Uveitis: Diagnosis, Types, Management and Associations
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Questions and Answers

What structures of the eye can be affected by uveitis?

  • The iris, choroid, and ciliary body (correct)
  • The cornea, retina, and optic nerve head
  • Only the iris
  • The sclera and vitreous humor
  • At what age is uveitis particularly prevalent?

  • Over 60 years
  • Between 50-60 years
  • Between 40-50 years
  • Under 40 years (correct)
  • What is the first step in diagnosing uveitis according to the text?

  • Reviewing all possible causes
  • Laboratory workup
  • Comparing with known uveitis patterns
  • Defining the problem (correct)
  • What is the process known as when comparing the assigned name to known uveitis patterns?

    <p>Naming and Meshing</p> Signup and view all the answers

    What is the purpose of constructing a probable list of etiologies or causes in diagnosing uveitis?

    <p>To perform differential diagnosis</p> Signup and view all the answers

    Which diagnostic step involves going through a systematic process of naming and meshing in uveitis diagnosis?

    <p>&quot;Comparing with known uveitis patterns&quot;</p> Signup and view all the answers

    Which type of uveitis affects the vitreous humor?

    <p>Intermediate uveitis</p> Signup and view all the answers

    What is the most common form of uveitis?

    <p>Anterior uveitis</p> Signup and view all the answers

    Which of the following diseases is NOT associated with uveitis?

    <p>Otitis media</p> Signup and view all the answers

    How is non-infectious uveitis primarily treated?

    <p>Systemic corticosteroids</p> Signup and view all the answers

    What type of therapy is increasingly used due to the side effects of systemic corticosteroids?

    <p>Local therapy with steroid implants</p> Signup and view all the answers

    Which imaging studies are used in the evaluation of uveitis?

    <p>Optical coherence tomography (OCT) and ultra-wide-field fluorescein angiography</p> Signup and view all the answers

    Study Notes

    Uveitis: An Overview, Diagnosis, and Management Strategy

    Uveitis is an inflammatory condition that affects the uveal tract and adjacent structures of the eye, including the iris, choroid, ciliary body, sclera, cornea, vitreous humor, retina, and optic nerve head. It can cause transient or permanent visual impairment and ocular complications that are not responsive to therapy. Uveitis can occur as a co-manifestation of various autoimmune disorders and infections or as a side effect of idiopathic ocular inflammation. It is particularly prevalent in younger people, with a mean age of onset under 40 years.

    Diagnosis of Uveitis

    Algorithmic Approach

    To diagnose uveitis, ophthalmologists follow an algorithmic approach that includes defining the problem and deriving a clinical diagnosis, reviewing all possible causes, comparing with known uveitis patterns, and proving the diagnosis through diagnostic modalities. The comprehensive workup of uveitis takes the clinician through a systematic process of naming and meshing, differential diagnosis, and laboratory workup.

    Naming and Meshing

    The first step in diagnosing uveitis is to assign a specific name to the clinical entity by using a set of descriptive terminologies in uveitis. This step is followed by comparing the assigned name to known uveitis patterns, a process known as "meshing".

    Differential Diagnosis

    A probable list of etiologies or causes is constructed, and this is known as differential diagnosis (DD). After arriving at a DD, investigations are sought to confirm or rule out the specific diagnoses.

    Laboratory Workup

    A comprehensive workup takes the clinician to the list of differential diagnosis and then to a laboratory workup. The choice of laboratory tests depends on the suspected etiology of uveitis.

    Types of Uveitis

    Uveitis is classified into anterior, intermediate, posterior, and panuveitis, depending on the anatomic location. Anterior segment uveitis is the most common form, manifesting as iritis or iridocyclitis. Intermediate uveitis affects the vitreous humor, and posterior uveitis affects the retina, choroid, and vitreous.

    Associations with Systemic Diseases

    Uveitis is often associated with systemic diseases such as sarcoidosis, psoriatic arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis (JRA), multiple sclerosis (MS), Vogt-Koyanagi-Harada's disease, Behçet's disease, systemic lupus erythematosus (SLE), and collagen vascular diseases.

    Treatment of Uveitis

    The management of uveitis involves a multidisciplinary approach, and treatment varies depending on the etiology. Infectious uveitis is treated based on the pathogens, while non-infectious uveitis is primarily treated with systemic corticosteroids. However, due to the side effects and limited function of systemic corticosteroids, immunosuppressants and local therapy with steroid implants are increasingly used. Recent advances in uveitis management include new immunosuppressive therapies based on biological agents and local therapy with steroid implants. Imaging studies such as optical coherence tomography (OCT) and ultra-wide-field fluorescein angiography are also used in the evaluation of uveitis.

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    Description

    Explore an overview of uveitis, including the diagnosis algorithm, classification based on anatomical location, associations with systemic diseases, and management strategies. Learn about the different types of uveitis and the multidisciplinary approach involved in its treatment, from systemic corticosteroids to new immunosuppressive therapies with biological agents.

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