Oral or genital ulcers
Skin rashes/lumps or bumps
Family/ancestors from Turkey, Middle East, central Asia
*BRVO (vasculitic changes) with posterior uveitis*
Anterior uveitis with shifting/sterile hypopyon + white eye
Smoky vitreous without condensations (vitritis)
ONH neuropathy (risk becoming atrophic) – life threatening! Refer to medics
Inflammatory markers – FBC / CRP / ESR
Syphilis serology and Quantiferon-TB Gold test – rule out the differentials
MRI brain – if neurological involvement
FFA – determine areas of ischaemia for treatment
Refer to physician
Differential diagnosis: TB ; Syphilis
Anterior uveitis – treat aggressively with topical steroids and mydrilates.
Laser photocoagulation – areas of ischaemia or macular oedema.
Neurology symptoms – physician involvement urgently
For any neurology associated symptoms or vasculitis or macular retinitis – pulsed IVMP then oral prednisolone (long-term). This is followed by immunosuppression.
Immunosuppression – mycophenolate mofetil (common) ; alternatives – cyclosporin or azathioprine.
Biologics – anti TNF agents (infliximab or adalimumab).
RRD – rare – usually after intravitreal steroid treatment or tractional related cause from prolonged vitritis – treat with scleral buckle or PPV