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Uveitis
 
 
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Uveitis specifically refers to inflammation
Inflammation

Inflammation is the complex biological response of Blood vessel tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue....
 of the middle layer of the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
, termed the "uvea
Uvea

The uvea , also called the uveal layer, uveal coat, uveal tract, or vascular tunic, is the pigmented middle of the three concentric layers that make up an eye....
" but in common usage may refer to any inflammatory process involving the interior of the eye, with inflammation specifically of the uvea termed iridocyclitis
Iridocyclitis

Iridocyclitis, a type of anterior uveitis, is a condition in which the uvea of the human eye suffers inflammation....
.

Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States. Uveitis requires an urgent referral and thorough examination by an ophthalmologist, along with urgent treatment to control the inflammation.

tis is usually categorized anatomically into anterior, intermediate, posterior and panuveitic forms.



ad conditions can lead to the development of uveitis, including systemic diseases as well as syndromes confined to the eye.






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Encyclopedia


Uveitis specifically refers to inflammation
Inflammation

Inflammation is the complex biological response of Blood vessel tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue....
 of the middle layer of the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
, termed the "uvea
Uvea

The uvea , also called the uveal layer, uveal coat, uveal tract, or vascular tunic, is the pigmented middle of the three concentric layers that make up an eye....
" but in common usage may refer to any inflammatory process involving the interior of the eye, with inflammation specifically of the uvea termed iridocyclitis
Iridocyclitis

Iridocyclitis, a type of anterior uveitis, is a condition in which the uvea of the human eye suffers inflammation....
.

Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States. Uveitis requires an urgent referral and thorough examination by an ophthalmologist, along with urgent treatment to control the inflammation.

Types

Uveitis is usually categorized anatomically into anterior, intermediate, posterior and panuveitic forms.

  • Anywhere from two-thirds to 90% of uveitis cases are anterior in location (anterior uveitis), frequently termed iritis
    Iritis

    Iritis is a form of anterior uveitis and refers to the inflammation of the iris of the eye....
     - or inflammation of the iris
    Iris (anatomy)

    The iris is a membrane in the eye, responsible for controlling the amount of light reaching the retina. The iris consists of pigmented fibrovascular tissue known as a stroma of iris....
     and anterior chamber
    Anterior chamber

    The anterior chamber is the fluid-filled space inside the eye between the iris and the cornea's innermost surface, the endothelium. Aqueous humor is the fluid that fills the anterior chamber....
    . This condition can occur as a single episode and subside with proper treatment or may take on a recurrent or chronic nature. Symptoms include red eye
    Red eye (medicine)

    In medicine, red eye is a non-specific term to describe an eye that appears red due to illness, injury, or some other condition. "Conjunctival injection" and "bloodshot eyes" are two forms of red eye....
    , injected conjunctiva
    Conjunctiva

    The conjunctiva is a clear mucous membrane consisting of cells and underlying basement membrane that covers the sclera and lines the inside of the eyelids....
    , pain and decreased vision. Signs include dilated ciliary vessel
    Ciliary body

    The ciliary body is the circumferential tissue inside the eye composed of the ciliary muscle and ciliary processes. It is triangular in horizontal section, and is coated by a double layer, the ciliary epithelium....
    s, presence of cells and flare in the anterior chamber, and keratic precipitates ("KP") on the posterior surface of the cornea
    Cornea

    The cornea is the transparency front part of the eye that covers the Iris , pupil, and anterior chamber. Together with the cilliary muscles, the cornea reflects light, and as a result helps the eye to dilate, accounting for approximately two-thirds of the eye's total optical power....
    .
  • Intermediate uveitis
    Intermediate uveitis

    Intermediate uveitis refers to inflammation localized to the vitreous and peripheral retina. Primary sites of inflammation include the vitreous of which other such entities as pars planitis, posterior cyclitis, and hyalitis are encompassed....
     (pars planitis) consists of vitritis - inflammatory cells in the vitreous cavity
    Vitreous humour

    The vitreous humour or vitreous humor is the clear gel that fills the space between the Lens and the retina of the eyeball of humans and other vertebrate....
    , sometimes with snowbanking, or deposition of inflammatory material on the pars plana
    Pars plana

    The pars plana is part of the uvea , choroidea, one of the three layers that comprise the eye. It is about 4 mm long and located near the point where the Iris and sclera touch....
    .
  • Posterior uveitis is the inflammation of the retina
    Retina

    The vertebrate retina is a light sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera....
     and choroid
    Choroid

    The choroid, also known as the choroidea or choroid coat, is the Blood vessel layer of the eye lying between the retina and the sclera....
    .
  • Pan-uveitis is the inflammation of all the layers of the uvea.


