What Causes Posterior Uveitis?

Post uveitis is also called choroiditis. Because choroids and the retina abut, choroidal inflammation often affects the retina, so it is also called chorioretinitis. Choroiditis is characterized by no ocular pain, but with decreased vision and obvious dark shadows in front of the eyes.

Basic Information

nickname: Choroiditis
English name: posterior uveitis
Visiting department: Ophthalmology

Common locations: eye
Common causes: Infection, posterior uveitis associated with systemic diseases, simple posterior uveitis
Common symptoms: No eye pain, but with decreased vision and obvious dark shadows

Causes of post uveitis

According to the etiology and related diseases, uveitis can be divided into two categories, one is infectious and the other is non-infectious. The former can be divided into viral infections, bacterial and borrelia infections, fungal infections, and parasitic infections; the latter can be divided into three categories: post uveitis, simple post uveitis, and camouflage syndrome related to systemic diseases.

Among infectious post uveitis, tuberculosis and syphilis, which were the main causes in the early 20th century, are rare now, but with the increase in the number of human immunodeficiency virus infections, tuberculosis has been re-emphasized as an opportunistic infection. Moreover, retinitis caused by opportunistic infections such as cytomegalovirus is also increasing. With the application of immunosuppressants in some specific populations, fungal endophthalmitis also occurs from time to time.

Among the non-infectious post (full) uveitis, Behcet's disease uveitis and Vogt-Koyanagihara's disease are the two most common types in China. Other types such as Crohn's disease, ulcerative colitis, sympathetic ophthalmia, Fuchs syndrome, claudication choroidal retinitis, acute posterior pole multifocal squamous pigment epithelial lesions, acute retinal pigment epitheliitis, Eales disease, subretinal fibrosis, and uveitis syndrome also occur from time to time.

Clinical manifestations of post uveitis

1. The shadow in front of me.

2. Vision loss: The degree of vision declines significantly when inflammation spreads to the macula; the inflammation can manifest as a slight decrease in vision when the inflammation is located in the periphery.

3. Flashing feeling in front of eyes.

4. Vitreous opacity: the posterior vitreous body is dominant.

5. Fundus examination: the fundus in the acute phase showed scattered or diffusely blurred yellow-white exudation sources, the source of which was located under the retinal vessels. At the later stage, there are small pigment particles and pigment shedding, which makes the entire fundus show diffuse and fine pigment distribution and decolorization. If it is a scattered sexual source, it appears as a clear-cut white choroid atrophy spot, often with pigmentation.

6. Exudative retinal detachment and retinal vasculitis may occur.

Post uveitis examination

Fluorescein fundus angiography

Fundus fluorescein angiography is of great significance in the diagnosis and differential diagnosis of retinitis and retinal vasculitis.

2. Indocyanine green angiography

Indocyanine green angiography is mainly used for judging choroidal lesions. It also has a good role in evaluating choroidal inflammation sites and activities. It is mainly used for Vogt-Koyanagihara disease, sympathetic ophthalmitis, and choroidal retina. Inflammatory diseases such as inflammation and shotgun-like retinal choroidal lesions involve choroids, choroidal capillaries, and retinal pigment epithelium.

3. Other auxiliary inspections

Optical coherence tomography is of great value in determining optic disc edema, macular cystoid edema, secondary retinal detachment, and macular retinal atrophy caused by uveitis. Ultrasonography can evaluate vitreous opacity and vitreous body caused by uveitis. Proliferative changes, retinal detachment, choroidal thickening and other lesions; ophthalmic ultrasound biomicroscopy is of great value in determining anterior segment changes caused by uveitis.