Autoimmunity, 43–45

B

Bacterial scleritis

actinomycetic scleritis, 254–255 chlamydial scleritis, 254

gram-positive coccus and gram-negative rod scleritis excisional scleral biopsy, 245

management, 242, 243 organisms, 242 pathogenesis, 242 prognosis, 244

Proteus mirabilis, 245 therapy, 243–244

mycobacterial scleritis

atypical mycobacterial disease, 246 leprosy, 249–250

tuberculosis, 246–248 spirochetal scleritis

lyme disease, 253–254 syphilis, 250–253 treatment, 254

Bamboo spine, 178, 196 Basophils, 38, 39

BEF. See B-lymphocyte-derived enhancing factor (BEF) Behçet, H., 218

Behçet’s disease, 63 Bilirubin, 282–283 Biochemistry, 22 Biomechanics, 23 Blood cell tumors

leukemia, 290

lymphoma and lymphosarcoma, 290 Blood platelets. See Platelets

Blood supply and emissary canals, 13–19 circulatory dynamics, 17, 19 vascular distribution, 13–18

Blood tests

antibody titers against infectious organisms, 78 anticyclic citrullinated peptide antibodies, 73 anti-neutrophil cytoplasmic antibodies, 75–76 antinuclear antibodies, 73–75

circulating immune complexes, 76 cell-binding assays, 76–77 fluid-phase binding assays, 76

complement cascade, 77 functional tests, 77–78 quantitation tests, 77

histocompatibility leukocyte antigen typing, 78 interferon-gamma release assays, 78–79 rheumatoid factor, 71–73

Blue sclerae acquired diseases

iron-deficiency anemia, 286–287 paralimbal scleromalacia, 287

inherited/congenital diseases buphthalmos, 286 coloboma, 286

Ehlers–Danlos syndrome, 285 keratoconus, 285–286 Marfan’s syndrome, 283–284 myopia, 286

osteogenesis imperfecta, 284 pseudoxanthoma elasticum, 284–285

B-lymphocyte-derived enhancing factor (BEF), 41 B-lymphocyte-derived suppressor factors (BSFs), 41 B lymphocytes, 35

Borrelia burgdorferi, 78, 254 Bovine serum albumin (BSA), 42 B-scan ultrasonography, 85–86

BSFs. See B-lymphocyte-derived suppressor factors (BSFs)

Buphthalmos, 286

C

Calcium deposition

age-related degeneration, 282 hypercalcemia, 282 hyperparathyroidism, 281–282

Caplan, A., 179 Carbohydrate deposition, 281 Cataract, 131–132

CD. See Clusters of differentiation (CD); Crohn’s disease (CD)

Cell-binding assays, 76–77 Cell-mediated immune responses, 50 Cellular mechanisms, 41

Central processing, adaptive immune response, 32 Chemosis, of posterior scleritis, 122–123 Chlamydial scleritis, 254

Chlamydia trachomatis, 254 Chondroitin sulfate, 145 Choroidal hemangiomas, 124 Churg, J., 152, 213, 214 Churg–Strauss syndrome

diagnosis, 214 epidemiology, 213 laboratory findings, 213, 214 ocular manifestations, 213 systemic manifestations, 213

CICs. See Circulating immune complexes (CICs) Circinate balanitis, 201

Circulating immune complexes (CICs), 76, 187 cell-binding assays, 76–77

fluid-phase binding assays, 76 Circulatory dynamics, 17, 19

Clusters of differentiation (CD), 32–34 Coca, A.F., 223

Cogan, D.G., 222, 223, 414 Cogan’s syndrome

clinical manifestations episcleritis, 223 scleritis, 223

laboratory findings, 223

Collagens, 7–8, 23–24, 48–49, 146–147 Coloboma, 286

Complement cascade functional tests, 77–78 quantitation tests, 77

Compression neuropathy, 180 Congenital porphyria, 278

Conjunctival biopsy, 149 Connective tissue inflammation

chronic granulomatous inflammation, 138 chronic nongranulomatous inflammation, 138 fibrinoid necrosis, 138–139

