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Oogheelkunde 1: Uveïtis van Sander Beers

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Samenvatting van HC 1 van Oogheelkunde, blok D, jaar 2.

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  • April 26, 2022
  • 12
  • 2021/2022
  • Class notes
  • Sander beers
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Oogheelkunde
1: Uveïtis

Uveïtis:
- Ontsteking van de uvea (vaatvlies) en aanliggende
structuren
- Ontsteking van de iris, corpus ciliare, pars plana en
choroidea
- Klinisch beeld is vooral afhankelijk van:
o Anatomische lokalisatie: SUN-classificatie
o Oorzaak:
 Specifieke oogheelkundig
 Infectieuze systeemaandoening
 Niet-infectieuze systeemaandoening

Ontsteking:
- Algemene, aspecifieke reactie van het lichaam op
beschadiging van weefsel
- Doel: verwijderen schadelijke agens en herstellen van de schade
- Oorzaak:
o Extern: microbieel (infectie), chemisch (verbranding
door zoutzuur), fysisch (verbranding door zonlicht)
o Intern: auto-immuun reactie
- Rubor: roodheid
- Calor: warmte
- Tumor: zwelling
- Dolor: pijn
- Functio laesa: functie vermindering

Anatomische classificatie (SUN):
- Uveïtis anterior: iris + corpus ciliare (90%)
o Iritis
o Iridocyclitis
o Cyclitis
- Uveïtis intermedia: pars plana
o Pars planitis
- Uveïtis posterior: choroidea
o Chorioiditis
o Chorioretinitis
- Panuveïtis: alle lagen van de uvea doen dan mee!

Klinisch beeld:
- Uveïtis anterior:
o Acuut: pijnlijk rood oog met visusdaling
o Chronisch: geleidelijke visusdaling
- Uveïtis intermedia: floaters met visusdaling
- Uveïtis posterior: geleidelijke pijnloze visusdaling
- Panuveïtis: rood, floaters, visusdaling

, Statistiek:
- Incidentie: 1-5 per 10.000
- Prevalentie: 10 per 10.000 (recidivering!)
- 94% volwassenen, 6% kinderen
- 90% uveïtis anterior

Uveïtis anterior
Kenmerken:
- Gemengde roodheid: ciliare- én bulbaire roodheid
- Miosis
- (pijn, visusdaling)
- Irregulaire pupil: pupil kan verkleven met de lens
- Descemetstippen: binnenkant cornea (KP’s), neerslag van leukocyten op het endotheel
- Granulomen: ontstekingshaartjes in de iris
- Hypopyon: neerslag van witte bloedlichaampjes onderin VOK
- Cellen
- Flare: eiwit




= descemetstippen




= granulomen




Flare (Tyndall): T+++ Cellen: C+++

Lichte uveïtis: T+ C+
Sterke uveïtis: T+++ C+++

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