Uveitis and vasculitis

Disease

The uvea consists of the middle, pigmented, vascular structures of the eye and includes the iris, ciliary body and choroid. Uveitis is broadly defined as inflammation of the uvea.

The classification of uveitis is based on anatomy (the portion of the uvea involved) into 4 groups:

  • anterior uveitis: inflammation of the iris and anterior chamber,
  • intermediate uveitis: inflammation of cells in the vitreous
  • posterior uveitis: inflammation of the retina and choroid,
  • panuveitis: inflammation of all the layers of the uvea.

Vasculitis is inflammation of retinal vessels and choroid. Vasculitis often complicate posterior uveitis.
Sometimes, vasculitis maybe confused with non inflammatory diseases (diabetes, atherosclerosis), an effort to investigate the underlying cause should be undertaken.

Diagnosis

Signs of uveitis include (but are not limited to): eye pain, photophobia, blurred vision and redness of the eye.
It can be infectious or autoimmune in origin. Uveitis is usually isolated or can be associated with systemic disease and in these cases, lab tests or radiology exams are used to diagnose specific underlying diseases. Often, these investigations do not show a possible underlying cause, they are negative, and in that case, it’s called idiopathic uveitis.

Children can be affected by uveitis. Uveitis in children with rheumatic disease is different from adult forms because it silently arises without many manifestations and it is often diagnosed when complications are already present.

Treatment and care

The treatment of uveitis must target the underlying cause.
In all cases, the goal of medical management of uveitis is to effectively control inflammation and to reduce the risk of complications (glaucoma, cataract, deformation of the pupil). If the underlying cause is unknown, uveitis is typically treated with anti-inflammatory drugs (corticosteroids or immunomodulatory agents).

Treatment requires coordination with other medical consultants in eliciting the cause, determining the therapeutic, monitoring treatment and side effects.

Last page modification: 2 Sep 2013