8 Uveitis

Anterior uveitis

Inflammation of iris (iritis) and ciliary body (cyclitis)

Most common cause of anterior uveitis in adults is idiopathic (followed by HLA-B27 associated)

Most common cause of acute, noninfectious, hypopyon iritis is HLA-B27-associated iritis


conjunctival and episcleral injection, ciliary injection (circumcorneal flush from branches of anterior ciliary arteries), miosis (iris sphincter spasm), AC reaction; may have hypopyon, keratic precipitates, iris nodules, dilated iris vessels (occasionally, rubeosis), synechiae (posterior [iris adhesions to lens; seclusio pupillae is a complete adhesion that can result in iris bombe] or anterior [iris adhesions to cornea and angle]) (Figure 8-1)


Intermediate uveitis

Pars Planitis

Most common cause of intermediate uveitis (85–90%)

Usually young adults; females > males; 75% bilateral

Accounts for 25% of uveitis in children

Associated with HLA-DR15 and MS

Posterior uveitis

Most common cause of posterior uveitis in adults is toxoplasmosis (followed by retinal vasculitis)


Cytomegalovirus (CMV)

Progressive hemorrhagic necrotizing retinitis involving all retinal layers

Occurs in 15–46% of AIDS patients; usually when CD4 count <50 cells/mm3

40% bilateral at presentation

Rare syndrome of neonatal cytomegalic inclusion disease


antiviral therapy (induction during first 2 weeks)

Acute Retinal Necrosis (ARN)

Acute self-limited confluent peripheral necrotizing retinitis due to infection with VZV, HSV, or rarely CMV

Usually occurs in immunocompetent individuals; 33% bilateral (BARN), commonly in immunosuppressed

Association with HLA-DQw7 (50%)

Jun 4, 2016 | Posted by in OPHTHALMOLOGY | Comments Off on Uveitis

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