Uveitis

as Uveitis becomes strictly speaking an inflammation of the Aderhautschicht (Uvea), consisting of the vein skin (Choroidea), the jet body (ciliary body) and the iris (iris), designates. Generally one seizes all forms of an inflammation of the eye inside and the adjacent fabric however under the term Uveitis together (thus inflammation of the leather skin Skleritis and the Sehnerven Neuritis nervi optici, Papillitis. Uveitis is to be understood thus as an upper grasp for a great many different illnesses and not as its own illness! An optician recognizes a Uveitis by the presence of free inflammation cells in the front chamber or in the glass body of the eye.


Table of contents

classification

it gives different possibilities, that in the first moment to range of the Uveitis hardly which can be grasped (approx. to divide 50 different disease pictures here summarized). A possibility is after the anatomical localization (where the inflammation is in the eye located?). One places oneself here the question: Where is the density of free inflammation cells highest in the eye?

As a function of the infestation sample that different forms are differentiated:

  1. the anteriore Uveitis is an inflammation of the front range of the Uvea, above all the iris and the ciliary muscle. Only if cells are in the eye front chamber speak one of an iritis, are also few cells behind the lens v.a. in the front glass body one speaks of a Iridozyklitis. Accompanying a Makulaödem and a Papillenödem can occur here.
  2. the intermediate Uveitis concerns the middle part of the Uvea. One finds here the highest density of free inflammation cells in the glass body. In addition, few cells can be present in the front chamber. A special form of the intermediate Uveitis is the Pars planitis, particularly with which one finds inflammatory deposits (snowbank) at the lower transient area between retina and ciliary body. Bundles the inflammation cells in the glass body area together, one speaks oneself of snowballs. Accompanying here a Periphlebitis retinae ( container inflammation of Netzhautvenen, Vaskulitis) can occur, a Makulaödem and a Papillenödem.
  3. the posteriore Uveitis covers now also changes (infiltration with inflammation cells) in the retina and vein skin. One speaks then depending upon infestation of Retinitis, Chorioiditis and Chorioretinitis.
  4. the Panuveitis shows in all 3 ranges inflammation cells, however nothing states over the weight of the inflammation.


In addition one can proceed during the organization of the Uveitis according to explanation models. One places oneself here the question: Is the infestation sample at the eye of a defined illness zuordenbar?

Here the following forms are differentiated:

  1. the primary Uveitis is not further explainable, apart from the anatomical allocation (s.o.), (approx. 40% of the patients). One called this form in former times also endogenously or idiopatisch
  2. the secondary Uveitis (approx. 60% of the patients), itself further divided into associated with system illness, infection and eyepiece the syndrome

of both forms one must define the Masquerade forms (pseudo Uveitis). These look in the first moment only in such a way; with further diagnostics one states however that it itself here e.g. around tumors in the eye (e.g. okulozerebrales lymphoma) acts. The alleged inflammation cells are here tumor cells. Other pseudo Uveitiden is among other things the Retinitis pigmentosa and the pigment dispersion syndrome.

symptoms

this distinction is again reflected in the severity level of the illness: The inflammation of rear vein skin portions (Posteriore Uveitis/Panuveitis) leads more frequently to a durable reduction of visual acuity (acute: Cloud-see, blurring seeing) as a anteriore Uveitis, with which the eye turning red stands in the foreground. Furthermore arise: Pain, foreign body feeling, luminous sensivity, flow of tears. Generally applies: the further the inflammation is located anatomically in the eye in front and outside, the more complaints it prepares for the patient. The typical symptoms of a Uveitis anterior are red eye, pain, luminous sensivity; the symptoms of a Uveitis intermedia are however veil and point marriages with outwardly white eye; the complaints of a Uveitis posterior can be either minimal for the patient (infiltrates to lie outside of the place of sharpest seeing) or a not moving cloud before the place of sharpest seeing.

secondary one forms

under secondary forms of a Uveitis one summarizes disease pictures of a intraokularen inflammation, which one - apart from the allocation to the anatomical localization (s.o.) - a defined name to give can. I.e. certain finding constellations step (e.g. at the eye, with laboratory values or other illnesses outside of the eye) up, with which one can build the individual puzzle parts up to an overall view, which one knows then an illness name to-wise in the sense of a puzzle play. This is from patient view a very much more meaningful organization, there now clear statements concerning therapy possibilities, prognosis, possibly. Infestation of the still healthy partner eye, process etc. to be made can. So far was one erroneous-proves assumed “first the cause of the Uveitis must be found, before one can therapieren at all ". Here the definition was the so-called. A “cause” unclearly. Often one understood by it simply illnesses outside of the eye, in whose attendants it admits is that in the process also a participation of the eye can occur (so-called. System illnesses or auto+immunological illnesses such as Sarkoidose, disease Bechterew or chronic-inflammatory intestine illnesses on (disease Crohn, Colitis joke-pink). In addition, a “cause” can be an infection illness, like Toxoplasmose, Herpes, Tuberkulose or Borelliose. Here the actual exciter must play no more role; often immunological Begleit or Folgereaktionen is the reason that possibly. persistent at the eye arising inflammation. Also to eyepieces the syndromes, therefore certain finding constellations, only at the eye arise with otherwise i.d.R. recover patients (e.g. Fuchs' Uveitissyndrom, Birdshot Chorioretinopathie, HLA-B27-positive acute anteriore Uveitis) after this classification naturally also among the secondary forms are ranked, because the experienced optician can it due to the clinical findings recognize and to the patient a therapy concept offer.

therapy

the acute treatment usually takes place with Kortikosteroiden (with a anterioren Uveitis as eye drops, otherwise as tablets). Additionally in the acute phase Mydriatica are recommended. With very frequent thrusts a durable systemic Immunsuppression, for example with Mycophenolat Mofetil, is recommended. An influence of the disease picture by climatic cures at the dead sea is very disputed and could not not be shown so far in founded scientific studies.

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