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Quan Dong Nguyen, MD, MSc; Richard L. Humphrey, MD; James P. Dunn, MD; Mark S. Humayun, MD, PhD

Arch Ophthalmol. 2001;119:293-296.

We report the clinical findings and analysis of the immunoglobulin (Ig) composition of the vitreous of a 10-year-old girl with juvenile rheumatoid arthritis–associated uveitis. The vitreous had a schlieren appearance at the time of pars plana lensectomy and vitrectomy. Analysis of the vitreous fluid revealed marked elevation of IgG, IgM, IgA, and albumin levels relative to vitreous fluids from control patients without uveitis. The immunoglobulin coefficients were also elevated for the IgG and IgM classes of immunoglobulins. Immunofixation electrophoresis of the vitreous fluid revealed 2 distinct bands of restricted electrophoretic mobility. These studies suggest that there may be local (intraocular) production of immunoglobulins as an immunologic response in ocular inflammatory diseases such as juvenile rheumatoid arthritis–associated uveitis and that this immunologic response may be monoclonal (possibly biclonal or oligoclonal) in nature.

From the Department of Ophthalmology, Wilmer Ophthalmological Institute (Drs Nguyen, Dunn, and Humayun), and the Departments of Medicine, Oncology, and Pathology, the Johns Hopkins University School of Medicine (Dr Humphrey), Baltimore, Md.

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