Uveitis Flashcards
Define uveitis.
Inflammation of the uveal tract—the iris, ciliary body, and choroid.
According to the Standardization of Uveitis Nomenclature (SUN) classification, what are the 4 types of uveitis?
- Anterior uveitis (the most common type)
- Intermediate uveitis
- Posterior uveitis
- Panuveitis
What are the clinical features of intermediate uveitis? (3)
- No or mild pain or redness
- Blurred vision
- Vitreous Floaters
- Visual field defect
What are the clinical features of anterior uveitis? (4)
- Painful red eye (typically a dull, aching pain)
- Photophobia (due to ciliary muscle spasm)
- Excessive lacrimation (tear production)
- Reduced visual acuity
- Constricted or irregular pupil: from posterior synechia (iris adhesions to anterior lens)
What are the clinical features of posterior uveitis? (3)
- Not usually with pain or redness
- Reduced visual acuity
- Floaters
- Visual field defect
- Photopsia or seeing flashing lights.
Give 4 risk factors of uveitis.
- Genetic predisposition
- Autoimmune disorders
- Infections like HIV
- Smoking
- Vitamin D deficiency
What is the etiology of uveitis? (4)
Idiopathic
Infections- See slide 14
Systemic immune-mediated causes- Diseases associated with HLA-B27, Sarcoidosis, Behçet’s disease: frequently a recurrent panuveitis, Multiple sclerosis, Systemic lupus erythematosus
Injury
Medications
Rifabutin
Fluoroquinolones: moxifloxacin, ciprofloxacin
Intravitreal medications: cidofovir, vancomycin
BRAF kinase inhibitors: dabrafenib, vemurafenib, trametinib
Describe the 3 proposed mechanisms for the pathophysiology of uveitis.
Microbial contamination: In cases of trauma, direct injury and necrosis trigger an inflammatory response at the site.
Molecular mimicry: Antigens of infectious or foreign agent(s) cross-reacts with ocular self-antigens.
Indirect effect of infection: Foreign antigens of infection stay undetected in ocular tissues and lead to recurrent immune-mediated tissue damage.
Name 4 investigations done in uveitis.
- OCT
- Fluorescein angiography
- Indocyanine green angiography
- B-scan
What would you find on examination in intermediate uveitis?
- Vitreous haze
- Snowballs- large inflammatory cells collection in the vitreous humor
- Snowbank- pars plana exudates
- Cystoid macular edema
- Neovascularisation
What would you find on examination in posterior uveitis?
- Focal chorioretinal spots
- Retinal whitening
- Retinal detachments
- Optic nerve edema
How is uveitis treated?
- Use of steroids
- Immunosuppressants
- Mydriatics
Give 4 complications of uveitis.
From the disease
- macular edema
- retinal detachment
- optic nerve damage
From treatment
- steroid induced glaucoma
- steroid induced cataract
What is the Schwartz-Matsuo syndrome?
A rare ocular condition characterized by a combination of rhegmatogenous retinal detachment (RRD), elevated intraocular pressure (IOP), and the presence of photoreceptor outer segments in the aqueous humor.
Which 2 places is the blood ocular barrier?
The blood-aqueous barrier and the blood-retinal barrier