vascular inflammation, 139

Connective tissue mast cell (CTMC), 38, 39 Corneoscleral junction, 11

C1q-binding assay, 76 Crohn’s disease (CD) diagnosis, 208

epidemiology, 206 gastrointestinal and articular

manifestations, 206–207 ocular manifestations

anterior uveitis, 207 episcleritis, 208 keratitis, 208 scleritis, 207

CTMC. See Connective tissue mast cell (CTMC) Cystinosis, 279–280

D

Delayed hypersensitivity reactions. See Type IV hypersensitivity reactions

Dense connective tissue tumors fibroma, 289

fibrous histiocytoma, 289 nodular fasciitis, 289 sarcomas, 289

Dermatan sulfate, 145 Dermoid choristomas, 288

Diffuse anterior scleritis, 103, 105–108 Diffuse illumination, 67

Diplopia, 221

Distal sensory neuropathy, 180, 181

E

EBV. See Epstein–Barr virus (EBV) Eddowes, A., 284

Efferent arc, adaptive immune response, 32 Ehlers–Danlos syndrome, 285

Elastase, 25

Elastin, 24

ELISAs. See Enzyme-linked immunoabsorbent assays (ELISAs)

Endogenous substances collagen, 48–49 glycosaminoglycans, 48

Enzyme-linked immunoabsorbent assays (ELISAs), 49, 73

Eosinophils, 37–39

Episcleritis, 57, 95

associated diseases, 100, 101 biopsy, 87

for suspected local/systemic infectious disease, 88 for suspected systemic vasculitic disease, 88

classification, 96, 99–100

nodular episcleritis, 99–100 simple episcleritis, 99

clinical classification, 58 clinical manifestations, 97–99

demographic and clinical characteristics, 97 diagnosis, 89

diagnostic tests, 71–87

anterior chamber polymerase chain reaction testing, 79

anterior segment fluorescein angiography, 80–84 anterior segment indocyanine green angiography,

84–85

blood tests, 71–79

computer tomography scanning, 86 magnetic resonance imaging, 87 optical coherence tomography, 86 radiologic studies, 80

skin testing, 79–80 smears and cultures, 79 ultrasonography, 85–86

diseases, 58

episcleral and scleral examination

external examination of eye in daylight, 66–67 slit-lamp examination, 67–68

family history, 60

general eye examination, 68 anterior uvea, 70 cornea, 70

fundus, 71

intraocular pressure, 71 lens, 71

pupils and extraocular muscles, 69–70 visual acuity, 69

head and extremities, general examination of, 62 major complaint and history of present illness, 59–60 past and present therapy history, 60

past history, 60

patient characteristics, 96–97 phases of clinical approach, 59 precipitating factors, 100, 102 review of systems, 60–62 systemic examination, 62–64 system questionnaire for, 61 therapeutic plan, 89 treatment, 299–300

Epithelial tumors

papillomas/intraepithelial epitheliomas, 288 squamous cell carcinoma, 288–289

Epstein–Barr virus (EBV), 35, 47

Escherichia coli, 79 Exogenous agents

mycobacteria, 48 viruses, 47–48

Extremities, 62–64

F

Farrell, P.L.R., 244

Felty, A.R., 181

Felty’s syndrome, 181

epidemiology, 259 pathogenesis, 259 treatment, 262–263

High-frequency ultrasound biomicroscopy, 86 Histocompatibility leukocyte antigen (HLA) typing, 78 HSV. See Herpes simplex virus (HSV)

Humoral mechanisms, 40–41 Hypercalcemia, 282 Hyperparathyroidism, 281–282 Hypersensitivity reactions, 41–43

type III hypersensitivity reactions, 41–42 local immune complex disease, 43 systemic immune complex disease, 42–43

type IV hypersensitivity reactions, 43

I

IBD. See Inflammatory bowel disease (IBD) ICG. See Indocyanine green (ICG)

Idiopathic central serous chorioretinopathy, 125 Idiopathic orbital inflammatory syndromes, 122 Idiotypic networks, 45

Idiotypic regulation mechanism, 41 IFA. See Immunofluorescent assay (IFA)

IGRAs. See Interferon-gamma release assays (IGRAs) Immune complex-mediated vasculitis, 50