Causes

Myriad conditions can lead to the development of uveitis, including systemic diseases as well as syndromes confined to the eye. In anterior uveitis, no specific diagnosis is made in approximately one-half of cases. However, anterior uveitis is often one of the syndromes associated with HLA-B27
HLA-B27

Human Leukocyte Antigen B*27 is a class I surface antigen encoded by the B locus in the major histocompatibility complex on chromosome 6 and presents microbial antigens to T-cells....
. Presence this type of HLA
Human leukocyte antigen

The human leukocyte antigen system is the name of the major histocompatibility complex in humans.The superlocus contains a large number of genes related to immune system function in humans....
 allele has a relative risk
Relative risk

In statistics and mathematical epidemiology, relative risk is the risk of an event relative to exposure. Relative risk is a ratio of the probability of the event occurring in the exposed group versus a non-exposed group....
 of evolving this disease by approximately 15%.

Systemic disorders causing uveitis

Systemic disorders that can cause uveitis include:
  • Acute posterior multifocal placoid pigment epitheliopathy
    Acute posterior multifocal placoid pigment epitheliopathy

    Acute posterior multifocal placoid pigment epitheliopathy, abbreviated APMPPE, is a rare eye disease that mainly affects Caucasian race people aged 20?30 years....
  • Ankylosing spondylitis
    Ankylosing spondylitis

    Ankylosing spondylitis It is a member of the group of the spondyloarthropathy with a strong genetic predisposition. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine....
  • Behçet's disease
    Behçet's disease

    Beh?et disease is a chronic condition due to disturbances in the body?s immune system. This system, which normally protects the body against infections through controlled inflammation, becomes overactive and produces unpredictable outbreaks of exaggerated inflammation....
  • Birdshot retinochoroidopathy
    Birdshot retinochoroidopathy

    Birdshot chorioretinopathy, also called birdshot retinochoroidopathy, is a rare form of bilateral posterior uveitis affecting the eye. It causes severe, progressive inflammation of both the choroid and retina....
  • Brucellosis
    Brucellosis

    Brucellosis, also called undulant fever, or Malta fever, is a highly contagious zoonosis caused by ingestion of Sterilization_ milk or meat from infected animals, or close contact with their secretions....
  • Chronic granulomatous disease
    Chronic granulomatous disease

    Chronic granulomatous disease is a diverse group of genetic disorder in which certain cells of the immune system have difficulty forming the reactive oxygen compounds used to kill certain ingested pathogens....
  • Enthesitis
    Enthesitis

    Enthesitis is an inflammation of the entheses, the location where a bone has an insertion to a tendon or a ligament. It is also called enthesopathy, or any Pathology condition involving the entheses....
  • Herpes simplex
    Herpes simplex

    Herpes simplex is a viral disease caused by Herpes simplex viruses; both herpes simplex virus 1 and herpes simplex virus 2 cause herpes simplex....
  • Herpes zoster
    Herpes zoster

    Herpes zoster , commonly known as shingles, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe....
  • Inflammatory bowel disease
    Inflammatory bowel disease

    In medicine, inflammatory bowel disease is a group of inflammation conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis.....
  • Juvenile rheumatoid arthritis
  • Kawasaki's disease
  • Leptospirosis
    Leptospirosis

    Leptospirosis is a infectious disease zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles....
  • Lyme disease
    Lyme disease

    Lyme disease, or borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia....
  • Multiple sclerosis
    Multiple sclerosis

    Multiple sclerosis is an autoimmune disease in which the immune system attacks the central nervous system, leading to demyelinating disease. Disease onset usually occurs in young adults, and it is more common in females....
  • Polyarteritis nodosa
    Polyarteritis nodosa

