Diagnostic vitrectomy for infectious uveitis

• Authors: Abdallah Jeroudi, Emory University; Steven Yeh, Emory University
• Journal Title: International Ophthalmology Clinics
• Volume: Volume 54, Number 2
• Publisher: Lippincott, Williams & Wilkins | 2014-01-01, Pages 173-197
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/IIO.0000000000000017
• Subjects: Health Sciences, Opthamology; Health Sciences, Pathology
• Keywords: Diagnosis, Differential; Diagnostic Techniques, Ophthalmological; Eye Infections; Humans; Reproducibility of Results; Uveitis; Vitrectomy; Vitreous Body

Abstract

Introduction Identifying the etiology of an infectious or noninfectious uveitis syndrome is important for the clinician and patient because of the range of therapeutic and prognostic implications for each disease entity. For the majority of uveitis syndromes, a diagnosis can be made with a combination of history, clinical examination, laboratory, and radiologic testing. Diagnostic dilemmas may arise, however, when discrepancies are observed in 3 specific settings'an atypical history, atypical clinical presentation, or an inconclusive diagnostic workup that has implications from a therapy standpoint. The dilemma is further compounded when intraocular inflammation persists or worsens after seemingly appropriate local or systemic immunosuppression, which may then raise concerns for an infectious or neoplastic etiology. In these situations, diagnostic vitrectomy may greatly assist in the diagnosis and guide alternative management strategies.