Posterior Uveitis

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