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G.R. Wallace, O.M. Durrani, V. Savant, K.M. Wloka, C.M. Cheung, M. Faint, S.J. Curnow, M. Salmon; Comparison of the Cellular Infiltrate in Aqueous Humour between Untreated and Corticosteroid-treated Active Uveitis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2393.
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Purpose: To compare the cellular infiltrate in the aqueous humour of patients with acute anterior uveitis and panuveitis on and off corticosteroid therapy. Methods: Aqueous humour samples were collected from 107 patients with acute anterior uveitis (AAU) and 41 patients with acute exacerbations of panuveitis. Samples were centrifuged, the cell pellet resuspended, counted by microscopy and cytocentrifuged. Staining of the cytospin slide with Diff-Quick allowed analysis of the leukocyte infiltrate. At the time of sampling 31/107 (28.9%) AAU and 23/41 (56.1%) panuveitis patients were on corticosteroid therapy. Results: In the AAU group there was no difference in mean cell number in patients on or off corticosteroid therapy (mean untreated 22,269 cells/ml vs treated 23,377 cells/ml). However, differential analysis of the cellular infiltrate in treated patients showed a slight decrease in polymorphs and monocytes, but an increase in lymphocytes (mean untreated 5,359 cells/ml vs treated 9,297 cells/ml). In the panuveitis treated group there was an increase in mean cell number (mean untreated 45,605 cells/ml vs treated 104,253 cells/ml), with a selective increase in polymorphs and lymphocytes (polys mean untreated 15,013 cells/ml vs treated 39,464 cells/ml; lymphos mean untreated 12,691 cells/ml vs treated 40,820 cells/ml), and a slight reduction in monocytes. Conclusions: In the AAU patients, corticosteroids did not affect mean cell number as the majority of samples were taken within days of starting treatment. The increased number of lymphocytes may reflect that sampling took place later in the course of the disease. The finding of increased polymorphs and lymphocytes in the panuveitis treated group occurred whilst patients were already on corticosteroids at the time of their flare-up of uveitis. Corticosteroid therapy, prior to an exacerbation of uveitis, may play a role in the selective recruitment of leukocytes into the anterior chamber.
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