ETIOLOGIC INQUIRY IN 110 CASES OF UVEITIS - CONTRIBUTION OF ANTERIOR-CHAMBER AND VITREOUS PARACENTESIS

Purpose Evaluation of the frequencey of each aetiology, comparison wit h recent and previous publications, focus on less classical pathologie s, and interest of some complementary investigations. Methods Prospect ive study of one hundred and ten cases of uveitis, submitted to aetiol ogical investigations, including when feasible or necessary, an anteri or chamber paracentesis and a vitreous paracentesis. Results An aetiol ogy was identified in 65 % of the cases. Toxoplasmosis still remained the most frequent diagnosis (one out of four), followed by viral infec tion (15 %), especially herpes simplex (9 %), a notion as yet not ment ioned in large statistical surveys, including recent ones. Tuberculosi s allergy and rhumatismal diseases (ankylosing spondylitis) represent the two other large groups (5 % each). The vest is divided among the o ther classical causes. These results, particularly toxoplasmosis and v iruses, are always based on biological criteria, on the Witmer-Desmont s ratio in aqueous humour, or even the same ratio in vitreous. Conclus ion This study confirms the predominant role of anterior chamber parac entesis, the only means of establishing a firm diagnosis for certain c ategories uveitis (toxoplasmosis and viruses); it is questioned to the benefit of a purely biomicroscopic diagnosis, leading to blatant erro rs, as demonstrated by the results of anterior chamber paracentesis. T his study also shows, due to this paracentesis, the increasing role of viruses in the aetiology of uveitis, emphasizing the risks taken when arty uveitis is systematically submitted to corticotherapy.