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Uveitis

Última revisão: 26 Sep 2025
Última atualização: 22 Aug 2025

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 20-60 years
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
  • slit-lamp biomicroscopy
  • tonometry
  • gonioscopy
Detalhes completos

Investigações a serem consideradas

  • 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
Detalhes completos

Algoritmo de tratamento

AGUDA

noninfectious: initial presentation

infectious

CONTÍNUA

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

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.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

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

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. Resumo

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  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
  • Diagnósticos diferenciais

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    • Leukemia
    • Intraocular solid tumors
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Vision rehabilitation preferred practice pattern
    • Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative
    Mais Diretrizes
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