Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2012

Open Access 01-12-2012 | Research

Uveitis- a rare disease often associated with systemic diseases and infections- a systematic review of 2619 patients

Authors: Talin Barisani-Asenbauer, Saskia M Maca, Lamiss Mejdoubi, Wolfgang Emminger, Klaus Machold, Herbert Auer

Published in: Orphanet Journal of Rare Diseases | Issue 1/2012

Login to get access

Abstract

Background

Uveitis is an autoimmune disease of the eye that refers to any of a number of intraocular inflammatory conditions. Because it is a rare disease, uveitis is often overlooked, and the possible associations between uveitis and extra-ocular disease manifestations are not well known. The aim of this study was to characterize uveitis in a large sample of patients and to evaluate the relationship between uveitis and systemic diseases.

Methods

The present study is a cross-sectional study of a cohort of patients with uveitis. Records from consecutive uveitis patients who were seen by the Uveitis Service in the Department of Ophthalmology at the Medical University of Vienna between 1995 and 2009 were selected from the clinical databases. The cases were classified according to the Standardization of Uveitis Nomenclature Study Group criteria for Uveitis.

Results

Data were available for 2619 patients, of whom 59.9% suffered from anterior, 14.8% from intermediate, 18.3% from posterior and 7.0% from panuveitis. 37.2% of all cases showed an association between uveitis and extra-organ diseases; diseases with primarily arthritic manifestations were seen in 10.1% of all cases, non-infectious systemic diseases (i.e., Behçet´s disease, sarcoidosis or multiple sclerosis) in 8.4% and infectious uveitis in 18.7%. 49.4% of subjects suffering from anterior uveitis tested positively for the HLA-B27 antigen. In posterior uveitis cases 29% were caused by ocular toxoplasmosis and 17.7% by multifocal choroiditis.

