Practical Diagnostic Approach to Uveitis
Practical Diagnostic Approach to Uveitis
Accounting for approximately 10% of blindness in the USA, uveitis refers to a group of heterogeneous diseases that share the features of intraocular inflammation but whose etiologies include idiopathic autoimmune disease, infections, rheumatologic diseases and masquerade syndromes. Correct diagnosis with timely and appropriate therapy is key to reducing disease-associated morbidity. The multitude of possible causes can create diagnostic challenges, but a successful approach includes a targeted history of the illness and associated symptoms, detailed ocular evaluation and specific laboratory investigations. The purpose of this article is to aid in the initial evaluation and decision-making strategy for uveitis according to the Standardization of Uveitis Nomenclature Working Group classification scheme and to provide a brief look at the anticipated future for diagnostic tools.
The word uvea comes from the Latin word 'uva', which means 'grape' as defined by early anatomists based on the tissue color and geometry and consists of the iris, ciliary body and the choroid. Uveitis can refer to inflammation of one or all three components, may also include primary inflammations of the retina and vitreous, and is often found in connection with systemic disease. The most critical question in evaluating a patient with intraocular inflammation is whether the disease can be classified into a specific, defined syndrome. If the answer is yes, then the treatment path is clarified. If the specific syndrome is elusive, one must take the appropriate steps to try to define the underlying pathophysiology, whether it be autoimmune, infectious, neoplastic or other masquerade syndromes, as the appropriate treatment for these types of diseases vary widely.
It is important to develop a targeted strategy for clinical and laboratory evaluation in order to maximize the potential for making a specific diagnosis while minimizing extraneous evaluations. Defining an underlying disease etiology is often helpful in providing the patient with prognostic information and attenuating disease-associated morbidity through use of appropriate therapeutic intervention.
Abstract and Introduction
Abstract
Accounting for approximately 10% of blindness in the USA, uveitis refers to a group of heterogeneous diseases that share the features of intraocular inflammation but whose etiologies include idiopathic autoimmune disease, infections, rheumatologic diseases and masquerade syndromes. Correct diagnosis with timely and appropriate therapy is key to reducing disease-associated morbidity. The multitude of possible causes can create diagnostic challenges, but a successful approach includes a targeted history of the illness and associated symptoms, detailed ocular evaluation and specific laboratory investigations. The purpose of this article is to aid in the initial evaluation and decision-making strategy for uveitis according to the Standardization of Uveitis Nomenclature Working Group classification scheme and to provide a brief look at the anticipated future for diagnostic tools.
Introduction
The word uvea comes from the Latin word 'uva', which means 'grape' as defined by early anatomists based on the tissue color and geometry and consists of the iris, ciliary body and the choroid. Uveitis can refer to inflammation of one or all three components, may also include primary inflammations of the retina and vitreous, and is often found in connection with systemic disease. The most critical question in evaluating a patient with intraocular inflammation is whether the disease can be classified into a specific, defined syndrome. If the answer is yes, then the treatment path is clarified. If the specific syndrome is elusive, one must take the appropriate steps to try to define the underlying pathophysiology, whether it be autoimmune, infectious, neoplastic or other masquerade syndromes, as the appropriate treatment for these types of diseases vary widely.
It is important to develop a targeted strategy for clinical and laboratory evaluation in order to maximize the potential for making a specific diagnosis while minimizing extraneous evaluations. Defining an underlying disease etiology is often helpful in providing the patient with prognostic information and attenuating disease-associated morbidity through use of appropriate therapeutic intervention.
