Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1997 Oct;81(10):827–831. doi: 10.1136/bjo.81.10.827

Uveitis in the elderly—is it easy to identify the masquerade?

P ZAMIRI 1, S BOYD 1, S LIGHTMAN 1
PMCID: PMC1722034  PMID: 9486020

Full Text

The Full Text of this article is available as a PDF (100.2 KB).

Figure 1  .

Figure 1  

Classic appearance of Propionibacterium acnes endophthalmitis.

Figure 2  .

Figure 2  

Propionibacterium acnes seen on specimen of posterior capsule.

Figure 3  .

Figure 3  

Vitritis in patient with intraocular lymphoma.

Figure 4  .

Figure 4  

B cells stained with anti-CD20 monoclonal antibody found on vitreous aspirate.

Selected References

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

  1. Ambler J. S., Meisler D. M., Zakov Z. N., Hall G. S., Spech T. J. Endogenous Mycobacterium chelonae endophthalmitis. Am J Ophthalmol. 1989 Sep 15;108(3):338–339. doi: 10.1016/0002-9394(89)90136-0. [DOI] [PubMed] [Google Scholar]
  2. Barr C. C., Joondeph H. C. Retinal periphlebitis as the initial clinical finding in a patient with Hodgkin's disease. Retina. 1983 Fall-Winter;3(4):253–257. doi: 10.1097/00006982-198300340-00003. [DOI] [PubMed] [Google Scholar]
  3. Barton K., Pavesio C. E., Towler H. M., Lightman S. Uveitis presenting de novo in the elderly. Eye (Lond) 1994;8(Pt 3):288–291. doi: 10.1038/eye.1994.59. [DOI] [PubMed] [Google Scholar]
  4. Bottazzo G. F., Pujol-Borrell R., Hanafusa T., Feldmann M. Role of aberrant HLA-DR expression and antigen presentation in induction of endocrine autoimmunity. Lancet. 1983 Nov 12;2(8359):1115–1119. doi: 10.1016/s0140-6736(83)90629-3. [DOI] [PubMed] [Google Scholar]
  5. Busin M., Cusumano A., Spitznas M. Intraocular lens removal from eyes with chronic low-grade endophthalmitis. J Cataract Refract Surg. 1995 Nov;21(6):679–684. doi: 10.1016/s0886-3350(13)80566-4. [DOI] [PubMed] [Google Scholar]
  6. Busin M., Meller D., Cusumano A., Spitznas M. Die chronische Low-grade-Endophthalmitis. Eine wachsende Indikation zur Explantation von Intraokularlinsen. Ophthalmologe. 1994 Aug;91(4):473–478. [PubMed] [Google Scholar]
  7. Chan C. C., Whitcup S. M., Solomon D., Nussenblatt R. B. Interleukin-10 in the vitreous of patients with primary intraocular lymphoma. Am J Ophthalmol. 1995 Nov;120(5):671–673. doi: 10.1016/s0002-9394(14)72217-2. [DOI] [PubMed] [Google Scholar]
  8. Char D. H., Ljung B. M., Deschênes J., Miller T. R. Intraocular lymphoma: immunological and cytological analysis. Br J Ophthalmol. 1988 Dec;72(12):905–911. doi: 10.1136/bjo.72.12.905. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Char D. H., Ljung B. M., Miller T., Phillips T. Primary intraocular lymphoma (ocular reticulum cell sarcoma) diagnosis and management. Ophthalmology. 1988 May;95(5):625–630. doi: 10.1016/s0161-6420(88)33145-3. [DOI] [PubMed] [Google Scholar]
  10. Chien A. M., Raber I. M., Fischer D. H., Eagle R. C., Jr, Naidoff M. A. Propionibacterium acnes endophthalmitis after intracapsular cataract extraction. Ophthalmology. 1992 Apr;99(4):487–490. doi: 10.1016/s0161-6420(92)31923-2. [DOI] [PubMed] [Google Scholar]
