Prise en charge diagnostique des uvéites : recommandations d’un groupe d’experts

Sève, P.; Bodaghi, Bahram; Trad, S.; Sellam, Jérémie; Bellocq, David; Bielefeld, P.; Sène, Damien; Kaplanski, Gilles; Monnet, Dominique; Brézin, Antoine P.; Weber, Michel; Saadoun, David; Cacoub, P.; Chiquet, Christophe; Kodjikian, Laurent

doi:10.1016/j.revmed.2017.09.015

Cited by 11 publications

(1 citation statement)

References 121 publications

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“…In a previous study, we had developed recommendations for the diagnosing of uveitis based on a review of the literature and the findings of the ULISSE study [31]. We proposed that bMRI should be reserved for patients over 40 presenting unexplained uveitis, when searching for cerebral lesions suggestive of OCL.…”

Section: Discussionmentioning

confidence: 99%

Relevance of brain MRI in patients with uveitis: retrospective cohort on 402 patients

Chirpaz

Kerever

Gavoille

et al. 2020

Preprint

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Aim To assess the diagnostic value of brain magnetic resonance imaging (bMRI) for the etiological diagnosis of uveitis and to establish predictive factors associated with its advantageous use. Methods Retrospective study on all patients with de novo uveitis who were referred to our tertiary hospital and who underwent a bMRI between 2003 and 2018. The bMRI was considered useful if it served to confirm a diagnosis or correct a misdiagnosis. We also collected characteristics of uveitis and associated ophthalmological and neurological clinical signs. Results Brain MRI was contributive in 19 out of 402 cases (5%): 10 multiple sclerosis, 5 radiologically isolated syndromes, and 4 oculocerebral lymphomas. A total of 34 (8%) patients had neurological signs and 13 (38%) of those patients had a contributive bMRI. Meanwhile, in the absence of neurological signs, 1% of bMRIs were contributive, none of them resulted in specific treatment. Among patients with a contributive bMRI, 68% had neurological signs. Univariate analysis established that neurological signs (p<0.001), granulomatous uveitis (p=0.003), retinal vasculitis (p=0.002), and intermediate uveitis (p<0.001) were significantly associated with a contributive bMRI. Multivariate analysis confirms the significant association of neurological signs (p<0.001) and intermediate uveitis (p=0.01). Patients with oculocerebral lymphoma were significantly older (p<0.001) and all were above 40 years of age. Conclusion Brain MRI appears to be a relevant and contributive exam, but it should be performed in cases of intermediate/posterior uveitis or panuveitis accompanied by neurological signs, retinal vasculitis, or in patients older than 40, to rule out an oculocerebral lymphoma.

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Section: Discussionmentioning

confidence: 99%