Optimizing the diagnostic process to realize precise diagnosis of uveitis_Chinese Journal of Ocular Fundus Diseases

Authors：

 Yang Peizeng , Liu Hui

Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

Yang Peizeng, Email: peizengycmu@126.com

Keywords：

Uveitis; Diagnosis; Auxiliary examinations; Laboratory examinations; Editorial

DOI：

10.3760/cma.j.cn511434-20240108-00009

Video：

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Uveitis is a group of inflammatory diseases affecting the uveal tract, retina, retinal blood vessels and vitreous. Due to its complex etiology, various entities, diverse and lack of constancy in treatment, some patients can experience visual impairment and even loss. In view of the fact that blindness caused by uveitis is mostly incurable and occurs usually in young and middle-aged people, it accounts for an important part of blinding eye diseases and has attracted worldwide attention. With the continuous development of precision medicine, clinicians will face new problems and challenges in disease diagnosis, and further in-depth research is needed to explore more optimized and efficient diagnostic processes and examinations to improve the diagnosis of uveitis in China.

Citation： Yang Peizeng, Liu Hui. Optimizing the diagnostic process to realize precise diagnosis of uveitis. Chinese Journal of Ocular Fundus Diseases, 2024, 40(1): 4-7. doi: 10.3760/cma.j.cn511434-20240108-00009 Copy

1.	Yang P, Zhong Z, Du L, et al. Prevalence and clinical features of systemic diseases in Chinese patients with uveitis[J]. Br J Ophthalmol, 2021, 105(1): 75-82. DOI: 10.1136/bjophthalmol-2020-315960.
2.	Rathinam SR, Namperumalsamy P. Global variation and pattern changes in epidemiology of uveitis[J]. Indian J Ophthalmol, 2007, 55(3): 173-183. DOI: 10.4103/0301-4738.31936.
3.	Rodriguez A, Calonge M, Pedroza-Seres M, et al. Referral patterns of uveitis in a tertiary eye care center[J]. Arch Ophthalmol, 1996, 114(5): 593-599. DOI: 10.1001/archopht.1996.01100130585016.
4.	Merrill PT, Kim J, Cox TA, et al. Uveitis in the southeastern United States[J]. Curr Eye Res, 1997, 16(9): 865-874. DOI: 10.1076/ceyr.16.9.865.5048.
5.	杨培增. 葡萄膜炎诊断概述[M]//杨培增. 临床葡萄膜炎. 北京: 人民卫生出版社, 2004: 43-44.Yang PZ. Overview of diagnosis of uveitis[M]//Yang PZ. Clinical uveitis. Beijing: People' Medical Publishing House, 2004: 43-44.
6.	Sève P, Cacoub P, Bodaghi B, et al. Uveitis: diagnostic work-up. A literature review and recommendations from an expert committee[J]. Autoimmun Rev, 2017, 16(12): 1254-1264. DOI: 10.1016/j.autrev.2017.10.010.
7.	杨培增. 葡萄膜炎的诊断程序[M]//杨培增. 葡萄膜炎诊断与治疗. 北京: 人民卫生出版社, 2009: 41-46.Yang PZ. Diagnostic procedures for uveitis[M]//Yang PZ. Diagnosis and treatment of uveitis. Beijing: People' Medical Publishing House, 2009: 41-46.
8.	Agarwal A, Pichi F, Invernizzi A, et al. Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis[J]. Surv Ophthalmol, 2023, 68(3): 446-480. DOI: 10.1016/j.survophthal.2023.01.006.
