Diagnosing Uveitis: Value and Limitations of Current Diagnostic Tests

The Dutch national uveitis guideline advises on the diagnostic work-up of uveitis patients. However, some of the included diagnostic tests as well as their value in the work-up for new uveitis patients were so far not systematically studied.
With the rise of novel diagnostic tests in the past decades (i.e. diagnostic aqueous humor analysis, QuantiFERON testing), diverse infectious agents were implicated in uveitis, such as Rubella Virus, Epstein-Barr Virus and M. tuberculosis. The clinical spectrum of uveitis caused by Rubella virus is not known since the previous studies had a strong inclusion bias and included mostly patients with Fuchs Uveitis Syndrome. Despite the multiple case series, EBV-associated uveitis and (latent) M.tuberculosis infection-associated uveitis remain an enigma, and the clinical characteristics of uveitis caused by these agents are not well documented.
The tests for sarcoidosis in patients with uveitis are commonly employed, but their diagnostic value during an early stage of uveitis was not systematically studied (e.g. ACE and chest X-ray). Also the diagnostic value of novel test for sarcoidosis (the soluble interleukine-2 receptor; sIL-2R) was not well investigated. General inflammation markers like lymphocyte count, ESR and CRP were since long used in the diagnostic work-up of uveitis patients, but their diagnostic value in the uveitis population is not known.