Conclusion

Ophthalmologists, rheumatologists, infectiologists, neurologists and general practitioners should be familiar with the differential diagnosis of uveitis. A better interdisciplinary approach could help in tailoring of the work-up, earlier diagnosis of co-existing diseases and management of uveitis patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Nussenblatt RB: The natural history of Uveitis. Int Ophthalmol. 1990, 14: 303-308. 10.1007/BF00163549.CrossRefPubMed Nussenblatt RB: The natural history of Uveitis. Int Ophthalmol. 1990, 14: 303-308. 10.1007/BF00163549.CrossRefPubMed
2.
go back to reference Gritz DC, Wong IG: Incidence and prevalence of uveitis in Northern California: the Northern California Epidemiology of Uveitis Study. Ophthalmology. 2004, 111: 491-500. 10.1016/j.ophtha.2003.06.014.CrossRefPubMed Gritz DC, Wong IG: Incidence and prevalence of uveitis in Northern California: the Northern California Epidemiology of Uveitis Study. Ophthalmology. 2004, 111: 491-500. 10.1016/j.ophtha.2003.06.014.CrossRefPubMed
3.
go back to reference Bodaghi B, Cassoux N, Wechsler B, Hannouche D, Fardeau C, Papo T, Huong DL, Piette JC, LeHoang P: Chronic severe uveitis: etiology and visual outcome in 927 patients from a single center. Medicine (Baltimore). 2001, 80: 263-270. 10.1097/00005792-200107000-00005.CrossRef Bodaghi B, Cassoux N, Wechsler B, Hannouche D, Fardeau C, Papo T, Huong DL, Piette JC, LeHoang P: Chronic severe uveitis: etiology and visual outcome in 927 patients from a single center. Medicine (Baltimore). 2001, 80: 263-270. 10.1097/00005792-200107000-00005.CrossRef
4.
go back to reference Gallagher MJ, Yilmaz T, Cervantes-Castaneda RA, Foster CS: The characteristic features of optical coherence tomography in posterior uveitis. Br J Ophthalmol. 2007, 91: 1680-1685. 10.1136/bjo.2007.124099.PubMedCentralCrossRefPubMed Gallagher MJ, Yilmaz T, Cervantes-Castaneda RA, Foster CS: The characteristic features of optical coherence tomography in posterior uveitis. Br J Ophthalmol. 2007, 91: 1680-1685. 10.1136/bjo.2007.124099.PubMedCentralCrossRefPubMed
5.
go back to reference Cassoux N, Giron A, Bodaghi B, Tran TH, Baudet S, Davy F, Chan CC, Lehoang P, Merle-Béral H: IL-10 measurement in aqueous humor for screening patients with suspicion of primary intraocular lymphoma. Invest Ophthalmol Vis Sci. 2007, 48: 3253-3259. 10.1167/iovs.06-0031.PubMedCentralCrossRefPubMed Cassoux N, Giron A, Bodaghi B, Tran TH, Baudet S, Davy F, Chan CC, Lehoang P, Merle-Béral H: IL-10 measurement in aqueous humor for screening patients with suspicion of primary intraocular lymphoma. Invest Ophthalmol Vis Sci. 2007, 48: 3253-3259. 10.1167/iovs.06-0031.PubMedCentralCrossRefPubMed
6.
go back to reference Menezo V, Bond SK, Towler HM, Kuo NW, Baharlo B, Wilson AG, Lightman S: Cytokine gene polymorphisms involved in chronicity and complications of anterior uveitis. Cytokine. 2006, 35: 200-206. 10.1016/j.cyto.2006.08.003.CrossRefPubMed Menezo V, Bond SK, Towler HM, Kuo NW, Baharlo B, Wilson AG, Lightman S: Cytokine gene polymorphisms involved in chronicity and complications of anterior uveitis. Cytokine. 2006, 35: 200-206. 10.1016/j.cyto.2006.08.003.CrossRefPubMed
7.
go back to reference De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De Boer JH, Schuurman R, Weersink AJ: Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol. 2006, 141: 313-318. 10.1016/j.ajo.2005.09.017.CrossRefPubMed De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De Boer JH, Schuurman R, Weersink AJ: Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol. 2006, 141: 313-318. 10.1016/j.ajo.2005.09.017.CrossRefPubMed
8.
