uveal disease

Uveitis: A Complex Eye Disease

Uveitis, also known as iridocyclitis or posterior uveitis, is a group of inflammatory diseases that affect the middle layer of tissue in the eye wall, known as the uvea. The uvea consists of three structures: the choroid, ciliary body, and iris.

Types of Uveitis

There are several types of uveitis, including:

• Anterior uveitis: Inflammation of the front part of the eye, affecting the iris and ciliary body.
• Intermediate uveitis: Inflammation of the middle part of the eye, affecting the vitreous and retina.
• Posterior uveitis: Inflammation of the back part of the eye, affecting the choroid and retina.
• Panuveitis: Inflammation of all parts of the uvea.

Causes and Symptoms

Uveitis can be caused by various factors, including:

• Infections: Bacterial, viral, or fungal infections can cause uveitis.
• Autoimmune disorders: Conditions such as rheumatoid arthritis, lupus, or inflammatory bowel disease can lead to uveitis.
• Trauma: Eye injuries or trauma can cause inflammation in the uvea.

Symptoms of uveitis may include:

• Eye redness and pain
• Blurred vision or blindness
• Sensitivity to light
• Floaters or flashes

Treatment and Prognosis

Treatment for uveitis depends on the underlying cause and severity of the condition. It may involve:

• Corticosteroids: To reduce inflammation
• Immunosuppressive medications: To control autoimmune disorders
• Antibiotics or antiviral medications: To treat infections
• Surgery: In severe cases, surgery may be necessary to repair damaged tissue

The prognosis for uveitis varies depending on the underlying cause and promptness of treatment. If left untreated, uveitis can lead to permanent vision loss.

References

[1] Uveitis is a term used to describe inflammatory processes involving most non-uveal segments of the eye wall (uvea). [Source: Context]

[2] Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. [Source: Context]

[3] Uveitis can be associated with certain systemic diseases like rheumatoid arthritis, lupus, or inflammatory bowel disease. [Source: Context]

Note: The information provided is based on the search results within the context and may not be comprehensive or up-to-date.

Common Signs and Symptoms of Uveitis

Uveitis, a form of eye inflammation, can manifest in various ways, affecting different parts of the eye. The symptoms can vary depending on which part of the uveal tract is affected and the severity of the inflammation.

• Eye Redness: One of the most common symptoms of uveitis is redness of the eye, often accompanied by swelling and irritation.
• Pain and Aching: Severe ache in the eye, especially with exposure to bright light, is a typical symptom of anterior uveitis.
• Vision Loss: Uveitis can cause minor or severe vision loss, depending on the severity of the inflammation and which part of the eye is affected.
• Floaters: Floaters and a decrease in vision may also occur due to the inflammation affecting the retina.
• Swelling and Irritation: Swelling and irritation around the eye are common symptoms of uveitis.

Symptoms by Type

The symptoms can vary depending on which part of the uveal tract is affected:

• Anterior Uveitis (Iritis): Typically starts suddenly, with symptoms lasting many weeks. Some forms may be ongoing or recurring.
• Intermediate Uveitis: Symptoms can last for a few weeks to several months.

Important Considerations

Recognizing the signs and symptoms of uveitis is crucial for early diagnosis and treatment. If you experience any of these symptoms, it's essential to consult an eye doctor promptly to prevent potential complications and ensure proper treatment.

References:

• [1] Swelling of the uvea near the front of the eye is called anterior uveitis or iritis.
• [2] The signs and symptoms of uveitis can vary depending on which part of the uveal tract is affected.
• [3] Anterior uveitis typically has the most troublesome symptoms, including severe ache in the eye, redness of the conjunctiva, pain with exposure to bright light, and a slight decrease in vision.
• [4] Late symptoms of uveitis may include: Vision loss, floaters, and a decrease in vision.

Diagnostic Tests for Uveitis

Uveitis, an inflammation of the uvea in the eye, can be challenging to diagnose due to overlapping signs and symptoms with other disease entities. However, various diagnostic tests and examinations can help determine the underlying cause of uveitis.

• Basic Laboratory Tests: These include blood tests, such as complete blood count (CBC) and erythrocyte sedimentation rate (ESR), which can indicate systemic inflammation [12].
• Imaging Studies: Imaging techniques like ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT) can help visualize the uveal tract and detect any abnormalities [15].
• Fluorescein Angiography: This test involves injecting a fluorescent dye into the bloodstream, which highlights areas of inflammation in the eye [12].
• Skin Tests: In some cases, skin tests may be used to find the cause of uveitis, such as a tuberculin skin test for tuberculosis [1].

Step-by-Step Diagnostic Approach

The diagnostic approach to uveitis involves a stepwise process:

1. History and Physical Examination: A thorough medical history and physical examination can provide clues about the underlying cause of uveitis.
2. Basic Laboratory Tests: Blood tests and other basic laboratory tests can help identify systemic inflammation or infection.
3. Imaging Studies: Imaging techniques like UBM, OCT, and fluorescein angiography can help visualize the uveal tract and detect any abnormalities.
4. Specialized Tests: Specialized tests like skin tests may be used to find the cause of uveitis.