Immune response abnormalities of

autoimmunity, 43–45 hypersensitivity reactions, 41–43

connective tissue, 45 fibroblast functions, 45 sclera

etiology, 47–49

immune characteristics, 46 pathogenesis, 49–50 susceptible host, 46

Immunofluorescence microscopy, 146 Immunofluorescent assay (IFA), 73 Immunogenetics, 46 Immunoglobulin, 35 Immunohistochemical study, 7

collagens, 7–8 glycoproteins, 8 proteoglycans, 8

Immunohistochemistry, 22–23 Immunologic considerations, 31–50

connective tissue and immune response, 45 etiology, 47–49

general immune response considerations, 32–45 abnormalities, of immune response, 41–45 adaptive immune response, components of, 32–39 immunoregulation, 40–41

immune characteristics, 46 pathogenesis, 49–50 susceptible host, 46

Immunoregulation, 40–41 cellular mechanisms, 41 humoral mechanisms, 40–41

major histocompatibility complex, 40 Immunoregulatory T cells, 45 Indocyanine green (ICG), 84

Infectious scleritis bacterial scleritis

actinomycetic scleritis, 254–255 chlamydial scleritis, 254

gram-positive coccus and gram-negative rod scleritis, 242–245

mycobacterial scleritis, 245–250 spirochetal scleritis, 250–254

classification, 242

filamentous and dimorphic fungal scleritis inferior sclera, 257

management, 255–256 organisms, 255 pathogenesis, 255

prolonged systemic and topical therapy, 257 therapy, 256–257

medical treatment, 304 parasitic scleritis

helminthic scleritis, 269 protozoal scleritis, 266–268

viral scleritis

herpes scleritis, 258–266 mumps scleritis, 266

Inflammatory bowel disease (IBD) diagnosis, 208

epidemiology, 206

gastrointestinal and articular manifestations, 206–207 laboratory and joint radiologic findings, 208

ocular manifestations anterior uveitis, 207 episcleritis, 208 keratitis, 208 scleritis, 207–208

Inflammatory microangiopathy, 88, 140, 147–148 Innate immune system, 32

Interferon-gamma release assays (IGRAs), 78–79, 247 Iron-deficiency anemia, 286–287

J

Jaundice, 282–283

Jayson, M.I., 157

Jerne, N., 41

Juvenile idiopathic arthritis (JIA), 224

K

K cells. See Killer (K) cells Keratitis, 184

Keratoconjunctivitis sicca (KCS), 176, 182, 183 Keratoconus, 285–286

Keratoderma blennorrhagicum, 201 Keratopathy, 126–129

peripheral corneal thinning, 126–127 peripheral ulcerative keratitis, 128–129 stromal keratitis, 127–128

Killer (K) cells, 35

Knox D.L., 207, 208

L

Lamina fusca, 13 Laminin, 25 Langerhans’ cells, 37 Leber, T., 13 Leprosy, 249–250 Leukemia, 290 Libman, E., 190

Lid swelling, of posterior scleritis, 122–123 Limb joint X-rays, 80

Lipid deposition

age-related degeneration, 281 familial hypercholesterolemia and

histiocytosis X, 281 Local immune complex disease, 43 Lyme disease

diagnosis, 254 epidemiology, 253

pathogenesis and clinical features, 253 scleritis and episcleritis, 253

Lymphangiomas, 290

Lymphocytes, 34–36 B lymphocytes, 35

third-population lymphocytes, 35–36 T lymphocytes, 34–35

Lymphoid line, 32 Lyne, A.J., 183 Lyons, C.J., 225

M

Macrophages

antigen-presenting cells, 36–37 phagocytosis, 36

secretory products, 36

Magnetic resonance imaging (MRI), 87 Major histocompatibility complex, 40 Marfan’s syndrome, 283–284

Massachusetts Eye Research and Surgery Institution (MERSI), 95

Mast cells

connective tissue mast cell, 38, 39 mucosal mast cell, 38, 39 secretory products, 39

