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$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.