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Anterior Uveitis, Posterior Uveitis, Uveitis shroffeye.org | American Uveitis Society: CHRONIC ANTERIOR UVEITIS uveitissociety.org |
Uveitis specifically refers to inflammation of the middle layer of the eye, termed the "uvea" but in common usage may refer to any inflammatory process involving the interior of the eye. Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States.[1] Uveitis requires an urgent referral and thorough examination by an ophthalmologist along with urgent treatment to control the inflammation.
[edit] Anatomical ClassificationUveitis may be classified anatomically into anterior, intermediate, posterior and panuveitic forms, based on which part of the eye is primarily affected by the inflammation.
In 2004, a group of international uveitis specialists convened in Baltimore, MD, to standardize the method of reporting data in uveitis clinical trials, including anatomical classification. The results of this meeting were published in the American Journal of Ophthalmology in 2005.[2] [edit] Conditions associated with uveitis and uveitis syndromesMyriad conditions can be associated with uveitis, including diseases with major extra-ocular involvement, as well as syndromes confined to the eye. In anterior uveitis, no associated condition or syndrome is found in approximately one-half of cases. However, anterior uveitis is often one of the syndromes associated with HLA-B27. Presence this type of HLA allele has a relative risk of evolving this disease by approximately 15%.[3] [edit] Systemic disorders associated with uveitisSystemic disorders that can be associated with uveitis include: [4]
[edit] Infectious causesUveitis may be a (normal) immune response to fight an infection inside the eye. While representing the minority of patients with uveitis, such possible infections include:
[edit] Uveitis SyndromesIn many cases, uveitis is not associated with a systemic (i.e. extraocular) condition: the inflammation is confined to the eye. In some of these cases, the presentation in the eye is characteristic of a described syndrome, and include the following diagnoses:
[edit] Masquerade syndromesMasquerade syndromes are ophthalmic disorders that clinically present as either an anterior or posterior uveitis, but are not primarily inflammatory. The following are some of the most common:
[edit] Symptoms
[edit] TreatmentThe prognosis is generally good for those who receive prompt diagnosis and treatment, but serious complication (including cataracts, glaucoma, band keratopathy, retinal edema and permanent vision loss) may result if left untreated. The type of uveitis, as well as its severity, duration, and responsiveness to treatment or any associated illnesses, all factor in to the outlook.[1] Uveitis is typically treated with glucocorticoid steroids, either as topical eye drops (prednisolone acetate) or oral therapy with corticosteroids. But before giving corticosteroids, rule out corneal ulcers by Florescence Dye test. In addition to corticosteroids, topical cycloplegics, such as atropine or homatropine, may be used. In some cases an injection of PSTTA can also be given to reduce the swelling of the eye. [6] Antimetabolite medications, such as methotrexate are often used for recalcitrant or more aggressive cases of uveitis. Experimental treatment with Infliximab or other anti-TNFs' infusions may prove helpful. [edit] See also
[edit] Footnotes
[edit] External links
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