Abstract
Abstract: :
Purpose: Non–infectious uveitis is an inflammatory disease that is limited to the eye or can be associated with a systemic inflammatory disease. In the vast majority of patients with autoimmune uveitis no definite systemic (autoimmune) disease can be found. With radionuclide coupled octreotide we are able to detect specific inflammatory sites in patients with rheumatoid disease and granulomatous disease. This radiopharmaceutical binds to its receptors at inflammatory sites and results in the local accumulation of radioactivity. Visualization of ocular and extra–ocular sites can be achieved by scintigraphy and can be helpfull in the diagnosis of underlying disease. We looked at the efficacy of this diagnostic examination in uveitis patients. Methods: 45 consecutive patients with autoimmune uveitis and 16 patients with ocular sarcoidosis were injected intravenously with 10 microgram of [111In–DTPA–D–Phe1]octreotide (200–250 MBq). Planar images were obtained 24 hours after injection and a SPECT of the orbit was obtained 4 hours after injection. Results: In 26 out of 45 patients with "autoimmune uveitis" extra–ocular sites could be detected i.e. lung, nose, joints, heart, parotids and sini. In 15 out of 16 ocular sarcoidosis patients extra ocular sites were detected. Most frequently lung involvement was detected, whereas the X–ray of the lungs was positive in only 7 cases. Conclusions: Octreotide scintigraphy is a method to detect inflammatory sites. In patients with autoimmune uveitis this method suggests much more inflammatory sites than the eye. In ocular sarcoidosis this method can be used to detect systemic granulomatous inflammatory sites which can be helpful in the diagnosis of such patients.
Keywords: uveitis–clinical/animal model • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • autoimmune disease