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Beitragstitel The Importance of Neuroimaging in Intermediate Uveitis
Beitragscode P82
Autor:innen
  1. Will Innes Augenklinik Wettingen Präsentierende:r
  2. Nicole Caroline Stern Augenklinik Wettingen
  3. Martina Monika Bösch Augenklinik Wettingen
  4. Pascal Knecht-Bösch Augenklinik Wettingen
Präsentationsform ePoster
Themengebiete
  • Neuroophthalmology / Strabology
  • Uveitis / Intraocular Inflammation
Abstract-Text Purpose
To report a patient who suffered of chronic intermediate uveitis with rare recurrences. Many years after onset and regular follow-up/treatment of the intraocular inflammation, an MRI study of the brain confirmed multiple disseminated T2 high signal lesions throughout the subcortical white matter.

Methods
Single case report and review of literature

Results
A 32-year-old male initially presented with a non-infectious intermediate uveitis in the absence of neurological symptomatology. A thorough work up at a tertiary centre was inconclusive, he was then treated successfully for five years using topical and subtenonal steroids. In order to reduce steroid treatment, biologicals were considered. Repeat detailed questioning revealed paresthesia of the upper extremities. MRI of the central nervous system was performed primarily to rule out demyelinating disease. The MRI showed clear evidence of demyelination with diagnostic, prognostic and therapeutic sequelae.
Disseminated encephalomyelitis (MS) can affect the eyes and visual system in a number of ways, demyelinating optic neuropathy and ocular motility disorders relating to brain stem lesions being the most commonly recognized. Whilst the association of MS with uveitis has long been established, the incidence of uveitis in MS patients is 1%, as well as 1% of patients in uveitis clinics having MS as a systemic association of their ocular inflammation. Most often, the demyelinating disease occurs in intermediate uveitis. However, anterior or panuveitis may also present, mostly with granulomatous features.
Furthermore, ocular and neuro-inflammatory activity may present asynchronously.

Conclusion
This case demonstrates the importance of repeated search for neurological symptoms in patients with intermediate uveitis to rule out MS.