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Speaker shares experiences managing uveitis
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KOLOA, Hawaii — When a sputum test is negative but there is a high degree of suspicion that a patient has tuberculosis, a decision whether to treat the disease needs to be made, a speaker said here.
Sharing from his own experiences, Thomas A. Albini, MD, said at Retina 2014, “There’s no easy way to make these types of treatment decisions except for familiarity with these types of disease.”
For suspected tuberculosis, physicians should be more concerned about people from endemic areas or those more likely to be exposed, such as family members of affected individuals and health care workers.
Thomas A. Albini
In other experience, Albini said that although lymphoma is a rare disease, “leopard spots” seen on ocular imaging may be a clue. If the physician suspects lymphoma, then magnetic resonance imaging of the brain should be ordered.
“It’s critical to get imaging of the brain in these patients. Making that diagnosis early is what can save them,” Albini said.
Another pearl for physicians treating uveitis is to sometimes reconsider the original diagnosis, especially when the patient is not responding to treatment as expected. For example, in a case where the patient is diagnosed with acute retinal necrosis and is not responding to treatment, reconsider the differential diagnosis: Behçet’s disease, syphilis, lymphoma and toxoplasmosis, he said. –by Patricia Nale
Disclosure: Albini is a consultant for Allergan, Bausch + Lomb, Biotherapeutics and Thrombogenoics; he has received grant support from Genentech.