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S. Kaidzu, M. Tanito, T. Katsube, S. Nonoyama, Y. Takai, A. Ohira; Lens-Induced Uveitis Diagnosed by Western Blot for Lens-Specific Proteins in Aqueous Fluid. Invest. Ophthalmol. Vis. Sci. 2008;49(13):798.
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Lens-induced uveitis has a varied presentation, making diagnosis difficult. However, correct diagnosis is important because removal of lens material is curative. We tried to detect lens-specific protein directly in the aqueous fluid by Western blotting.
Report of a case. Aqueous fluid collected by anterior chamber tap was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis, followed by Western blot with phospho- α-A, phospho-α-B, and pan α crystalline antibodies.
A 31-year-old Japanese woman hit her right eye while skipping rope. On posttraumatic day (PTD) 16, severe uveitis with keratic precipitates (KPs), fibrin formation, and hypopyon were observed in the right eye (RE). On PTD 41, the best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were counting fingers and 25 mmHg RE. Western blotting was performed on PTD 54, because the uveitis was prolonged and the etiology undetermined, Protein bands probed by phospho- α-A, phospho- α-B, and pan α crystalline antibodies were observed in the aqueous fluid from the patient; no protein band was observed in aqueous specimens from three patients with senile cataract. Densitometric analysis indicated that the crystalline concentration in the aqueous fluid of the patient was 67 ng/ µl (senile cataracts; < 0.1 ng/ µl). On PTD 57, the patient underwent cataract surgery and intraocular lens implantation. On PTD 105, the VA and IOP RE were 1.2 and 14 mmHg, respectively, no inflammation was observed, and all medications were stopped. She has not had a recurrence of uveitis during the 7-month follow-up period.
Western blotting using multiple antibodies detected lens-specific proteins in the aqueous fluid 2 months after trauma; the lens-specific proteins were undetected in the aqueous fluid of the control patients, suggesting this method is sensitive and specific. This method described could be another option for diagnosing patients suspected of having lens-induced uveitis.
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