Current Diagnostic Approaches to Infectious Anterior Uveitis

Hunter, Rebecca S.; Lobo, Ann-Marie

doi:10.1097/iio.0b013e31822d6807

Cited by 15 publications

(7 citation statements)

References 55 publications

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“…After the standard assessment, a specific etiology was found in 62% of cases, with 38% labeled as idiopathic uveitis. This distribution is consistent with previously published data (1,18,19), highlighting the current limitations of the microbiological diagnostic techniques while questioning the criteria applied to systemic inflammatory diseases (20,21). The first outcome of this study is that cytokine pattern analysis can be used as a diagnostic approach.…”

Section: Discussionsupporting

confidence: 78%

Intraocular Levels of Interleukin 17A (IL-17A) and IL-10 as Respective Determinant Markers of Toxoplasmosis and Viral Uveitis

Sauer

Villard

Creuzot‐Garcher

et al. 2014

Clin. Vaccine Immunol.

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e Uveitis is a potentially blinding inflammatory disease. Thirty to 50% of uveitis cases are considered idiopathic. The present study sought to determine the intraocular cytokine patterns in the different etiological types of uveitis in order to better understand their immunological regulation and to determine whether the cytokine pattern may be a useful diagnostic tool. From a multicenter institutional prospective study, the clinical and biological data from patients with uveitis of various etiologies, determined after a complete workup, were compared with those from a control group of cataract patients. A multiplex assay was used to assess the profiles of 27 cytokines and chemokines in aqueous humor samples from these patients. In total, 62 patients with infectious or noninfectious uveitis and 88 controls were included. After a complete workup, the cause of uveitis remained unknown in 25 patients (40% idiopathic uveitis). Interleukin 1␤ (IL-1␤) levels were markedly increased in viral uveitis, as were IL-10 levels, whereas IL-17A levels were augmented in toxoplasmic uveitis. Based on the cytokine pattern, the patients were reassigned to specific groups. At the end of the study, the diagnosis of idiopathic uveitis was still valid in only 11 patients (18%). The observation that some markers are specific to certain diseases enables a better understanding of the disease pathogenesis and paves the way for new diagnostic methods aimed to identify inflammatory markers, which may perhaps be targeted by therapy.

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Section: Discussionsupporting

confidence: 78%

Intraocular Levels of Interleukin 17A (IL-17A) and IL-10 as Respective Determinant Markers of Toxoplasmosis and Viral Uveitis

Sauer

Villard

Creuzot‐Garcher

et al. 2014

Clin. Vaccine Immunol.

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“…Rapid analysis of aqueous humor by polymerase chain reaction (PCR) in uveitis can be very helpful in leading to a specific diagnosis of infectious etiology and efficient treatment [1–7]. However, aqueous humor PCR analysis is not routine and remains controversial because of a low proportion of therapeutic change based on the PCR results in some studies, invasiveness of paracentesis bearing potential complications, and false negatives and positives [5–7].…”

Section: Introductionmentioning

confidence: 99%

Aqueous humor polymerase chain reaction in uveitis – utility and safety

et al. 2016

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BackgroundTo study the value and safety of aqueous humor polymerase chain reaction (PCR) analysis for Herpes simplex, varicella zoster, cytomegalovirus, Epstein-Barr virus and Toxoplasma gondii in patients with uveitis.MethodsRecords of 45 consecutive patients with anterior and posterior uveitis who underwent AC paracentesis with PCR were reviewed. The main outcome measure was frequency of PCR positivity. Secondary outcomes were alteration of treatment, safety of paracentesis, and correlation of keratitic precipitates with PCR positivity,ResultsThe overall PCR positivity was 48.9 % (22/45). Therapy was changed because of the PCR results in 14/45 patients (37.7 %). One patient experienced a paracentesis related complication (1/45, 2.2 %) without long-term sequelae.ConclusionAqueous PCR altered the diagnosis and treatment in over a third of our patients and was relatively safe. Aqueous PCR should be considered for uveitis of atypical clinical appearance, recurrent severe uveitis of uncertain etiology, and therapy refractory cases.

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“…For this reason, the International Uveitis Study Group established a standardized methodology for classifying uveitis based on the location of inflammation [188]. However, in many cases, the etiology of the disease remains hidden, being diagnosed as "idiopathic," making its treatment difficult [189,190].…”

Section: Anterior Uveitismentioning

confidence: 99%

Oxidative Stress in the Anterior Ocular Diseases: Diagnostic and Treatment

et al. 2023

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The eye is a metabolically active structure, constantly exposed to solar radiations making its structure vulnerable to the high burden of reactive oxygen species (ROS), presenting many molecular interactions. The biomolecular cascade modification is caused especially in diseases of the ocular surface, cornea, conjunctiva, uvea, and lens. In fact, the injury in the anterior segment of the eye takes its origin from the perturbation of the pro-oxidant/antioxidant balance and leads to increased oxidative damage, especially when the first line of antioxidant defence weakens with age. Furthermore, oxidative stress is related to mitochondrial dysfunction, DNA damage, lipid peroxidation, protein modification, apoptosis, and inflammation, which are involved in anterior ocular disease progression such as dry eye, keratoconus, uveitis, and cataract. The different pathologies are interconnected through various mechanisms such as inflammation, oxidative stress making the diagnostics more relevant in early stages. The end point of the molecular pathway is the release of different antioxidant biomarkers offering the potential of predictive diagnostics of the pathology. In this review, we have analysed the oxidative stress and inflammatory processes in the front of the eye to provide a better understanding of the pathomechanism, the importance of biomarkers for the diagnosis of eye diseases, and the recent treatment of anterior ocular diseases.

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Current Diagnostic Approaches to Infectious Anterior Uveitis

Cited by 15 publications

References 55 publications

Intraocular Levels of Interleukin 17A (IL-17A) and IL-10 as Respective Determinant Markers of Toxoplasmosis and Viral Uveitis

Intraocular Levels of Interleukin 17A (IL-17A) and IL-10 as Respective Determinant Markers of Toxoplasmosis and Viral Uveitis

Aqueous humor polymerase chain reaction in uveitis – utility and safety

Oxidative Stress in the Anterior Ocular Diseases: Diagnostic and Treatment

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