go back to reference Muthiah MN, Michaelides M, Child CS, Mitchell SM: Acute retinal necrosis: a national population based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the United Kingdom. Br J Ophthalmol. 2007, 91: 1452-1455. 10.1136/bjo.2007.114884.PubMedCentralCrossRefPubMed Muthiah MN, Michaelides M, Child CS, Mitchell SM: Acute retinal necrosis: a national population based study to assess the incidence, methods of diagnosis, treatment strategies and outcomes in the United Kingdom. Br J Ophthalmol. 2007, 91: 1452-1455. 10.1136/bjo.2007.114884.PubMedCentralCrossRefPubMed
9.
go back to reference Green LK, Pavan-Langston D: Herpes simplex ocular inflammatory disease. Int Ophthalmol Clin. 2006, 46: 27-37.CrossRefPubMed Green LK, Pavan-Langston D: Herpes simplex ocular inflammatory disease. Int Ophthalmol Clin. 2006, 46: 27-37.CrossRefPubMed
10.
go back to reference Huerva V, Sanchez MC, Canto LM: Post-streptococcal syndrome uveitis. Acta Ophthalmol Scand. 2007, 85: 223-224.CrossRefPubMed Huerva V, Sanchez MC, Canto LM: Post-streptococcal syndrome uveitis. Acta Ophthalmol Scand. 2007, 85: 223-224.CrossRefPubMed
11.
go back to reference Khairallah M, Yahia SB, Ladjimi A, Messaoud R, Zaouali S, Attia S, Jenzeri S, Jelliti B: Pattern of uveitis in a referral centre in Tunisia, North Africa. Eye. 2007, 21: 33-39. 10.1038/sj.eye.6702111.CrossRefPubMed Khairallah M, Yahia SB, Ladjimi A, Messaoud R, Zaouali S, Attia S, Jenzeri S, Jelliti B: Pattern of uveitis in a referral centre in Tunisia, North Africa. Eye. 2007, 21: 33-39. 10.1038/sj.eye.6702111.CrossRefPubMed
12.
go back to reference Soheilian M, Heidari K, Yazdani S, Shahsavari M, Ahmadieh H, Dehghan M: Patterns of uveitis in a tertiary eye care center in Iran. Ocul Immunol Inflamm. 2004, 12: 297-310. 10.1080/092739490500174.CrossRefPubMed Soheilian M, Heidari K, Yazdani S, Shahsavari M, Ahmadieh H, Dehghan M: Patterns of uveitis in a tertiary eye care center in Iran. Ocul Immunol Inflamm. 2004, 12: 297-310. 10.1080/092739490500174.CrossRefPubMed
13.
go back to reference Smith RL, Baarsma GS, de Vries J: Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. Int Ophthalmol. 1993, 17: 71-76. 10.1007/BF00942778.CrossRef Smith RL, Baarsma GS, de Vries J: Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. Int Ophthalmol. 1993, 17: 71-76. 10.1007/BF00942778.CrossRef
14.
go back to reference Tran VT, Auer C, Guex-Crosier Y, Pittet N, Herbort CP: Epidemiological characteristics of uveitis in Switzerland. Int Ophthalmol. 1994-1995, 18: 293-298.CrossRef Tran VT, Auer C, Guex-Crosier Y, Pittet N, Herbort CP: Epidemiological characteristics of uveitis in Switzerland. Int Ophthalmol. 1994-1995, 18: 293-298.CrossRef
15.
go back to reference Guyton JS, Woods AC: Etiology of uveitis: a clinical study of 562 cases. Arch Ophthalmol. 1941, 26: 983-1018. 10.1001/archopht.1941.00870180061004.CrossRef Guyton JS, Woods AC: Etiology of uveitis: a clinical study of 562 cases. Arch Ophthalmol. 1941, 26: 983-1018. 10.1001/archopht.1941.00870180061004.CrossRef
16.
go back to reference Henderly DE, Genstler AJ, Smith RE, Rao NA: Changing patterns of uveitis. Am J Ophthalmol. 1987, 103: 131-136.CrossRefPubMed Henderly DE, Genstler AJ, Smith RE, Rao NA: Changing patterns of uveitis. Am J Ophthalmol. 1987, 103: 131-136.CrossRefPubMed
17.
go back to reference Chang JH, Wakefield D: Uveitis: a global perspective. Ocul Immunol Inflamm. 2002, 10: 263-279. 10.1076/ocii.10.4.263.15592.CrossRefPubMed Chang JH, Wakefield D: Uveitis: a global perspective. Ocul Immunol Inflamm. 2002, 10: 263-279. 10.1076/ocii.10.4.263.15592.CrossRefPubMed
18.
go back to reference Rathinam SR, Namperumalsamy P: Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol. 2007, 55: 173-183. 10.4103/0301-4738.31936.CrossRefPubMed Rathinam SR, Namperumalsamy P: Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol. 2007, 55: 173-183. 10.4103/0301-4738.31936.CrossRefPubMed