Matrix-degrading enzymes, 25–26 McGavin, D.D., 102, 183, 224 Medical treatment

Adamantiades–Behçet’s disease, 304 granulomatosis with polyangiitis, 303 infectious scleritis, 304

polyarteritis nodosa, 303 posterior scleritis, 304 relapsing polychondritis, 303 rheumatoid arthritis, 301–302

systemic lupus erythematosus, 302–303

Melanocytoma, 291–292

MERSI. See Massachusetts Eye Research and Surgery Institution (MERSI)

MHC genes, allelic variation, 44 Microhemagglutination test for Treponema pallidum

(MHA-TP), 78

MMC. See Mucosal mast cell (MMC) Molecular structure

collagen, 23–24 elastin, 24

fibroblast growth regulation, 26 glycoproteins, 25 matrix-degrading enzymes, 25–26 proteoglycans, 24–25

Monoclonal antibodies, 32, 33 Monocytes

antigen-presenting cells, 36–37 phagocytosis, 36

secretory products, 36 Mucopolysaccharidosis, 281 Mucosal mast cell (MMC), 38, 39 Mumps scleritis, 266 Mycobacterial scleritis

atypical mycobacterial disease, 246 leprosy, 249–250

tuberculosis, 246–248

Mycobacterium leprae, 249 Mycobacterium tuberculosis, 246–248 Myeloid line, 32

Myopia, 286

N

Nanophthalmos, 287 Natural killer (NK) cells, 35

Necrotizing scleritis, 109–111, 177, 184, 212, 215 Neovascular glaucoma, 131

Nerve supply, 19 Nervous tumors

neurilemmomas, 290–291 neurofibromas, 290

Neurilemmomas, 290–291 Neurofibromas, 290 Neutrophils, 37, 38, 43 Nevus, 291

NK cells. See Natural killer (NK) cells

Nocardia asteroides, 254 Nocardiosis, 254–255

Nodular anterior scleritis, 106, 108–109 Nodular episcleritis, 99–100

Nodular fasciitis, 289 Noninfectious scleritis atopy, 223–224

chemical injury, 227–228 classification, 174 dermatological disease, 226 foreign body granuloma, 227 juvenile idiopathic arthritis, 224 metabolic disease, 226–227

sclerokeratitis, 225 suture-related episcleritis, 226

tubulointerstitial nephritis and uveitis, 225 vasculitides

Adamantiades–Behçet’s disease, 217–220 adult rheumatoid arthritis (See Rheumatoid

arthritis (RA))

allergic granulomatous angiitis, 213, 214 ankylosing spondylitis, 194–199 Cogan’s syndrome, 222–223

giant-cell arteritis, 220–222 granulomatosis with polyangiitis, 214–217 inflammatory bowel disease, 206–208 polyarteritis nodosa, 211–213

psoriatic arthritis, 203–206 reactive arthritis, 199–203 relapsing polychondritis, 208–211

systemic lupus erythematosus, 189–195 Vogt–Koyanagi–Harada syndrome, 224, 225

Noninflammatory diseases bilirubin, 282–283 blood cell tumors

leukemia, 290

lymphoma and lymphosarcoma, 290 calcium deposition

age-related degeneration, 282 hypercalcemia, 282 hyperparathyroidism, 281–282

classification, 278

dense connective tissue tumors fibroma, 289

fibrous histiocytoma, 289 nodular fasciitis, 289 sarcomas, 289

dermoid choristomas, 288 epithelial tumors

papillomas/intraepithelial epitheliomas, 288 squamous cell carcinoma, 288–289

metabolic diseases, 278 nervous tumors

neurilemmomas, 290–291 neurofibromas, 290

pigmented tumors melanocytoma, 291–292 nevus, 291

scleral carbohydrate deposition, 281 scleral lipid deposition

age-related degeneration, 281

familial hypercholesterolemia and histiocytosis X, 281

scleral protein deposition alkaptonuria, 280 amyloidosis, 280 cystinosis, 279–280 porphyria, 277–279

scleral thickening nanophthalmos, 287 phthisis bulbi, 287 scleropachynsis, 287

scleral thinning buphthalmos, 286 coloboma, 286

Ehlers–Danlos syndrome, 285 iron-deficiency anemia, 286–287 keratoconus, 285–286

Marfan’s syndrome, 283–284 myopia, 286

osteogenesis imperfecta, 284 paralimbal scleromalacia, 287 pseudoxanthoma elasticum, 284–285

