2023-04-20 09:03:32
Uveitis is a rare eye disease that includes a wide spectrum of manifestations in the eye, up to blindness. It may be associated with other systemic diseases, such as rheumatology, infections or even neoplasms. Although it can affect all age ranges, it is more frequent in the young active population.
Currently, uveitis represents the third cause of blindness in Spain and includes a wide spectrum of rare eye diseases. According to the Spanish Society of Rheumatology, 10% of total visual losses are due to uveitis; hence the importance of going to the doctor as soon as possible at the slightest symptom.
“It can affect 52 people per 100,000 inhabitants per year of any age in Spain. Depending on the anatomical region of the eye affected or its cause, the treatment and prognosis of uveitis vary,” says the Dr. Inés Hernanz, a specialist in uveitis at the Ophthalmology Service of the Infanta Elena de Valdemoro University Hospital (Madrid).
Possible symptoms and causes
As this specialist explains, the disorder manifests itself through inflammation of the inner layers of the eye (uvea) and is characterized, among other symptoms, by eye redness, blurred vision, decreased visual acuity, floaters or sensitivity to light (photophobia).
“From eye injuries to systemic inflammatory diseases that are mediated by alterations in our defense mechanisms, such as inflammatory bowel disease, lupus, Behçet’s disease, sarcoidosis or rheumatoid arthritis, among others, as well as infections such as tuberculosis, herpes zoster, toxoplasmosis or syphilis can give rise to uveitis”, details this expert, while acknowledging that, despite advances in the field, one in three uveitis today is considered ‘idiopathic’ or of unknown origin .
Thus, he explains that uveitis can have a diverse origin (autoimmune, infectious, neoplastic, paraneoplastic…), but it always has an immune-mediated basis that triggers inflammatory processes in the eye. “Hence, its treatment, with few exceptions, is based on or complemented by immunomodulatory therapy,” appreciates the ophthalmologist at the Valdemoreño hospital.
Precisely, the Infanta Elena University Hospital, integrated into the Madrid public health network, has launched a specialized care service for uveitis, the result of this etiological variety of the disease that can lead to blindness.
How is uveitis diagnosed?
“The diagnosis can only be carried out by an ophthalmologist and requires the performance of a battery of ophthalmological and systemic tests, including blood tests, imaging tests and biopsies,” says Dr. Hernanz, while pointing out that “On numerous occasions” this disease requires a multidisciplinary approach in collaboration with services such as Rheumatology, Internal Medicine, Neurology, Hematology and Oncology, among others.
Likewise, the center monitors the patient thanks to the weekly monographic Uveitis Consultation, associated with the Uveitis-Rheumatology Consultation and attended by Dr. Inés Hernanz and Dr. Celia Arconada, the latter’s associate head of the Rheumatology Service and responsible for uveitis from the focus of his hospital specialty, which establishes systemic treatment and monitors the possible adverse effects of the medication.
“A clear example of the coexistence of rheumatological disease and uveitis is ankylosing spondylitis, since it is estimated that around a third of patients will have uveitis during the process of their disease”, maintains Dr. Arconada.
uveitis treatment
This expert also emphasizes that the treatments used depend on the type of uveitis that the patient has, and can be topical, with eye drops, or systemic treatments, mainly by mouth or injections.
“The objective of treatments today is to control inflammation, as well as pain, and to avoid recurrences and their possible complications. These can lead to cataracts, glaucoma, macular edema or retinal detachment, among others”, clarifies the specialist from the Madrid hospital.
However, the rheumatologist stresses that “thanks to the great evolution of drugs in recent years”, and with the appearance of biologics, “the prognosis for this type of disease has totally changed” improving the quality of life of patients who suffer from it and their environment.
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