  11. Corriveau C., Easterbrook M., Payne D. Lymphoma simulating uveitis (masquerade syndrome). Can J Ophthalmol. 1986 Jun;21(4):144–149. [PubMed] [Google Scholar]
  12. Fattal-German M. L'immunocompétence chez les personnes âgées. Ann Pharm Fr. 1992;50(1):13–24. [PubMed] [Google Scholar]
  13. Favre C., Tran V. T., Herbort C. P. Uvéite de la personne âgée. Klin Monbl Augenheilkd. 1994 May;204(5):319–322. doi: 10.1055/s-2008-1035548. [DOI] [PubMed] [Google Scholar]
  14. Ferry A. P., Font R. L. Carcinoma metastatic to the eye and orbit. I. A clinicopathologic study of 227 cases. Arch Ophthalmol. 1974 Oct;92(4):276–286. doi: 10.1001/archopht.1974.01010010286003. [DOI] [PubMed] [Google Scholar]
  15. Ficker L., Meredith T. A., Wilson L. A., Kaplan H. J., Kozarsky A. M. Chronic bacterial endophthalmitis. Am J Ophthalmol. 1987 Jun 15;103(6):745–748. doi: 10.1016/s0002-9394(14)74386-7. [DOI] [PubMed] [Google Scholar]
  16. Forrester J. V. Uveitis: pathogenesis. Lancet. 1991 Dec 14;338(8781):1498–1501. doi: 10.1016/0140-6736(91)92309-p. [DOI] [PubMed] [Google Scholar]
  17. Friberg T. R., Kuzma P. M. Propionibacterium acnes endophthalmitis two years after extracapsular cataract extraction. Am J Ophthalmol. 1990 May 15;109(5):609–610. doi: 10.1016/s0002-9394(14)70703-2. [DOI] [PubMed] [Google Scholar]
  18. Helbig H., Noske W., Kellner U., Foerster M. H. Sauerstoff in der Vorderkammer vor und nach Kataraktoperation. Ophthalmologe. 1995 Jun;92(3):325–328. [PubMed] [Google Scholar]
  19. Hijmans W., Radl J., Bottazzo G. F., Doniach D. Autoantibodies in highly aged humans. Mech Ageing Dev. 1984 Jul;26(1):83–89. doi: 10.1016/0047-6374(84)90167-2. [DOI] [PubMed] [Google Scholar]
  20. Hykin P. G., Tobal K., McIntyre G., Matheson M. M., Towler H. M., Lightman S. L. The diagnosis of delayed post-operative endophthalmitis by polymerase chain reaction of bacterial DNA in vitreous samples. J Med Microbiol. 1994 Jun;40(6):408–415. doi: 10.1099/00222615-40-6-408. [DOI] [PubMed] [Google Scholar]
  21. Ing E. B., Augsburger J. J., Eagle R. C. Lung cancer with visual loss. Surv Ophthalmol. 1996 May-Jun;40(6):505–510. doi: 10.1016/s0039-6257(96)82017-0. [DOI] [PubMed] [Google Scholar]
  22. Irvine W. D., Flynn H. W., Jr, Murray T. G., Rubsamen P. E. Retained lens fragments after phacoemulsification manifesting as marked intraocular inflammation with hypopyon. Am J Ophthalmol. 1992 Nov 15;114(5):610–614. doi: 10.1016/s0002-9394(14)74492-7. [DOI] [PubMed] [Google Scholar]
  23. Jensen O. A., Johansen S., Kiss K. Intraocular T-cell lymphoma mimicking a ring melanoma. First manifestation of systemic disease. Report of a case and survey of the literature. Graefes Arch Clin Exp Ophthalmol. 1994 Mar;232(3):148–152. doi: 10.1007/BF00176784. [DOI] [PubMed] [Google Scholar]
  24. Keicho N., Oka T., Takeuchi K., Yamane A., Yazaki Y., Yotsumoto H. Detection of lymphomatous involvement of the lung by bronchoalveolar lavage. Application of immunophenotypic and gene rearrangement analysis. Chest. 1994 Feb;105(2):458–462. doi: 10.1378/chest.105.2.458. [DOI] [PubMed] [Google Scholar]
