Benign Masquerade Syndromes in Differential Diagnosis of Uveitis
Authors:
P. Svozílková 1; E. Říhová 1; prof. MUDr. Jarmila Heissigerová, Ph.D., MBA 1; M. Brichová 1; D. Jeníčková 1; J. Šach 2
Authors‘ workplace:
Oční klinika VFN a 1. LF UK Praha, přednostka doc. MUDr. B. Kalvodová, CSc.
1; Ústav patologie FNKV a 3. LF UK Praha, přednosta prof. MUDr. V. Mandys, CSc.
2
Published in:
Čes. a slov. Oftal., 64, 2008, No. 5, p. 175-184
Overview
Purpose:
To present our experience with the diagnosis of benign masquerade syndromes, to evaluate the prevalence, clinical features and diagnostic tests.
Methods:
A retrospective study of 42 patients treated for benign uveitis masquerade syndromes at our Department for Diagnosis and Treatment of Uveitis, 1st Faculty of Medicine in Prague, between 1996 and 2006, was performed.
Results:
Seventy-nine patients with masquerade syndromes (7.1%) from all 1112 patients with uveitis were included. Malign masquerade syndromes were recognized in 37 patients (19 females and 18 males, mean age 55 years) and benign masquerade syndromes in 42 patients (23 females and 19 males, mean age 33.7 years). The most frequent cause of benign masquerade syndromes was a group of vascular anomalies (22 patients). The primary diagnosis was infectious or idiopathic uveitis in many cases. The most valuable diagnostic procedures were fluorescein angiography and analysis of intraocular fluids.
Conclusion:
Diagnosis of masquerade syndromes should be considered in all patients with idiopathic corticosteroid-resistant chronic uveitis. Timely diagnosis and treatment may improve the prognosis of masquerade syndromes.
Key words:
benign masquerade syndrome, uveitis, diagnostic pars plana vitrectomy
Sources
1. Akpek, E.K., Ahmed, I., Hochberg, F.H. et al.: Intraocular – central nervous system lymphoma: clinical features, diagnosis and outcomes. Ophthalmology, 106, 1999: 1805-1810.
2. deBarge, L.R., Chan, C.C., Greenberg, S.C. et al.: Chorioretinal, iris and ciliary body infiltration by juvenile xanthogranuloma masquerading as uveitis. Surv. Ophthalmol., 39, 1994: 65-71.
3. deBoer, J.H., Verhagen, C., Bruinenberg, M. et al.: Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis. Am. J. Ophthalmol., 121, 1996: 650-658.
4. Bovey, E.H. and Herbort, C.P.: Vitrectomy in the management of uveitis. Ocul. Immunol. Inflamm., 8, 2000: 285-291.
5. Char, D.H.: Coats syndrome: long term follow up. Br. J. Ophthalmol., 84, 2000: 37-39.
6. Foster, C.S. and Vitale, A.T.: Diagnosis and treatment of uveitis. WB Saundres company, Philadelphia, 2002: 1-868.
7. Galloway, G.D., Ang, G.S., Shenoy, R. et al.: Retained anterior chamber cilium causing endophthalmitis after phacoemulsification. J. Cataract Refract. Surg., 30, 2004: 521-522.
8. Gündüz, K.: Transpupillary thermotherapy in the management of circumscribed choroidal hemangioma. Surv. Ophthalmol., 49, 2004: 316-327.
9. Islam, N. and Dabbagh, A.: Inert intraocular eyelash foreign body following phacoemulsification cataract surgery. Acta Ophthalmol. Scand., 84, 2006: 432-434.
10. Kadrmas, E.F. and Weiter, J.J.: Choroidal osteoma. Int. Ophthalmol. Clin., 37, 1997: 171-182.
11. Kirath, H. and Eldem, B.: Management of moderate to advanced Coats disease. Ophthalmologica, 212, 1998: 19-22.
12. Liu, K., Klintworth, G.K. and Dodd, L.G.: Cytologic findings in vitreous fluids. Acta Cytol., 43, 1999: 201-206.
13. Matsuo T.: Photoreceptor outer segments in aqueous humor: key to understanding a new syndrome: Surv. Ophthalmol., 39, 1994: 211-233.
14. Nussenblatt R.B., Whitcup S.M. and Palestine A.G.: Masquerade syndromes. In: Uveitis: Fundamentals and clinical practice. Mosby-Year Book, Inc., St. Louis, 1996: 385-395.
15. Plskova, J., Greiner, K. and Forrester, J.V.: Interferon-alpha as an effective treatment for noninfectious posterior uveitis and panuveitis. Am. J. Ophthalmol., 144, 2007: 55-61.
16. Rothova, A., Ooijman, F., Kerkhoff, F. et al.: Uveitis masquerade syndromes. Ophthalmology, 108, 2001: 386-399.
17. Sauer, A., Lenoble, P., Bader, P. et al.: Ocular complications of hepatitis C treatment. J. Fr. Ophthalmol., 30, 2007: e20.
18. Shields, J.A., Shields, C.L., Honavar, S.G. et al.: Clinical variations and complications of Coats disease in 150 cases: The 2000 Sanford Gifford memorial lecture. Am. J. Ophthalmol., 131, 2001: 561-571.
19. Stewart, J., Halliwell, T. and Gusta, R.K.: Cytodiagnosis of Coats disease from an ocular aspirate. Acta Cytol., 37, 1993: 717-720.
20. Theodore, F.H.: Conjunctival carcinoma masquerading as chronic conjunctivitis. Eye Ear Nose Throat Mon., 46, 1967: 1419-1420.
21. Velasque, L., Ducousso, F., Pernod, L. et al.: Anterior uveitis and topical brimonidine: a case report. J. Fr. Ophthalmol., 27, 2004: 1150-1152.
22. Zamir, E., Wang, R.C., Krishnakumar, S. et al.: Juvenile xanthogranuloma masquerading as pediatric chronic uveitis: a clinicopathologic study. Surv. Ophthalmol., 46, 2001: 164-171.
23. Zierhut , M.: Masquerade syndromes. In: Uveitis, differential diagnosis. AEP Press Science Publisher, the Netherlands, 1995: 184-188.
Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2008 Issue 5
Most read in this issue
- Benign Masquerade Syndromes in Differential Diagnosis of Uveitis
- Long Term Outcomes of Chronic Abducens Palsy Surgical Treatment in Children and Adults
- 3D Ultrasonography Diagnostics of the Eye and Orbit
- Ophthalmic Complications after the Embolization of the Internal Carotid Artery – a Case Report