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From the JAMA Network
May 14, 2014

Implications of the Pacific Ocular Inflammation Uveitis Epidemiology Study

Author Affiliations
  • 1Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia
  • 2Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
  • 3Casey Eye Institute, Oregon Health and Science University, Portland
  • 4Veterans Affairs Medical Center, Portland, Oregon
JAMA. 2014;311(18):1912-1913. doi:10.1001/jama.2014.2294

Uveitis, defined broadly as inflammation of the uveal tract (iris, ciliary body, and choroid), encompasses inflammation that affects not only the uvea, but also inflammation of related structures including the retina, sclera, and orbit. The differential diagnosis of uveitis includes noninfectious and infectious etiologies, including sarcoidosis, syphilis, tuberculosis, and herpetic infections, although the precise etiology is unknown in many patients. Several associated autoimmune diseases, including HLA-B27–associated spondyloarthropathies and juvenile idiopathic arthritis, most commonly cause anterior uveitis while other conditions, including toxoplasmosis and the herpes family of viruses, may cause panuveitis or posterior uveitis. Slitlamp examination and indirect ophthalmoscopy are required to identify the hallmarks of active inflammation: anterior chamber inflammatory cells and vitreous haze, a proteinaceous clouding of the vitreous caused by breakdown of the blood-ocular barrier. Because uveitis often is associated with local and systemic autoimmunity, a combination of local and systemic immunosuppressive medications (corticosteroids, steroid-sparing medications) may be required to properly manage noninfectious uveitis.

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