Clinical features of infectious uveitis in a Tunisian population

Infectious uveitis (IU), one of the main causes of ocular inflammation in Tunisia, has various etiologies and clinical presentations.

To report the causes and clinical features of IU in a Tunisian population.

Patients with IU referred to our department from February 2019 to January 2022 were included in a retrospective observational study. Ophthalmic examination and appropriate ancillary tests were performed.

Eighty eyes of 63 patients were included (37 female and 26 male). The mean age was 45 years. IU was unilateral in 43 cases, bilateral in 17, and unilateral alternating in three cases. Panuveitis was the most common anatomic location (35% of cases) followed by posterior (31%), anterior (18 eyes), intermediate (6 eyes) and anterior and intermediate uveitis (3 eyes). Non granulomatous uveitis (55%) occurred more frequently than granulomatous uveitis (45%). Etiologies were dominated by bacterial infections (29 patients; 46%), mainly tuberculosis (23 patients), followed by viruses (19 patients), mainly Herpes simplex virus. Fungal infection was found in one patient, while parasites accounted for 14 cases, mostly toxoplasmosis. Mean initial diagnostic delay was 16 months. The most common complications included occlusive retinal vasculitis (19 eyes), cataract (17 eyes), cystoid macular edema (17 eyes) and papilledema (15 eyes).

This study highlighted the causes and clinical features of IU in our setting. Tuberculosis remains one of its most frequent etiologies in Tunisia. However, a larger multicenter national study would allow a more precise evaluation.