Investigations

Establishing the aetiology of uveitis is often a challenge

It is important to obtain a detailed ocular and medical history, together with an accurate ocular examination and eye imaging.

Laboratory tests can be helpful in establishing the underlying cause of uveitis.

However, a positive investigation should be always interpreted in view of the type of uveitis and patient’s clinical history.

History

Including age, gender, race, geographic origin, past ocular history, past medical history, sexual practices, pets, medications/drugs are of importance when considering specific uveitic conditions.

Blood tests

Include non-specific tests, such as full blood count, inflammatory markers (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)), renal and liver function. Syphilis serology and Quantiferon test for tuberculosis are usually performed in all patients with uveitis.

Additional infectious tests, such as toxoplasmosis serology, are performed in case of clinical suspicion. Angiotensin-converting enzyme (ACE) and lysozyme are performed with the diagnostic suspicion of granulomatous disease, such as sarcoidosis. HLA tissue typing, including HLA-B27, HLA-A29, HLA-B51, is requested based on the type of uveitis and the diagnostic hypothesis.

Radiology

Including chest Xray and/or chest computed tomography (CT) to exclude tuberculosis or sarcoidosis, brain magnetic resonance (MRI) to exclude multiple sclerosis, might be necessary.

Ocular imaging

includes optical coherence tomography and angiography.

Optical coherence tomography (OCT)

OCT is a non-invasive diagnostic test, proving information on the retina and choroid. The test is commonly used for the diagnosis of several uveitis conditions.

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Fluorescein and indocyanine green angiography

Angiography is a diagnostic procedure providing information on the retina, choroid and blood vessels of the eye. The test is commonly used to help in the diagnosis of uveitis, assess it severity, and as a monitoring to assess the response to treatment and the presence of complications.

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