Uveitis Diagnostic Testing Options

Steven Yeh, MD: One of the key considerations is ruling out an infectious process. Syphilis needs to be excluded via rapid plasma reagin (RPR) or microhemagglutination assay (MHAPT); sarcoidosis should be ruled out via angiotensin-converting enzyme (ACE) lysozyme and possibly an Iodized calcium test. If the patient presents with lower back pain or if the uveitis is acute onset or if the patient has a typical pattern of acute anterior uveitis -including redness and light sensitivity -I may order a human leukocyte antigen (HLA) B27. There are also rare disease syndromes, such as tubular interstitial nephritis in uveitis, that should be tested for via beta2 microglobulan (B2M). In pediatric uveitis, I consider ANA rheumatoid factor erythrocyte sedimentation rate (ESR), as well as HLA-B27. If a patient has risk factors for tuberculosis or is from an at-risk population, I consider a purified protein derivative (PPD) or QuantiFERON test.