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The corneal buttons after corneal graft of 22 patients with herpetic keratitis were studied (16 male, 6 female; 7–87 years of age). Ten still had active inflammation, while 12 had stabilized by the time of the study. Different degrees of neovascularization were observed in 19 cases. HLA-DR antigen was detected in the corneal epithelium in 7 of 22 cases (32%), in the corneal stroma in 17 of 22 cases (77%), and in the endothelium in 9 cases (41%) by using the immunohistochemical technique. The expression of HLA-DR antigen was more common and more marked in active herpetic keratitis (90%) and in neovascularized corneas (84%). The frequency and density of HLA-DR expression in perforating corneal ulcers were no higher than in other cases, but anterior synechia was accompanied by strong expression of HLA-DR antigen in the corneas. The expression of HLA-DR antigen was not only detected in the peripheral, but also in the central area of the specimens. The cells expressing HLA-DR antigen in corneas were mainly corneal cells. The results showed a close relationship between HSV-keratitis and the expression of HLA-DR antigen, which may be induced during the clinical course of the disease. The expression of HLA-DR might be one of the factors in the recurrent onset of the disease and a significant sign of the prognosis of corneal transplantation for these patients.

In the present study, we specifically investigated the presence of the main immune cells, namely T helper/inducer lymphocytes, T suppressor/cytotoxic lymphocytes, B lymphocytes and macrophages, for HLA-DR antigen expression and the cytokines IL-1 alpha and IL-2 in epiretinal membranes of proliferative diabetic retinopathy (PDR) using immunohistochemical staining. The levels of the two cytokines (IL-1 alpha and IL-2) in the vitreous were measured by ELISA. The results show that 18 out of the 32 epiretinal specimens reacted positively with monoclonal anti-CD4 (marker for T helper/inducer cell subset) antibody (56%), 21 reacted with monoclonal anti-CD8 (marker for T suppressor/cytotoxic subset) antibody (66%), 15 reacted with monoclonal anti-CD22 (marker for B lymphocytes) antibody (47%), and 25 (78%) were positive for monoclonal anti-macrophage and anti-HLA-DR antibodies. IL-1 alpha and IL-2 were detected in the epiretinal membranes in 8 out of 13 tested cases (62%). However, in the vitreous, IL-1 alpha was detected in only 3 out of 13 cases (70, 75 and 80 pg/ml, respectively), while IL-2 was not detected in any of the vitreous samples. The results clearly demonstrate that immune cells and their cytokines were found in about half of the epiretinal membrane specimens. The invasion of the immunocompetent cells in the membranes seems to be a secondary event. They would not participate in the pathogenesis of PDR, but probably induce unspecific reactions and thus complicate the disease.

Macrophages, monocytes and the expression of HLA-DR antigen in 52 cases of various vitreal and epiretinal membranes in human eyes were studied with the immunohistochemical technique. The results showed that more than 80% of the specimens were macrophage positive and expressed HLA-DR antigen, and monocytes were mainly seen in the specimens of proliferative diabetic retinopathy (41.7%). Macrophages were considered to play an important role in the development of epiretinal membranes, and immuno-response was also one of the related factors.

Immunopathological hypersensitivity reactions frequently involve the eye and its adnexa. Owning to their exposed position in the body, the eyelids and eyes are affected by a variety of allergic reactions. Autoimmune diseases often involve the highly vascular uvea, but also the conjunctiva, cornea and retina.

A new noninvasive technique for observing structures in the living eye has been developed: the technique is based on intravenous application of specific antibodies, labeled with fluorescein. The immunologically marked substructures of the fundus of the eye, the only transparent organ in mammals, are photographed directly using high speed film. Combined with a digital image processor to enhance low contrast contours, this technique can be used for diagnostic purposes, as shown in rabbits with experimental toxoplasmic chorioretinitis.

Seventy percent of patients with AIDS have AIDS-related ocular involvement. This is a special challenge for the ophthalmologist which requires specific knowledge. The nature and frequency of the ocular involvement as well as the time of manifestation during the HIV-disease are discussed. The potential therapy for such opportunistic infections is discussed. Furthermore, the HIV-specific aspects for disinfection procedures in the office (tonometry, three-mirror lens, contact lenses) are also elucidated.

Macrophages and macrophage-like cells have been reported as cellular components of epiretinal and vitreous membranes. The origin and function of these versatile cells in the membranes are not fully understood. In the present study we used monoclonal antibodies reacting with macrophages, HLA-DR and monocytes (OKM5) to investigate cells in 52 specimens of various human epiretinal and vitreous membranes collected by vitrectomy. The results show that more than 80% of all membranes are positive for macrophage and HLA-DR antigen. HLA-DR is considered to be expressed by the macrophages. Cells reacting with antimonocyte (OKM5) are seen sporadically only in proliferative diabetic retinopathy. These results are discussed with respect to the possible origin of the macrophages and their important role in the development and formation of epiretinal and vitreal membranes.