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. 1984 Mar;140(3):421–432.

Uveitis—A Review

Careen Y Lowder, Devron H Char
PMCID: PMC1021702  PMID: 6369795

Abstract

Uveitis is the term used to describe most intraocular inflammations. The classification of uveitis into anterior, posterior and diffuse is based on the physical appearance of an inflamed eye. Diagnosis is usually on the basis of a thorough history, a review of systems to uncover any systemic diseases known to be associated with uveitis and a complete eye examination. We review the most common types of uveitis, the pertinent laboratory investigations and different therapeutic aspects.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ACERS T. E. TOXOPLASMIC RETINOCHOROIDITIS: A DOUBLE BLIND THERAPEUTIC STUDY. Arch Ophthalmol. 1964 Jan;71:58–62. doi: 10.1001/archopht.1964.00970010074010. [DOI] [PubMed] [Google Scholar]
  2. Abrams J., Schlaegel T. F., Jr The role of the isoniazid therapeutic test in tuberculous uveitis. Am J Ophthalmol. 1982 Oct;94(4):511–515. doi: 10.1016/0002-9394(82)90245-8. [DOI] [PubMed] [Google Scholar]
  3. Aguilar G. L., Blumenkrantz M. S., Egbert P. R., McCulley J. P. Candida endophthalmitis after intravenous drug abuse. Arch Ophthalmol. 1979 Jan;97(1):96–100. doi: 10.1001/archopht.1979.01020010036008. [DOI] [PubMed] [Google Scholar]
  4. Andrews B. S., McIntosh J., Petts V., Penny R. Circulating immune complexes in acute uveitis: a possible association with the histocompatibility complex locus antigen B27. Int Arch Allergy Appl Immunol. 1979;58(3):313–321. doi: 10.1159/000232207. [DOI] [PubMed] [Google Scholar]
  5. Argon laser photocoagulation for senile macular degeneration. Results of a randomized clinical trial. Arch Ophthalmol. 1982 Jun;100(6):912–918. doi: 10.1001/archopht.1982.01030030920003. [DOI] [PubMed] [Google Scholar]
  6. Azar H. A., Jaffe E. S., Berard C. W., Callihan T. R., Braylan R. R., Cossman J., Triche T. J. Diffuse large cell lymphomas (reticulum cell sarcomas, histiocytic lymphomas). Correlation of morphologic features with functional markers. Cancer. 1980 Sep 15;46(6):1428–1441. doi: 10.1002/1097-0142(19800915)46:6<1428::aid-cncr2820460624>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  7. Bachman D. M., Rodrigues M. M., Chu F. C., Straus S. E., Cogan D. G., Macher A. M. Culture-proven cytomegalovirus retinitis in a homosexual man with the acquired immunodeficiency syndrome. Ophthalmology. 1982 Jul;89(7):797–804. doi: 10.1016/s0161-6420(82)34733-8. [DOI] [PubMed] [Google Scholar]
  8. Biglan A. W., Glickman L. T., Lobes L. A., Jr Serum and vitreous Toxocara antibody in nematode endophthalmitis. Am J Ophthalmol. 1979 Nov;88(5):898–901. doi: 10.1016/0002-9394(79)90568-3. [DOI] [PubMed] [Google Scholar]
  9. Char D. H., Margolis L., Newman A. B. Ocular reticulum cell sarcoma. Am J Ophthalmol. 1981 Apr;91(4):480–483. doi: 10.1016/0002-9394(81)90236-1. [DOI] [PubMed] [Google Scholar]
  10. Char D. H., Stein P., Masi R., Christensen M. Immune complexes in uveitis. Am J Ophthalmol. 1979 May;87(5):678–681. doi: 10.1016/0002-9394(79)90303-9. [DOI] [PubMed] [Google Scholar]
  11. Coppeto J., Lessell S. Retinopathy in systemic lupus erythematosus. Arch Ophthalmol. 1977 May;95(5):794–797. doi: 10.1001/archopht.1977.04450050072005. [DOI] [PubMed] [Google Scholar]
  12. Davis K. C., Horsburgh C. R., Jr, Hasiba U., Schocket A. L., Kirkpatrick C. H. Acquired immunodeficiency syndrome in a patient with hemophilia. Ann Intern Med. 1983 Mar;98(3):284–286. doi: 10.7326/0003-4819-98-3-284. [DOI] [PubMed] [Google Scholar]