secondary tumors, 292 vascular tumors

hemangiomas, 289 lymphangiomas, 290

Nonsteroidal anti-inflammatory drugs (NSAIDs), 300, 301, 304

Normal anterior segment fluorescein angiography, 82 arterial phase, 82–83

capillary phase, 83 venous phase, 83–84

Null lymphocytes. See Third-population lymphocytes

O

Ocular movements, 122–123

Open-angle glaucoma, 131

Optical coherence tomography, 86

Optic nerve, 12

Orbital tumors, 122–124

Osteogenesis imperfecta, 284

P

PA. See Psoriatic arthritis (PA) PAN. See Polyarteritis nodosa (PAN) Paralimbic scleromalacia, 112–113 Parasitic scleritis

helminthic scleritis, 269 protozoal scleritis, 266–269

Parvoviruses, 47–48 Pathology

biopsy

biopsy technique, 165–166 infectious scleritis, 165 nodular scleritis, 164–165

noninfectious necrotizing scleritis, 164 dexamethasone sodium, 163

episcleritis, 141

Gomori methenamine silver stain, 163 Gram’s stain, 162

noninfectious scleritis cell subsets, 144 cellular infiltrates, 142

Churg–Strauss syndrome, 151–152 conjunctiva, 149

connective tissue diseases, 156–158 cornea, 149

episclera, 149

Pathology (cont.)

extracellular matrix, 144–147 granuloma, 143

granulomatosis with polyangiitis, 152–156 hystopathology, 143

iris, ciliary body, and choroid, 149 mononuclear cell subset, 144 ocular structures, 149 polyarteritis nodosa, 150–151 scleral biopsy, 142, 143

vessels, 147–148 systemic infections

herpes simplex, 159–161 herpes zoster, 159 syphilis, 161–162 tuberculosis, 161

Pavan-Langston, D., 265

PCR. See Polymerase chain reaction (PCR) PDGF. See Platelet-derived growth factor (PDGF) Peripheral corneal thinning, 126–128

Peripheral neuropathy, 190

Peripheral ulcerative keratitis (PUK), 98, 128–129, 177 Phagocytosis, 36

Phthisis bulbi, 287

Pigment deposition, 282–283 Pigmented tumors

melanocytoma, 291–292 nevus, 291

Platelet-derived growth factor (PDGF), 26 Platelets, 38–39

Pokeweed mitogen, 35 Polyarteritis nodosa (PAN)

diagnosis, 213 epidemiology, 211

laboratory and angiographic findings, 212 medical treatment, 303

ocular manifestations episcleritis, 212 scleritis, 212

systemic manifestations, 211 Polyclonal B-lymphocyte activation, 44–45 Polymerase chain reaction (PCR), 79 Polymorphonuclear granulocytes, 37–38

basophils/mast cells, 38 eosinophils, 37–38 neutrophils, 37

Porphyria cutanea tarda, 279 Porphyria variegata, 279 Posterior scleritis, 105, 113–125

ancillary tests, 116–122 CT scanning, 117, 121

fluorescein angiography, 121–122 radioactive phosphorus (32P) uptake, 121 ultrasonography, 116–120

associated diseases, 116, 125–126 choroidal folds, 115, 124 complications, 116

differential diagnosis

annular ciliochoroidal detachment, 124–125 chemosis, 122–123

choroidal folds, 124

disk and macular edema, 125 lid swelling, 122–123

ocular movements, limitation of, 122–123 proptosis, 122–123

serous retinal detachment, 124–125 subretinal mass, 123–124

disk and macular edema, 115, 125 fundus findings

annular ciliochoroidal detachment, 115 choroidal folds, 115

disk edema and macular edema, 115 serous retinal detachment, 115–116 subretinal mass, 115