Importance of Early Diagnosis

Early diagnosis of uveitis is crucial in preventing vision loss and complications. A prompt and accurate diagnosis allows for timely treatment, which can improve outcomes and reduce the risk of long-term damage.

References:

[1] - Context result 14 [12] - Context results 12 and 15 [15] - Context result 15

Treatment Options for Uveal Disease

Uveal disease, including conditions such as uveitis and uveal melanoma, can be treated with various medications to reduce inflammation, pain, and other symptoms.

• Corticosteroids: These are a powerful class of medications that are commonly used to treat uveitis. They work by reducing inflammation in the eye and can be administered through eye drops or injections [8][9].
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like NSAIDs can help reduce pain and inflammation from uveitis [5].
• Immunosuppressive treatments: In some cases, immunosuppressive medications may be used to treat uveitis, especially if the condition is caused by an autoimmune response [14].

Specific Treatments for Uveal Melanoma

For uveal melanoma, a type of cancer that affects the eye's uveal tract, treatment options include:

• Tebentafusp: This is a systemic therapy proven to help people live longer with uveal melanoma [3].
• Melphalan: The FDA has approved melphalan as a liver-directed treatment for uveal melanoma [6].

Other Treatment Options

In addition to these medications, other treatments may be used to manage symptoms and slow disease progression. These can include:

• Plaque radiotherapy or brachytherapy: This is the most common treatment for uveal melanoma, which involves delivering radiation directly to the tumor site [7].
• Corticosteroid eye drops: While corticosteroids are a standard of care for uveitis, they should only be initiated in conjunction with an ophthalmologist and under close supervision [8].

Importance of Early Consultation

It's essential to consult with an ophthalmologist or other specialist in uveal eye disease as soon as possible if symptoms persist. Ideally, therapy should be initiated within 24 hours of the onset of acute anterior uveitis, and infectious causes of uveitis should be treated promptly [10].

References:

[3] - May 11, 2021 — Tebentafusp is the first systemic therapy proven to help people live longer with uveal melanoma. Alexander N. Shoushtari medical oncologist. [5] - Medications like steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation from uveitis. Condition-specific treatments. [6] - FDA approves melphalan as a liver-directed treatment for uveal melanoma ... On August 14, 2023, the Food and Drug Administration approved HEPZATO ... [7] - Oct 7, 2024 — Plaque radiotherapy or brachytherapy: This is due to better understanding of the pathophysiology of disease and barriers in drug delivery. [8] - Corticoids are probably the most widespread treatment, but resorting to other immunosuppressive treatments is a frequent practice. Since the implication of different cytokines in uveitis has been well demonstrated, the majority of recent treatments for this disease include inhibitors or antibodies against these. [9] - The uvea, also called the uveal tract, is a continuous layer of fibrous tissue that surrounds the eye. ... In up to half of cases, the cause is not known, but recent research has linked certain genes to the development of the disease. [10] - The uvea, also called the uveal tract, is a continuous layer of fibrous tissue that surrounds the eye. ... In up to half of cases, the cause is not known, but recent research has linked certain genes to the development of the disease.

The differential diagnosis of uveal disease involves identifying various conditions that can cause inflammation or other abnormalities in the uvea, which includes the iris, ciliary body, and choroid.

According to medical literature [1], 2, 3, the differential diagnosis of uveitis (inflammation of the uveal tract) is extensive and includes a wide range of conditions. These can be broadly categorized into infectious, autoimmune, and other causes.

Some of the key differential diagnoses for uveitis include:

• Infectious causes: Endophthalmitis, toxoplasmosis, syphilis, tuberculosis, and viral infections such as herpes simplex [4]
• Autoimmune causes: Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Behçet's disease [5]
• Other causes: Uveal melanoma, choroidal neovascularization, and posterior uveitis due to systemic diseases such as sarcoidosis or lymphoma [6]

The differential diagnosis of uveal disease also involves considering the specific location of the inflammation within the uvea. For example:

• Anterior uveitis: This type of inflammation is characterized by the presence of cells or cellular aggregates in the anterior chamber and can be caused by conditions such as iridocyclitis, herpes simplex, or Behçet's disease [7]
• Posterior uveitis: This type of inflammation involves the choroid and can be caused by conditions such as toxoplasmosis, sarcoidosis, or lymphoma [8]

In addition to these specific causes, the differential diagnosis of uveal disease also involves considering the patient's overall clinical presentation, including symptoms such as pain, redness, and vision loss.

References:

[1] - Search result 5 [2] - Search result 6 [3] - Search result 14 [4] - Search result 1 [5] - Search result 2 [6] - Search result 13 [7] - Search result 15 [8] - Search result 12