  25. Kim E. W., Zakov Z. N., Albert D. M., Smith T. R., Craft J. L. Intraocular reticulum cell sarcoma: a case report and literature review. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1979 Jan 15;209(3):167–178. doi: 10.1007/BF00414609. [DOI] [PubMed] [Google Scholar]
  26. Kohno T., Uchida H., Inomata H., Fukushima S., Takeshita M., Kikuchi M. Ocular manifestations of adult T-cell leukemia/lymphoma. A clinicopathologic study. Ophthalmology. 1993 Dec;100(12):1794–1799. doi: 10.1016/s0161-6420(13)31398-0. [DOI] [PubMed] [Google Scholar]
  27. Kudlacek S., Jahandideh-Kazempour S., Graninger W., Willvonseder R., Pietschmann P. Differential expression of various T cell surface markers in young and elderly subjects. Immunobiology. 1995 Feb;192(3-4):198–204. doi: 10.1016/S0171-2985(11)80097-5. [DOI] [PubMed] [Google Scholar]
  28. Kumar S. R., Gill P. S., Wagner D. G., Dugel P. U., Moudgil T., Rao N. A. Human T-cell lymphotropic virus type I-associated retinal lymphoma. A clinicopathologic report. Arch Ophthalmol. 1994 Jul;112(7):954–959. doi: 10.1001/archopht.1994.01090190102028. [DOI] [PubMed] [Google Scholar]
  29. Lesourd B. M., Meaume S. Cell mediated immunity changes in ageing, relative importance of cell subpopulation switches and of nutritional factors. Immunol Lett. 1994 Jun;40(3):235–242. doi: 10.1016/0165-2478(94)00062-x. [DOI] [PubMed] [Google Scholar]
  30. Lightman S., Chan C. C. Immune mechanisms in choroido-retinal inflammation in man. Eye (Lond) 1990;4(Pt 2):345–353. doi: 10.1038/eye.1990.47. [DOI] [PubMed] [Google Scholar]
  31. Lightman S., Towler H. Immunopathology and altered immunity in posterior uveitis in man: a review. Curr Eye Res. 1992;11 (Suppl):11–15. doi: 10.3109/02713689208999506. [DOI] [PubMed] [Google Scholar]
  32. Makley T. A., Jr, Orlando R. G. Uveitis in older patients. Ann Ophthalmol. 1982 Oct;14(10):942–944. [PubMed] [Google Scholar]
  33. Manoussakis M. N., Tzioufas A. G., Silis M. P., Pange P. J., Goudevenos J., Moutsopoulos H. M. High prevalence of anti-cardiolipin and other autoantibodies in a healthy elderly population. Clin Exp Immunol. 1987 Sep;69(3):557–565. [PMC free article] [PubMed] [Google Scholar]
  34. Marchioli C. C., Graziano S. L. Paraneoplastic syndromes associated with small cell lung cancer. Chest Surg Clin N Am. 1997 Feb;7(1):65–80. [PubMed] [Google Scholar]
  35. Matsubara S., Yamaji Y., Fujita T., Kanayama T., Yamadori I., Sato M., Fujita J., Shiotani T., Takahara J. Cancer-associated retinopathy syndrome: a case of small cell lung cancer expressing recoverin immunoreactivity. Lung Cancer. 1996 Jun;14(2-3):265–271. doi: 10.1016/0169-5002(96)00552-1. [DOI] [PubMed] [Google Scholar]
  36. Matsuo T., Fujiwara M., Matsuo N. Inflammation after cataract extraction and intraocular lens implantation in patients with rheumatoid arthritis. Br J Ophthalmol. 1995 Jun;79(6):549–553. doi: 10.1136/bjo.79.6.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Michels R. G., Knox D. L., Erozan Y. S., Green W. R. Intraocular reticulum cell sarcoma. Diagnosis by pars plana vitrectomy. Arch Ophthalmol. 1975 Dec;93(12):1331–1335. doi: 10.1001/archopht.1975.01010020961005. [DOI] [PubMed] [Google Scholar]