  13. Dawson C. R., Schachter J., Ostler H. B., Gilbert R. M., Smith D. E., Engleman E. P. Inclusion conjunctivitis and Reiter's syndrome in a married couple. Chlamydia infections in a series of both diseases. Arch Ophthalmol. 1970 Mar;83(3):300–306. doi: 10.1001/archopht.1970.00990030302006. [DOI] [PubMed] [Google Scholar]
  14. De Venecia G., Zu Rhein G. M., Pratt M. V., Kisken W. Cytomegalic inclusion retinitis in an adult. Arch Ophthalmol. 1971 Jul;86(1):44–57. doi: 10.1001/archopht.1971.01000010046010. [DOI] [PubMed] [Google Scholar]
  15. Dernouchamps J. P., Vaerman J. P., Michiels J., Masson P. L. Immune complexes in the aqueous humor and serum. Am J Ophthalmol. 1977 Jul;84(1):24–31. doi: 10.1016/0002-9394(77)90319-1. [DOI] [PubMed] [Google Scholar]
  16. Druery C., Bashir H., Geczy A. F., Alexander K., Edmonds J. Search for Klebsiella cell wall components cross-reactive with lymphocytes of B27+ AS+ individuals. Hum Immunol. 1980 Sep;1(2):151–160. doi: 10.1016/0198-8859(80)90102-0. [DOI] [PubMed] [Google Scholar]
  17. Edmonds J., Macauley D., Tyndall A., Liew M., Alexander K., Geczy A., Bashir H. Lymphocytotoxicity of anti-Klebsiella antisera in ankylosing spondylitis and related arthropathies: patient and family studies. Arthritis Rheum. 1981 Jan;24(1):1–7. doi: 10.1002/art.1780240101. [DOI] [PubMed] [Google Scholar]
  18. Egbert P. R., Pollard R. B., Gallagher J. G., Merigan T. C. Cytomegalovirus retinitis in immunosuppressed hosts. II. Ocular manifestations. Ann Intern Med. 1980 Nov;93(5):664–670. doi: 10.7326/0003-4819-93-5-664. [DOI] [PubMed] [Google Scholar]
  19. Ersoy F., Berkel I., Firat T., Kazokoğlu H. HLA antigens associated with Behçet's disease. Arch Dermatol. 1977 Dec;113(12):1720–1721. [PubMed] [Google Scholar]
  20. Gamble C. N., Wiesner K. B., Shapiro R. F., Boyer W. J. The immune complex pathogenesis of glomerulonephritis and pulmonary vasculitis in Behçet's disease. Am J Med. 1979 Jun;66(6):1031–1039. doi: 10.1016/0002-9343(79)90461-3. [DOI] [PubMed] [Google Scholar]
  21. Gilbert G. J. Herpes zoster ophthalmicus and delayed contralateral hemiparesis. Relationship of the syndrome to central nervous system granulomatous angiitis. JAMA. 1974 Jul 15;229(3):302–304. [PubMed] [Google Scholar]
  22. Gottlieb M. S., Schroff R., Schanker H. M., Weisman J. D., Fan P. T., Wolf R. A., Saxon A. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med. 1981 Dec 10;305(24):1425–1431. doi: 10.1056/NEJM198112103052401. [DOI] [PubMed] [Google Scholar]
  23. Griffin J. R. Ocular indicator for Candida endophthalmitis. Arch Ophthalmol. 1978 Jun;96(6):1095–1095. doi: 10.1001/archopht.1978.03910050605026. [DOI] [PubMed] [Google Scholar]
  24. Griffin J. R., Pettit T. H., Fishman L. S., Foos R. Y. Blood-borne Candida endophthalmitis. A clinical and pathologic study of 21 cases. Arch Ophthalmol. 1973 Jun;89(6):450–456. doi: 10.1001/archopht.1973.01000040452002. [DOI] [PubMed] [Google Scholar]
  25. Gupta R. C., O'Duffy J. D., McDuffie F. C., Meurer M., Jordon R. E. Circulating immune complexes in active Behçet's disease. Clin Exp Immunol. 1978 Nov;34(2):213–218. [PMC free article] [PubMed] [Google Scholar]
  26. HOGAN M. J., KIMURA S. J., THYGESON P. Signs and symptoms of uveitis. I. Anterior uveitis. Am J Ophthalmol. 1959 May;47(5 Pt 2):155–170. doi: 10.1016/s0002-9394(14)78239-x. [DOI] [PubMed] [Google Scholar]
  27. Holland G. N., Gottlieb M. S., Yee R. D., Schanker H. M., Pettit T. H. Ocular disorders associated with a new severe acquired cellular immunodeficiency syndrome. Am J Ophthalmol. 1982 Apr;93(4):393–402. doi: 10.1016/0002-9394(82)90127-1. [DOI] [PubMed] [Google Scholar]
