Uveitis, Anterior, Nongranulomatous
- Author: Abdullah Al-Fawaz, MD, FRCS; Chief Editor: Hampton Roy Sr, MD more...
Background
Iritis, or anterior uveitis, is the most common form of ocular inflammation encountered. It is a common cause of a painful red eye. Inflammation of the iris may appropriately be termed iritis, whereas inflammation of the iris and the ciliary body is called iridocyclitis. Iritis may be subdivided into 2 broad categories: granulomatous and nongranulomatous.
This article addresses nongranulomatous iritis, although iritis due to a granulomatous disease process may have a nongranulomatous appearance. For information about granulomatous disease, see Uveitis, Anterior, Granulomatous. The most common form of nongranulomatous anterior uveitis is acute anterior uveitis (AAU), which is associated with the HLA-B27 allele in half to two thirds of patients.
Pathophysiology
The exact pathophysiology is not known. Inflammation of the iris and the ciliary body causes a breakdown of the blood-ocular barrier. This condition allows both protein and WBCs to extravasate into the aqueous, resulting in the typical iritis signs of cell and flare. Frequently, the cause is idiopathic, but certain ocular and systemic diseases may be the underlying cause of the iritis.[1]
Epidemiology
Frequency
United States
Iritis is the most frequent form of uveitis that is encountered by ophthalmologists. In one community-based study, anterior uveitis accounted for more than 90% of all cases of uveitis. The annual incidence rate is approximately 8 cases per 100,000 population.[2]
International
No particular geographic distribution for iritis has been noted.
Mortality/Morbidity
- Morbidity arises from iritis and any associated disease process, if present.
- Patients may develop posterior synechiae, and, if severe, a secluded pupil and subsequent angle-closure glaucoma may result.
- Associated ocular complications (eg, cataract, glaucoma) may result in severe vision loss.
Race
No significant racial differences exist. HLA-B27–associated anterior uveitis is more common in Caucasians.
Sex
No significant sexual differences exist. Although, the male-to-female ratio of ankylosing spondylitis, which is a common cause of iritis, is 3:1.[3]
Age
Iritis may develop in patients of any age but most commonly in the fourth and fifth decade of life.
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