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Research Letter |

T-Lymphocyte Predominance and Cellular Atypia in Tattoo-Associated Uveitis

Ashvini K. Reddy, MD1; Yevgeniy Shildkrot, MD1; Steven A. Newman, MD1; Jennifer E. Thorne, MD, PhD2
[+] Author Affiliations
1Department of Ophthalmology, University of Virginia, Charlottesville
2Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Ophthalmol. 2015;133(11):1356-1357. doi:10.1001/jamaophthalmol.2015.3354.
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This case report describes a T-lymphocyte infiltrate and cellular atypia in a patient with tattoo-associated uveitis.

Tattoo-associated uveitis is a rare but increasingly recognized form of uveitis. We describe a patient with severe tattoo-associated uveitis who underwent vitreous biopsy, revealing a T-lymphocyte infiltrate and cellular atypia.

Article InformationCorresponding Author: Jennifer E. Thorne, MD, PhD, Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Woods 470, Baltimore, MD 21287 (jthorne@jhmi.edu).

Published Online: September 24, 2015. doi:10.1001/jamaophthalmol.2015.3354.

Author Contributions: Drs Reddy and Shildkrot had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Reddy.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Reddy.

Critical revision of the manuscript for important intellectual content: All authors.

Administrative, technical, or material support: Shildkrot, Thorne.

Study supervision: Reddy, Thorne.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Thorne reported receiving grants from the National Eye Institute and Allergan and serving on advisory boards for AbbVie and Xoma. No other disclosures were reported.

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Figure 1.
Cytological Findings

A, Skin biopsy showing noncaseating granulomas surrounding exogenous pigment (eosin, original magnification ×10). B, Vitreous cellularity with pleomorphism and mitotic figures. Well-defined granulomas are notably absent, and lymphocytes admixed with larger cells with binucleate and multinucleate forms were present (eosin, original magnification ×10).

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Figure 2.
Tattoo-Associated Panuveitis

A, Granulomatous keratic precipitates and large, granulomatous, vascularized iris nodule in the right eye. B, Inflammation and induration of tattoos coincident with worsening of uveitis. C, Slitlamp photograph showing that despite immunomodulatory therapy and fluocinolone acetonide implantation, the patient developed severe vitritis in each eye.

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