How to avoid the perils of uveitis diagnostic management
WAIKOLOA, Hawaii — It is important for physicians to consider “the perils that dwell” in the diagnostic management of patients with uveitis, Steven Yeh, MD, said during a presentation at Hawaiian Eye 2022.
“With these patients being very complex oftentimes, we really just don’t want to miss something,” Yeh said.
To better identify “the pearls amongst the perils” in uveitis diagnosis, it is important to recognize key history elements and systemic symptoms during patient evaluation, Yeh explained. Yeh also noted that clinical pattern of uveitis can influence selective, confirmatory testing, and that ophthalmologists should rule out infectious disease processes during differential diagnosis and avoid empiric local corticosteroids in those scenarios.
Yeh explained that he uses a “rubric-based approach” for diagnosing uveitis that relies on classifying uveitis’ anatomic location, ruling out infection and identifying systemic disease associations.
When evaluating intermediate uveitis, factors to consider include syphilis, tuberculosis, sarcoidosis, primary vitreoretinal lymphoma and pars plana subtype.
For primary vitreoretinal lymphoma, Yeh said that although there are variations between institutions, cytopathology remains the “gold standard” in terms of diagnostic tools.
“It's important to work with the cytopathologist as well as the hematology team in terms of which [diagnostic] is most appropriate for a setting,” Yeh said.
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Yeh S. Diagnostic management of uveitis: Finding pearls amongst the perils. Presented at: Hawaiian Eye; Jan. 15-21, 2022; Waikoloa, Hawaii.
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