20.
go back to reference Rothova A, Suttorp-van Schulten MS, Frits Treffers W, Kijlstra A: Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol. 1996, 80: 332-336. 10.1136/bjo.80.4.332.PubMedCentralCrossRefPubMed Rothova A, Suttorp-van Schulten MS, Frits Treffers W, Kijlstra A: Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol. 1996, 80: 332-336. 10.1136/bjo.80.4.332.PubMedCentralCrossRefPubMed
21.
go back to reference Suttorp-Schulten MS, Rothova A: The possible impact of uveitis in blindness: a literature survey. Br J Ophthalmol. 1996, 80: 844-848. 10.1136/bjo.80.9.844.PubMedCentralCrossRefPubMed Suttorp-Schulten MS, Rothova A: The possible impact of uveitis in blindness: a literature survey. Br J Ophthalmol. 1996, 80: 844-848. 10.1136/bjo.80.9.844.PubMedCentralCrossRefPubMed
22.
go back to reference De Smet MD, Taylor SRJ, Bodaghi B, Miserocchi E, Murray PI, Pleyer U, Zierhut M, Barisani-Asenbauer T, LeHoang P, Lightman S: Understanding uveitis: The impact of research on visual outcomes. Prog Retin Eye Res. 2011, 30: 452-470. 10.1016/j.preteyeres.2011.06.005.CrossRefPubMed De Smet MD, Taylor SRJ, Bodaghi B, Miserocchi E, Murray PI, Pleyer U, Zierhut M, Barisani-Asenbauer T, LeHoang P, Lightman S: Understanding uveitis: The impact of research on visual outcomes. Prog Retin Eye Res. 2011, 30: 452-470. 10.1016/j.preteyeres.2011.06.005.CrossRefPubMed
23.
go back to reference Bloch-Michel E, Nussenblatt RB: International uveitis study group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol. 1987, 103: 234-235.CrossRefPubMed Bloch-Michel E, Nussenblatt RB: International uveitis study group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol. 1987, 103: 234-235.CrossRefPubMed
24.
go back to reference Jabs DA, Nussenblatt RB, Rosenbaum JT: Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005, 140: 509-516.CrossRefPubMed Jabs DA, Nussenblatt RB, Rosenbaum JT: Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005, 140: 509-516.CrossRefPubMed
25.
go back to reference Rothova A, Buitenhuis HJ, Meenken C, Brinkman CJ, Linssen A, Alberts C, Luyendijk L, Kijlstra A: Uveitis and systemic disease. Br J Ophthalmol. 1992, 76: 137-141. 10.1136/bjo.76.3.137.PubMedCentralCrossRefPubMed Rothova A, Buitenhuis HJ, Meenken C, Brinkman CJ, Linssen A, Alberts C, Luyendijk L, Kijlstra A: Uveitis and systemic disease. Br J Ophthalmol. 1992, 76: 137-141. 10.1136/bjo.76.3.137.PubMedCentralCrossRefPubMed
26.
27.
go back to reference Chang JH, McCluskey PJ, Wakefield D: Acute anterior uveitis and HLA-B27. Surv Ophthalmol. 2005, 50: 364-388. 10.1016/j.survophthal.2005.04.003.CrossRefPubMed Chang JH, McCluskey PJ, Wakefield D: Acute anterior uveitis and HLA-B27. Surv Ophthalmol. 2005, 50: 364-388. 10.1016/j.survophthal.2005.04.003.CrossRefPubMed
28.
go back to reference Levinson RD, Rajalingam R, Park MS, Reed EF, Gjertson DW, Kappel PJ, See RF, Rao NA, Holland GN: Human leukocyte antigen A29 subtypes associated with birdshot retinochoroidopathy. Am J Ophthalmol. 2004, 138: 631-634. 10.1016/j.ajo.2004.06.016.CrossRefPubMed Levinson RD, Rajalingam R, Park MS, Reed EF, Gjertson DW, Kappel PJ, See RF, Rao NA, Holland GN: Human leukocyte antigen A29 subtypes associated with birdshot retinochoroidopathy. Am J Ophthalmol. 2004, 138: 631-634. 10.1016/j.ajo.2004.06.016.CrossRefPubMed
29.
go back to reference Zierhut M: Die Diagnostik der Uveitis. Uveitis: Differentialdiagnosen. Edited by: Zierhut M. 1993, Kohlhammer Verlag, Stuttgart, Germany, 15-33. Zierhut M: Die Diagnostik der Uveitis. Uveitis: Differentialdiagnosen. Edited by: Zierhut M. 1993, Kohlhammer Verlag, Stuttgart, Germany, 15-33.
