The Clinical Spectrum and Outcome of Uveomeningitis: A Comprehensive Analysis of 110 Cases

ABSTRACT

Purpose

Uveitis can be associated with meningitis (uveomeningitis) and the inflammation shared with the central nervous system. We aimed to describe the characteristics and outcome of uveomeningitis.

Methods

We retrospectively analyzed 110 consecutive adult patients with uveomeningitis.

Results

The main causes of uveomeningitis were Vogt–Koyanagi–Harada (31%), syphilis (16%), sarcoidosis (12%), Behçet’s disease (7%), and multiple sclerosis (5%). Sixteen percent of uveomeningitis remained of undetermined origin. Compared to etiology-matched uveitis without meningitis, patients with uveomeningitis were younger, had more frequent neurological manifestations, and had more frequent abnormal cerebral magnetic resonance imaging findings. In contrast, no ocular feature upon examination was significantly associated with the presence of meningitis. Patients with uveomeningitis were more frequently treated with immunosuppressants but uveitis relapse and systemic complications did not differ between groups.

Conclusion

Uveomeningitis is associated with a limited spectrum of diseases. Meningitis does not seem to impact ocular and extraocular outcomes. Therefore, lumbar puncture should be performed on an individual basis during the diagnostic workup of uveitis.

KEYWORDS:

• Uveitis
• meningitis
• uveomeningitis
• sarcoidosis
• syphilis
• Behcet’s disease
• Vogt–Koyanagi–Harada disease

Competing interests

B. Terrier reports personal fees and research grants from Roche, AstraZeneca, and GlaxoSmithKline, outside the submitted work. MG: consulting fees from AstraZeneca and GlaxoSmithKline (outside the submitted work). CLJ: consulting fees from AstraZeneca and Iovia (outside the submitted work). The remaining authors have nothing to disclose.

Ethical approval information

Patient consent for publication is not required. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

Data sharing statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Additional information

Funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.