Diagnostic strategy in uveitis: A prospective study in 125 cases

Background: The diagnosis of uveitis is a difficult one and subject to much debate between ophthalmologists and internists. In 1992, we carried out a prospective study to assess the importance of the internist's consultation, the contribution of an extensive laboratory evaluation and to propose a well considered diagnostic strategy. Material and methods: From 1992 to 1995, all patients seen at consultation at the Grenoble University Hospital had a complete ophthalmologic evaluation, an internist's consultation, an extensive laboratory evaluation and a follow-up for at least 6 months. Results: One hundred twenty five patients were included. The rate of diagnosis was 72%. The internist's help was useful in at least 68% of the diagnoses. Laboratory and radiography tests provided pertinent information in 77% of the cases. Follow-up allowed finding 11% of the diagnoses. The analysis of the clinical and laboratory tests enabled us to establish a diagnostic strategy chart where the key pint is clinical and ophthalmologic evaluation. A minimal laboratory evaluation systematically performed for all cases of uveitis is proposed and, according to some characteristics of uveitis, a well-targeted laboratory evaluation is recommended. Conclusion: This diagnostic strategy enabled establishment of the diagnosis in 92% of the cases and limited laboratory evaluation for 68 patients. We are performing a new prospective study to better validate this diagnostic chart.