2. COMPLICATIONS OF UVEITIS
By H.R.Ziai MD

3. Calcific Band-shaped Keratopathy
Cataract
Glaucoma
Hypotony
Cystoid Macular Edema
Iris Atrophy
Vitrous Opacification and vitritis
Retinal detachment
Retinal & choroidal NV

4. Calcific Band-shaped Keratopathy
Chronic Lasting Uveitis
Often childhood onset uveitis ( JRA )
Other causes Keratitis , Trauma , …
Tx : EDTA scrub

7. Cataract
Causes : - Inflammation
- Corticosteroids

8. Cont : 3 m quiet eye before surgery
1-2 w Pre op frequent CS before surg.
3-5 m Post op CS

9. Glaucoma Uveitis has two effect on IOP
- ↓ IOP , 2' to ciliary body shut down
- ↑ IOP with multiple mechanisms

10. Cont. ↑ IOP : 1) Ocular hypertension :
↑ IOP without glaucomatus damage
2) Uveitic glaucoma :
↑ IOP with glaucomatus damage

11. Mechanisms of glaucoma
1- Occlusion of TM with inflamatory produts
2- Closed angle ( PAS )
3- Pupilary block ( PS )
4- Open angle ( primary / trabeculitis , … )
5- CS induced

14. Treatment Medical : rutine drugs PI TrabX ( usually with shunt )
TX is recommened in IOP > 30 mmHg even in absence of optic nerve damage
Medical : rutine drugs PI
TrabX ( usually with shunt )

15. Note : Avoid : 1- Myotics 2- PG. Analogs such as :
latanoprost ( Xalatan ), …

16. Hypotony Caused by low secretion , 2 ' to ciliary body damage
TX with Increasing secrition agents like Ibopamin 2 %

17. Cystoid Macular Edema
CME : can occure in any type of Uveitis but is more common in :
- Pars planitis
- Birdshot retinochoniditis
- Retinal vesculitis

19. Treatment : Anti inflammatory drugs :
1- CS ( PO ,Topical , Subtenon , …)
20-40 mg triamcinolone suprotemporal subtenon
2- NSAID : ↓ effect
3- Intrvitreal ( 2-4 mg triamcinolone )

21. Iris Atrophy :
- Late complication
- In HZV more common

23. Vitrous Opacification and vitritis
- During active phase
- Permanent
P.P vitx is thrapeutic and diagnostic

26. Retinal detachment R.RD is occurred in 3% of Uveitic patient.
More frequent in - Panuveitis
- Infectious Uveitis
- Pars Planitis
- Post. Uveitis
R.RD often occurs during active phase of dis. , so surgery often becomes complicated and poor PX.

27. Retinal & choroidal Neovascularization
NV: In any Uveitis
But more common in - PP
- Sarcoidosis
- Retinal vasculitis
Mechanism - Chronic inflammation
- Capillary nonperfusion

29. Cont . NV : - Post. Uveitis - Pan Uveitis TX : - ↓ Inflammation
- Laser therapy
- CS
- Immunomodulators
- VEGF inhibitors

30. Thank you
for
your attention