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Uveitis

最后审阅: 24 Sep 2025
最后更新: 22 Aug 2025

小结

定义

病史和体格检查

关键诊断因素

  • pain (anterior uveitis)
  • decreased vision
  • synechiae
  • flare
  • keratic precipitates
完整详情

其他诊断因素

  • 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
完整详情

危险因素

  • inflammatory diseases of the joints, bowel, or skin
  • human leukocyte antigen (HLA)-B27 positive
  • ocular trauma
  • age 20-60 years
完整详情

诊断性检查

首要检查

  • clinical diagnosis
  • slit-lamp biomicroscopy
  • tonometry
  • gonioscopy
完整详情

需考虑的检查

  • 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
完整详情

治疗流程

急症处理

noninfectious: initial presentation

infectious

持续性治疗

noninfectious: after immediate control of inflammation

撰稿人

作者

John J. Huang, MD

President

Connecticut Uveitis Foundation

Associate Clinical Professor

Yale University

New Haven

New England Retina Associates

Hamden

CT

利益声明

JJH declares that he has no competing interests.

Maxwell Elia, MD

Uveitis and Retina Specialist

Medical Eye Center of New Hampshire

Manchester

NH

利益声明

ME declares that he has no competing interests.

鸣谢

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.

利益声明

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

同行评议者

Jessica Ackert, MD

Assistant Professor

Ophthalmology

Mount Sinai Hospital

New York

NY

利益声明

JA declares that she has no competing interests.

Anthony J. Hall, MD, FRANZCO

Director of Ophthalmology

Alfred Hospital

Melbourne

Australia

利益声明

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

利益声明

DAJ declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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. 摘要

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. 摘要

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. 摘要

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.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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    • Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative
    更多 指南
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