January 19, 2025
2 min learn
Key takeaways:
- Keep away from a “kitchen sink” work-up, as a substitute specializing in historical past, findings and imaging.
- Remedy choices embody antimicrobials and steroids.
KOLOA, Hawaii — Begin with the affected person’s chief criticism when making a differential analysis in uveitis, a retina specialist mentioned at Retina 2025.
“You see a brand new uveitis affected person in your schedule, and also you’re pondering that is form of a clinic killer, as a result of these sufferers undoubtedly take a bit of extra time,” Roger A. Goldberg, MD, MBA, mentioned.

When making a differential analysis in uveitis, keep away from a “kitchen sink” work-up. Picture: Adobe Inventory
Whereas many elements go into uveitis analysis, Goldberg mentioned it is very important keep away from a “kitchen sink” workup. As an alternative, he steered that clinicians ought to goal their method based mostly on historical past, findings and imaging. Nonetheless, he all the time checks sufferers for syphilis.
Goldberg additionally mentioned it is very important deal with the highest of the chart when figuring out a analysis, beginning with the chief criticism/historical past of current sickness, exposures and previous medical historical past.
“With uveitis, it’s a must to hearken to the affected person,” he mentioned. “The indicators in ophthalmology are very particular, signs often nonspecific. Nevertheless it’s useful to hearken to the signs the affected person is complaining about.”
Goldberg mentioned anterior uveitis comes with ache, mild sensitivity and redness; intermediate uveitis comes with floaters and blurred imaginative and prescient; posterior uveitis comes with blurred imaginative and prescient, blind spot and flashes or photopsias; and, “panuveitis is a bit of little bit of the entire above,” he mentioned.
Goldberg additionally advised clinicians to have a look at the entire affected person, together with their age, gender, ethnicity and look. Issues like rashes, poliosis, scleritis or episcleritis may be seen and not using a slit lamp and assist decide a analysis.
Though there may be grading system for uveitis, Goldberg mentioned it may possibly have excessive interobserver variability. As an alternative, he likes to quantify the variety of cells per high-powered subject and measure the peak of the hypopyon.
Imaging additionally performs an essential position, based on Goldberg. He mentioned OCT may also help determine which layers of the retina are concerned, infrared imaging may also help search for modifications above the retinal pigment epithelium, and fundus autofluorescence may also help monitor illness exercise in choroiditis.
Clinicians have quite a lot of therapy choices accessible for uveitis, together with antimicrobials for infectious uveitis and native steroids delivered topically for anterior or intermediate or intravitreally for intermediate or posterior, Goldberg mentioned.
“I’ll prescribe systemic steroids — oral steroids — for sufferers,” Goldberg mentioned. “I can’t prescribe steroid-sparing brokers. I work with a rheumatologist.”
He famous that Genentech is creating a brand new therapy known as vamikibart, an anti-IL-6 antibody.