Uveitis due to connective tissue diseases

A group of connective tissue diseases causes inflammation of the uveal tract, causing uveitis.

Spondyloarthropathies

Seronegative spondyloarthropathies are a common cause of anterior uveitis. Inflammation of the eye most often occurs with ankylosing spondylitis, as well as with reactive arthritis and psoriatic arthritis; inflammation of the gastrointestinal tract, which includes both ulcerative colitis and Crohn's disease. Usually uveitis is one-sided, but frequent relapses, which can be on one or the other eye. Men are sick more often than women. Most patients, regardless of gender, HLA - B27-positive. Treatment requires topical application of glucocorticoids and mydriatic. Sometimes it is necessary to introduce glucocorticoids parabulbar.

Juvenile idiopathic arthritis (JIA, also known as juvenile RA)

Juvenile rheumatoid arthritis causes chronic bilateral iridocyclitis in children. Unlike most forms of anterior uveitis, JIA, however, does not tend to cause pain, photophobia and conjunctival injection, but only blurring of vision and miosis and is therefore often referred to as "white" iritis. Juvenile uveitis develops more often in girls than in boys. Recurrent attacks of inflammation are best treated with a local glucocorticoid and a cycloplegic and mydriatic remedy. Long-term monitoring often requires the use of a non-steroid immunosuppressor, such as methotrexate or mucofenolate modafil.

Sarcoidosis

Sarcoidosis occurs in 10-25% of uveitis, and approximately 25% of patients with sarcoidosis develop uveitis. Sarcoidosis uveitis is most common in blacks and elderly people. In fact, any symptoms and signs of anterior, middle and posterior uveitis can develop. Signs of sarcoidosis uveitis are conjunctival granulomas, large corneal precipitates on the corneal endothelium (the so-called granulomatous precipitates), iris granulomas and retinal vasculitis. A biopsy of the presumed foci provides the most reliable diagnosis. Treatment usually includes local, periocular and systemic administration of glucocorticoids along with the mydriatic. Patients with moderate and severe inflammation may require a non-steroid immunosuppressor, such as methotrexate, mycophenolate modafil or azathioprine.

Behcet's Syndrome

This disease is rare in North America, but a fairly common cause of uveitis in the Middle and Far East. A typical clinic is the development of severe anterior uveitis with hypopion (accumulation of leukocytes in the anterior chamber), retinal vasculitis and inflammation of the optic nerve disk. The clinical course is usually severe with numerous relapses. For the diagnosis is required the presence of concomitant systemic manifestations, such as aphthous stomatitis and genital ulcers; dermatitis, including erythema nodosa; thrombophlebitis or epididymitis. Aftoznye rashes of the mouth and the contents of ulcerative rashes on the genitals can be subjected to a biopsy to demonstrate occlusive vasculitis. There are no laboratory tests for Behcet's syndrome. Treatment with local or systemic glucocorticoids and mydriatic can reduce manifestations, but most patients need systemic glucocorticoids and non-steroid immunosuppressors, such as cyclosporine or chlorambucil, to control inflammation and avoid serious complications of the use of glucocorticoids.

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Vogt-Koyanagi-Harada Syndrome (FKH)

Vogt-Koyanagi-Harada syndrome is a rare systemic disease characterized by uveitis in combination with skin and neurological anomalies. Vogt-Koyanagi-Harada syndrome is especially often noted in people of Asian, Asian-Indian and American Indian origin. Women aged 20-30 years are more likely than men. The etiology is unknown, although an autoimmune reaction is directed against melanin-containing cells in the uveal tract, skin, inner ear and meningeal membrane.

Neurological symptoms tend to appear early and include ringing in the ears, hearing disorder (auditory agnosia), dizziness, headache and meningism. Skin manifestations often appear later and include vitiligo (especially often on the eyelids, down on the back and buttocks), polyosis (eyelash squinting) and alopecia (baldness). Additional eye complications include cataract, glaucoma, optic disc swelling and choroiditis, often with exudative retinal detachment.

Early therapy is represented by local and systemic glucocorticoids and mydriatica. Many patients also require a non-glucocorticoid immunosuppressor, such as methotrexate, azathioprine or mucofenol modafil.