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What is the Difference Between Granulomatous and Nongranulomatous Uveitis

September 5, 2022 Posted by Dr.Samanthi

The key difference between granulomatous and nongranulomatous uveitis is that granulomatous uveitis is characterized by blurred vision, mild pain, eye tearing, and mild sensitivity to light, while nongranulomatous uveitis is characterized by acute onset, severe pain, and intense sensitivity to light.

Granulomatous and nongranulomatous uveitis are two types of uveitis. Uveitis is the inflammation of the middle layer of the eye, which is known as the uvea or uveal tract. The warning signs of uveitis often come on suddenly and get worse quickly.

CONTENTS

1. Overview and Key Difference
2. What is Granulomatous Uveitis
3. What is Nongranulomatous Uveitis
4. Similarities – Granulomatous and Nongranulomatous Uveitis
5. Granulomatous vs Nongranulomatous Uveitis in Tabular Form
6. Summary – Granulomatous vs Nongranulomatous Uveitis

What is Granulomatous Uveitis?

Granulomatous uveitis is an inflammation of the uveal tract characterized by the formation of granulomas due to infectious and non-infectious causes. It may occur in any part of the uveal tract that may be associated with a systematic disease. The infectious causes of granulomatous uveitis include tuberculosis, syphilis, herpes viruses, cytomegalovirus, Lyme disease, toxoplasmosis, toxocariasis, trematodes, propionibacterium acne, post-streptococcal infections, and some fungal infections. Non-infectious causes are sarcoidosis, multiple sclerosis, Vogt Koyanagi Harada disease, sympathetic ophthalmia, lymphoma, Blau syndrome, histiocytosis, granuloma annulare, idiopathic, common variable immune deficiency, juvenile idiopathic arthritis, high-density silicone oil tamponade, intraocular foreign bodies including caterpillar hair, and tattoo associated granulomatous uveitis. The symptoms of granulomatous uveitis include blurred vision, mild pain, eye tearing, and mild sensitivity to light.

Granulomatous uveitis can be diagnosed through laboratory investigations (west blotting, PCR testing, cytopathological examination, and microbiological testing), imaging testing (ocular B scan ultrasonography, fluorescein angiography), and tissue biopsy. Furthermore, treatment options for granulomatous uveitis include ocular treatment, such as topical application of steroids and cycloplegics and intravitreal antimicrobial injections and systemic treatments include systemic steroids and immunomodulatory agents such as azathioprine.

What is Nongranulomatous Uveitis?

Nongranulomatous uveitis is a type of uveitis that is characterized by acute onset, severe pain, and intense sensitivity to light. The causes of nongranulomatous uveitis include seronegative arthropathy, trauma, Behcet’s syndrome, leptospirosis, sarcoidosis, tuberculosis, and syphilis. Nongranulomatous uveitis typically has an acute onset and shows fine KP (keratic precipitates). Though there are many causes for nongranulomatous uveitis, it is more likely to be idiopathic. The symptoms of nongranulomatous uveitis may include pain, redness, and photophobia (sensitivity to light). Moreover, the presence HLA-B27 allele, ankylosing spondylitis, psoriatic arthritis, and certain medications are risk factors for this condition.

Granulomatous vs Nongranulomatous Uveitis in Tabular Form

Figure 01: Nongranulomatous Uveitis

Nongranulomatous uveitis can be diagnosed through physical examination, HLA-B27 testing, CRP (C-reactive protein) testing, complete blood count, X-ray, and ocular fluid testing. Furthermore, the treatments for nongranulomatous uveitis may include topical drops containing corticosteroids (prednisolone), local injection of corticosteroids, and surgery.

What are the Similarities Between Granulomatous and Nongranulomatous Uveitis?

  • Granulomatous and nongranulomatous uveitis are the two main types of uveitis.
  • Both are categorized under anterior uveitis.
  • In both conditions, the uvea, iris, and ciliary body are primarily affected.
  • Both conditions can be caused due to infectious causes.
  • They are typically treated through topical applications such as corticosteroids.

What is the Difference Between Granulomatous and Nongranulomatous Uveitis?

Granulomatous uveitis is a type of uveitis that causes blurred vision, mild pain, eye tearing, and mild sensitivity to light, while nongranulomatous uveitis is a type of uveitis that causes acute onset, severe pain, and intense sensitivity to light. Thus, this is the key difference between granulomatous and nongranulomatous uveitis. Furthermore, granulomatous uveitis is a chronic condition, while nongranulomatous uveitis is an acute condition.

The below infographic presents the differences between granulomatous and nongranulomatous uveitis in tabular form for side-by-side comparison.

Summary – Granulomatous vs Nongranulomatous Uveitis

Granulomatous and nongranulomatous uveitis are the two main types of uveitis. Both conditions are categorized under anterior uveitis. Anterior uveitis causes problems in the uvea, iris, and ciliary body. Granulomatous uveitis results in blurred vision, mild pain, eye tearing, and mild sensitivity to light, while nongranulomatous uveitis results in acute onset, severe pain, and intense sensitivity to light. So, this is the summary of the difference granulomatous and nongranulomatous uveitis.

Reference:

1. “Granulomatous Uveitis.” Statpearls – NCBI Bookshelf.
2. “Nongranulomatous Uveitis.” Encyclopædia Britannica, Encyclopædia Britannica, Inc.

Image Courtesy:

1. “Acute anterior uveitis” By Community Eye Health (CC BY-NC 2.0) via Flickr

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Filed Under: Eye

About the Author: Dr.Samanthi

Dr.Samanthi Udayangani holds a B.Sc. Degree in Plant Science, M.Sc. in Molecular and Applied Microbiology, and PhD in Applied Microbiology. Her research interests include Bio-fertilizers, Plant-Microbe Interactions, Molecular Microbiology, Soil Fungi, and Fungal Ecology.

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