Uveitis
Uveitis includes a number of diseases that are associated with intraocular inflammation. It can be unilateral or bilateral. Five to 20 percent of globally registered cases of blindness result from uveitis.1 A meta-analysis of incidence studies revealed a pooled incidence of of 50.45 per 100,000 of the population.2 Worldwide, uveitis is the fourth most reason of visual impairment in the working-age population of developed countries1
Depending on the age, the location of the inflammatory process (anterior, intermediate, posterior uveitis, panuveitis), gender and histopathology (granulomatous, non-granulomatous), the type of inflammatory process (acute, chronic, recurrent) and the etiology (infectious, non-infectious) the incidence and prevalence of uveitis differs.3
Five to ten percent of all uveitis cases affect children. Five to 25 percent of blindness in children is due to uveitis. The rate of infectious uveitis in children is between 20 and 25 percent.4 The most important risk factors for uveitis in children are rheumatic diseases.5 44 percent of all uveitis cases in Germany are the result of systemic diseases.6
The complexity and clinical relevance of uveitis is also reflected in the number of publications found on the PubMed medical database in 2024. Just by entering the keyword “Uveitis 2024”, 1,935 clinical and scientific publications were found on 23.01.2025 for the relevant year.
Clinical guidelines for the management of uveitis exist from the professional associations of ophthalmology and optometry. Examples of these include the relevant guidelines of the “Professional Association of Ophthalmologists in German (BVA) and the German Society of Ophthalmology (DGO)7 as well as the Clinical Management Guidelines of the British professional association “The College of Optometrists”.8
In this context, the publication by Ghadiri et al.9, who carried out a “systematic review of clinical guidelines for uveitis” in academic databases (MEDLINE, Embase, CINAHL, Global Health, Global Index Medicus) and guideline databases, is also interesting.
The current OCL is also focusing on two uveitis case reports:
• Ocular inflammation associated with sarcoidosis: anterior uveitis, vitritis and macular edema
• Ocular manifestation of Behçet's syndrome
which are certainly of interest for clinical practice.
Uveitis in general requires not only up-to-date specialist knowledge and good clinical expertise, but also good cooperation between the eye care professions and above all with other medical disciplines, as uveitis is often associated with systemic diseases.
[1] Llorenç, V., Mesquida, M., Sainz de la Maza, M., Keller, J., Molins, B., Espinosa, G., Hernandez, M. V., Gonzalez-Martín, J., Adán, A. (2015). Epidemiology of uveitis in a Western urban multiethnic population. The challenge of globalization. Acta Ophthalmol., 93, 561-567.
[2] Garcia-Aparicio, A., de Yébenes, M. J. G., Oton, T., Munoz-Fernandez, S. (2021). Prevalence and Incidence of Uveitis: A Systematic Review and Meta-Analysis. Ophthalmic Epidemiology, 28, 461-468.
[3] Tsirouki, T., Dastiridou, A., Symeonidis, C., Tounakaki, O., Brazitikou, I., Kalogeropoulos, C., Androudi, S. (2016). A Focus on the Epidemiology of Uveitis. Ocul. Immunol. Inflamm., 26, 2–16.
[4] Ngathaweesuk, Y., Hendrikse, J., Groot-
Mijnes, J. D. F., de Boer, J. H., Hettinga Y. M.
(2024). Causes of infectious pediatric uveitis: A review. Surv. Ophthalmol., 69, 483-494.
[5] Thurau, S. (2020). Childhood Uveitis. Klin. Monbl. Augenheilkd., 237, 1177-1186.
[6] Stübiger, N., Farrokhi, S., Gkanatsas, Y., Deuter, C., Kötter, I. (2022). Assoziation der verschiedenen Uveitisformen mit entzündlich rheumatischen Erkrankungen und ihre Therapie [Association of the different forms of uveitis with inflammatory rheumatic diseases and their treatment]. Z. Rheumatol., 81, 667-681.
[7] Berufsverband der Augenärzte Deutsch-
lands e.V. (BVA) und Deutsche Ophthalmologische Gesellschaft (DOG). (2023). S1 Leitlinie „Nicht-infektiöse anteriore Uveitis“. https://register.awmf.org/assets/guidelines/045-022l_S1_Nicht-infektioese-anteriore Uveitis_2024-03.pdf. Referencing: 06 January 2025.
[8] College of Optometrists. (2023). Clinical Management Guidelines: Uveitis (anterior). https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/uveitis_anterior. Referencing: 06 January 2025.
[9] Ghadiri, N., Reekie, I. R., Gordon, I., Safi, S., Lingham, G., Evans, J. R., Keel, S. (2023). Systematic review of clinical practice guidelines for uveitis. BMJ Open Ophthalmol., 8, e001091.