  28. James D. G. Behcet's syndrome. N Engl J Med. 1979 Aug 23;301(8):431–432. doi: 10.1056/NEJM197908233010811. [DOI] [PubMed] [Google Scholar]
  29. James D. G., Spiteri M. A. Behçet's disease. Ophthalmology. 1982 Nov;89(11):1279–1284. doi: 10.1016/s0161-6420(82)34644-8. [DOI] [PubMed] [Google Scholar]
  30. Korelitz B. I., Coles R. S. Uveitis (iritis) associated with ulcerative and granulomatous colitis. Gastroenterology. 1967 Jan;52(1):78–82. [PubMed] [Google Scholar]
  31. Kwok S., O'Donnell J. J., Wood I. S. Retinal cotton-wool spots in a patient with Pneumocystis carinii infection. N Engl J Med. 1982 Jul 15;307(3):184–185. doi: 10.1056/NEJM198207153070313. [DOI] [PubMed] [Google Scholar]
  32. Laurent M. R., Panayi G. S., Shepherd P. Circulating immune complexes, serum immunoglobulins, and acute phase proteins in psoriasis and psoriatic arthritis. Ann Rheum Dis. 1981 Feb;40(1):66–69. doi: 10.1136/ard.40.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Lawley T. J., James S. P., Jones E. A. Circulating immune complexes: their detection and potential significance in some hepatobiliary and intestinal diseases. Gastroenterology. 1980 Mar;78(3):626–641. [PubMed] [Google Scholar]
  34. Levinsky R. J., Lehner T. Circulating soluble immume complexes in recurrent oral ulceration and Behçet's syndrome. Clin Exp Immunol. 1978 May;32(2):193–198. [PMC free article] [PubMed] [Google Scholar]
  35. Loewenfeld I. E., Thompson H. S. Fuchs's heterochromic cyclitis: A critical review of the literature. I. Clinical characteristics of the syndrome. Surv Ophthalmol. 1973 May-Jun;17(6):394–457. [PubMed] [Google Scholar]
  36. Macoul K. L. Ocular changes in granulomatous ileocolitis. Arch Ophthalmol. 1970 Jul;84(1):95–97. doi: 10.1001/archopht.1970.00990040097023. [DOI] [PubMed] [Google Scholar]
  37. Mamo J. G., Azzam S. A. Treatment of Behçet's disease with chlorambucil. Arch Ophthalmol. 1970 Oct;84(4):446–450. doi: 10.1001/archopht.1970.00990040448008. [DOI] [PubMed] [Google Scholar]
  38. Melamed S., Lahav M., Sandbank U., Yassur Y., Ben-Sira I. Fuch's heterochromic iridocyclitis: an electron microscopic study of the iris. Invest Ophthalmol Vis Sci. 1978 Dec;17(12):1193–1199. [PubMed] [Google Scholar]
  39. Miyachi Y., Taniguchi S., Ozaki M., Horio T. Colchicine in the treatment of the cutaneous manifestations of Behçet's disease. Br J Dermatol. 1981 Jan;104(1):67–69. doi: 10.1111/j.1365-2133.1981.tb01713.x. [DOI] [PubMed] [Google Scholar]
  40. Neuwirth J., Gutman I., Hofeldt A. J., Behrens M., Marquardt M. D., Abramovsky-Kaplan I., Kelsey P., Odel J. Cytomegalovirus retinitis in a young homosexual male with acquired immunodeficiency. Ophthalmology. 1982 Jul;89(7):805–808. doi: 10.1016/s0161-6420(82)34732-6. [DOI] [PubMed] [Google Scholar]
  41. Nichols C. W., Eagle R. C., Jr, Yanoff M., Menocal N. G. Conjunctival biopsy as an aid in the evaluation of the patient with suspected sarcoidosis. Ophthalmology. 1980 Apr;87(4):287–291. doi: 10.1016/s0161-6420(80)35236-6. [DOI] [PubMed] [Google Scholar]
  42. Nosal A., Schleissner L. A., Mishkin F. S., Lieberman J. Angiotensin-I-converting enzyme and gallium scan in noninvasive evaluation of sarcoidosis. Ann Intern Med. 1979 Mar;90(3):328–331. doi: 10.7326/0003-4819-90-3-328. [DOI] [PubMed] [Google Scholar]
  43. O Connor G. R. The infleunce of hypersensitivity on the pathogenesis of ocular toxoplasmosis. Trans Am Ophthalmol Soc. 1970;68:501–547. [PMC free article] [PubMed] [Google Scholar]
