Uveitis and neurologic diseases: an often overlooked relationship.
OBJECTIVE
Eye and brain are linked by development, and immune privileges preserve the integrity of these delicate organs thereby preventing irreversible defects in function. Manifestation of inflammatory or immune-mediated diseases in both systems seems perspicuous, yet during check-up of patients with uveitis they are rarely considered. In this study we aimed to determine the frequency of neurologic diseases in our uveitis patients and to describe the characteristics of ophthalmologic findings.


METHODS
We analyzed the database of 1973 consecutive patients seen between 2000 and 2004 at the uveitis clinic at the hospital of the Medical University of Vienna. All cases of uveitis associated with neurologic co-manifestations of immune-mediated diseases were selected.


RESULTS
Of 1973 patients with uveitis, 52 (2.6%) had neurologic diseases that were considered to be related to the eye inflammation. The most frequent entities were multiple sclerosis, Vogt-Koyanagi-Harada's disease, neurobehcet, central nervous system lymphoma, neurosyphilis and neurosarcoidosis. Uveitis was only rarely seen with infectious meningoencephalitis (neuroborreliosis, mumps, measles), Takayasu arteritis, Guillain-Barre syndrome or orbital pseudotumor.


CONCLUSIONS
Several diseases can cause both ocular and/or central nervous system inflammation. This should prompt ophthalmologists and neurologists in the presence of one to rule out the other. In uveitis patients without evident neurological symptoms, specific ocular pathologies can help the treating ophthalmologist to tailor the work-up, whereas neurologists should always screen their patients, even when they are asymptomatic for ocular disease. Early diagnosis in both cases can help to initiate adequate treatment, thereby modulating the course of the disease and preventing complications.
Maca
Saskia M
SM
Department of Ophthalmology, AKH, Medical University Vienna, Vienna, Austria.
Scharitzer
Martina
M
Barisani-Asenbauer
Talin
T
D001317:Austria / Q000453:epidemiology; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D009422:Nervous System Diseases / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013223:Statistics as Topic; D014605:Uveitis / Q000453:epidemiology*