$Unique_ID{BRK04134} $Pretitle{} $Title{Posterior Uveitis} $Subject{Posterior Uveitis Choroiditis Anterior Uveitis Pars Planitis Heterochromic Uveitis} $Volume{} $Log{} Copyright (C) 1987, 1988, 1989 National Organization for Rare Disorders, Inc. 494: Posterior Uveitis ** IMPORTANT ** It is possible the main title of the article (Posterior Uveitis) is not the name you expected. Please check the SYNONYMS listing on the next page to find alternate names, disorder subdivisions, and related disorders covered by this article. Synonyms Choroiditis Information on the following diseases can be found in the Related Disorders section of this report: Anterior Uveitis Pars Planitis Heterochromic Uveitis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Posterior Uveitis is a vision disorder characterized by inflammation of the layer of blood vessels underlying the retina, and usually of the retina as well. Major symptoms include blurred vision, distortion of the size or shape of objects (metamorphopsia), and floating black spots in the visual field. The resulting scars may impair clear vision and cause dimness of vision (amblyopia). In many cases, this disorder occurs as a complication of Toxoplasmosis or other infections. In other cases, the cause cannot be determined. Symptoms Posterior Uveitis is marked by inflammation of the entire uveal tract of the eye which includes the iris, ciliary body and choroid. The iris is the circular-colored membrane (surrounding the pupil) forming the anterior one- sixth of the middle coat of the eyeball. The ciliary body is a specialized structure in the eye composed of the ciliary muscles and processes, and connecting the anterior part of the choroid to the circumference of the iris. The choroid is the middle pigmented, vascular coat of the posterior five- sixths of the eyeball, continuous with the iris in front. The choroid lies between the sclera externally and the retina internally and prevents the passage of light rays. Symptoms include blurred vision, distortion of the size and shape of objects (metamorphopsia), and floating black spots in the visual field. Occasionally, eye pain and the excess secretion of tears may occur. Marked reduction of vision may occur when the inflammation is centered on the posterior pole inside the eyeball. Inflammation limited to the edges of the inside of the eyeball often does not affect vision. Scars inside the eye can indicate recurrent Uveitis. Other symptoms may be associated with Posterior Uveitis including oozing (exudative) retinal detachment, loss of transparency of the lens of the eye (cataract), and inflammation of the internal structures of the tissues in the eyeball (endophthalmitis). Causes Posterior Uveitis often occurs as a complication of Toxoplasmosis, or other infections such as Syphilis. Behcet's Syndrome, Sarcoidosis, Arthritis, or Tuberculosis can also cause Uveitis. (For more information on these disorders, choose toxoplasmosis, syphilis, behcet, sarcoidosis, arthritis, and TB as your search terms in the Rare Disease Database.) Some medical researchers believe Posterior Uveitis may be an autoimmune disorder. In other cases no cause may be determined. In children, inflammation of parts of the eye including the choroid and retina (chorioretinitis) with vitreous membranes may result from the presence of a parasite inside the eyeball. Affected Population Posterior Uveitis affects individuals who may have another health condition such as Toxoplasmosis, Syphilis, Behcet's Syndrome, Sarcoidosis, Arthritis, Tuberculosis, or who have been exposed to the parasite Toxacara. The disorder affects males and females in equal numbers. Related Disorders Symptoms of the following disorders can be similar to those of Posterior Uveitis. Comparisons may be useful for a differential diagnosis: Anterior Uveitis is characterized by inflammation limited to the ciliary body and iris of the eye. The choroid of the eye is not affected, as in Posterior Uveitis. Pars Planitis is a vision disorder characterized by inflammation of the peripheral retina and pars plana (a section of the ciliary body connected to the retina) sections of the eye. Fluid and foreign cells can infiltrate the clear gelatin-like substance (vitreous humor) near the retina and/or pars plana. Swelling inside the eye can also occur. These abnormalities may appear in one or both eyes. (For more information on this disorder, choose "Pars Planitis" as your search term in the Rare Disease Database). Heterochromic Uveitis is characterized by pigmentary changes in the iris of the eye. This occurs in conjunction with inflammation of the anterior uvea complicated by deposits on the posterior lining of the cornea (Descemet's membrane) and by clouding (opacities) of the clear lens of the eye. Therapies: Standard Active choroid and/or retinal inflammation associated with Posterior Uveitis is frequently treated with systemic corticosteroid drugs. Other treatment depends on determination of the exact cause of the disorder. When a parasite such as Toxacara (associated with Toxoplasmosis) is identified as the cause, treatment should be prescribed to eliminate this infection. Ibuprofen may be a useful drug for control of inflammation associated with Posterior Uveitis. Therapies: Investigational Cyclosporine (Sandimmune) may be of potential benefit for treating a number of dermatologic diseases. These include Pemphigus and Bullous Pemphigoid, Posterior Uveitis and Behcet's Syndrome, collagen vascular disorders such as severe Dermatomyositis, Sjogren's Syndrome, and Scleroderma, Mycosis Fungoides, and Alopecia Areata. Certain types of skin grafts have also shown improvement after cyclosporine treatment, in some cases. However, this drug may also be associated with severe and life-threatening side effects which would limit its use in many patients. Careful monitoring of this drug by a physician is necessary to guard against possible toxic side effects. Relapses can occur when the drug is discontinued. More research is needed before cyclosporine can be recommended as a treatment for all but the most severe cases of the disorders listed above. Even for the most severe cases its use is still experimental, and long-term effects are unknown. Trials involving another immunosuppressive drug, mizoribine, has benefited some patients. More research is necessary to determine safety and effectiveness of these experimental treatments. This disease entry is based upon medical information available through March 1988. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on this Posterior Uveitis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 NIH/National Eye Institute 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5248 Vision Foundation, Inc. 818 Mt. Auburn Street Watertown, MA 02172 (617) 926-4232 1-800-852-3029 (inside Massachusetts) For information about associated infections such as Toxoplasmosis: NIH/National Institute of Allergy and Infections Diseases (NIAID) 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5717 References CYCLOSPORIN A IN THE TREATMENT OF POSTERIOR UVEITIS: E.M. Graham, et al.; Eye (1985, issue 104 (Part 2)). Pp. 146-151. RENAL HISTOPATHOLOGIC ALTERATIONS IN PATIENTS TREATED WITH CYCLOSPORINE FOR UVEITIS: A.G. Palestine, et al.; N Engl J Med (May 15, 1986, issue 314 (20)). Pp. 1293-1298. APPLICATION OF MIZORIBINE AFTER KERATOPLASTY AND IN THE TREATMENT OF UVEITIS: A. Nakajima, et al.; Am J Ophthalmol (July 15, 1985, issue 100 (1)). Pp. 161-163. MODULATION OF LENS-INDUCED UVEITIS BY SUPEROXIDE DISMUTASE: N.A. Rao, et al.; Ophthalmic Res (1986, issue 18 (1)). Pp. 41-46. IBUPROFEN IN THE TREATMENT OF UVEITIS: W.F. March, et al.; Ann Ophthalmol (February 1985, issue 17 (2)). Pp. 103-104. TREATMENT OF EXPERIMENTAL GRANULOMATOUS UVEITIS BY LIPOXYGENASE AND CYCLO-OXYGENASE INHIBITORS: N.A. Rao, et al.; Arch Ophthalmol (March 1987, issue 105(3)). Pp. 413-415.