Resumo
Definição
Anamnesis y examen
Principales factores de diagnóstico
- pain (anterior uveitis)
- decreased vision
- synechiae
- flare
- keratic precipitates
Otros factores de diagnóstico
- 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
Factores de riesgo
- inflammatory diseases of the joints, bowel, or skin
- human leukocyte antigen (HLA)-B27 positive
- ocular trauma
- age 20-60 years
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
- slit-lamp biomicroscopy
- tonometry
- gonioscopy
Pruebas diagnósticas que deben considerarse
- visual field testing
- optical coherence tomography (OCT)
- fluorescein angiography
- 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 (ANAs)
- HLA-B27
- Lyme titer
- purified protein derivative (PPD) skin test
- cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA)
- perinuclear antineutrophil 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
- chest x-ray
- real-time polymerase chain reaction (PCR) for ocular infectious disease
- diagnostic vitrectomy biopsy
Algoritmo de tratamiento
noninfectious: initial presentation
infectious
noninfectious: after immediate control of inflammation
Colaboradores
Autores
John J. Huang, MD
President
Connecticut Uveitis Foundation
Associate Clinical Professor
Yale University
New Haven
New England Retina Associates
Hamden
CT
Divulgaciones
JJH declares that he has no competing interests.
Maxwell Elia, MD
Uveitis and Retina Specialist
Medical Eye Center of New Hampshire
Manchester
NH
Divulgaciones
ME declares that he has no competing interests.
Agradecimientos
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.
Divulgaciones
RG, ZV, VLP, and CAM declare that they have no competing interests.
Revisores por pares
Jessica Ackert, MD
Assistant Professor
Ophthalmology
Mount Sinai Hospital
New York
NY
Divulgaciones
JA declares that she has no competing interests.
Anthony J. Hall, MD, FRANZCO
Director of Ophthalmology
Alfred Hospital
Melbourne
Australia
Divulgaciones
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
Divulgaciones
DAJ declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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. Resumen
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. Resumen
Foster CS, Kothari S, Anesi SD, et al. The Ocular Immunology and Uveitis Foundation preferred practice patterns of uveitis management. Surv Ophthalmol. 2016 Jan-Feb;61(1):1-17. Resumen
Dick AD, Rosenbaum JT, Al-Dhibi HA, et al. Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative. Ophthalmology. 2018 May;125(5):757-73.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

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