00:01
Infectious etiologies
for Uveitis are many.
00:05
Viral infections are probably
the most common out of this list.
00:08
We're going to have four
different causes but viruses
are probably going to be
number one on the hit parade.
00:14
So Herpes simplex 1 and
2, Cytomegalovirus,
particularly immunocompromised
patients, Varicella zoster.
00:21
Those are going to be the more
common causes for uveitis overall
of the infectious form.
00:27
Bacterial infections can also
do this but tuberculosis,
bartonella,
that's cat scratch disease.
00:33
Those are going to be less common overall
particularly in developed countries.
00:38
In developing
portions of the world,
these may be an important
contributor to infectious uveitis.
00:45
Fungal infections can also
in certain endemic areas
be an etiology again,
these are much less common
than the viral
causes of uveitis.
00:55
And histoplasmosis,
blastomycosis, candidiasis.
00:59
And then finally, parasitic infections-
toxo, cysticercosis, onchocerciasis.
01:04
All of these things
not quite as common,
particularly in the developed
portions of the world.
01:11
There are also many immune
mediated etiologies.
01:14
So uveitis, inflammation of the
uvea, inflammation of the choroid,
of the ciliary body, of the iris
actually, is part and parcel
frequently occurs in other
immune mediated diseases,
autoimmune diseases and
other places in the body.
01:31
So uveitis may be a secondary
manifestation of Multiple sclerosis
or a Behcet's disease,
a kind of an oral mucosal
and vascular inflammatory
autoimmune disease.
01:45
It can be part and parcel of
Juvenile idiopathic arthritis,
it can be part of Sarcoidosis,
it can be part of
Tubulointerstitial nephritis
and uveitis that's
an entity (TINU).
01:57
You can have it as part
of Ulcerative colitis,
you can have it as part
of Ankylosing spondylitis,
you can have as part
of Crohn's disease,
you can have as part of
Systemic lupus erythematosus.
02:09
So, any of a variety
of autoimmune diseases
probably as a consequence
either immune complex deposition
or a secondary T cell that
response that is recognizing
some antigenicity within the eye
is responsible for driving
immune-mediated uveitis.
02:30
There are also therapies
that can cause uveitis
and these are tend
to be idiosyncratic,
not everyone who gets these
drugs is going to get it.
02:39
So, Rifabutin,
which is used for the treatment of
atypical mycobacteria infections
in patients with HIV AIDS
can cause idiopathic uveitis.
02:50
Some patients who receive
the Fluoroquinolones
such as ciprofloxacin for bacterial
infection can get uveitis.
02:58
Some intravitreal medications,
for example, if we get into the
vitreous for other reasons, vancomycin,
that can induce it, again,
not an every patient.
03:09
Kinase inhibitors,
particularly the BRAF kinase inhibitors
use for the treatment
of melanomas
can be a cause of uveitis.
03:17
And then, if we muck around in the
eye with an intraocular surgery,
that just inflammation that's associated
with intraocular surgery trauma
can lead to an inflammation,
secondary inflammation.
03:33
So, overall, idiopathic,
even though we talked about viruses
and we talked about all those other
manifestations, secondary autoimmune.
03:41
Idiopathic uveitis is the most
common etiology, meaning...
03:44
Yeah, you got it.
03:46
We don't know what's causing
it but we're going to treat it
because it can lead to
significant morbidity,
loss of vision, and we're going to
treat it because it's an inflammation
and we know how to
treat inflammation.