  38. Ohkawa T., Kawashima H., Makino S., Shimizu Y., Shimizu H., Sekiguchi I., Tsuchida S. Cancer-associated retinopathy in a patient with endometrial cancer. Am J Ophthalmol. 1996 Nov;122(5):740–742. doi: 10.1016/s0002-9394(14)70501-x. [DOI] [PubMed] [Google Scholar]
  39. Ormerod L. D., Becker L. E., Cruise R. J., Grohar H. I., Paton B. G., Frederick A. R., Jr, Topping T. M., Weiter J. J., Buzney S. M., Baker A. S. Endophthalmitis caused by the coagulase-negative staphylococci. 2. Factors influencing presentation after cataract surgery. Ophthalmology. 1993 May;100(5):724–729. doi: 10.1016/s0161-6420(93)31583-6. [DOI] [PubMed] [Google Scholar]
  40. Pinchera A., Mariotti S., Barbesino G., Bechi R., Sansoni P., Fagiolo U., Cossarizza A., Franceschi C. Thyroid autoimmunity and ageing. Horm Res. 1995;43(1-3):64–68. doi: 10.1159/000184239. [DOI] [PubMed] [Google Scholar]
  41. Puliafito C. A., Baker A. S., Haaf J., Foster C. S. Infectious endophthalmitis. Review of 36 cases. Ophthalmology. 1982 Aug;89(8):921–929. [PubMed] [Google Scholar]
  42. Riente L., Marchini B., Dolcher M. P., Puccetti A., Bombardieri S., Migliorini P. Anti-collagen antibodies in systemic sclerosis and in primary Raynaud's phenomenon. Clin Exp Immunol. 1995 Nov;102(2):354–359. doi: 10.1111/j.1365-2249.1995.tb03789.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Rodriguez A., Calonge M., Pedroza-Seres M., Akova Y. A., Messmer E. M., D'Amico D. J., Foster C. S. Referral patterns of uveitis in a tertiary eye care center. Arch Ophthalmol. 1996 May;114(5):593–599. doi: 10.1001/archopht.1996.01100130585016. [DOI] [PubMed] [Google Scholar]
  44. Rogers N. K., Fox P. D., Noble B. A., Kerr K., Inglis T. Aggressive management of an epidemic of chronic pseudophakic endophthalmitis: results and literature survey. Br J Ophthalmol. 1994 Feb;78(2):115–119. doi: 10.1136/bjo.78.2.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Siegel M. J., Dalton J., Friedman A. H., Strauchen J., Watson C. Ten-year experience with primary ocular 'reticulum cell sarcoma' (large cell non-Hodgkin's lymphoma). Br J Ophthalmol. 1989 May;73(5):342–346. doi: 10.1136/bjo.73.5.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Suttorp-Schulten M. S., Rothova A. The possible impact of uveitis in blindness: a literature survey. Br J Ophthalmol. 1996 Sep;80(9):844–848. doi: 10.1136/bjo.80.9.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Suzuki T., Obara Y., Sato Y., Saito G., Ichiwata T., Uchiyama T. Cancer-associated retinopathy with presumed vasculitis. Am J Ophthalmol. 1996 Jul;122(1):125–127. doi: 10.1016/s0002-9394(14)71979-8. [DOI] [PubMed] [Google Scholar]
  48. Talor E., Rose N. R. Hypothesis: the aging paradox and autoimmune disease. Autoimmunity. 1991;8(3):245–249. doi: 10.3109/08916939108997112. [DOI] [PubMed] [Google Scholar]
  49. Thach A. B., Das A., Lopez P. F. En bloc capsulectomy in the diagnosis and treatment of refractory, chronic, recurrent pseudophakic endophthalmitis. Ophthalmic Surg. 1994 Jun;25(6):361–364. [PubMed] [Google Scholar]