9.	Pichi F, Sarraf D, Arepalli S, et al. The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases[J]. Prog Retin Eye Res, 2017, 59: 178-201. DOI: 10.1016/j.preteyeres.2017.04.005.
10.	Abraham A, Saboo US, Ducca BL, et al. The detection of occult retinal vasculitis on fluorescein angiography in pediatric uveitis[J]. Ophthalmol Retina, 2020, 4(2): 198-203. DOI: 10.1016/j.oret.2019.09.007.
11.	Invernizzi A, Cozzi M, Staurenghi G. Optical coherence tomography and optical coherence tomography angiography in uveitis: a review[J]. Clin Exp Ophthalmol, 2019, 47(3): 357-371. DOI: 10.1111/ceo.13470.
12.	Piette S, Canlas OA, Tran HV, et al. Ultrasound biomicroscopy in uveitis-glaucoma-hyphema syndrome[J]. Am J Ophthalmol, 2002, 133(6): 839-841. DOI: 10.1016/s0002-9394(02)01386-7.
13.	Gu J, Chen Q, Zhang P, et al. Characteristics of vitreoretinal lymphoma in B-scan ultrasonography: a case-control study[J/OL]. Ophthalmol Retina, 2023, 18: S2468-6530(23)00494-3[2023-11-18]. https://pubmed.ncbi.nlm.nih.gov/37820767/. DOI: 10.1016/j.oret.2023.10.002.
14.	Yang P. Auxiliary Ocular Examinations[M]//Yang P. Atlas of uveitis: diagnosis and treatment[M]. Springer Nature, 2020: 81-138..Yang P. Auxiliary Ocular Examinations[M]//Yang P. Atlas of uveitis: diagnosis and treatment[M]. Springer Nature, 2020: 81-138.
15.	Guo S, Liu H, Gao Y, et al. Analysis of vascular changes of fundus in Behcet uveitis by widefield swept source optical coherence tomography angiography and fundus fluorescein angiography[J]. Retina, 2023, 43(5): 841-850. DOI: 10.1097/IAE.00000000 00003709.
16.	Passo MS, Rosenbaum JT. Ocular syphilis in patients with human immunodeficiency virus infection[J]. Am J Ophthalmol, 1988, 106(1): 1-6. DOI: 10.1016/s0002-9394(14)76378-0.
17.	Tramont EC. Syphilis in the AIDS era[J]. N Engl J Med, 1987, 316(25): 1600-1601. DOI: 10.1056/NEJM198706183162510.
18.	Fauci AS, Haynes BF, Katz P, et al. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years[J]. Ann Intern Med, 1983, 98(1): 76-85. DOI: 10.7326/0003-4819-98-1-76.
19.	Nölle B, Specks U, Lüdemann J, et al. Anticytoplasmic autoantibodies: their immunodiagnostic value in Wegener granulomatosis[J]. Ann Intern Med, 1989, 111(1): 28-40. DOI: 10.7326/0003-4819-111-1-28.
20.	Soukiasian SH, Foster CS, Niles JL, et al. Diagnostic value of anti-neutrophil cytoplasmic antibodies in scleritis associated with Wegener's granulomatosis[J]. Ophthalmology, 1992, 99(1): 125-132. DOI: 10.1016/s0161-6420(92)32027-5.
21.	Goldmann H, Witmer R. Antibodies in the aqueous humor[J]. Ophthalmologica, 1954, 127(4-5): 323-330. DOI: 10.1159/000301976.
22.	杨培增. 葡萄膜炎的诊断及相关问题[J]. 中华眼科杂志, 2002, 38(4): 250-253. DOI: 10.3760/j:issn:0412-4081.2002.04.022.Yang PZ. Diagnosis and related problems of uveitis[J]. Chin J Ophthalmol, 2002, 38(4): 250-253. DOI: 10.3760/j:issn:0412-4081.2002.04.022.
23.	杨培增, 徐菁, 苏冠男. 葡萄膜炎诊断中正确应用眼内液检测[J]. 眼科, 2020, 29(3): 161-165. DOI: 10.13281/j.cnki.issn.1004-4469.2020.03.001.Yang PZ, Xu J, Su GN. Application of intraocular fluid testing in the diagnosis of uveitis[J]. Ophthalmol CHN, 2020, 29(3): 161-165. DOI: 10.13281/j.cnki.issn.1004-4469.2020.03.001.