    Polyarteritis nodosa is a vasculitis of medium-sized arteries, which become swollen and damaged from attack by rogue immune cells. Polyarteritis nodosa is also called Adolph Kussmaul disease or Kussmaul-Rudolf Robert Meier disease....
  • Presumed ocular histoplasmosis syndrome
    Presumed ocular histoplasmosis syndrome

    Presumed ocular histoplasmosis syndrome is a syndrome affecting the eye that is characterized by peripheral atrophic chorioretinal scars, atrophy or scarring adjacent to the optic disc and maculopathy....
  • Psoriatic arthritis
    Psoriatic arthritis

    Psoriatic arthritis is a type of inflammatory arthritis that, according to the National Psoriasis Foundation, affects around 10-30% of people suffering from the chronic skin condition psoriasis....
  • Reiter's syndrome
  • Sarcoidosis
    Sarcoidosis

    Sarcoidosis, also called sarcoid or Besnier-Boeck disease, is a multisystem disorder characterized by non-caseating granulomas . It most commonly arises in young adults....
  • Syphilis
    Syphilis

    Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The route of transmission of syphilis is almost always through sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero....
  • Systemic lupus erythematosus
    Systemic lupus erythematosus

    Systemic lupus erythematosus is a chronic Autoimmunity connective tissue disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body?s cells and tissue, resulting in inflammation and tissue damage....
  • Toxocariasis
    Toxocariasis

    Toxocariasis is a zoonotic, helminthic infection of humans caused by the dog roundworm or cat roundworm . Humans normally become infected by ingestion of embryonated eggs from contaminated sources....
  • Toxoplasmosis
    Toxoplasmosis

    Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii. The parasite infects most genera of warm-blooded animals, including humans, but the primary host is the Felidae....
  • Tuberculosis
    Tuberculosis

    Tuberculosis is a common and often deadly infectious disease caused by mycobacterium, mainly Mycobacterium tuberculosis . Tuberculosis usually attacks the lungs but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal system, bones, joints, and even the...
  • Vitiligo
    Vitiligo

    Vitiligo or leukoderma is a Chronic skin disorder that causes loss of Biological pigment, resulting in irregular pale patches of skin. It occurs when the melanocytes, cells responsible for skin pigmentation, die or are unable to function....
  • Vogt-Koyanagi-Harada syndrome
    Vogt-Koyanagi-Harada syndrome

    Vogt-Koyanagi-Harada syndrome is a condition seen in humans and dogs involving various melanocyte-containing organs, characterized by uveitis , poliosis , vitiligo , and meningitis, although dogs with this syndrome rarely develop meningitis....
  • Whipple disease


Masquerade syndromes

Masquerade 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:
  • Anterior segment
  • Intraocular foreign body
    Foreign body

    In physiology, a foreign body is any object originating outside the body. In machinery, it can mean any unwanted intruding object....
  • Juvenile xanthogranuloma
    Juvenile xanthogranuloma

    Juvenile xanthogranuloma is a form of histiocytosis, classified as "non-Langerhans cell histiocytosis", or more specifically, "type 2"....
  • Leukemia
    Leukemia

    Leukemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation of blood Cell , usually white blood cells ....
  • Malignant melanoma
  • Retinal detachment
    Retinal detachment

    Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness....
  • Retinoblastoma
    Retinoblastoma

    Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light sensitive cells of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers , with more than nine out of every ten sufferers surviving into adulthood....


  • Posterior segment
  • Lymphoma
    Lymphoma

    Lymphoma is a type of cancer that originates in lymphocytes of the immune system. They often originate in lymph nodes, presenting as an enlargement of the node ....
  • Malignant melanoma
  • Multiple sclerosis
    Multiple sclerosis

    Multiple sclerosis is an autoimmune disease in which the immune system attacks the central nervous system, leading to demyelinating disease. Disease onset usually occurs in young adults, and it is more common in females....
  • Reticulum cell sarcoma
  • Retinitis pigmentosa
    Retinitis pigmentosa

    Retinitis pigmentosa is a group of genetic eye conditions. In the progression of symptoms for RP, nyctalopia generally precedes tunnel vision by years or even decades....
  • Retinoblastoma
    Retinoblastoma

    Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light sensitive cells of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers , with more than nine out of every ten sufferers surviving into adulthood....

