Non-Neoplastic Uveitis Masquerade Syndromes: Insights from a Case Series

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Non-neoplastic uveitis masquerade syndromes (NNUMS) present diagnostic challenges.
• These conditions mimic true ocular inflammatory diseases, potentially leading to misdiagnosis.

Purpose of the Study:

• To investigate the clinical characteristics and implications of NNUMS.
• To understand the diagnostic delays and treatment outcomes associated with NNUMS.

Main Methods:

• Retrospective analysis of 1595 patients evaluated for uveitis at a South Indian tertiary referral center (July 2019 - July 2025).
• Evaluation of clinical characteristics and outcomes for patients diagnosed with NNUMS.
• Utilized multimodal imaging for diagnosis.

Main Results:

• NNUMS diagnosed in 53 patients (80 eyes), with 83% exhibiting fundus lesions.
• Common causes included retinal vascular diseases (22.6%), inherited retinal diseases (20.8%), and central serous chorioretinopathy (11.3%).
• Diagnostic delays (>100 days) occurred in 24.5% of patients, significantly increasing the likelihood of unnecessary anti-inflammatory treatment.
• Underlying systemic diseases were present in 24.5% of patients, often undiagnosed prior to ocular diagnosis.
• Retinal vascular involvement strongly correlated with underlying systemic conditions.

Conclusions:

• NNUMS represent a diverse group of entities mimicking ocular inflammation.
• Accurate diagnosis requires recognizing specific clinical and imaging features to avoid misdiagnosis and inappropriate treatment.
• Prompt diagnosis is crucial for preventing visual morbidity and unnecessary therapeutic interventions.