From the Guidelines
Uveitis is typically characterized by physical findings such as redness of the eye, pain, photophobia, blurred vision, and constricted pupil, with cells and flare in the anterior chamber, keratic precipitates, synechiae, and hypopyon in severe cases, as noted in the 2019 American College of Rheumatology guideline 1. The physical findings of uveitis can vary based on the anatomical location and underlying cause of the inflammation.
- Anterior uveitis may present with symptoms such as eye pain, redness, and photophobia, as well as signs like cells and flare in the anterior chamber, and keratic precipitates on the corneal endothelium 1.
- Posterior uveitis, on the other hand, may exhibit findings like vitreous cells, retinal vasculitis, chorioretinal lesions, and optic disc edema 1. Intraocular pressure may be elevated or decreased depending on the type and stage of uveitis.
- It is essential to promptly diagnose and treat uveitis to prevent complications like cataracts, glaucoma, macular edema, and permanent vision loss, with treatment typically involving corticosteroids and potentially immunosuppressive agents or antimicrobials 1. The American College of Rheumatology guideline recommends regular ophthalmology screening and monitoring of children with uveitis, with treatment initiated with topical glucocorticoids and potentially escalated to systemic therapy with methotrexate or tumor necrosis factor inhibitors like adalimumab and infliximab 1.
From the FDA Drug Label
The primary efficacy endpoint in both studies was ´time to treatment failure´ Treatment failure was a multi-component outcome defined as the development of new inflammatory chorioretinal and/or inflammatory retinal vascular lesions, an increase in anterior chamber (AC) cell grade or vitreous haze (VH) grade or a decrease in best corrected visual acuity (BCVA)
The physical findings of uveitis include:
- Inflammatory chorioretinal lesions
- Inflammatory retinal vascular lesions
- Increased anterior chamber (AC) cell grade
- Increased vitreous haze (VH) grade
- Decrease in best corrected visual acuity (BCVA) 2
From the Research
Uveitis Physical Findings
- Uveitis is characterized by inflammation of the uvea, causing eye redness, pain, photophobia, floaters, and blurred vision 3
- The condition can lead to complications such as cataracts, glaucoma, macular edema, retinal detachment, optic nerve damage, and vision loss if left untreated 3
- Uveitis can be classified into different types, including anterior, intermediate, posterior, and panuveitis, each affecting different parts of the eye 3
Symptoms and Classification
- Anterior uveitis affects the iris and ciliary body, accounting for 41%-60% of cases 3
- Intermediate uveitis affects the pars plana and peripheral retina, accounting for 9%-15% of cases 3
- Posterior uveitis involves the choroid and/or retina, accounting for 17%-23% of cases 3
- Panuveitis involves all uveal layers, accounting for 7%-32% of cases 3
Treatment and Management
- Corticosteroids are the first line of therapy for noninfectious ocular inflammatory disease, including uveitis 4, 5
- Topical corticosteroids are typically used for anterior uveitis, while periocular or intravitreal agents are used for intermediate or posterior intraocular inflammation 4
- Systemic corticosteroids may be required for vision-threatening uveitis, bilateral inflammation, or uveitis occurring in the setting of systemic involvement 4
- Immunomodulatory therapy, such as methotrexate and adalimumab, may be used in cases where corticosteroids are not effective or have significant side effects 3, 6, 7