- James T Rosenbaum, MD
James T Rosenbaum, MD
- Professor of Ophthalmology, Medicine, and Cell Biology
- Oregon Health & Science University
- Chief of Ophthalmology
- Devers Eye Institute, Portland, Oregon
Intraocular inflammation (ie, uveitis) results from many causes. The approach to therapy depends upon the etiology, location, and severity of the inflammation . The management of a patient with uveitis will require consultation with an ophthalmologist or other specialist in uveal eye disease. Ideally, therapy should be initiated within 24 hours of the onset of acute, anterior uveitis, and infectious causes of uveitis should be treated promptly.
This topic will focus primarily on the treatment of uveitis that is not related to an active infection. A general approach to evaluation and treatment of the patient presenting with a painful red eye is discussed separately. Treatment of uveitis that is due to infection is discussed in more detail in topic reviews that address management of the specific infection. The etiology, clinical manifestations, and diagnostic approach to a patient with uveitis are presented separately. (See "Evaluation of the red eye" and "Uveitis: Etiology, clinical manifestations, and diagnosis".)
The uvea is the middle portion of the eye. The anterior portion of the uvea includes the iris and ciliary body. The pars plana is the tissue just posterior to the ciliary body and just anterior to the retina. The posterior portion of the uvea is known as the choroid (figure 1).
●Inflammation of the anterior uveal tract is called anterior uveitis and is synonymous with iritis. When the adjacent ciliary body is also inflamed, the process is known as iridocyclitis.
●Terms used to describe uveitis posterior to the lens include vitritis, intermediate uveitis, pars planitis, choroiditis, retinitis, chorioretinitis, or retinochoroiditis. Panuveitis refers to inflammation in the anterior chamber, vitreous humor, and choroid or retina simultaneously. The presence of inflammatory cells in the vitreous humor posterior to the lens is termed intermediate uveitis, even though the vitreous humor is not technically part of the uveal tract.
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- Quentin CD, Reiber H. Fuchs heterochromic cyclitis: rubella virus antibodies and genome in aqueous humor. Am J Ophthalmol 2004; 138:46.
- Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 2000; 130:492.
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- Artornsombudh P, Pistilli M, Foster CS, et al. Factors predictive of remission of new-onset anterior uveitis. Ophthalmology 2014; 121:778.
- UVEITIS DUE TO INFECTION
- NONINFECTIOUS UVEITIS
- Initial treatment
- Disease resistant to initial treatment
- - Oral glucocorticoids
- - Antimetabolites or cytotoxic agents
- - Anti-tumor necrosis factor-alpha
- - Intraocular glucocorticoid releasing implant
- Investigational approaches
- Prevention of recurrent episodes
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS