#29. Posterior uveitis, chorioretinitis.

Question 1

What is POSTERIOR UVEITIS?

Answer 1

INFLAMMATION of the CHOROID (POSTERIOR Part of the UVEAL TRACT)

• ALSO inflammation of the OTHER POSTERIOR Parts of the eye / Pars Plana AND Ciliary Body
• May be:
  a. Focal
  b. Multifocal
  c. Diffuse in Location

Question 2

What are the 2 FORMS of POSTERIOR UVEITIS?

Answer 2

1) GRANULOMATOUS
- DIRECT Pathogenic Infection

2) NON-GRANULOMATOUS
- DUE to ALLERGIC Reaction

Question 3

What are the 3 CLINICAL TYPES of POSTERIOR UVEITIS?

Answer 3

1) DISSEMINATED
- Lesions are SCATTERED ALL OVER the FUNDUS
E.g. Syphilis, TB

2) ANTERIOR
- Lesions are seen in PERIPHERAL PARTS of the FUNDUS
E.g. Syphilis

3) CENTRAL
- Involves the MACULAR AREA or POSTERIOR POLE
E.g. Toxoplasmosis

4) JUXTAPAPILLIARY
- Lesions are present around the OPTIC DISC
- Occurs in YOUNG People

4) JUX

Question 4

What are the SYMPTOMS of POSTERIOR UVEITIS?

Answer 4

• Floaters = Vitreous Opacities consisting of DEBRIS + INFLAMMATORY CELLS
• Photopsia = Flashing Light
• DECREASED Vision
• Pain / Redness (Rare)

Question 5

What are the SIGNS of POSTERIOR UVEITIS?

Answer 5

• VARIABLE Cells in the ANTERIOR CHAMBER / VITREOUS
• MACULAR Oedema
• EXUDATIVE Retinal DETACHMENT

Question 6

What is the DIAGNOSIS of POSTERIOR UVEITIS?

Answer 6

DISTINGUISH whether the Posterior Uveitis is Infective OR Non-infective

• Full Blood Count
• Urea
• Chest X-Ray
• Angio-Converting Enzyme (ACE)
• Human Leukocyte Antigen (HLA-B27)

Question 7

What is the TREATMENT for POSTERIOR UVEITIS?

Answer 7

• ATROPINE
• HEAT Application = Electric Pad
• CORTICOSTEROIDS
• Specific Tx for = Toxoplasmosis, TB, Syphilis

Question 8

What is CHORIORETINITIS?

Answer 8

• INFLAMMATION of LIGHT SENSITIVE LAYER on the RETINA and the CHOROID

Question 9

What is the CAUSE of CHORIORETINITIS?

Answer 9

• Toxoplasma Gondii
• Syphilis
• Cat Scratch Disease
• TB

Question 10

What are the CLINICAL FEATURES of CHORIORETINITIS?

Answer 10

• LESIONS / DAMAGE to Retina, leading to SCOTOMA (Blind Spot in Visual Field)

Question 11

What are the SYMPTOMS of CHORIORETINITIS?

Answer 11

• Sudden / Gradual Onset
• Blurred / Decreased Vision
• Sensitivity to Light
• Floaters (Floating Dark Spots)

Question 12

What is the DIAGNOSIS of CHORIORETINITIS?

Answer 12

• CONSTRICTED or IRREGULAR Pupil
• CLOUDED Vitreous
• SMALL Light-Coloured PATCHES in Retina

Question 13

What is the TREATMENT for CHORIORETINITIS?

Answer 13

• Antibiotic / Antifungal Drugs
• Corticosteroids
• Laser Beam = LIMIT Retinal Hemorrhages
• Anti-parasitic Drug = ATOVAQUONE
• VITRECTOMY = REMOVAL of Affected Tissue