1. Yang P, Zhong Z, Du L, et al. Prevalence and clinical features of systemic diseases in Chinese patients with uveitis[J]. Br J Ophthalmol, 2021, 105(1): 75-82. DOI: 10.1136/bjophthalmol-2020-315960.
2. Rathinam SR, Namperumalsamy P. Global variation and pattern changes in epidemiology of uveitis[J]. Indian J Ophthalmol, 2007, 55(3): 173-183. DOI: 10.4103/0301-4738.31936.
3. Rodriguez A, Calonge M, Pedroza-Seres M, et al. Referral patterns of uveitis in a tertiary eye care center[J]. Arch Ophthalmol, 1996, 114(5): 593-599. DOI: 10.1001/archopht.1996.01100130585016.
4. Merrill PT, Kim J, Cox TA, et al. Uveitis in the southeastern United States[J]. Curr Eye Res, 1997, 16(9): 865-874. DOI: 10.1076/ceyr.16.9.865.5048.
5. 杨培增. 葡萄膜炎诊断概述[M]//杨培增. 临床葡萄膜炎. 北京: 人民卫生出版社, 2004: 43-44.Yang PZ. Overview of diagnosis of uveitis[M]//Yang PZ. Clinical uveitis. Beijing: People' Medical Publishing House, 2004: 43-44.
6. Sève P, Cacoub P, Bodaghi B, et al. Uveitis: diagnostic work-up. A literature review and recommendations from an expert committee[J]. Autoimmun Rev, 2017, 16(12): 1254-1264. DOI: 10.1016/j.autrev.2017.10.010.
7. 杨培增. 葡萄膜炎的诊断程序[M]//杨培增. 葡萄膜炎诊断与治疗. 北京: 人民卫生出版社, 2009: 41-46.Yang PZ. Diagnostic procedures for uveitis[M]//Yang PZ. Diagnosis and treatment of uveitis. Beijing: People' Medical Publishing House, 2009: 41-46.
8. Agarwal A, Pichi F, Invernizzi A, et al. Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis[J]. Surv Ophthalmol, 2023, 68(3): 446-480. DOI: 10.1016/j.survophthal.2023.01.006.
9. Pichi F, Sarraf D, Arepalli S, et al. The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases[J]. Prog Retin Eye Res, 2017, 59: 178-201. DOI: 10.1016/j.preteyeres.2017.04.005.
10. Abraham A, Saboo US, Ducca BL, et al. The detection of occult retinal vasculitis on fluorescein angiography in pediatric uveitis[J]. Ophthalmol Retina, 2020, 4(2): 198-203. DOI: 10.1016/j.oret.2019.09.007.
11. Invernizzi A, Cozzi M, Staurenghi G. Optical coherence tomography and optical coherence tomography angiography in uveitis: a review[J]. Clin Exp Ophthalmol, 2019, 47(3): 357-371. DOI: 10.1111/ceo.13470.
12. Piette S, Canlas OA, Tran HV, et al. Ultrasound biomicroscopy in uveitis-glaucoma-hyphema syndrome[J]. Am J Ophthalmol, 2002, 133(6): 839-841. DOI: 10.1016/s0002-9394(02)01386-7.
13. Gu J, Chen Q, Zhang P, et al. Characteristics of vitreoretinal lymphoma in B-scan ultrasonography: a case-control study[J/OL]. Ophthalmol Retina, 2023, 18: S2468-6530(23)00494-3[2023-11-18]. https://pubmed.ncbi.nlm.nih.gov/37820767/. DOI: 10.1016/j.oret.2023.10.002.
14. Yang P. Auxiliary Ocular Examinations[M]//Yang P. Atlas of uveitis: diagnosis and treatment[M]. Springer Nature, 2020: 81-138..Yang P. Auxiliary Ocular Examinations[M]//Yang P. Atlas of uveitis: diagnosis and treatment[M]. Springer Nature, 2020: 81-138.
15. Guo S, Liu H, Gao Y, et al. Analysis of vascular changes of fundus in Behcet uveitis by widefield swept source optical coherence tomography angiography and fundus fluorescein angiography[J]. Retina, 2023, 43(5): 841-850. DOI: 10.1097/IAE.00000000 00003709.
16. Passo MS, Rosenbaum JT. Ocular syphilis in patients with human immunodeficiency virus infection[J]. Am J Ophthalmol, 1988, 106(1): 1-6. DOI: 10.1016/s0002-9394(14)76378-0.
17. Tramont EC. Syphilis in the AIDS era[J]. N Engl J Med, 1987, 316(25): 1600-1601. DOI: 10.1056/NEJM198706183162510.
18. Fauci AS, Haynes BF, Katz P, et al. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years[J]. Ann Intern Med, 1983, 98(1): 76-85. DOI: 10.7326/0003-4819-98-1-76.
19. Nölle B, Specks U, Lüdemann J, et al. Anticytoplasmic autoantibodies: their immunodiagnostic value in Wegener granulomatosis[J]. Ann Intern Med, 1989, 111(1): 28-40. DOI: 10.7326/0003-4819-111-1-28.
20. Soukiasian SH, Foster CS, Niles JL, et al. Diagnostic value of anti-neutrophil cytoplasmic antibodies in scleritis associated with Wegener's granulomatosis[J]. Ophthalmology, 1992, 99(1): 125-132. DOI: 10.1016/s0161-6420(92)32027-5.
21. Goldmann H, Witmer R. Antibodies in the aqueous humor[J]. Ophthalmologica, 1954, 127(4-5): 323-330. DOI: 10.1159/000301976.
22. 杨培增. 葡萄膜炎的诊断及相关问题[J]. 中华眼科杂志, 2002, 38(4): 250-253. DOI: 10.3760/j:issn:0412-4081.2002.04.022.Yang PZ. Diagnosis and related problems of uveitis[J]. Chin J Ophthalmol, 2002, 38(4): 250-253. DOI: 10.3760/j:issn:0412-4081.2002.04.022.
23. 杨培增, 徐菁, 苏冠男. 葡萄膜炎诊断中正确应用眼内液检测[J]. 眼科, 2020, 29(3): 161-165. DOI: 10.13281/j.cnki.issn.1004-4469.2020.03.001.Yang PZ, Xu J, Su GN. Application of intraocular fluid testing in the diagnosis of uveitis[J]. Ophthalmol CHN, 2020, 29(3): 161-165. DOI: 10.13281/j.cnki.issn.1004-4469.2020.03.001.

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