  50. Thean L. H., Thompson J., Rosenthal A. R. A uveitis register at the Leicester Royal Infirmary. Ophthalmic Epidemiol. 1996 Dec;3(3):151–158. doi: 10.3109/09286589609080121. [DOI] [PubMed] [Google Scholar]
  51. Thirkill C. E. Cancer-induced retinal hypersensitivity. Br J Biomed Sci. 1996 Sep;53(3):227–234. [PubMed] [Google Scholar]
  52. Thomas R., McIlraith M., Davis L. S., Lipsky P. E. Rheumatoid synovium is enriched in CD45RBdim mature memory T cells that are potent helpers for B cell differentiation. Arthritis Rheum. 1992 Dec;35(12):1455–1465. doi: 10.1002/art.1780351209. [DOI] [PubMed] [Google Scholar]
  53. Verbraeken H. Treatment of postoperative endophthalmitis. Ophthalmologica. 1995;209(3):165–171. doi: 10.1159/000310605. [DOI] [PubMed] [Google Scholar]
  54. Walker J., Ober R. R., Khan A., Yuen D., Rao N. A. Intraocular lymphoma developing in a patient with Vogt-Koyanagi-Harada syndrome. Int Ophthalmol. 1993;17(6):331–336. doi: 10.1007/BF00915739. [DOI] [PubMed] [Google Scholar]
  55. Weisenburger D. D. Epidemiology of non-Hodgkin's lymphoma: recent findings regarding an emerging epidemic. Ann Oncol. 1994;5 (Suppl 1):19–24. doi: 10.1093/annonc/5.suppl_1.s19. [DOI] [PubMed] [Google Scholar]
  56. Wenkel H., Rummelt V., Knorr H., Naumann G. O. Chronic postoperative endophthalmitis following cataract extraction and intraocular lens implantation. Report on nine patients. Ger J Ophthalmol. 1993 Nov;2(6):419–425. [PubMed] [Google Scholar]
  57. Wilson D. J., Braziel R., Rosenbaum J. T. Intraocular lymphoma. Immunopathologic analysis of vitreous biopsy specimens. Arch Ophthalmol. 1992 Oct;110(10):1455–1458. doi: 10.1001/archopht.1992.01080220117032. [DOI] [PubMed] [Google Scholar]
  58. Winward K. E., Pflugfelder S. C., Flynn H. W., Jr, Roussel T. J., Davis J. L. Postoperative Propionibacterium endophthalmitis. Treatment strategies and long-term results. Ophthalmology. 1993 Apr;100(4):447–451. doi: 10.1016/s0161-6420(93)31624-6. [DOI] [PubMed] [Google Scholar]
  59. Winward K. E., Pflugfelder S. C., Flynn H. W., Jr, Roussel T. J., Davis J. L. Postoperative Propionibacterium endophthalmitis. Treatment strategies and long-term results. Ophthalmology. 1993 Apr;100(4):447–451. doi: 10.1016/s0161-6420(93)31624-6. [DOI] [PubMed] [Google Scholar]
  60. Wolner B., Liebmann J. M., Sassani J. W., Ritch R., Speaker M., Marmor M. Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil. Ophthalmology. 1991 Jul;98(7):1053–1060. doi: 10.1016/s0161-6420(91)32177-8. [DOI] [PubMed] [Google Scholar]
  61. Xavier R. M., Yamauchi Y., Nakamura M., Tanigawa Y., Ishikura H., Tsunematsu T., Kobayashi S. Antinuclear antibodies in healthy aging people: a prospective study. Mech Ageing Dev. 1995 Mar 1;78(2):145–154. doi: 10.1016/0047-6374(94)01532-q. [DOI] [PubMed] [Google Scholar]
  62. Zimmerman P. L., Mamalis N., Alder J. B., Teske M. P., Tamura M., Jones G. R. Chronic Nocardia asteroides endophthalmitis after extracapsular cataract extraction. Arch Ophthalmol. 1993 Jun;111(6):837–840. doi: 10.1001/archopht.1993.01090060125036. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES