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The clinical importance of uveomeningeal syndromes

Klinische Bedeutung von Uveomeningealsyndromen

  • review article
  • Published:
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Summary

Background

The aim of this review is to summarize the current knowledge about clinical findings, diagnostic work-up, and treatment of uveomeningeal syndromes, with special emphasis on the uveitic features of these pathologies.

Materials and methods

A thorough literature search was performed in the PubMed database. An additional search was conducted in Google Scholar to complete the collected items.

Results

Uveomeningeal syndromes is an umbrella term for a group of pathologies that affect the uvea, retina, and meninges. They present with a plethora of clinical features ranging from meningitis and meningoencephalitis to uveitis. A wide spectrum of infectious, inflammatory, and neoplastic conditions have been associated with these clinical entities. However, these syndromes are probably an autoimmune and inflammatory disorder, as they mainly cause inflammation to the ocular and neurologic body structures. However, less frequently, infectious uveitis with concomitant acute or chronic meningoencephalitis can also lead to uveomeningeal syndrome. Primary vitreoretinal (and central nerve system) lymphoma, as well as paraneoplastic disorders, should also be part of the differential diagnosis, before diagnosing a case as uveomeningeal syndrome.

Conclusion

The diagnostic approach in a patient with uveomeningeal syndrome can be extremely challenging. Thorough ophthalmic and medical history together with a detailed ophthalmic and systematic assessment forms the cornerstone of a holistic approach to these cases. A systematic algorithm is necessary for a methodical diagnostic and treatment approach, to organize an effective management plan for patients with uveomeningeal syndromes.

Zusammenfassung

Hintergrund

Ziel dieser Übersicht ist es, das aktuelle Wissen über die klinischen Befunde, die diagnostische Aufarbeitung und den therapeutischen Ansatz von Uveomeningealsyndromen zusammenzufassen, wobei der Schwerpunkt auf den uveitischen Merkmalen dieser pathologischen Veränderungen liegt.

Material und Methode

Eine gründliche Literaturrecherche wurde in der PubMed-Datenbank durchgeführt. In Google Scholar erfolgte eine zusätzliche Suche, um die gesammelten Elemente zu vervollständigen.

Resultate

Das Uveomeningealsyndrom ist ein Überbegriff für eine Gruppe von pathologischen Veränderungen, welche die Uvea, die Netzhaut und die Meningen betreffen. Sie weisen eine Vielzahl klinischer Merkmale auf, die von Meningitis und Meningoenzephalitis bis Uveitis reichen. Mit diesen klinischen Einheiten wurde ein breites Spektrum an infektiösen, entzündlichen und neoplastischen Zuständen in Verbindung gebracht. Diese Syndrome stellen jedoch wahrscheinlich eine Autoimmunerkrankung und eine entzündliche Erkrankung dar, da sie hauptsächlich Entzündungen der Augen- und neurologischen Körperstrukturen verursachen. Weniger häufig kann eine infektiöse Uveitis mit einer damit einhergehenden akuten oder chronischen Meningoenzephalitis auch zu einem Uveomeningealsyndrom führen. Das primäre vitreoretinale Lymphom (und das Lymphom des zentralen Nervensystems) sowie paraneoplastische Erkrankungen sollten ebenfalls Teil der Differenzialdiagnose sein, bevor ein Fall als Uveomeningealsyndrom diagnostiziert wird.

Schlussfolgerung

Die diagnostische Abklärung bei einem Patienten mit Uveomeningealsyndrom kann äußerst schwierig sein. Eine gründliche ophthalmologische und medizinische Anamnese sowie eine detaillierte ophthalmologische und systematische Beurteilung bilden den Eckpfeiler eines ganzheitlichen Ansatzes. Ein systematischer Algorithmus ist für einen methodischen Diagnose- und Behandlungsansatz erforderlich, um einen effektiven Managementplan für Patienten mit Uveomeningealsyndrom zu organisieren.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Ave., 45110, Ioannina, Greece

    Dimitrios Kalogeropoulos MD, MSc, PhD candidate, Ioannis Asproudis, Maria Stefaniotou & Chris Kalogeropoulos

  2. Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, B18 7QH, Birmingham, UK

    Dimitrios Kalogeropoulos MD, MSc, PhD candidate & Soon Wai Ch’ng

  3. 1st Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Marilita Moschos

  4. Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Spyridon Konitsiotis

  5. Laboratory of Microbiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece

    Constantina Gartzonika

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  1. Dimitrios Kalogeropoulos MD, MSc, PhD candidate
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All authors participated in the planning, research, and writing of the final manuscript, as well as in the reviewing and rewriting of the revised version.

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Correspondence to Dimitrios Kalogeropoulos MD, MSc, PhD candidate.

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D. Kalogeropoulos, I. Asproudis, M. Stefaniotou, M. Moschos, S. Wai Ch’ng, S. Konitsiotis, C. Gartzonika, and C. Kalogeropoulos declare that they have no competing interests.

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Kalogeropoulos, D., Asproudis, I., Stefaniotou, M. et al. The clinical importance of uveomeningeal syndromes. Spektrum Augenheilkd. 38, 1–16 (2024). https://doi.org/10.1007/s00717-021-00500-x

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