DIAGNOSIS OF UVEITIS

Infection & Immunology Division

INTRODUCTION
• Inflammation of the uvea
• Anatomical classification
– Anterior uveitis: anterior chamber
– Intermediate uveitis: vitreous
– Posterior uveitis: retina or choroid
– Panuveitis: anterior chamber, vitreous, and retina or
choroid
INTRODUCTION
The SUN Working Group Descriptors
• Onset:
– Sudden
– Insidious
• Duration:
– Limited: < 3 months duration
– Persistent: > 3 months duration
• Course:
– Acute: sudden onset and limited duration
– Recurrent: repeated episodes separated by periods of
inactivity without treatment > 3 months duration
– Chronic: persistent uveitis with relapse in < 3 months after
discontinuing treatment
INTRODUCTION
The SUN Working Group Activity of Uveitis
Terminology
• Inactive: Grade 0 cells (anterior chamber)
• Worsening activity: 2-step increase in level of
inflammation (eg, anterior chamber cells, vitreous
haze) or increase from grade 3+ to 4+
• Improved activity: 2-step decrease in level of
inflammation or decrease to grade 0
• Remission: inactive disease for > 3 months after
discontinuing all treatments for eye disease
CLASSIFICATION OF UVEITIS
CLASSIFICATION OF UVEITIS
CLASSIFICATION OF UVEITIS
CLASSIFICATION OF UVEITIS
CLASSIFICATION OF UVEITIS
HISTORY TAKING
• Presenting symptoms:
– Visual loss: longstanding or chronic
– Bilateral
– Photophobia: iris involvement  anterior uveitis
– Floaters: vitreous involvement  vitritis
• History of present illness
– Chronicity: onset of symptoms
– Recurrence: prior episodes of patient’s current
symptoms  HLA-B27 related iritis
HISTORY TAKING
• Review of systems
– Joints stiffness and pain: JIA, HLA-B27 associated
disorders, RA, SLE
– Skin rashes: syphilis, SLE, sarcoidosis, Behçet disease,
Kawasaki disease, Lyme disease
– Gastrointestinal symptoms (nausea, vomit, diarrhea,
melena): HLA-B27 related, Behçet disease
– Oral ulcers: SLE, Behçet disease
– Genital findings: Behçet disease, syphilis
– Neurologic symptoms (headache): Behçet disease, VKH
– Pulmonary findings: Sarcoidosis, tuberculosis
• AAO
• Huang JJ, Gaudio PA. Ocular imflamatory disease
and uveitis manual. Philadelphia: Lippincott
Williams & Wilkins. 2010.
• Nussenblat RB, Whitcup SM. Uveitis Fundamentas
and clinical practice. 4th Ed. California: Elsevier.
2010