What is Uveitis? What is Diagnosis and Treatment?

Uveitis in short; It means intraocular inflammation. The eye is an organ with a complex structure consisting of different layers. One of the layers in the eye is the uvea. uvea; It includes the iris, which is the colored part of the eye that plays a role in blood supply, the ciliary body located around the eye lens, and the choroid tissue located at the back of the eye. Uveitis is generally inflammation that occurs in this layer of the eye (1). In addition, in some cases, inflammation may also occur in the retina layer or the white part of the eye (2). Although various infectious diseases, cancers or rheumatic diseases are the main causes of intraocular inflammation, it may not always be possible to determine the exact cause of intraocular inflammation. It is important to make an early diagnosis in the presence of intraocular inflammation, which manifests itself with symptoms such as eye redness, pain, blurred vision, and vision loss. During the treatment of uveitis, treatment methods such as antibiotics or antiviral drugs and the use of eye drops can be used. “What is uveitis, how is it diagnosed?”, “How is uveitis treated?” Questions about uveitis such as these are covered in detail in the following parts of the article.

what is uveitis

What is Uveitis?

Uveitis is a health problem characterized by inflammation of the uvea, the middle layer of the eye, which can be seen in one or both eyes, and is characterized by symptoms such as sensitivity to light, blurred vision and redness. Eye inflammation, a common health problem all over the world, poses a significant threat to eye health, accounting for approximately 10-15% of all blindness cases (3). Although intraocular inflammation, which can affect people of all ages, usually occurs in the vascular-rich uvea layer in the middle part of the eye, in some cases it can also affect other structures within the eye, such as the retina, causing intraocular inflammation. Uveitis, also known as eye inflammation among the public, is an important eye disease that impairs the quality of life of affected people.

What are the symptoms of uveitis?

Uveitis symptoms vary depending on the severity of the disease and in which part of the uvea the inflammation occurs. Common symptoms of uveitis are as follows:

Pain,
Blurry of the image,
Redness in one or both eyes,
Sensitivity to light in the eye,
Floating objects in the eye,
Decrease in vision.

The symptoms listed above may occur over time or suddenly. can also be seen as. If any of these symptoms are noticed, it is important to make an appointment with a specialist doctor without delay in terms of early diagnosis and initiation of treatment.

What Causes Uveitis?

The cause of approximately 38% of uveitis cases is not known exactly. When we look at Western countries, idiopathic uveitis patients, that is, whose cause is unknown, are more common. In Turkey, one of the leading causes of uvetitis is Behçet's disease. This situation suggests to experts that the causes may differ geographically and ethnically (1). The main known causes of uveitis can be listed as follows (1, 2):

Rheumatic diseases such as Behçet and lupus: Behçet's disease causes wounds in the mouth and genital area, arteriosclerosis and eye diseases. It is an autoimmune disease that affects many systems in the body and manifests itself with symptoms such as inflammation. The disease can affect many organs and tissues in the body, especially joints and vessels. Intraocular inflammation is observed in approximately 50-70% of Behçet's patients (1, 4). Like Behçet's disease, butterfly disease, that is, lupus, is one of the rheumatic diseases that can involve many tissues and organs in the body, including the eye.
Infectious diseases:Especially herpes zoster, cytomegalovirus (CMV). Infectious diseases caused by microorganisms such as bacteria, viruses or fungi, such as diarrhea, toxoplasma and syphilis, can also cause inflammation in the eye.
Trauma and Injuries:A trauma or injury to the eye may cause inflammation of the uvea layer.

In addition to those listed above, some medications used may also cause intraocular inflammation.

Who Gets Uveitis?

Unlike eye diseases such as macular degeneration and cataracts, which generally affect people in older age groups, intraocular inflammation can occur in all age groups. Some factors can increase the risk of eye inflammation. These are as follows (5, 6):

Age: Although it is seen at all ages, the risk of intraocular inflammation may be higher, especially in those between the ages of 40-60.
Genetics:Although the studies on this subject are insufficient, according to some studies, the risk may be higher in those with a family history of intraocular inflammation.
Smoking: >There are some studies showing that the risk may be higher in people who smoke.

What are the Types of Uveitis?

Classifying uveitis according to different criteria is important in terms of correctly planning the treatment process of the disease. Experts first make a classification according to the causes. At this point uveitis; It is divided into three classes: unknown cause (idiopathic), infection-related, and non-infectious (usually due to rheumatic diseases). In addition to this classification, today eye inflammation is divided into different classes according to the affected area. The main types of uveitis are as follows:

Anterior uveitis: Anterior uveitis, which accounts for approximately 80% of all cases, is the most common type of intraocular inflammation. In anterior eye inflammation, which manifests itself as inflammation in the front part of the eye, symptoms such as redness and pain in the eyes may begin suddenly. Viruses such as herpes virus (herpes virus) and autoimmune diseases such as Behçet's disease are the main causes of anterior uveitis.
Mid uveitis: Middle uveitis, which usually affects young people, is the inflammation of the middle layer of the eye. It often affects both eyes, and its most important causes include central nervous system diseases such as Multiple sclerosis (MS).
Posterior uveitis: It is the least common and most serious type of eye inflammation. . Symptoms such as eye redness are not common in posterior eye inflammation, which is characterized by inflammation in the inner part of the eye, such as the retina layer. However, vision loss may be more severe.
Panuveitis:Intraocular inflammation may rarely affect the front, middle and back floor of the eye. Health problems such as tuberculosis, brucellosis, lupus, and syphilis can cause inflammation of all three layers of the eye.

Uveitis Diagnosis

Uveitis is a disease that can show severe symptoms in some cases and sometimes have mild symptoms. It is important to diagnose uveitis at an early stage. Otherwise, more serious health problems such as macular edema, cataracts, retinal damage and permanent vision loss may occur. Patients who apply to ophthalmologists with complaints such as eye redness, pain, blurred vision are first physically examined by physicians. In addition, some imaging techniques are also used to diagnose eye inflammation. These methods are as follows (7):

Fundus Fluorescein Angiography:It is a method used to examine the vessels at the back of the eye, that is, at the bottom of the eye, to detect changes in the retina and whether there is inflammation within the eye. It is an imaging method.
Optical Coherence Tomography:It is used to determine whether there is another problem such as macular edema along with eye inflammation.
B- Scan Ultrasonography: Helps examine the back layer of the eye in detail.

Uveitis Treatment

Uveitis treatment physicians first determine the factor causing intraocular inflammation and prepare an appropriate treatment process. While recovery may be faster in early-stage uveitis cases that present with mild symptoms, recovery may take longer in severe cases. The main treatment methods used in the treatment of eye inflammation are as follows:

Antibiotic, antiviral or antifungal drug treatment can help relieve inflammation in intraocular inflammation caused by infection.
Eye drops can cause eye pain and burning.
Medications such as drops containing steroids, injections around the eyes, and creams can help relieve inflammation in the eye.
Steroids or other immunosuppressive drugs, that is, drugs that suppress the immune system, can help relieve autoimmune problems. It may be effective in relieving intraocular inflammation caused by diseases.
In addition to immunosuppressive drugs that target the entire immune system, biological agents that target proteins that are naturally present in the body and play a role in the inflammation process are also used in the treatment of uveitis.

If intraocular inflammation is not treated early, it can cause more serious health problems such as retinal damage and permanent vision loss. If you notice symptoms such as redness, pain, blurred vision in your eyes, do not forget to make an appointment with a specialist ophthalmologist and have the necessary checks done without delay.

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Tarih: 31/07/2023