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1/12BMJ | 16 OCTOBER2010 | VOLUME 341 53

For the full versio s of these !rti"les see #$%&"o$ CLINICAL R E VI E W

' vesti( ! tio ! ) $! !(e$e t of uveitisC!theri e M *ul+,1 Joh VForr ester 2

1-#er )ee Ro+!l ' fir$!r+,-#e r )ee -B2. 2/0, U 2' stitute of Me)i"!l "ie "es,U iversit+ of -#er)ee ,-#er)ee-B2. 2/Corr es o )e "e to5 C M*ul+"!theri e&(u l+ 6)o " to rs& o r( &u7

Cite this !s5 B M J 2010 8341 5"49:6)oi510&1136;#$%&"49:6

- full, $u"h lo (er ! rt i"le,i "lu) i ( sever!l $ore i$!(es! ) < e # refere "es, is o

#$%&"o$&

Uveitis is esti$!te) to !""ou t for 10= of #li ) ess i eo> le of

!tie ts )ers th!t $!+ #e rel!te) to i fe"tio or !re o >i f e"tive& Th e uve! "o$ rises the iris, "ili!r+ #o)+, ! )"horoi)& Uveitis $ ! + !ffe"t other tissues i the e+e,ho

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CLINICAL R E VI E W

5' BMJ | 16 OCTOBER2010 | VOLUME 341

st!rts, ! ) is $ost i te se, !rou ) the e)(e of the "o r e! @"ir"u$"or e!lB&' !e+e

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BoG1 | t! )!r)ise) o$e "l!ture for uveitisI

- ! to$ i"! lJ - teriorK ri$!r+ site of i fl!$$!tio is the ! terior "h!$#er J ' te r $ e) i! te K ri$ ! r + site of i fl!$$!tio is the vitr eousJ Hos terior K ri$ ! r + site of i fl!$$!tio is the reti ! or "horoi)J H! uveitis K i f l! $$ ! tio i ! terior "h!$#er ! ) vitreous ! ) reti ! or "horoi)

O setJ u))e or i s i) ious

ur ! tioJ Li$ ite) @ 3$o ths or ersiste t @M3 $ o thsCour seJ - "ute K su))e o set ! ) li$ite) ) ur ! tioJ R e"urr e t K r e e! te) e iso)es se !r!te) #+ erio)s of i !"tivit+ !re hi(her i ) evelo >i ( th! )evelo e)

"ou t r ies&< 14

$ow do %atients with uveitis )osevision!C!uses of visio loss i uveitis i "lu)e "+stoi) $ ! "u l! roe)e$!, "!t!r!"t, se"o )!r+ (l!u"o$!, vitreouso ! "i ties

BoG2 | ' f e"tio s ! ) s+ste$i" )ise!ses !sso"i!te) i f e"tious ero e(!tive! r thr o ! th+ - 7 +los i ( s o ) +litis R eiter Ds s+ ) r o$ e' f l! $$ ! tor + #oi f e"tious

! r "oi) os isMulti le s"ler os isL+$ ho$ !Hosterior uveitis ! ) ! uveitis 0o >i f e"tious

! r "oi) os isBeh etDs s+ ) r o$ eVo( t> o+! ! ( i> ! r ! ) ! ) ise! seI L+$ ho$ !' f e"tio r el! te)ToGo l! s$ os isTu #e r "ulos is

C+to$ e( ! lovir us+ hilis

ToGo"! ri! s iser es s i$ leG virus

V! ri"ell! Poster virusE ) o( e ous e ) o hth! l$ itisI- $ultis+ste$ i fl!$$!tor+ "o )itio of u 7 o< "!use! ff e"ti ( the e+es, !u)itor+ s+ste$, $e i (es, ! ) s7 i

@i fl!$$!tor+ "ell )e#ris or vitreous h!e$orrh!(eB,re ti ! l v!s"ul!r o""lusio s, "horioreti !l s"!rri (,i fl! $$ !t or + o ti" euro !th+, ! ) reti !l) et! "h$e t &2

C+stoi) $!"ul!r oe)e$! ! ) se"o )!r+ "!t!r!"t !reth e le!)i ( "!uses of visu!l loss fro$ uveitis i the U! ) Euro e&2 . C+stoi) $!"ul!r oe)e$! refers to thef or $ ! >

* i++ e&entia) dia nosis o+&ed e , e - t , %i( a) %&e s entin s,.%to.s

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Pain R edu ( ed vision Photo%ho/ia $ a)oe s * is ( ha & e Othe&

- "ute ! terior uve itis Mil) to $ o) er ! te R e)u "e) or or $ ! l Hr ese t R ! r el+ Te! ri ( or ! #se t- "ute ( l! u"o$ ! evere ever e l+ r e)u "e) Hrese t or ! #s e t Hr ese t Te! ri ( or ! #se t Vo$ iti (

"leritis evere R e) u"e) or or $ ! l - #se t - #s e t - #se tE is"leritis Mil) or ! #se t or$!l - #se t - #s e t - #se t *ritt+Cor e! l ul"er # ! "teri! l Mo) er ! te R e) u"e) or or $ ! l Hr ese t - #s e t Hur ule t

er es si$ leG 7 er ! titis Mo) er ! te R e)u "e) or or $ ! l Hr ese t - #s e t ? ! ter +Cor e! l er os io Mo) er ! te R e) u"e) or or $ ! l Hr ese t - #s e t Te! ri (B!"teri!l " o %u "tivitis - #se t or$!l - #se t - #s e t Hur ule t *ritt+Vir ! l "o %u "tivitis - #se t or$!l - #se t - #s e t ? ! te r + *ritt+

- ller ( i" "o %u "tivitis - #se t or$!l - #s e t - #s e t Mu"oi) or !#se t ' t"h

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CLINICAL R E VI E W

'f i fe"tio rel!te) uveitis or $!li( ! "+ is sus e"t e),l!#or!tor+ eG!$i !tio of ! !Queous or vitreouss! $ le usi ( $ole"ul!r te"h iQues "! #e useful i$!7i ( ! )i!( osis ! ) (ui)i ( tre!t$e t& !l e+e tio is ee)e) to est!#lish

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CLINICAL R E VI E W$ow does o(u)a& i.a in he)%!O"ul!r i$!(i ( is use) to !ssess the site ! ) severit+ of i fl!$$!tio i the

oster ior se($e t of the e+e ! ) to $o itor the res o se to tre!t$e t& Fu )usflu ore s"ei ! (io(r! h+ is erfor$e) #+ (ivi ( ! i tr!ve ous i %e"> tio of )+e ! )t!7i ( seri!l reti !l i$!(es to sho< re ti ! l v!s"ulitis ! ) reti !l ! ) "horoi)!l )ise!se@fi( 3 &O ti" ! l "ohere "e to$o(r! h+ is ! o >i v!sive te"h olo(+ th!t uses lo