TREATMENT OF UVEITIS
All the information about Uveitis: Causes, Symptoms and Treatment
WHAT IS UVEITIS?
Ocular uveitis is the inflammation of the uvea, that is, the intermediate layer between the sclera and the retina. It affects the iris, choroid and ciliary body, which is where aqueous humour occurs. The zone of the uvea is very susceptible to infections because there are numerous arteries and blood vessels in that zone that supply blood to the greater part of the ocular globe.
It affects a very small percentage of the population, being more common in young and middle-aged patients, although it can occur at any age.
CAUSES OF UVEITIS
Although currently most of the factors that cause this disease are idiopathic, in some cases it is related to the presence of other pathologies or diseases such as:
- AIDS
- Rheumatoid or reactive arthritis
- Herpes zoster
- Sarcoidosis
- Syphilis
- Toxoplasmosis
- Ankylosing spondylitis
- Behcet's disease
- Cytomegalovirus retinitis
- Psoriasis
TYPES OF UVEITIS
According to its location:
- Anterior uveitis (iritis): is the most frequent within this pathology, inflammation affects the anterior chamber of the eyeball. They are frequently associated with rheumatic diseases, such as spondyloarthropathies and patients with a positive HLA B27 marker.
- Posterior uveitis (choroid): affects the choroid, producing inflammation (choroiditis), but if this inflammation reaches the retina, it will lead to chorioretinitis. Its origin can be a general infection or it can be due to a process of the eye itself (syndrome of white spots).
- Parsplanitis (intermediate uveitis): causes inflammation of the area between the iris and the choroid (pars plana). Its origin is not associated with another general disease, but is a process specific to the eyeball. Although it can also be caused by diseases such as:
- Multiple sclerosis
- Sarcoidosis
- Rheumatic diseases
- Panuveitis (diffuse uveitis): among the different types of uveitis, this is the most serious, since it affects structures such as: retina, choroid, anterior chamber, vitreous cavity and retinal vessels.
Its origin is usually in general diseases such as:
- Sarcoidosis
- Behcet's disease
- Vogt-KOyanagi-Harada syndrome
- Tuberculosis
- Syphilis
- Herpetic infection
SYMPTOMS AND DIAGNOSIS
Depending on the type of uveitis before us, the symptoms of uveitis will vary:
- Anterior uveitis (iritis):
- Red eye
- Eye pain
- Photophobia
- Blurry vision
- Pupil size smaller than that of the other eye
- Posterior uveitis (choroids):
- In this case the eye does not usually redden
- Blurry vision
- Myodesopsias or "floaters"
- Loss of vision, which will be less or greater depending on whether the inflammation is in the retina or choroid.
- Parsplanitis (intermediate uveitis):
- In this case the eye does not usually redden
- Blurry vision
- Myodesopsias or "floaters"
- Loss of vision, which will be less or greater depending on whether the inflammation is in the retina or choroid.
- Panuveitis (diffuse uveitis):
- Red eye
- Loss of vision
- Myodesopsias or "floaters"
TREATMENT OF UVEITIS
- Anterior uveitis (iritis): depending on the origin and the causes, the treatment may include the following drugs.
- Corticosteroid eye drops for inflammation
- Cycloplegic-mydriatic eye drop to dilate the pupil
- Local infiltration of corticosteroids
- Corticosteroid tablets
- Antiviral drugs
- Hypotensive eye drops
- Posterior uveitis (choroids):
- Oral or intravenous anti-infective drugs
- Topical corticosteroids, oral
- Immunosuppressive drugs
- Parsplanitis (intermediate uveitis): depending on whether it affects one eye or both.
- Periocular corticosteroid injections
- Topical corticosteroids, orally
- Vitrectomy: surgical removal of the vitreous may be necessary
- Panuveitis (diffuse uveitis): it is the most complex when treating, the first step is to rule out that the origin is in one of the previously mentioned infections. Among the drugs used for the treatment of panuveitis are:
- Corticosteroids in drops, orally or injections
- Immunosuppressants
- Laser photocoagulation
- Antiangiogenic injections
HOW TO PREVENT ITS APPEARANCE?
To avoid having to resort to a treatment of uveitis or to minimise the risks of this disease, it is essential to assist the ophthalmologist for a complete eye examination. It is important to detect early the cause of the inflammation, since normally these cases are related to other pathologies of the human body.
