ISSN 2398-2969      

Uveitis

icanis

Synonym(s): Panuveitis, iritis, iridocyclitis, cyclitis, choroiditis, anterior uveitis


Introduction

  • Inflammation of the uveal tract (iris, ciliary body and choroid).
  • Cause: infection (eg viral, bacterial, parasitic, fungal), trauma, lens damage, immune-mediated.
  • Signs: severe pain, hyphemia, miosis, cloudy cornea, conjunctival hyperemia.
  • Treatment: medical - many approaches.
  • Prognosis: serious consequences if disease is uncontrolled.
    Follow the diagnostic tree on Anterior Uveitis Anterior Uveitis.

Pathogenesis

Etiology

  • Often undetermined.
  • Reflex uveitis Reflex uveitis.
  • Systemic viral disease, eg infectious canine hepatitis Canine adenovirus type 1 disease with corneal opacity, very common.
  • Systemic bacterial disease, eg leptospirosis Leptospirosis , brucellosis Brucellosis , Lyme disease Arthritis: borrelial , tuberculosis Pulmonary tuberculosis.
  • Local bacterial disease, eg pasteurellosis, staphyloccocal infection (toxins).
  • Septic bacterial focus, eg pyometra Pyometra.
  • Parasitic, eg toxoplasmosis Toxoplasmosis , leishmaniasis Canine leishmaniosis (imported animals?).
  • Mycotic infection, eg cryptococcosis , blastomycosis, histoplasmosis. Rare in temperate climate/country.
  • Neoplasia - primary or secondary. Lymphoma is most common.
  • Trauma, eg blunt or sharp injury or foreign bodies.
  • Primary lens damage to expose lens proteins to aqueous.
  • Diabetes.
  • Lens-induced uveitis from cataract formation.
  • Systemic hypertension.
  • Auto-immune, eg uveodermatological syndrome. VKH syndrome.
  • Rickettsial diseases, eg Ehlichiosis Ehrlichiosis , Rocky Mountain spotted fever.
  • Immune-mediated.
  • Hypermature cataracts cause lens proteins to elicit inflammation.

Pathophysiology

  • Inflammation of uveal tract may involve iris (iritis), ciliary body (cyclitis), or choroid (choroiditis).
  • More commonly involves all 3 (panuveitis).
  • Breakdown of the blood-aqueous barrier causes anterior uveal tissue destruction.
  • Increased vascular permeability is mediated by histamine, serotonin, prostaglandins and leukotrines, and causes extravasation of plasma proteins, cells and fluid.
  • Iridal congestion, aqueous flare, hypopyon, keratitic precipitates and corneal edema develop along with cellular infiltration.
  • Inflammation causes muscular spasm giving miosis and pain.

Timecourse

  • Anterior uveitis therapy should last at least 2 months as the blood-aqueous barrier remains disrupted for about 8 weeks after insult.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Michau T M, Breitschwerdt E B, Gilger B C et al (2003) Bartonella vinsonii subspecies berkhoffi as a possible cause of anterior uveitis and choroiditis in a dog. Vet Ophthalmol (4), 299-304 PubMed.
  • Sansom J (2000) Diseases involving the anterior chamber of the dog and cat. In Practice 22 (2), 58-70 VetMedResource.
  • Huss B T, Collier L L, Collins B K et al (1994) Polyarthropathy and chonoretinitis with retinal detachment in a dog with systemic histoplasmosis. JAAHA 30 (3), 217-224 VetMedResource.
  • Håkanson N & Forrester S D (1990) Uveitis in the dog and cat. Vet Clin North Am Small Anim Pract 20 (3), 715-35 PubMed.
  • Crispin S M (1988) Uveitis in the dog and cat. JSAP 29 (7), 429-447 PubMed.

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RELATED PDFS

Anterior uveitis

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