  44. O'Connor G. R., Frenkel J. K. Editorial: Dangers of steroid treatment in toxoplasmosis. Periocular injections and systemic therapy. Arch Ophthalmol. 1976 Feb;94(2):213–213. doi: 10.1001/archopht.1976.03910030093001. [DOI] [PubMed] [Google Scholar]
  45. Obenauf C. D., Shaw H. E., Sydnor C. F., Klintworth G. K. Sarcoidosis and its ophthalmic manifestations. Am J Ophthalmol. 1978 Nov;86(5):648–655. doi: 10.1016/0002-9394(78)90184-8. [DOI] [PubMed] [Google Scholar]
  46. Oh J. O. Primary and secondary herpes simplex uveitis in rabbits. Surv Ophthalmol. 1976 Sep-Oct;21(2):178–184. doi: 10.1016/0039-6257(76)90097-7. [DOI] [PubMed] [Google Scholar]
  47. Ohno S., Char D. H., Kimura S. J., O'Connor G. R. HLA antigens and antinuclear antibody titres in juvenile chronic iridocyclitis. Br J Ophthalmol. 1977 Jan;61(1):59–61. doi: 10.1136/bjo.61.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Ohno S., Char D. H., Kimura S. J., O'Connor G. R. Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. 1977 May;83(5):735–740. doi: 10.1016/0002-9394(77)90142-8. [DOI] [PubMed] [Google Scholar]
  49. Ono S., Aoki K., Sugiura S., Nakayama E., Itakura K. Letter: HL-A5 and Behçet's disease. Lancet. 1973 Dec 15;2(7842):1383–1384. doi: 10.1016/s0140-6736(73)93343-6. [DOI] [PubMed] [Google Scholar]
  50. Pollard Z. F., Jarrett W. H., Hagler W. S., Allain D. S., Schantz P. M. ELISA for diagnosis of ocular toxocariasis. Ophthalmology. 1979 May;86(5):743–752. doi: 10.1016/s0161-6420(79)35465-3. [DOI] [PubMed] [Google Scholar]
  51. Retinal cotton-wool patches in acquired immunodeficiency syndrome. N Engl J Med. 1982 Dec 30;307(27):1704–1705. doi: 10.1056/NEJM198212303072710. [DOI] [PubMed] [Google Scholar]
  52. Robb R. M., Ervin L. D., Sallan S. E. A pathological study of eye involvement in acute leukemia of childhood. Trans Am Ophthalmol Soc. 1978;76:90–101. [PMC free article] [PubMed] [Google Scholar]
  53. Russell A. S. Arthritis, inflammatory bowel disease, and histocompatibility antigens. Ann Intern Med. 1977 Jun;86(6):820–821. doi: 10.7326/0003-4819-86-6-820. [DOI] [PubMed] [Google Scholar]
  54. Russell A. S., Lentle B. C., Percy J. S., Jackson F. I. Scintigraphy of sacroiliac joints in acute anterior uveitis. A study of thirty patients. Ann Intern Med. 1976 Nov;85(5):606–608. doi: 10.7326/0003-4819-85-5-606. [DOI] [PubMed] [Google Scholar]
  55. Scharf Y., Zonis S. Histocompatibility antigens (HLA) and uveitis. Surv Ophthalmol. 1980 Jan-Feb;24(4):220–228. doi: 10.1016/0039-6257(80)90043-0. [DOI] [PubMed] [Google Scholar]
  56. Schlaegel T. F., Jr, Kao S. F. A review (1970-1980) of 28 presumptive cases of syphilitic uveitis. Am J Ophthalmol. 1982 Apr;93(4):412–414. doi: 10.1016/0002-9394(82)90129-5. [DOI] [PubMed] [Google Scholar]
  57. Schlaegel T. F., Jr, O'Connor G. R. Tuberculosis and syphilis. Arch Ophthalmol. 1981 Dec;99(12):2206–2207. doi: 10.1001/archopht.1981.03930021082022. [DOI] [PubMed] [Google Scholar]
  58. Schwartz L. K., O'Connor G. R. Secondary syphilis with iris papules. Am J Ophthalmol. 1980 Sep;90(3):380–384. doi: 10.1016/s0002-9394(14)74921-9. [DOI] [PubMed] [Google Scholar]
  59. Shields J. A., McDonald P. R., Leonard B. C., Canny C. L. The diagnosis of uveal malignant melanomas in eyes with opaque media. Am J Ophthalmol. 1977 Jan;83(1):95–105. doi: 10.1016/0002-9394(77)90196-9. [DOI] [PubMed] [Google Scholar]
  60. Shimada K., Kogure M., Kawashima T., Nishioka K. Reduction of complement in Behçet's disease and drug allergy. Med Biol. 1974 Aug;52(4):234–239. [PubMed] [Google Scholar]
