"Coming from South to North" What kind of eye disease is the "uveitis" that Old Wu suffers from?

Recently, the TV series "South to North" has been popular. In the play, Wu Changgui's vision gradually deteriorates due to "uveitis", which affects his train driving work and has attracted widespread attention from the audience. So, what kind of eye disease is "uveitis"? Next, let us learn about this disease together.

1. What is “uveitis”?

Uveitis is an inflammatory disease that occurs in the uvea, retina, retinal blood vessels, and vitreous body of the eye. It is a common eye disease in ophthalmology. Because it is closely related to many systemic diseases, has many types, and is prone to recurrence, it poses great challenges to diagnosis and treatment. Therefore, it is also called "a hard nut to crack in ophthalmology." It can occur at any age, but it is more common in young people and adults. Some people describe uveitis as a "red eye disease" that causes blindness quietly. About 10% of blindness in the United States is caused by uveitis, and it ranks 3rd to 10th among eye diseases that cause blindness in my country [1]. This inflammatory disease seriously affects the patient's visual health and quality of life, and requires sufficient attention and timely treatment.

2. What is the “uvea”?

The uvea, also known as the pigment membrane, is named for its shape resembling a purple grape. As the second layer of the eyeball wall, it is divided into three parts: the front, middle, and back, namely the iris in the front, the ciliary body in the middle, and the choroid in the back. Because the uvea has abundant blood flow and slow blood flow rate, it provides sufficient blood nutrition for the eyeball. However, pathogenic antigens in the blood are also precipitated here, making the uvea one of the most easily inflamed parts of the body and closely related to a variety of systemic diseases.

3. What are the causes of uveitis?

(1) Infectious factors: The uveal tract is susceptible to invasion by microorganisms such as bacteria, fungi, viruses, and parasites. Infection can originate from within the body (endogenous) or from the external environment (such as after surgery or trauma).

(2) Autoimmune factors: Normal eye tissue contains a variety of uveitis-related antigens. When the body's immune function is disordered, it may produce an immune response to these antigens, thereby causing uveitis. If you have symptoms of uveitis, scleritis, etc., you should be alert to the possibility that they are related to autoimmune diseases. While seeking help from an ophthalmologist to clarify the nature of the eye disease, please also be sure to visit the rheumatology and immunology department to rule out potential autoimmune diseases. Early diagnosis and early treatment are crucial.

(3) Metabolic disorders: Due to various reasons, the amount of oxygen free radical metabolites increases significantly, which may not only directly cause tissue damage, but also induce the release of other inflammatory mediators, thereby aggravating the inflammatory response.

(4) Family genetic history: The onset of uveitis may also be affected by family genetics.

4. What are the symptoms of uveitis?

(1) Red and painful eyes, photophobia, tearing, and gradual decrease in vision.

(2) Some people do not experience redness or eye pain, but may experience floating shadows, blurred or distorted vision, flashing lights, and their vision may be affected.

(3) If uveitis is not treated promptly, the condition may worsen and cause complications such as cataracts, glaucoma, macular edema, optic nerve atrophy, and eyeball atrophy, which may eventually lead to permanent blindness.

5. How to treat uveitis?

If you have symptoms related to uveitis, please seek medical help as soon as possible to avoid delaying treatment. The diagnosis of uveitis requires caution because its causes are complex and diverse. Ophthalmologists need to have a deep understanding of the causes, types, and relationship with systemic diseases to provide key guidance for treatment and prognosis.

The treatment plan needs to be formulated according to the specific situation of the patient and varies from person to person. Some patients only need local medication, while others need systemic treatment; the type of medication and duration vary from disease to disease. If there is an immune disease, a two-pronged approach is needed, treating both the eye disease and the immune disease at the same time.

6. Fluocinolone implant: New hope for the treatment of uveitis In the era of "South to North", due to the limited level of medical technology, many patients could not receive timely treatment and eventually became blind. The emergence of the latest intraocular injection drug, fluocinolone vitreous implant, in June 2022 has provided a new treatment approach for the treatment of uveitis. It became the first drug approved for import registration in my country based on overseas clinical trial data and real-world clinical data of domestic patients. What's even more exciting is that on December 13, 2023, fluocinolone vitreous implant was officially included in the medical insurance reimbursement scope through national negotiations. From January 1, 2024, the new policy came into effect, bringing tangible economic relief to patients with uveitis and opening up a new path for treatment for them.

Data source:

[1] Zhang Yang, Liu Jing. Research progress on the treatment of anterior uveitis with traditional Chinese and Western medicine [C]//The 5th Annual Academic Conference of the Ophthalmology Committee of the World Federation of Chinese Medicine Societies, the 13th Annual Academic Conference of the Ophthalmology Committee of the Chinese Society of Integrated Traditional Chinese and Western Medicine, the 13th Annual Academic Conference of the Ophthalmology Branch of the Chinese Association of Traditional Chinese Medicine, and the 2nd China (Hebei) International Ophthalmology Academic Conference. 0[2024-02-26].

Image source: TV series "South to North"