Uveitis

Uveitis

Uveitis is an intraocular inflammatory condition that affects various parts of the eye, and it can occur due to different etiologies, including autoimmune disorders and infections. The inflammation can involve the uvea, which consists of the iris, ciliary body, and choroid, and uveitis can be classified based on the anatomic location as anterior, intermediate, posterior, or panuveitis. Anterior uveitis is the most common subtype and often presents with symptoms like eye pain, redness, and sensitivity to light. Early and accurate diagnosis, followed by appropriate management, is crucial to minimize the risk of vision loss, as complications such as cataract, glaucoma, or macular edema can arise from ongoing inflammation^1,2

Risk Factors

Risk factors for uveitis can vary depending on the specific context of the condition. For instance, in the context of juvenile idiopathic arthritis (JIA), factors such as antinuclear antibody (ANA) positivity, young age at the onset of arthritis, and female gender are associated with an increased risk of developing uveitis.³  Certain systemic diseases, such as Behçet's disease, juvenile idiopathic arthritis, ankylosing spondylitis, and systemic lupus erythematosus, have been linked with a higher risk of uveitis in some populations.⁴ Overall, recognizing the risk factors is crucial for the early identification and management of uveitis to prevent potential vision-threatening complications.

Symptoms of Uveitis

Overall, uveitis symptoms are varied and can range from mild to severe, often requiring careful evaluation to determine the underlying cause and appropriate management. Symptoms can include a range of ocular manifestations like blurred vision, redness, and ocular pain, although the severity and type can vary depending on the specific cause and type of uveitis being experienced by the patient.⁵

Diagnosis of Uveitis

The diagnosis of uveitis involves the identification of specific patterns and the location of inflammation within the eye. It often requires distinguishing among anterior, intermediate, posterior uveitis, and panuveitis using the clinical presentation.⁶ Diagnosis is crucial as the treatment strategy, involving immunomodulatory therapies or corticosteroids, can vary depending on whether the uveitis is infectious or non-infectious. ⁷ Noninfectious uveitis, for instance, may be managed with newer biologic agents that offer therapeutic advantages by reducing corticosteroid burden, albeit with their potential side effects.⁸

References

1. Cunningham ET. Uveitis in children. Ocular immunology and inflammation. 2000;8(4):251-261. doi:10.1076/ocii.8.4.251.6459
2. Al Dhibi HA, Al Shamsi HN, Al-Mahmood AM, et al. Patterns of Uveitis in a Tertiary Care Referral Institute in Saudi Arabia. Ocular immunology and inflammation. 2017;25(3):388-395. doi:10.3109/09273948.2015.1133836
3. Saurenmann RK, Levin AV, Feldman BM, Laxer RM, Schneider R, Silverman ED. Risk factors for development of uveitis differ between girls and boys with juvenile idiopathic arthritis. Arthritis and rheumatism. 2010;62(6):1824-1828. doi:10.1002/art.27416
4. Rim TH, Kim SS, Ham D-I, et al. Incidence and prevalence of uveitis in South Korea: a nationwide cohort study. The British journal of ophthalmology. 2018;102(1):79-83. doi:10.1136/bjophthalmol-2016-309829
5. Eser-Ozturk H, Sullu Y. Pediatric Uveitis in a Referral Center in North Part of Turkey. Ocular immunology and inflammation. 2021;29(7-8):1299-1303. doi:10.1080/09273948.2020.1758158
6. McClellan KA, Coster DJ. Uveitis: a strategy for diagnosis. Australian and New Zealand journal of ophthalmology. 1987;15(3):227-241. doi:10.1111/j.1442-9071.1987.tb00076.x
7. Dick AD, Rosenbaum JT, Al-Dhibi HA, et al. Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative. Ophthalmology. 2018;125(5):757-773. doi:10.1016/j.ophtha.2017.11.017
8. Rosenbaum JT, Bodaghi B, Couto C, et al. New observations and emerging ideas in diagnosis and management of non-infectious uveitis: A review. Seminars in arthritis and rheumatism. 2019;49(3):438-445. doi:10.1016/j.semarthrit.2019.06.004

SE-OPHTHU-240001 v1.0 November 2024