30.
go back to reference McCannel CA, Holland GN, Helm CJ, Cornell PJ, Winston JV, Rimmer TG: Causes of uveitis in the general practice of ophthalmology. UCLA Community-Based Uveitis Study Group. Am J Ophthalmol. 1996, 121: 35-46.CrossRefPubMed McCannel CA, Holland GN, Helm CJ, Cornell PJ, Winston JV, Rimmer TG: Causes of uveitis in the general practice of ophthalmology. UCLA Community-Based Uveitis Study Group. Am J Ophthalmol. 1996, 121: 35-46.CrossRefPubMed
31.
go back to reference Kijlstra A, Rothova A, Baarsma GS, Zaal MJ, Fortuin ME, Schweitzer C, Glasius E, de Jong PT: Computer registration of uveitis patients. Doc Ophthalmol. 1987, 67: 139-143. 10.1007/BF00142708.CrossRefPubMed Kijlstra A, Rothova A, Baarsma GS, Zaal MJ, Fortuin ME, Schweitzer C, Glasius E, de Jong PT: Computer registration of uveitis patients. Doc Ophthalmol. 1987, 67: 139-143. 10.1007/BF00142708.CrossRefPubMed
32.
go back to reference Mortensen KK, Sjolie AK, Goldschmidt E: Uveitis. Eine epidemiologische Untersuchung. Ber Dtsch Ophthalmol Ges. 1981, 78: 97-101. Mortensen KK, Sjolie AK, Goldschmidt E: Uveitis. Eine epidemiologische Untersuchung. Ber Dtsch Ophthalmol Ges. 1981, 78: 97-101.
33.
go back to reference Jakob E, Reuland MS, Mackensen F, Harsch N, Fleckenstein M, Lorenz HM, Max R, Becker MD: Uveitis subtypes in a German interdisciplinary uveitis center — analysis of 1916 patients. J Rheumatol. 2009, 36: 127-136.PubMed Jakob E, Reuland MS, Mackensen F, Harsch N, Fleckenstein M, Lorenz HM, Max R, Becker MD: Uveitis subtypes in a German interdisciplinary uveitis center — analysis of 1916 patients. J Rheumatol. 2009, 36: 127-136.PubMed
34.
go back to reference Päivönsalo-Hietanen T, Tuominen J, Vaahtoranta-Lehtonen H, Saari KM: Incidence and prevalence of different uveitis entities in Finland. Acta Ophthalmol Scand. 1997, 75: 76-81.CrossRefPubMed Päivönsalo-Hietanen T, Tuominen J, Vaahtoranta-Lehtonen H, Saari KM: Incidence and prevalence of different uveitis entities in Finland. Acta Ophthalmol Scand. 1997, 75: 76-81.CrossRefPubMed
35.
go back to reference Päivönsalo-Hietanen T, Vaahtoranta-Lehtonen H, Tuominen J, Saari KM: Uveitis survey at the University Eye Clinic in Turku. Acta Ophthalmol. 1994, 72: 505-512.CrossRef Päivönsalo-Hietanen T, Vaahtoranta-Lehtonen H, Tuominen J, Saari KM: Uveitis survey at the University Eye Clinic in Turku. Acta Ophthalmol. 1994, 72: 505-512.CrossRef
36.
go back to reference Chao JR, Khurana RN, Fawzi AA, Reddy HS, Rao NA: Syphilis: reemergence of an old adversary. Ophthalmology. 2006, 113: 2074-2079. 10.1016/j.ophtha.2006.05.048.CrossRefPubMed Chao JR, Khurana RN, Fawzi AA, Reddy HS, Rao NA: Syphilis: reemergence of an old adversary. Ophthalmology. 2006, 113: 2074-2079. 10.1016/j.ophtha.2006.05.048.CrossRefPubMed
37.
go back to reference Cimino L, Herbort CP, Aldiferi R, Salvarani C, Boiardi L: Tuberculous uveitis, a resurgent and underdiagnosed disease. Int Ophthalmol. 2009, 29: 67-74. 10.1007/s10792-007-9071-8.CrossRefPubMed Cimino L, Herbort CP, Aldiferi R, Salvarani C, Boiardi L: Tuberculous uveitis, a resurgent and underdiagnosed disease. Int Ophthalmol. 2009, 29: 67-74. 10.1007/s10792-007-9071-8.CrossRefPubMed
Metadata
Title
Uveitis- a rare disease often associated with systemic diseases and infections- a systematic review of 2619 patients
Authors
Talin Barisani-Asenbauer
Saskia M Maca
Lamiss Mejdoubi
Wolfgang Emminger
Klaus Machold
Herbert Auer
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2012
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/1750-1172-7-57

Other articles of this Issue 1/2012

Orphanet Journal of Rare Diseases 1/2012 Go to the issue