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La uveítis
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La uveítis

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Definición:

La uveítis es la inflamación de la úvea, parte del ojo dividida en la úvea anterior (formada por el iris y los cuerpos ciliares) y la úvea posterior (formada por la coroides).

La úvea es la capa intermedia del globo ocular, situada entre la esclerótica (más externa) y la retina (más interna).

Clasificación:

Existen tres tipos principales de uveítis en función de la zona afectada:

Uveítis anterior: Está inflamada la úvea anterior. Se denomina iritis si afecta al iris y iridociclitis si afecta al iris y a los cuerpos ciliares

Uveítis posterior: Se denomina también coroiditis por afectar a la coroides. Si además de la coroides afecta a la retina se denomina coriorretinitis

Uveítis intermedia: Se denomina también pars planitis si afecta a una parte posterior del cuerpo ciliar llamada pars plana.

Además existen dos formas de aparición de uveítis:

Aguda: Inflamaciones bruscas de pocos días. Son habituales en la uveítis anterior

Crónica o persistente: La inflamación puede durar meses o años. Es la forma habitual de la uveítis posterior

Causas:

La uveítis puede ser idiopática (sin causa aparente) o ser causada por otras enfermedades. En la mitad de los casos no se conoce la causa.

Su aparición es más frecuente entre los 20 y 45 años.

La uveítis anterior suele ser unilateral (sólo aparece en un ojo) y aparece en personas que padecen

Enfermedad de Crohn

Espondilitis anquilosante

Síndrome de Reiter

Artritis reumatoide

Artritis crónica juvenil

En cuanto a la uveítis posterior puede aparecer de tres formas diferentes:

Asociada a enfermedades sistémicas:

Sarcoidoisis

Síndrome de Vogt-Koyanagi-Harada

Enfermedad de Behçet

No asociada a enfermedades sistémicas:

Oftalmia simpática

Vasculitis de retina

Por causas infecciosas:

Coriorretinitis por citomegalovirus

Coriorretinitis por toxoplasma

Uveitis posterior herpética producida por el virus del herpes

La uveítis intermedia (pars planitis) puede estar relacionada con:

Enfermedad de Chron

Esclerosis múltiple

Síntomas:

Los síntomas varían dependiendo del tipo de uveítis que se padezca:

Uveítis anterior:

Ojos rojos

Dolor

Fotofobia

Dificultad para la acomodación

Uveítis posterior:

No produce enrojecimiento de los ojos o si lo produce es muy leve

Moscas volantes (miodespsias)

Disminución de la agudeza visual

Uveítis intermedia:

Moscas volantes (miodespsias)

Diagnóstico:

Se puede diagnosticar mediante el examen de fondo de ojo que permite observar el interior del globo ocular.

En la uveítis anterior se aprecia turbidez de la cámara anterior (espacio situado entre la córnea y el iris) y en la uveítis posterior se observa turbidez del humor vítreo (vitritis).

Tratamiento:

El tratamiento principal es eliminar la causa que ha provocado la uveítis.

La uveítis anterior se puede tratar usando:

Midriáticos para dilatar la pupila y evitar dolores

Corticoides para disminuir la inflamación

La uveítis posterior se puede tratar usando:

Corticoesteroides

Inmunodepresores (Ciclosporina)

La pars planitis (uveítis intermedia) se trata con gotas que contengan esteroides.tuotromedico

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