PATTERNS OF UVEITIS AS A GUIDE IN MAKING RHEUMATOLOGIC AND IMMUNOLOGICAL DIAGNOSES

Objective. To describe the patterns of clinical presentation in a seri es of 407 patients with uveitis and to establish the relationship betw een these patterns and the final diagnosis. Methods. Patients were ref erred to the Uveitis Clinic of a tertiary hospital from January 1992 t o January 1996, All patients received a complete ophthalmologic examin ation, and a general clinical history was obtained, The current Intern ational Uveitis Study Group classification system was used for anatomi c classification, To establish the final diagnosis of the most common entities causing uveitis, current diagnostic criteria were used, A dis criminant analysis, with diagnostic grouping as the outcome variable a nd the clinical presentation features as discriminating variables, was performed. Results. With our classification system, 66.5% of the case s could be correctly classified according to the clinical pattern and morphologic findings, By diagnostic groups, discriminant analysis show ed that 75% of patients with Behcet's disease, 77.1% of those with spo ndylarthropathy (including inflammatory bowel disease), 33.3% of those with sarcoidosis, 97.9% of those with toxoplasmosis, 85.7% of those w ith Vogt-Koyanagi-Harada syndrome, 100% of those with herpes, and 50.4 % of those with idiopathic uveitis were correctly classified, In the m iscellaneous group, which included disease entities with fewer than 5 cases, 42.9% were correctly classified. Conclusion. Rheumatologic eval uation of the patient with uveitis can be more cost-effective if the r eferring ophthalmologist follows the classification system described h erein, allowing a tailored approach in which only specific and necessa ry diagnostic tests are used.