Presentation
Overview Intermediate uveitis most commonly presents in young adults. [aao.org]
Patients with pars planitis may present with bullous retinoschisis and/or exudative retinal detachment. [ncbi.nlm.nih.gov]
Eyes
- Blurred Vision
The Humphrey ultrasound biomicroscope was used for examination of the right eye of a 17-year-old boy, referred to our clinic because of blurred vision. The lens showed a posterior subcapsular cataract precluding fundus visualization. [ncbi.nlm.nih.gov]
Symptoms of pars planitis include blurred vision, floaters, flashes, redness of the eye and eye pain. [monmouthretina.com]
The most common presenting symptoms are floaters and blurred vision. Diffuse vitreous cells, haze, snowballs and snowbanks are typical findings of pars planitis. Peripheral retinal vasculitis, optic disc edema and… CONTINUE READING [semanticscholar.org]
- Anterior Uveitis
Iritis (Anterior Uveitis) http://drstevenodrich.com/iritis-anterior-uveitis/ Iritis, also called “anterior uveitis” is an inflammatory disorder of the iris, the colored portion of the eye that surrounds the pupil. [rul.sarkatvolley.net]
uveitis, uveitis anterior, Anterior uveitis (diagnosis), Anterior uveitis, NOS, Anterior uveitis [Ambiguous], Anterior uveitis (disorder), Anterior Uveitis Dutch voorste uveïtis, uveïtis anterior, Uveitis anterior German anteriore Uveitis, Uveitis anterior [fpnotebook.com]
Resources Other names: Iritis; Uveitis ; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis [checkorphan.org]
International Uveitis Study Group (IUSG) Anatomic Classification of Uveitis* Anterior uveitis Primary site of inflammation: anterior chamber Intermediate uveitis Primary site of inflammation: vitreous Posterior uveitis Primary site of inflammation: retina [slideshare.net]
- Visual Impairment
Visual acuity improved in all patients after treatment, with an average of 4 lines of improvement. Conclusions: : Pars planitis in pediatric patients may cause significant visual impairment, and its presentation may vary considerably. [iovs.arvojournals.org]
Although a subset of patients with pars planitis do not have macular edema or visual impairment and may be observed, the majority of patients need treatment. [entokey.com]
Complications Decreased Visual Acuity Severe Visual Impairment : 35% Legally blind: 10% Iris scarring Impaired pupillary movement Secondary Glaucoma XIII. [fpnotebook.com]
- Band-Shaped Keratopathy
Presentation • Peripheral vasculitis • CME, Peripapillary retinal edema • Vitritis, Cyclitis • Vitreous hemorrhage • Band shaped keratopathy 13. [slideshare.net]
Common complications seen are: disc edema, CME, cataract, glaucoma, and band-shaped keratopathy. Epiretinal and neovascular membranes occur. [ijo.in]
- Progressive Loss of Vision
This form is more difficult to treat, and is often associated with progressive loss of vision. Pan-uveitis - When inflammation affects all three areas of the uvea it is referred to as pan-uveitis. [bausch.com]
Workup
The diagnosis workup including blood work, MRI, and neurological exam were ordered; results, treatment, and prognosis for this case is discussed. [aaopt.org]
Although most pediatric IU cases are idiopathic, a systemic workup is recommended to evaluate for underlying disorders (see “Possible Etiologies”). [aao.org]
Systemic workup for conditions associated with intermediate uveitis including sarcoidosis evaluation was negative. [joii-journal.springeropen.com]
Signs of dermatitis may point to Lyme disease, tuberculosis, or syphilis, whereas arthritis of the knee may suggest the possibility of Lyme's, disease, and contact with cats may raise the possibility of Bartonella infection. [1] A routine baseline workup [ijo.in]
Other Pathologies
- Lymphocytic Infiltrate
infiltration of retinal veins • Pars plana exudates consist of fibroglial tissue with inflammatory cells DIFFERENTIAL DIAGNOSIS • Primary central nervous system lymphoma • Endophthalmitis • Other uveitic conditions, including Vogt–Koyanagi–Harada disease [entokey.com]
• Intermediate uveitis seems to be a T-cell- mediated disease • Lymphocytic infiltration of the retinal venules leads to the clinical picture of vasculitis. • T-cells are the predominant cell type in the vitreous up to 95% of all cells, of which CD4 [slideshare.net]
Introduction Pars planitis (PP) is a chronic inflammatory ocular disease characterized by lymphocytic infiltration in the pars plana and vitreous cavity, as well as the presence of peripheral retinal vasculitis [1]. [joii-journal.springeropen.com]
Lymphocytic infiltration of the retinal venules leads to the clinical picture of vasculitis. [ijo.in]
HLA Type
- HLA-B8
Forty patients with pars planitis who met these criteria underwent HLA analysis of class I and II phenotypes. RESULTS: HLA-B8 was present in 15 (37.5%) of 40 patients versus 85 (19.7%) of 431 controls (relative risk, 2.44; P = 0.011). [ncbi.nlm.nih.gov]
HLA in intermediate uveitis. Dev Ophthalmol 1992; 23 :35–7. 2. Malinowski SM, Pulido JS, Goeken NE, Brown CK, Folk JC. The association of HLA-B8, B 51, DR 2, and multiple sclerosis in pars planitis. Ophthalmology 1993; 100 :1199–205. 3. [nature.com]
