Uveitis andsystemic disease

A prospective studywasconducted of865 patients withuveitis todetermine thefrequency ofassociated systemic diseases andto assess thevalue oflimited laboratory screeningofthese patients. Allpatients underwent a standard diagnostic protocol followed -when indicated - byspecial tests andprocedures performed inorderoflikelihood ('tailored approach'). For628patients (73%)aspecific diagnosis wasestablished basedonhistory, ophthalmologic examination, andlaboratory andradiographic studies. A definite association withsystemic disease wasdetermined for 220patients (26%). A relationship withasubclinical systemic disorder couldbepresumed in201cases (23%) andawell-established clinicaluveitis entity without arecognisable systemic disorder waspresent in207cases(24%). For237patients (27%) adiagnosis could notbe determined. Themostfrequently observed systemic diseases weresarcoidosis (7%)and HLA-B27-associated seronegative spondylarthropathies (6%).Presumedor definite toxoplasmosis wasencountered in10%of cases.HLA-B27-associated acuteanterior uveitis wasthemostcommonclinical entity (17%). Inthemajority ofcases thepresence of asystemic disease wasnotsuspected prior to eyeinvolvement andwasonly recognised after thesubsequent diagnostic procedures.