-
Survey of Ophthalmology 2017The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular... (Review)
Review
The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.
Topics: Diagnostic Techniques, Ophthalmological; Eye Infections, Viral; Global Health; Humans; Morbidity; Uveitis, Posterior
PubMed: 28012878
DOI: 10.1016/j.survophthal.2016.12.008 -
Developments in Ophthalmology 2016Posterior uveitis is a major cause of ocular morbidity worldwide. Systemic corticosteroids (CS) remain the primary method of treatment for noninfectious posterior... (Review)
Review
Posterior uveitis is a major cause of ocular morbidity worldwide. Systemic corticosteroids (CS) remain the primary method of treatment for noninfectious posterior uveitis; however, CS are associated with many side effects. Immunomodulatory therapy (IMT) is recommended when inflammatory control is not attained with a tolerable level of systemic CS (<10 mg/day of prednisone). IMT agents are associated with several toxicities and limited benefits in some patients. Locally administered therapies (e.g. intravitreal CS implants) offer the promise of providing therapeutic levels of anti-inflammatory agents while avoiding systemic complications. This chapter will briefly discuss common posterior uveitis entities that are amenable to retinal pharmacotherapy.
Topics: Glucocorticoids; Humans; Immunomodulation; Uveitis, Posterior
PubMed: 26502276
DOI: 10.1159/000438968 -
Ocular Immunology and Inflammation Sep 2023To report and illustrate the main clinical presentations of posterior herpetic uveitis. (Review)
Review
PURPOSE
To report and illustrate the main clinical presentations of posterior herpetic uveitis.
METHODS
Narrative review.
RESULTS
The ocular manifestations of posterior herpetic uveitis include different clinical presentations. Herpes simplex and varicella zoster can cause acute retinal necrosis, progressive outer retinal necrosis, and non-necrotizing herpetic retinopathies. Cytomegalovirus has been associated with fulminant retinitis with confluent areas of retinal necrosis and retinal hemorrhages, indolent/granular retinitis, and frosted branch angiitis. These diverse clinical presentations are often associated with specific risk factors and different immunological profiles of the host.
CONCLUSIONS
Herpetic viruses can cause posterior uveitis, presenting various clinical findings. Specific ocular manifestations and the immunological status of the host can help to differentiate the various herpetic entities before laboratory tests confirm the diagnosis.
Topics: Humans; Herpesviridae Infections; Retinal Necrosis Syndrome, Acute; Retinitis; Retinal Diseases; Uveitis, Posterior; Necrosis
PubMed: 37364039
DOI: 10.1080/09273948.2023.2221338 -
Ocular Immunology and Inflammation Dec 2023To describe the most important cause of infectious posterior uveitis in pediatric patients. (Review)
Review
PURPOSE
To describe the most important cause of infectious posterior uveitis in pediatric patients.
METHODS
Review of the literature.
RESULTS
The most important causes of infectious uveitis in pediatric patients are: cat-scratch disease, toxocariasis, tuberculosis, viral diseases and toxoplasmosis. Ocular manifestations include retinitis, neuroretinitis, choroidal granulomas, peripheral granulomas and posterior pole granulomas.
CONCLUSION
Infectious posterior uveitis is a challenging subject and should be considered in the differential diagnosis of any posterior uveitis in children. Infectious uveitis must be excluded before initiating immunosuppressive therapy.
Topics: Animals; Humans; Child; Uveitis, Posterior; Uveitis; Retinitis; Eye Infections; Eye Infections, Bacterial; Choroid; Granuloma
PubMed: 38096404
DOI: 10.1080/09273948.2023.2284990 -
Retinal Cases & Brief Reports Jan 2022
Topics: Fluorescein Angiography; Humans; Uveitis; Uveitis, Posterior; Vaccines
PubMed: 31971925
DOI: 10.1097/ICB.0000000000000958 -
Retina (Philadelphia, Pa.) Apr 2020
Topics: Adult; Female; Humans; Male; Uveitis, Posterior; Vaccination; Vaccines; Visual Acuity
PubMed: 32221173
DOI: 10.1097/IAE.0000000000002816 -
International Ophthalmology Jun 2021Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a... (Review)
Review
INTRODUCTION
Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a significant personal and social impact. Although steroids and nonbiologic- Disease-Modifying Antirheumatic Drugs (nbDMARDs) are effective both in acute and long- lasting diseases, however they are increasingly being replaced by biologic (DMARDs). bDMARD. This article therefore aims to identify recent advances in the therapy of noninfectious posterior segment uveitis.
METHODS
A Medline-search was conducted using the terms: nbDMARD, bDMARD, posterior uveitis, intermediate uveitis, treatment, corticosteroid. In addition, clinical studies were included as registered at ClinicalTrials.gov.
RESULTS
Currently two major lines of treatments can be identified: (1) the intraocular application of anti-inflammatory agents and (2) the introduction of new agents, e.g., (bDMARDs) and small-molecule-inhibitors. Whereas intravitreal treatments have the advantage to avoid systemic side effects, new systemic agents are progressively earning credit on the basis of their therapeutic effects.
CONCLUSION
Even when current treatment strategies are still hampered by the limited number of randomized controlled trials, promising progress and continuous efforts are seen.
Topics: Adolescent; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Antirheumatic Agents; Humans; Uveitis; Uveitis, Intermediate; Uveitis, Posterior
PubMed: 33634341
DOI: 10.1007/s10792-021-01763-8 -
International Ophthalmology Clinics 2005
Review
Topics: Humans; Tuberculosis, Ocular; Uveitis, Posterior
PubMed: 15791159
DOI: 10.1097/01.iio.0000155934.52589.e3 -
International Ophthalmology Clinics 2005
Review
Topics: Antiviral Agents; Herpes Simplex; Herpes Zoster Ophthalmicus; Humans; Uveitis, Posterior
PubMed: 15791160
DOI: 10.1097/01.iio.0000155906.72432.28 -
Ocular Immunology and Inflammation Apr 2022To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis. (Review)
Review
PURPOSE
To describe and illustrate the main optical coherence tomography (OCT) findings of infectious uveitis.
METHODS
Narrative review.
RESULTS
Posterior segment OCT in patients with infectious uveitis reveals posterior hyaloid face precipitates, superficial retinal precipitates and infiltrates, foveolitis, retinitis, neuro-retinitis, choroidal granulomas, and choroiditis as main imaging biomarkers. Some of these features are specific to the underlying causing etiology and may support the diagnosis and the initiation of treatment. Some OCT features disappear completely with resolution; some others are associated with irreversible retinal damage.
CONCLUSIONS
OCT identifies different features of infectious uveitis into the vitreous, the retina, and the choroid. OCT characteristics, combined with other multimodal imaging features, are helpful in the differential diagnosis of infectious uveitis, the early detection of complications, and the assessment of the response to therapy.
Topics: Choroid; Eye Infections; Fluorescein Angiography; Humans; Retinitis; Tomography, Optical Coherence; Uveitis; Uveitis, Posterior
PubMed: 35226572
DOI: 10.1080/09273948.2022.2032197