Ophthalmology (1994) [ Pubmed ] The association of HLA-B8, B51, DR2, and multiple sclerosis in pars planitis. Malinowski, S.M., Pulido, J.S., Goeken, N.E., Brown, C.K., Folk, J.C. [wikigenes.org]
HLA associations have been reported in IU. HLA-DR is the most significant occurring in 67-72% of patients; others include HLA-B8 and HLA-B51. Clinical Manifestations History IU classically affects younger patients, aged 15 to 40 years. [eyewiki.aao.org]
Treatment
If corticosteroid treatment fails or patients develop side effects or require prolonged high-dose treatment (unable to taper below 10 to 15 mg/day for longer than three months), then steroid-sparing agents—such as azathioprine, cyclosporine, methotrexate [aao.org]
It can be a useful tool for the follow-up of these patients, and allows monitoring the response to treatment. [eyewiki.aao.org]
Three patients (five eyes) received scatter diode or argon photocoagulation treatment alone. [ncbi.nlm.nih.gov]
Prognosis
PURPOSE: To measure the incidence of pars planitis in a community-based population and to report clinical features, complications, and visual prognosis. DESIGN: Population-based, retrospective, 20-year cohort study. [ncbi.nlm.nih.gov]
Some authorities believe that patients with pars planitis have worse vitritis, more severe macular edema, and a guarded prognosis compared to other patients with intermediate uveitis. [wikidoc.org]
Visual potential and prognostic factors can also be determined by OCT: correlations have been shown between: vision and foveal thickness IS/OS junction abnormalities and poorer visual prognosis CMO with healthy IS/OS junction and better visual prognosis [eyewiki.aao.org]
Despite this visual prognosis is relatively good. Vi- 85 Intermediate Uveitis sion-tlueateuing complications are CMlJ, secondary cataract, tractional retinal detachment and cyciitic membranes. [docksci.com]
Etiology
The etiology of the antigenic stimulus is not clear and may be either vitreal or perivascular in nature. It is evident that genetics plays some role in the pathophysiology of intermediate uveitis, but the importance remains unclear. [wikidoc.org]
It is important to examine the area for neovascularization, which can be a source of vitreous hemorrhage. 2 Etiology. [aao.org]
Clinical and histopathological findings suggest an autoimmune etiology, most likely as a reaction to endogenous antigen of unknown source, with T cells predominant in both vitreous and pars plana infiltrations. [ncbi.nlm.nih.gov]
Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system that is presumed to be an autoimmune etiology. [aaopt.org]
Although an autoimmune process with a genetic predisposition has been suggested, its etiology still remains unknown. The most common presenting symptoms are floaters and blurred vision. [semanticscholar.org]
Epidemiology
Pars Planitis: Epidemiology, Clinical Characteristics, Management and Visual Prognosis., Ozdal PC,Berker N,Tugal-Tutkun I,, Journal of ophthalmic & vision research, 2015 Oct-Dec [PubMed] Standardization of uveitis nomenclature for reporting clinical data [knowledge.statpearls.com]
METHODS: Multicenter study using the Rochester Epidemiology Project medical records linkage system, which allows analysis of almost all patients within Olmsted County, Minnesota, with a given medical condition. [ncbi.nlm.nih.gov]
@article{Ozdal2015ParsPE, title={Pars Planitis: Epidemiology, Clinical Characteristics, Management and Visual Prognosis}, author={Pinar Cakar Ozdal and Nilufer Berker and Ilknur Tugal-Tutkun}, journal={Journal of Ophthalmic & Vision Research}, year={2015 [semanticscholar.org]
Pathophysiology
It is evident that genetics plays some role in the pathophysiology of intermediate uveitis, but the importance remains unclear. [wikidoc.org]
• The pathophysiology of IU/pars planitis is not well understood – It is probably an autoimmune reaction against an ocular antigen • Peripheral retinal veins are the primary foci for inflammation COMMONLY ASSOCIATED CONDITIONS • Sarcoidosis • Multiple [entokey.com]
Here, we report a case of peripapillary CNV in a patient with intermediate uveitis and explore the pathophysiology and outcome of this condition. [joii-journal.springeropen.com]
[…] exists.[5] MS has been characterized into four different subtypes, which include relapsing/remitting, primary progressive, secondary progressive and relapsing progressive, depending on the time course and progression of neurologic disability.[6] The pathophysiology [medscape.com]
Prevention
Prevention Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease. Diagnosis A complete medical history and eye examination should be performed. [checkorphan.org]
Physical Examination Laboratory Findings Imaging Findings Other Diagnostic Studies Treatment Medical Therapy Surgery Prevention References [wikidoc.org]
Anti-inflammatory medication in the form of eye drops, pills, or injections is usually recommended to alleviate pain, prevent further tissue damage and restore loss of vision. [monmouthretina.com]
Research comparing fluocinolone acetonide intravitreal implants to standard-of-care treatments (prednisolone with immunosuppressive agents) found that while the steroid implant treatment possibly prevents the recurrence of uveitis, there may be adverse [en.wikipedia.org]