title: Uveitis in adults: What do rheumatologists need to know?
abstract: Rheumatologists may need to establish the etiological diagnosis and handle the therapeutic management of adults with uveitis. To date, no diagnostic strategy for uveitis has been validated by prospective studies. Investigations are selected based on the clinical features and on the anatomic location of the ocular abnormalities. Infections such as syphilis, Lyme disease, tuberculosis, and Whipple's disease may cause uveitis, with concomitant joint inflammation in a few cases. In patients with a known history of chronic inflammatory joint disease, causes of uveitis include bisphosphonate therapy and immunodepression-related infections (e.g., due to Toxoplasma or a herpes virus). Sarcoidosis is an underestimated cause of uveitis, which occurs in 15% of cases, with a predilection for middle-aged women. In spondyloarthritis, uveitis is almost always acute, unilateral, and anterior. Among patients with uveitis and spondyloarthritis, about two thirds have their joint disease diagnosed during an evaluation for uveitis. Therefore, patients with inflammatory or noninflammatory back pain should be routinely evaluated for spondyloarthritis, which is the leading cause of uveitis in western countries. The risk of blindness is extremely low, and the main complication is recurrent uveitis, seen in 50% to 60% of cases. Sulfasalazine decreases the frequency, duration, and severity of uveitis and can be used prophylactically.
authors.affiliation: Service de médecine interne, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, 69361 Lyon cedex 07, France. Electronic address: pascal.seve@chu-lyon.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Sève
authors.affiliation: Université de Lyon, 69361 Lyon cedex 07, France; Service d'ophtalmologie, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Kodjikian
authors.affiliation: Service de médecine interne, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, 69361 Lyon cedex 07, France.
authors.forename: Léopold
authors.initials: L
authors.lastname: Adélaïde
authors.affiliation: Service de médecine interne, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, 69361 Lyon cedex 07, France.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Jamilloux
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D003941:Diagnostic Techniques, Ophthalmological; D019468:Disease Management; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D008297:Male; D012219:Rheumatology / Q000379:methods*; D014605:Uveitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Sarcoidosis; Spondyloarthritis; Sulfasalazine; TNFα antagonists; Uveitis