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Uveite: infiammazione dell’uvea




 

 

Introduzione


L’uvea è una membrana a struttura  vascolare formata dalla coroide, dal corpo ciliare e dall’iride. Le infiammazioni quindi di questa parte dell’occhio vengono definite uveiti, più precisamente, sebbene l’uveite per definizione sia una flogosi dell’uvea, il termine è usato per descrivere molte forme di infiammazione intraoculare che possono colpire non solo l’iride ma anche anche strutture adiacenti.






Definizione




L’ uveite è un’infiammazione della tunica vascolare media dell’occhio. Spesso coinvolge anche strutture oculari adiacenti come la sclera, retina o la cornea. 




Classificazione 




Ancora oggi non esiste una classificazione ottimale dell’uveite, 
si preferisce seguire la seguente classificazione.




Correlata alla sede:




– uveite anteriore


– intermedia


– posteriore 


– panuveite 




Basata sull’ evolutività:


– acuta


– acuta ricorrente 


– cronica  




Classificazione descrittiva:




– uveite granulomatosa 


– non granulomatosa.




Eziopatogenesi 






L’ uveite anteriore è nella maggioranza dei casi idiopatica e 
HLA-B27- negativa. Le forme idiopatiche e HLA-B27- positive 
non associate a una patologia sistemica sono al secondo posto in termini di frequenza, seguita dalle forme associate ad artropatia sieronegativa, spondilite anchilosante, sindrome di Reiter. 
Nelle varie casistiche diversi quadri sono attribuiti anche a cheratouveite da herpes simplex e herpes zoster. Meno frequenti sono l’uveite di Fuchs e le forme secondarie a sarcoidosi, artrite reumatoide giovanile, malattia di Behçet. 


La maggioranza dei casi di uveite intermedia è idiopatica. 
Sono riportati in maniera variabile ma sporadica, eccetto che in casistiche selezionate, forme associate a sarcoidosi, sclerosi multipla, linfomi oculari o del sistema nervoso centrale. 


L’ uveite posteriore è prevalentemente una retinocoroidite  toxoplasmatica. Seguono le forme idiopatiche e sono meno comuni i quadri di sarcoidosi, la malattia di Behçhet, le retinite virali, la toxocariasi. 
Anche la panuveite è più frequentemente idiopatica e si riscontrano quadri di sarcoidosi, malattia di Behçet, 
uveomeningite di Vogt-Koyanagi-Harada (in Oriente e Medio Oriente), toxoplasmosi. 


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