  61. Siegal F. P., Lopez C., Hammer G. S., Brown A. E., Kornfeld S. J., Gold J., Hassett J., Hirschman S. Z., Cunningham-Rundles C., Adelsberg B. R. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981 Dec 10;305(24):1439–1444. doi: 10.1056/NEJM198112103052403. [DOI] [PubMed] [Google Scholar]
  62. Simpson G. V. Diagnosis and treatment of uveitis in association with sarcoidosis. Trans Am Ophthalmol Soc. 1968;66:117–141. [PMC free article] [PubMed] [Google Scholar]
  63. Smith R. E., Godfrey W. A., Kimura S. J. Complications of chronic cyclitis. Am J Ophthalmol. 1976 Aug;82(2):277–282. doi: 10.1016/0002-9394(76)90434-7. [DOI] [PubMed] [Google Scholar]
  64. Snyder D. A., Tessler H. H. Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. 1980 Jul;90(1):69–75. [PubMed] [Google Scholar]
  65. Stone R. D., Irvine A. R., O'Connor G. R. Candida endophthalmitis: report of an unusual case with isolation of the etiologic agent by vitreous biopsy. Ann Ophthalmol. 1975 Jun;7(6):757–762. [PubMed] [Google Scholar]
  66. Studdy P., Bird R., James D. G. Serum angiotensin-converting enzyme (SACE) in sarcoidosis and other granulomatous disorders. Lancet. 1978 Dec 23;2(8104-5):1331–1334. doi: 10.1016/s0140-6736(78)91972-4. [DOI] [PubMed] [Google Scholar]
  67. Sullivan S. F., Dallow R. I. Intraocular reticulum cell sarcoma: its dramatic response to systemic chemotherapy and its angiogenic potential. Ann Ophthalmol. 1977 Apr;9(4):401–406. [PubMed] [Google Scholar]
  68. Tabbara K. F., O'Connor G. R. Treatment of ocular toxoplasmosis with clindamycin and sulfadiazine. Ophthalmology. 1980 Feb;87(2):129–134. doi: 10.1016/s0161-6420(80)35268-8. [DOI] [PubMed] [Google Scholar]
  69. Tagawa Y., Sugiura S., Yakura H., Wakisaka A., Aizawa M. Letter: HLA and Vogt-Koyanagh-Harada syndrome. N Engl J Med. 1976 Jul 15;295(3):173–173. doi: 10.1056/NEJM197607152950322. [DOI] [PubMed] [Google Scholar]
  70. Weinberg R. S., Tessler H. H. Serum lysozyme in sarcoid uveitis. Am J Ophthalmol. 1976 Jul;82(1):105–108. doi: 10.1016/0002-9394(76)90673-5. [DOI] [PubMed] [Google Scholar]
  71. Weinreb R. N., Barth R., Kimura S. J. Limited gallium scans and angiotensin converting enzyme in granulomatous uveitis. Ophthalmology. 1980 Mar;87(3):202–209. doi: 10.1016/s0161-6420(80)35261-5. [DOI] [PubMed] [Google Scholar]
  72. Weinreb R. N., Kimura S. J. Uveitis associated with sarcoidosis and angiotensin converting enzyme. Am J Ophthalmol. 1980 Feb;89(2):180–185. doi: 10.1016/0002-9394(80)90109-9. [DOI] [PubMed] [Google Scholar]
  73. Womack L. W., Liesegang T. J. Complications of herpes zoster ophthalmicus. Arch Ophthalmol. 1983 Jan;101(1):42–45. doi: 10.1001/archopht.1983.01040010044004. [DOI] [PubMed] [Google Scholar]
  74. Yakura H., Wakisaka A., Aizawa M., Itakura K., Tagawa Y. HLA-D antigen of Japanese origin (LD-Wa) and its association with Vogt-Koyanagi-Harada syndrome. Tissue Antigens. 1976 Jul;8(1):35–42. doi: 10.1111/j.1399-0039.1976.tb00549.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Yazici H., Chamberlain M. A., Schreuder I., D'Amaro J., Muftuoglu M. HLA antigens in Behçet's disease: a reappraisal by a comparative study of Turkish and British patients. Ann Rheum Dis. 1980 Aug;39(4):344–348. doi: 10.1136/ard.39.4.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  76. ZSCHEILE F. P. RECURRENT TOXOPLASMIC RETINITIS WITH WEAKLY POSITIVE METHYLENE BLUE DYE TEST. Arch Ophthalmol. 1964 May;71:645–648. doi: 10.1001/archopht.1964.00970010661009. [DOI] [PubMed] [Google Scholar]

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