Intermediate Uveitis

Question 1

What is intermediate uveitis?

Answer 1

Intermediate uveitis (IU) is a chronic, relapsing disease of insidious onset.
Intraocular inflammation mainly focused on the vitreous and peripheral retina.
* Clinical examination of the vitreous is important – you may need to
dilate the pupil
* Sight threatening complications such as cataract and macula oedema
are common
* Due to it small but significant association with multiple sclerosis all
need to be referred for further investigation including brain MRI scan

Question 2

What are the clinical features of intermediate uveitis?

Answer 2

• Patients with IU present with minimal symptoms, floaters or blurred
  vision
• In severe cases they can present with visual loss due to aggregation of
  floaters in the vitreous or due to macular oedema.
• The anterior chamber may be quiet or may have signs of inflammation in the form of keratic precipitates (KPs) or flare and cells, which are usually minimal.
• Posterior synechiae may or may not be seen, if present, are seen usually
  involving the inferior iris.
• Vitritis is a characteristic feature of IU, and it is typically described as vitreous haze ranging from trace to 4+
  Vitreous snowballs : typically are yellow-white inflammatory aggregates, and are found in the mid vitreous and inferior periphery. Optic disc oedema is seen in 3-39% of eyes with IU.
  Epiretinal membranes may occur.

Question 3

What is fluorescein angiography?

Answer 3

used to check blood vessels.
* Vascular leakage on FA may be
much more extensive than you
think - Classic fern-like pattern (looks like a leave).
* Retinal changes in IU
include sheathing of
peripheral veins. Peripheral sheathing may cause ischaemia. May be ischaemic or non-ischaemic in IU but not pars planitis.

Question 4

What systemic conditions is intermediate uveitis associated with?

Answer 4

Multiple sclerosis

Question 5

What is multiple sclerosis?

Answer 5

A disease that affects central nervous system. The immune system attacks the myelin, the protective layer around nerve fibres and causes Inflammation and lesions. This makes it difficult for the brain to send signals to rest of the body.

Question 6

What is the treatment for intermediate uveitis?

Answer 6

topical steroids
local injections of corticosteroids
oral steroids for disease control