Definition:

Posterior uveitis is inflammation of the choroid, also referred as choroiditis or chorioretinitis if the retina is also involved.

Characteristics of Posterior uveitis

  • Can be focal, multifocal or diffuse, depending on the nature of the inflammatory lesions seen on the fundus
  • Can be any form of retinitis, choroiditis, or inflammation of the optic disk
  • Can be associated with disorders like Behcet’s syndrome, ankylosing spondylitis, Lyme disease, sarcoidosis, and psoriasis.
  • Usually bilateral
  • Rare form of uveitis
  • Form of uveitis that can cause loss of vision

Causes of posterior uveitis

Most of the cases of uveitis have no reason but others may be associated with following reasons:

  • Infectious causes include bacterial, fungal, parasitic, and viral infections
  • Non-infectious causes include immunologic problems, allergies, malignancies
  • Eye trauma
  • Toxoplasmosis, (in immunocompetent patients)
  • CMV (in patients with HIV/AIDS)
  • Autoimmune retinal vasculitis
  • Idiopathic (most common)

Symptoms of Posterior uveitis

Posterior uveitis causes diverse symptoms in patients but the most commonly occurring symptoms are the following:

  • Blurred vision
  • Gradual loss of vision
  • Floaters
  • Occasional photophobia
  • Symptoms typically occur in both eyes
  • No pain, discomfort or redness

Diagnosis of Posterior uveitis

Posterior uveitis can be diagnosed with thorough eye examination and medical history along with certain tests like:

  • Slit-lamp examination
  • Ophthalmoscopy after pupil dilation

Treatment of Posterior uveitis

Posterior uveitis needs active treatment to avoid any complication. Line of treatment may include any of the following depending upon patient condition:

  • Corticosteroids (usually topical eyedrops or by periocular or intraocular injection)
  • Severe or chronic cases may require systemic corticosteroids (e.g., prednisone)
  • Cycloplegic-mydriatic drugs ((e.g., homatropine 2% or 5% drops)
  • Systemic noncorticosteroid immunosuppressive drugs (e.g., methotrexate)
  • Laser phototherapy
  • Cryotherapy
  • Vitrectomy

Complications of Posterior uveitis

If posterior uveitis is not diagnosed properly, left untreated or both, it may give rise to certain serious complications like:

  • Cataract
  • Glaucoma
  • Retinal detachment
  • Neovascularization of the retina, optic nerve, or iris
  • Cystoid macular edema (the most common cause of decreased vision in patients with uveitis)
  • Profound and irreversible vision loss