Tests and diagnosis of Uveitis

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The ophthalmologist may perform a variety of successive tests to diagnose uveitis:

Visual test

Visual acuity. The most important functional parameter is visual acuity. It may decrease due to corneal or crystalline lens opacity, inflammation of the anterior chamber or the vitreous chamber, altered function of the retina or optic nerve, or due to the onset of complications, such as macular oedema. Visual acuity should be measured at each visit and can be used to monitor the clinical evolution of uveitis and the response to treatment and is therefore extremely useful when it comes to making therapeutic decisions. It is quick and easy to assess and provides a lot of information.

Drop in the eye to dilate it

Intraocular pressure in both eyes. The most accurate test is called Goldmann applanation tonometry and involves instilling a fluorescein eyewash, often yellowish in colour, with a short-acting local anaesthetic. It is important to evaluate the intraocular pressure because some types of uveitis are associated with ocular hypertension. Inflammatory ocular hypertension (uveitic glaucoma) entails complicated treatment as it has a negative long-term effect on visual acuity.

slit lamp examination

Slit lamp examination. During the ophthalmological examination the doctor observes the eye with a special microscope called a slit lamp. In cases of uveitis the specialist may observe the presence of inflammatory cells floating in the intraocular fluids and can determine the degree and type of inflammation. To examine the back of the eye, where the retina and optic nerve are located, the ophthalmologist will place some pupil dilating eye drops, called mydriatics, such as tropicamide or cyclopentolate. These drops can temporarily blur your vision.

retinography

Retinography. A retinography is a photo of the eye fundus used to examine the retina, optic nerve, vascular tree and macula. Thanks to new wide-field imaging techniques, ophthalmologists can now observe a 200° extension of the retina and even up to the peripheral retina.

In function of the results, additional tests may be required:

campimetry

Perimetry. A perimetry, campimetry or visual field test is an examination used to assess any alterations in the patient’s visual field. The visual field is the total space the eye can capture while focusing on a central point. Ophthalmologists can use this test to detect any type of peripheral vision loss and they also obtain a map of this loss which guides them in the diagnosis of certain pathologies (glaucoma, diseases of the retina, optic tract lesions, etc.).

Patients do not need to do anything to prepare for this type of test, which is painless and does not have any contraindications.

optical coherence tomography

Optical coherence tomography (OCT). OCT is a complementary test used to determine whether the retina is working correctly and if there is any intra/subretinal fluid present.

Angiografía

Fluorescein angiography (FAG). Fluorescein angiography examines blood flow in the posterior portion of the eye. A contrast agent is injected intravenously and circulates through vessels in the retina, thus affording a real-time evaluation of the retina’s vascular tree. In cases of uveitis, the fluorescein dye can be seen leaking from the vessels because they are inflamed. Whereas in retinal vascular diseases, including vasculitis, FAG reveals whether there are any areas of the retina with poor blood flow (ischaemia) or which have even developed new vessels.

Blood extraction tube

Further complementary tests that can help guide the diagnosis are a blood analysis and other imaging tests, such as a chest X-ray, a CAT or MRI scan.

Substantiated information by:
Alfredo Manuel AdánOphthalmologist — Ophthalmology DepartmentMarina MesquidaOphthalmologist — Ophthalmology DepartmentVíctor LlorensOphthalmologist — Ophthalmology Department

Published: 20 February 2018
Updated: 20 February 2018

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