PURPOSE

This study was conducted to identify the group at highest risk for autoimmune inflammation through a comparative analysis among patients with chronic post-traumatic uveitis (CPTU).

MATERIAL AND METHODS

The clinical group included 50 patients (aged 18 to 87 years, mean age 41±2.6 years) with CPTU resulting from penetrating injury, contusion, or intraocular surgery. All patients underwent comprehensive clinical and diagnostic evaluation, including immunological assessments: leukocyte migration inhibition test (LMIT), analysis of lymphocyte subpopulation composition, and cytokine profile analysis in both blood serum (BS) and aqueous humor (AH).

All patients underwent removal of the blind, non-functional eye with formation of a support-motor stump, followed by morphological examination.

Patients were divided into four groups based on the presence of immune inflammation, confirmed by morphological analysis, as well as organ-specific sensitization to ocular tissue antigens. Group 1 — histology+, LMIT+ (n=36); group 2 — histology+, LMIT– (n=50); group 3 — histology–, LMIT+ (n=12); group 4 — histology–, LMIT– (n=52). The control group consisted of 30 individuals without ocular pathology, matched by sex and age to the main patient groups.

RESULTS

In long-term CPTU, statistically significant alterations in major regulatory subpopulations were observed in group 1, with immune inflammation and a positive LMIT. The findings were confirmed in comparisons with both the control group and across study groups.

CONCLUSION

The clinical and immunomorphological analysis identified an association between decreased levels of transforming growth factor β1 (TGF-β1) in AH and its increased levels in BS, with the risk of autoimmune inflammation in CPTU. The observed changes in the local and systemic cytokine status — reduction of TGF-β1 in AH and increase in BS — may serve as early predictors of autoimmune inflammation, which is important in clinical practice for preventing sympathetic ophthalmia.