[The clinico-immunological validation of a differentiated approach to the use of corticosteroids in treating S-dependent uveoretinitis].

A total of 630 patients with uveitis of different etiology aged 5 to 70 were examined. Signs of autoimmunization with retinal S-antigens (mol. weight 48 kD) associated with retinal involvement were detected in more than half of them. A moderate level of S-antigen in the tears was found to promote a favorable outcome of uveoretinitis. Deficit or a drastic increase of S-antigen titers in the tears, accumulation of S-antibodies and circulating S-antigen-antibody complexes in the serum, and blood leukocyte migration inhibition in response to S-antigen were observed in chronic and complicated cases. As many as 75% focal chorioretinitis and panuveitis cases, 50% of posterior and 37% of peripheral uveitis were referred to S-related forms. The authors validate a differentiated approach to the treatment of S-uveoretinitis. If S-antibodies are accumulated only in the tears, local corticosteroids are effective; if both local and total-systems reactions are boosted, the maximal effect may be achieved by local and systemic corticosteroids and cytostatics. In case of a deficiency of S-antibodies in the tears immunodepressive therapy was of no avail, and good results could be attained only by immunomodulating therapy: corticosteroids+hemoperfusion in adults and corticosteroids+thymus preparations and/or interferonogens in children.