Appraisal, Work-Up and Diagnosis of Anterior Uveitis: A Practical Approach

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

This article presents a comprehensive approach of the diagnosis of anterior uveitis and appropriate investigational tests based on clinical signs.

Uveitis has classically been presented by uveitis specialists as an obscure and complicated field in ophthalmology that was supposed to be restricted to the happy few who had the knowledge, which in some countries was even prevented from being diffused. The effect was that ophthalmologists turned away from uveitis or were not correctly armed when they chose to take care of uveitis patients. The consequences of this situation often fell upon the patients. Since more than 15 years our group has been represented by the Society for Ophthalmo-Immunoinfectiology in Europe (SOIE), which has been working to alter this image of uveitis and ensure that the knowledge of the basics of uveitis reaches the practicing ophthalmologist. Our firm believe is that up to 70% of uveitis cases, especially anterior uveitis, can be taken care of by the practicing ophthalmologist following a structured approach in the appraisal of the uveitis case. Judging from the attendance obtained, the response to our approach in every country (where we organise courses) has been inversely proportional to the previous disinterest since we started publicizing it.

Related collections

Most cited references 13

Record: found
Abstract: found
Article: not found

Enhanced recognition, treatment, and prognosis of tubulointerstitial nephritis and uveitis syndrome.

Friederike Mackensen, Derek Smith, Aaron Rosenbaum (2007)

Tubulointerstitial nephritis and uveitis syndrome (TINU) is a specific form of uveitis that is unfamiliar to most ophthalmologists. Thus, it is frequently overlooked in differential diagnosis. We hypothesized that recognition of subsets of uveitis can facilitate the diagnosis of rare entities such as TINU. Retrospective case series. One thousand nine hundred eighty-five patients with uveitis. We performed a computerized database analysis of patients evaluated for uveitis at the Casey Eye Institute from September 1985 until May 2005. The database includes details about ocular inflammation, including specific diagnosis, anatomic location, laterality, continuity, onset, complications, HLA-B27 status, and relative diagnostic certainty. Additionally, we reviewed all charts of patients diagnosed with TINU or with a presentation of uveitis that was typical of TINU (i.e., bilateral sudden-onset anterior uveitis). Prevalence of TINU in identifiable subsets of patients with uveitis, visual acuity (VA), and renal function. Individuals with TINU (n = 33) represented 1.7% of all patients with uveitis. However, TINU was diagnosed in 32 of the 316 patients (10%) presenting with bilateral sudden-onset anterior uveitis and in 20 of 62 of these patients (32%) who were younger than 20 years. Creatinine levels were more likely to be elevated in patients older than 40. Most patients maintained excellent VA and did not develop clinically significant renal impairment. Tubulointerstitial nephritis and uveitis syndrome is a common cause of uveitis among patients who present with bilateral sudden-onset anterior uveitis. The size of this series clarifies the understanding of the relationship between renal and ocular disease; facilitates recognition of the syndrome; and adds to the knowledge on prognosis, complications, and role of antecedent medications.

0 comments Cited 36 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Signs and symptoms of uveitis. I. Anterior uveitis.

P THYGESON, S Kimura, Brigid L M Hogan (1959)

0 comments Cited 29 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Diagnosis and treatment of cytomegalovirus iridocyclitis without retinal necrosis.

S Michelson, P Kestelyn, B Bodaghi … (2006)

To describe the diagnostic and therapeutic management of cytomegalovirus (CMV) anterior uveitis unassociated with retinal necrosis in immunocompetent patients. Patients referred between 2001 and 2003 for management of unilateral, chronic, recurrent uveitis associated with secondary glaucoma underwent extensive investigation including laboratory tests for herpes virus infections. Specific antiviral treatment was initiated in all cases and the level of ocular inflammation was evaluated during the follow up. Five patients, three men and two women, were included. Median age was 50 years old (range 30-80 years). Anterior unilateral uveitis without iris atrophy was observed in all cases. Uveitis was chronic in three cases and recurrent in two cases. Glaucoma was observed in all patients with a median intraocular pressure of 30 mm Hg (range 22-43 mm Hg). Five patients responded initially to specific anti-CMV therapy. Even though glaucoma surgery was necessary in two cases, both ocular inflammation and glaucoma were controlled in all cases. Relapses occurred in three cases after cessation of therapy, requiring prolonged maintenance therapy with valganciclovir. CMV infection and specific antiviral therapy should be considered in all cases of relapsing or chronic iridocyclitis and secondary glaucoma. Maintenance regimens of valganciclovir may be necessary to prevent further relapses.

0 comments Cited 28 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Middle East Afr J Ophthalmol

Journal ID (publisher-id): MEAJO

Title: Middle East African Journal of Ophthalmology

Publisher: Medknow Publications (India )

ISSN (Print): 0974-9233

ISSN (Electronic): 0975-1599

Publication date (Print): Oct-Dec 2009

Volume: 16

Issue: 4

Pages: 159-167

Affiliations

Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care and University of Lausanne, Lausanne, Switzerland

Author notes

Corresponding Author: Dr. Carl P. Herbort, Retinal, Inflammatory and External Eye Diseases, Centre for Specialized Ophthalmic Care (COS), 6, Rue de la Grotte, CH-1003 Lausanne, Switzerland. E-mail: carl.herb@ 123456bluewin.ch

Article

Publisher ID: MEAJO-16-159

DOI: 10.4103/0974-9233.58416

PMC ID: 2855658

PubMed ID: 20404984

SO-VID: 4a33fcb8-b70e-4eee-adf5-7fe223a10a1c

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.