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Uveitis

Última revisão: 29 Jun 2025
Última atualização: 10 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • pain (anterior uveitis)
  • decreased vision
  • synechiae
  • flare
  • keratic precipitates
Detalhes completos

Outros fatores diagnósticos

  • tearing
  • photophobia
  • floaters
  • eye redness without discharge
  • constricted or nonreactive pupil
  • decreased intraocular pressure
  • retinal exudates and edema, optic nerve edema
  • retinal vascular sheathing
  • macular edema
  • optic disk swelling
  • retinal hemorrhages
  • ciliary flush
  • corneal edema
  • cataract
Detalhes completos

Fatores de risco

  • inflammatory diseases of the joints, bowel, or skin
  • human leukocyte antigen (HLA)-B27 positive
  • ocular trauma
  • age 30 to 40 years
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Investigações a serem consideradas

  • CBC
  • erythrocyte sedimentation rate (ESR)
  • CRP
  • fluorescent treponemal antibody (FTA-ABS), Venereal Disease Research Laboratory (VDRL), and rapid plasma reagin (RPR)
  • serum ACE
  • antinuclear antibodies
  • HLA-B27
  • Lyme titer
  • purified protein derivative (PPD) skin test
  • cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANCA)
  • perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
  • anti-double-stranded DNA antibody (anti-dsDNA)
  • rheumatoid factor
  • anti-cyclic citrullinated peptide (anti-CCP) antibodies
  • Bartonella henselae titer
  • toxoplasma serologic titer
  • other HLA antigens
  • biochemistry screen
  • CXR
  • polymerase chain reaction (PCR)
Detalhes completos

Novos exames

  • vitreous biopsy

Algoritmo de tratamento

AGUDA

noninfectious, initial presentation: not pregnant

noninfectious, initial presentation: pregnant

infectious

CONTÍNUA

noninfectious, after immediate control of inflammation: not pregnant

noninfectious, after immediate control of inflammation: pregnant

Colaboradores

Autores

John J. Huang, MD

President

Connecticut Uveitis Foundation

Associate Clinical Professor

Yale University

New Haven

New England Retina Associates

Hamden

CT

Declarações

JJH declares that he has no competing interests.

Maxwell Elia, MD

Uveitis and Retina Specialist

Medical Eye Center of New Hampshire

Manchester

NH

Declarações

ME declares that he has no competing interests.

Agradecimentos

Dr John J. Huang and Dr Maxwell Elia would like to gratefully acknowledge Dr Richard Gale, Dr Zsolt Varga, Dr Victor L. Perez, and Dr Carlos A. Medina, the previous contributors to this topic.

Declarações

RG, ZV, VLP, and CAM declare that they have no competing interests.

Revisores

Jessica Ackert, MD

Assistant Professor

Ophthalmology

Mount Sinai Hospital

New York

NY

Declarações

JA declares that she has no competing interests.

Anthony J. Hall, MD, FRANZCO

Director of Ophthalmology

Alfred Hospital

Melbourne

Australia

Declarações

AJH has been reimbursed by Novartis, the manufacturer of Lucentis, for lecture fees. AJH's employer, the Alfred Hospital, has received research funding from Novartis, the manufacturer of Lucentis, and from Bayer, the manufacturer of Eylea.

Daniel A. Johnson, MD

Chairman

Department of Ophthalmology

The University of Texas Health Science Center at San Antonio

San Antonio

TX

Declarações

DAJ declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Deschenes J, Murray PI, Rao NA, et al; International Uveitis Study Group. International Uveitis Study Group (IUSG): clinical classification of uveitis. Ocul Immunol Inflamm. 2008 Jan-Feb;16(1):1-2. Resumo

Jabs DA, Nussenblatt RD, Rosenbaum JT; Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005 Sep;140(3):509-16. Resumo

Kempen JH, Altaweel MM, Holbrook JT, et al; Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group. Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior, and panuveitis: the multicenter uveitis steroid treatment trial. Ophthalmology. 2011 Oct;118(10):1916-26.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Uveitis images
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  • Diretrizes

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    • 2019 American College of Rheumatology/Arthritis Foundation guideline for the screening, monitoring, and treatment of juvenile idiopathic arthritis-associated uveitis
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