Uveitis Flashcards by American Mouse

ant uveitis

iritis

iridocyclitis

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iridocyclitis?

iris + pars plicata

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intermediate uveitis

pars plana

extreme periphery

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posterior uveitis

choroid

retina post to vitreous base

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acute uveitis

up to 3 months

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chronic uveitis

longer than 3 months

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uveitis causes

systemic
infection
infestation
idiopathic non/specific

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acute ant uveitis

presentation

photophobia
pain
redness
decreased vision
lacrimation

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acute ant uveitis

signs

ciliary injection
endothelial dusting w/ inflam cells
aqueous cells + flare
fibrinous exudate + hypopyon

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acute ant uveitis

grading use

aqueous cells + flare

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acute ant uveitis

causes

HLA-B27 PAIR
UC/Crohns
sarcoidosis
behcet
herpes zoster
syphilis

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chronic ant uveitis

mild redness + floaters

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chronic ant uveitis signs

KP = keratic precipitates
mutton-fat KP
Iris nodules Koeppe at middle, Busacca at periphery

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chronic ant uveitis

comp

post synechiae
band keratopathy
glaucoma
macular oedema + EPM
Cyclitic membrane + phthisis bulbi

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chronic ant uveitis

causes

Fuchs uveitis
sarcoid
JIA
VKH
TB

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Intermediate uveitis

floaters

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Intermediate uveitis

signs

mild ant uveitis
vitreous cells
peripheral retina periphlebitis
inf snowbanking in pars planitis

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Intermediate uveitis

comp

cataract
CMO
Cyclitic membrane
retinal detachment

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Intermediate uveitis

causes

idiopathic
sarcoid
MS
Lyme
Whipple
Cat scratch fever

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posterior uveitis

floaters

visual impairment

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posterior uveitis

signs

spill over ant U
Vitritis
choriditis - doesn't obscure retinal vessels
retinitis - obscure retinal vessels
vasculitis

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posterior uveitis

morphology

focal
multifocal
geographic

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posterior uveitis

comp

maclar oedema/ ischaemia
ERM
vascular occlusion
CNV
Retinal detachment
optic neuropathy

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posterior uveitis

causes

toxoplasmosis
sarcoid
behcet
CMV
toxocariasis
histoplasmosis
VKH
Birdshot retinochoroidopathy

uveitis tx drug classes

mydriatics steroids immunosuppressives

mydriatics prep

short-acting tropicamide cyclopentate phenylephrine long acting atropine

mydriatics indications

comfort relieve ciliary/ pupillary spasm | prevent/ breakdown post synechiae

steroid topical for

acute + chronic ant uveitis

steroid comp

``` glaucoma cataract secondary microbial keratitis herpes simplex keratitis comes back corneal melting ```

periocular steroids for | ant/ post sub-Tenon

severe acute ant u adjunct to topical/systemic in resistant chronic ant u intermediate u poor compliance

systemic steroids for

panuveitis | ant/ intermediate u not responding to sub-Tenon injections

systemic steroid short term comp

dyspepsia mental changes aseptic necrosis of femoral head hyperosmolar hyperglycaemic non-ketotic coma

systemic steroid long term comp

``` cushings osteoporosis limit growth in kids reactivate TB Cataract worsen DM ```

immunosuppressives EG

``` Azathioprine methotrexate cyclosporin tacrolimus mycophenalate mofetil ```

Azathioprine for

behcets

Azathioprine SEs, monitoring

bone marrow suppression GI upset hepatotox FBC every 4-6 wks LFTs every 12 wks

methotrexate for

steroid resistant non infectious u

methotrexate SEs, monitoring

bone marrow suppression GI upset hepatotox pneumonitis FBC, LFT every 1-2 months

cyclosporin for

behcets VKH Birdshot retinopathy sympathetic ophthalmitis

cyclosporin SEs, monitoring

``` HTN Nephrotox hepatotox hirsuitism gingival hyperplasia ``` BP, FBC, RFT, LFT every 6 wks

tacrolimus for

alternative to cyclosporin

tacrolimus SEs, monitoring

``` HTN Nephrotox GI upset hyperglycemia neurological ``` weekly BP, Renal + glucose at first

mycophenalate mofetil for

indications not established!

mycophenalate mofetil SEs, monitoring

BM suppression GI upset FBC weekly for 4 wks

ank spon is found

in 30% of patients with acute ant uveitis

what other eye problems do ank spon pts have?

conjunctivitis peripheral corneal infiltrates papillitis

what % of Reiters pts have acute ant uveitis

20%

what other eye problems do Reiters pts have?

conjuncitivitis | punctate epithelial keratitis

what % of psoriatic arthritis pts have acute ant uveitis

10%

what other eye problems do psoriatic arthritis pts have?

conjunctivitis raised corneal infiltrates secodary sjögrens

JIA uveitis signs

aSx | small-medium KP

JIA uveitis Prognosis

25% mild 50% moderate but responds to tx 25% severe --> band keratopathy, cataract, glaucoma, phthisis bulbi

JIA uveitis high risk

onset before age 6 pauciarticular disease <5 joints + ANA

JIA uveitis MEDIUM risk

polyarticular disease >4 joints, + ANA | pauciarticular disease <5 joints, - ANA

JIA DDx

``` juvenile AS juvenile Reiters (post-dysenteric) juvenile psoriatic arthritis sarcoidosis lyme ```

what % of UC pts have acute ant uveitis

what % of crohns pts have acute ant uveitis