medical treatment, 304 symptoms and signs, 114

Postnatal development and age-related changes, 8–9

PPD. See Protein-purified derivative (PPD) Prenatal development

immunohistochemical studies, 7–8 collagens, 7–8

glycoproteins, 8 proteoglycans, 8

ultrastructural studies, 1–6 fifth week, 2–4

first week, 1 fourth week, 2 ninth week, 5 second week, 1 seventh week, 5

sixteenth week, 5, 6 sixth week, 4–5 tenth week, 5

third week, 1–2 thirteenth week, 5 twenty-fourth week, 5

Primary open-angle glaucoma, 131 Promonocytes, 36

Proptosis, 122–123 Protein deposition

alkaptonuria, 280 amyloidosis, 280 cystinosis, 279–280 porphyria, 277–279

Protein-purified derivative (PPD), 246–248 Proteoglycanase, 25, 26

Proteoglycans, 8, 22, 24–25, 145–146 Protozoal scleritis, 266–269

Pseudomonas aeruginosa, 242 Pseudoxanthoma elasticum, 284–285 Psoriatic arthritis (PA)

diagnosis, 205–206 epidemiology, 203–204

laboratory and radiographic findings, 205 ocular manifestations

episcleritis, 205 scleritis, 205

skin and articular involvement, 204–205 PUK. See Peripheral ulcerative keratitis (PUK)

Scleritis (cont.) diagnosis, 89 diagnostic tests

anterior chamber polymerase chain reaction testing, 79

anterior segment fluorescein angiography, 80–84 anterior segment indocyanine green

angiography, 84–85 blood tests, 71–79

computer tomography scanning, 86 magnetic resonance imaging, 87 optical coherence tomography, 86 radiologic studies, 80

skin testing, 79–80 smears and cultures, 79 ultrasonography, 85–86

diseases associated with, 58, 107 drug management, 304–305 episcleral and scleral examination, 65

external examination of eye in daylight, 66–67 slit-lamp examination, 67–68

family history, of illness, 60 general eye examination, 68

anterior uvea, 70 cornea, 70 fundus, 71

intraocular pressure, 71 lens, 71

pupils and extraocular muscles, 69–70 visual acuity, 69

head and extremities, general examination of, 62 major complaint and history of present illness, 59–60 medical treatment

Adamantiades–Behçet’s disease, 304 granulomatosis with polyangiitis, 303 infectious scleritis, 304

polyarteritis nodosa, 303 posterior scleritis, 304 relapsing polychondritis, 303 rheumatoid arthritis, 301–302

systemic lupus erythematosus, 302–303 past and present therapy history, 60

past history, of illness, 60 patient characteristics, 102 phases of clinical approach, 59 review of systems, 60–62 surgical treatment, 305–307 systemic examination, 62–64 system questionnaire for, 61 therapeutic plan, 89

Scleritis Clinic at Moorfields Eye Hospital (London), 95 Sclerokeratitis, 225

Scleromalacia perforans, 111–113 Scleropachynsis, 287 Self-molecule, modification of, 44

Senile scleral hyaline plaques, 113, 282 Senile scleral plaques, 9

Serous retinal detachment, 115–116, 124–125

Simple episcleritis, 99 Sinus films, 80

Sjögren, H., 181, 182, 186, 192, 224 Skin testing, 79–80

SLE. See Systemic lupus erythematosus (SLE) Slit-lamp examination

diffuse illumination, 67 red-free illumination, 68 slit-lamp illumination, 67–68

Slit-lamp illumination, 67–68 Smith, R.E., 244

Southern General Hospital and Victoria Infirmary (Glasgow), 96

Spirochetal scleritis

lyme disease, 253–254 syphilis, 250–253 treatment, 254

Spondyloarthropaties, 194, 195 Spurway, J., 284

Squamous cell carcinoma, 288–289 Steere, A.C., 253

Steroid-induced open-angle glaucoma, 131 Strauss, L., 152, 213

Stromal keratitis, 127–128 Structural considerations, 1–26

anatomy, 9–22

gross and microscopic, 9–19 ultramicroscopic, 19–22

biochemistry, 22 biomechanics, 23 development, 1–9

postnatal development and age-related changes, 8–9

prenatal development, 1–8 immunohistochemistry, 22–23 molecular structure, 23–26

collagen, 23–24 elastin, 24

fibroblast growth regulation, 26 glycoproteins, 25 matrix-degrading enzymes, 25–26 proteoglycans, 24–25