Symptoms

  • Redness of the eye
  • Blurred vision
  • Sensitivity to light (photophobia)
  • Dark, floating spots along the visual field
  • Eye pain


Treatment

The prognosis is generally good for those who receive prompt diagnosis and treatment, but serious complication (including cataracts, glaucoma
Glaucoma

Glaucoma is a group of diseases of the optic nerve involving loss of ganglion cell in a characteristic pattern of optic atrophy. Raised intraocular pressure is a significant risk factor for developing glaucoma ....
, band keratopathy
Band keratopathy

Band keratopathy is a corneal disease derived from the appearance of calcium on the central cornea. ...
, 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.

Uveitis is typically treated with glucocorticoid
Glucocorticoid

Glucocorticoids are a class of steroid hormones which bind to the glucocorticoid receptor , which is present in almost every animal cell.GCs are part of the feedback mechanism in the immune system which turns immune activity down....
 steroid
Steroid

A steroid is a terpenoid lipid characterized by a carbon skeleton with four fused rings, generally arranged in a 6-6-6-5 fashion.Steroids vary by the functional groups attached to these rings and the oxidation state of the rings....
s, either as topical eye drops (prednisolone acetate) or oral therapy with prednisolone
Prednisolone

Prednisolone is the active metabolite of prednisone....
 tablets. In addition topical cycloplegics, such as atropine
Atropine

Atropine is a tropane alkaloid extracted from deadly nightshade , jimsonweed , Mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a hard drug with a wide variety of effects....
 or homatropine
Homatropine

Homatropine is an anticholinergic medication that inhibits muscarinic acetylcholine receptors and thus the parasympathetic nervous system. It is used in eye drops as a cycloplegic, to temporarily paralyze accommodation , and as a mydriatic, to dilate the pupil....
, may be used. In some cases an injection of PSTTA can also be given to reduce the swelling of the eye.

Antimetabolite
Antimetabolite

An antimetabolite is a chemical that enzyme inhibition the use of a metabolite, which is another chemical that is part of normal metabolism. Such substances are often similar in structure to the metabolite that they interfere with, such as the antifolates that interfere with the use of folic acid....
 medications, such as methotrexate
Methotrexate

Methotrexate , abbreviated MTX and formerly known as amethopterin, is an antimetabolite and antifolate drug used in treatment of cancer and autoimmune diseases....
 are often used for recalcitrant or more aggressive cases of uveitis. Experimental treatment with Infliximab
Infliximab

Infliximab is a drug used to treat autoimmune List of autoimmune diseases. Infliximab is known as a "chimeric monoclonal antibody" . The drug blocks the action of the pleiotropic proinflammatory TNFa by binding to it and preventing it from signaling the receptor for TNFa on the surface of cell ....
 infusions may prove helpful.

Glucosamine
Glucosamine

Glucosamine is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylation proteins and lipids. A type of glucosamine forms chitosan and chitin, which composes the exoskeletons of crustaceans and other arthropods, cell walls in fungi and many higher organisms....
 Sulfate is a non expensive suplement, and has been used in cases of autoimmune diseases. Scientists in Taiwan are currently testing with rats.

See also

  • List of eye diseases and disorders
    List of eye diseases and disorders

    This is a partial list of human eye diseases and disorders.The World Health Organization publishes a classification of known diseases and injuries called the ICD or ICD....
  • List of systemic diseases with ocular manifestations
    List of systemic diseases with ocular manifestations

    This is a list of systemic diseases with ocular manifestations.An ocular manifestation of a systemic disease is an eye condition that directly or indirectly results from a disease process another part of the body....
  • Intermediate uveitis
    Intermediate uveitis

    Intermediate uveitis refers to inflammation localized to the vitreous and peripheral retina. Primary sites of inflammation include the vitreous of which other such entities as pars planitis, posterior cyclitis, and hyalitis are encompassed....


Footnotes


External links