Jeevakala, C (2009) Etiological pattern of anterior uveitis in a referral hospital. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Uveitis is such a small word and yet in common usage in most medical circles it encomposes the entire spectrum of intraocular inflammation:- iritis, iridocyclitis, parsplanitis, posterior uveitis, choroiditis, retinitis and retinal vasculitis The Uvea of the eye consist of iris, ciliary body and choroid which is the eyes major blood supply. Uveitis is broadly defined as inflammation of [i.e:-itis]of uvea [from the latina uva meaning grape] The study of uveitis is complicated by the fact that the cause of inflammatory reaction of the inner layer can be infection, traumatic, neoplastic or autoimmune. Inflammation may be acute, subacute or chronic. With inflammation and repair that as a protective response may not only damage inflamed target tissue but also may participate in collateral damage of surrounding normal tissue. Pathological classification of uveitis is into granulomatous and non granulomatous with distinct etiologies, features, sequelae and treatment for each category. Some uveitis entities occur bilaterally eg;-APMPPE and others occur unilaterally-ARPE ( acute retinal pigment epithelitis) Age sex and race may also help the clinician to narrow the diagnostic possibilities. AIM OF THE STUDY: Etiological pattern of anterior uveitis in a referral hospital 1. To identify the different causes of anterior uveitis and syndromes causing anterior uveitis in our hospital population. 2. To compare the pattern of anterior uveitis with that of the other studies MATERIALS AND METHODS: STUDY DESIGN AND METHODOLOGY A prospective study of 83 cases of anterior uveitis was conducted at uvea clinic, Department of Ophthalmology, GRH during the period from January 2008 to June 2008. Any case of anterior uveitis that was presented for the first time to our hospital was included in the study. Lens induced uveitis like phacolytic glaucoma was also included in the study. Cases of anterior uveitis secondary to trauma was also included. Cases with corneal pathology like infection were excluded from the study. Cases were followed up for a period of 4-5 months from the period of onset and were documented thereby avoiding repetition. After clinical examination the defined cases were subjected to a battery of questions regarding the time of onset progression and regarding various etiologies associated. The patients were subjected to relevant laboratory investigations, a clinical diagnosis made and appropriate treatment started. AGE : HLA-B27 associated uveitis and Behcet syndrome usually affect young adults. Uveitis associated with JRA and ocular toxocariasis typically affects children. It is less common for primary uveitis to first manifest in old age, suspect a masquerade syndrome. SUMMARY: That the mean age of presentation of the 83 cases of anterior uveitis was found to be 41.8 years with S.D of 15.1 years. Sex wise the number of male patients were 62.7% and female patients were 37.3% Acute anterior uveitis was seen in 92% of the cases and the rest 7.2% were chronic anterior uveitis. Majority of acute anterior uveitis was unilateral with 79 case (95.2%). CAU involved in both eyes seen in 4 cases (4.8%). Koeppe’s nodule were seen in CAU in 8.4%. That 43.9% the majority of the cases that had anterior uveitis were idiopathic Trauma and postoperative anterior uveitis were the next major cause with 31.7% One case of uveitis was seen in Fuch’s heterochromic cyclitis, IBD and RD induced. Lens induced uveitis was seen in 5 cases (6.1%), Phacolytic glaucoma and treatment consisted of surgical removal of lens. Tuberculosis as cause of uveitis was seen in 3 (3.7%) patients. Systemic association was absent in 92.8% of the patients while 7.2% had anterior uveitis associated with a systemic condition Complication included complicated cataract 3.6%, secondary glaucoma in 1.2% of patients and corneal opacity following corneal trauma in 13.4%. Final visual acuity following treatment of an episode of acute anterior uveitis was excellent in 77.1% of cases. 18.1% had acuity between <6/18 – 6/60 and preexisting lenticular changes contributed to decrease in vision. CONCLUSION: The cause of uveitis vary greatly by geographical region throughout the world. Such variation is due largely to complex ecological, racial, nutritional and socioeconomic differences. Many developing countries have a tropical climate allowing unique disease pathogens, vectors and host reservoir to flourish. Poverty, overcrowding, limited formal and public education, poor hygiene and finite medical resources also play a role. The perineal migration of people from city to city and around the world requires that all phycisians be aware of global variations in disease pattern to provide optimal medical care. There are an estimate 45 million blind people in the world today of whom approximately 75% live in developing nations. Although data on the prevalence and incidence of uveitis as a cause of vision loss in developing region are scarce, it is probably safe to say that ocular complications of well recognised and endemic infection constitute a major cause of blindness. we review those infectious and non infectious cause of anterior uveitis encountered most often in the developing world.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Etiological pattern; anterior uveitis |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 22 Sep 2017 05:57 |
| Last Modified: | 22 Sep 2017 05:57 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3252 |
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