Subretinal mass, 115, 123–124 Subungual hyperkeratosis, 201 Susceptible host, 46

Syphilis, 161–162 congenital, 251 diagnosis, 251–252 epidemiology, 250

pathogenesis and clinical features, 250 primary, 250

secondary, 250–251 tertiary, 251 therapy, 252–253

Systemic immune complex disease, 42–43 Systemic lupus erythematosus (SLE)

diagnosis, 194, 195 epidemiology, 189

laboratory findings, 193–194 medical treatment, 302–303 ocular involvement

anterior uveitis, 192 central nervous system, 193 conjunctivitis, 192 episcleritis, 192

scleritis, 191–192

Raynaud’s phenomenon, 178, 190 systemic manifestations

acute pancreatitis, 191

atypical verrucous endocarditis, 190 kidney, 190

lung, 191 musculoskeletal, 189

myocardial involvement, 190 nervous system, 191

subacute bacterial endocarditis, 190–191 tegument, 189–190

vessels, 190

Systemic vasculitic disease, 88

T

Tarr, K.H., 244

T-cell receptors (TCRs), 35

T cytotoxic/suppressive lymphocytes, 34–35 T-helper lymphocytes, 34, 35

T-helper 1 lymphocytes, 35 T-helper 2 lymphocytes, 35 Third-population cells (TPCs), 35

Third-population lymphocytes, 35–36 Thymus-derived cells. See T lymphocytes Thyroid ophthalmopathy, 123

TINU. See Tubulointerstitial nephritis and uveitis (TINU)

T lymphocytes, 34–35 Toxocariasis, 269

Toxoplasma gondii, 79 Toxoplasmosis, 268–269

TPCs. See Third-population cells (TPCs) Trelstad, R.L., 287

Treponema pallidum, 250, 251 Tuberculosis, 161, 246–248

Tubulointerstitial nephritis and uveitis (TINU), 225 Tuft, S.J., 105, 106, 108, 183

Type III hypersensitivity reactions, 41–42 local immune complex disease, 43 systemic immune complex disease, 42–43

Type IV hypersensitivity reactions, 43

U

UBM. See Ultrasound biomicroscopy (UBM) Ulcerative colitis (UC)

anterior uveitis, 207 diagnosis, 208 epidemiology, 206

episcleritis, 208 gastrointestinal and articular

manifestations, 206–207 scleritis, 207–208

Ultramicroscopic anatomy sclera, 19–20

vessels, 20–22 Ultrasonography, 116–120

A-scan, 85 B-scan, 85–86

high-frequency ultrasound biomicroscopy, 86 Ultrasound biomicroscopy (UBM), 86 Ultrastructural study

fifth week, 2–4 first week, 1 fourth week, 2 ninth week, 5 second week, 1 seventh week, 5

sixteenth week, 5, 6 sixth week, 4–5 tenth week, 5

third week, 1–2 thirteenth week, 5 twenty-fourth week, 5

Urinalysis, 193

Uveal effusion syndrome, 125 Uveitis, 129–130

V

van der Hoeve, J., 112, 284 Varicella-zoster virus (VZV), 159 Vascular distribution, 13–18 Vascular tumors

hemangiomas, 289 lymphangiomas, 290

Vasculitic syndromes, 139, 140, 150 Vasculitides

Adamantiades-Behçet’s disease, 217–220 adult rheumatoid arthritis (See Rheumatoid

arthritis (RA))

allergic granulomatous angiitis, 213, 214 ankylosing spondylitis, 194–199 Cogan’s syndrome, 222–223

giant-cell arteritis, 220–222 granulomatosis with polyangiitis, 214–217 inflammatory bowel disease, 206–208 polyarteritis nodosa, 211–213

psoriatic arthritis, 203–206 reactive arthritis, 199–203 relapsing polychondritis, 208–211

systemic lupus erythematosus, 189–195 Viral scleritis

herpes simplex scleritis, 263–265 herpes zoster scleritis, 258–263 mumps scleritis, 266

Vogt–Koyanagi–Harada syndrome, 125, 224, 225 VZV. See Varicella-zoster virus (VZV)