Uveitis in Eyes: How swelling and irritation occur? Know about the new diagnostic method

Uveitis, a rare inflammatory eye illness, is responsible for five to ten percent of blindness worldwide. In particular, posterior uveitis is frequently associated with significant disease progression and the requirement for immunosuppressive medication. In posterior uveitis, inflammation develops in the retina as well as the underlying choroid, which gives nutrients to the retina.

Colour-coded fundus autofluorescence was investigated as a potential innovative diagnostic tool by researchers at the University of Bonn’s Department of Ophthalmology. The fluorescence of the retina can be used to determine the type of uveitis. This is a necessary requirement for appropriate disease diagnosis and therapy.

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Blurred vision, floaters and unusual light perception – those affected by the rare disease posterior uveitis feel no pain. “But the consequences can be severe: About five to ten percent of blindness worldwide is caused by uveitis. Uveitis is a rare disease, but posterior uveitis in particular potentially has a poor prognosis and often requires immunosuppressive therapy,” explains Dr. Maximilian Wintergerst of the Ophthalmology Department at the University of Bonn. There are different forms of the disease. In posterior uveitis, the retina or choroid in the eye becomes inflamed. While the retina converts the incident light into nerve impulses, the choroid supplies the outer layers of the retina with nutrients.

“It’s not easy to distinguish between the numerous subtypes of uveitis,” says Wintergerst. However, since the different subtypes often require a different therapeutic approach, a reliable diagnosis is all the more important. This is why researchers from the Ophthalmology Department at the University of Bonn, together with colleagues from the Medical Biometry and Rheumatology Departments at the University Hospital Bonn and the University Hospital of Ophthalmology in Bern (Switzerland), investigated a new imaging technique that can assist in the diagnosis of posterior uveitis.

The team evaluated colour-coded fundus autofluorescence (Spectrally Resolved Autofluorescence Imaging). The CenterVue (iCare) company from Padua (Italy) provided the newly developed device to the researchers for the examinations. This process involves illuminating the retina with bluish light. The retina absorbs the light and emits it again at a different wavelength. The device measures this fluorescence and splits the signals into a green and a red component.

“The green-to-red ratio of the light emitted from each inflammatory focus depends, among other factors, on the exact posterior uveitis subtype involved,” Wintergerst explains. The researchers examined the eyes of 45 study participants. In all of them, the exact subtype of uveitis was diagnosed beforehand. This included ophthalmologic examination findings, laboratory investigations, serologic and radiologic findings, and in some cases genetic and interdisciplinary clinical examinations.

“In the current study, we present the precise technical background of color-coded fundus autofluorescence in ophthalmology in collaboration with our international partners,” says head of department Prof. Dr. Frank Holz. “This technology may also allow better monitoring of posterior uveitis in the future, in addition to more reliable diagnoses.”