Intermediate uveitis

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Intermediate uveitis
Synonyms	Pars planitis, peripheral uveitis
Pronounce	N/A
Specialty	N/A
Symptoms	Floaters, blurred vision, photophobia
Complications	Cystoid macular edema, cataract, glaucoma
Onset	Typically in young adults
Duration	Chronic
Types
Causes	Often idiopathic, can be associated with multiple sclerosis, sarcoidosis, Lyme disease
Risks
Diagnosis	Ophthalmoscopy, fluorescein angiography, optical coherence tomography
Differential diagnosis	Posterior uveitis, anterior uveitis, retinal detachment
Prevention
Treatment	Corticosteroids, immunosuppressive therapy, cryotherapy, vitrectomy
Medication	Corticosteroids, methotrexate, infliximab
Prognosis	Variable, can lead to vision loss if untreated
Frequency	Rare
Deaths

Intermediate uveitis is a form of uveitis that primarily affects the vitreous body and the peripheral retina. It is characterized by inflammation of the pars plana, the area between the ciliary body and the retina. This condition is also known as "pars planitis" when it occurs without an associated systemic disease.

Clinical Features

Intermediate uveitis typically presents with floaters and blurred vision. Patients may also experience mild discomfort or redness in the affected eye. The hallmark of intermediate uveitis is the presence of inflammatory cells in the vitreous humor, which can be observed during an eye examination.

Symptoms

• Floaters
• Blurred vision
• Mild eye discomfort
• Redness of the eye

Signs

• Vitreous cells and haze
• Snowbanking or snowballs in the peripheral retina
• Possible cystoid macular edema

Diagnosis

The diagnosis of intermediate uveitis is primarily clinical, based on the presence of vitreous cells and the exclusion of other causes of uveitis. Ancillary tests such as fluorescein angiography and optical coherence tomography (OCT) may be used to assess the extent of retinal involvement and macular edema.

Etiology

Intermediate uveitis can be idiopathic or associated with systemic diseases such as multiple sclerosis, sarcoidosis, or Lyme disease. It is important to evaluate patients for these conditions, especially if the uveitis is bilateral or recurrent.

Treatment

The treatment of intermediate uveitis aims to reduce inflammation and prevent complications. Corticosteroids are the mainstay of therapy, administered either topically, orally, or via periocular injections. In cases where corticosteroids are insufficient or contraindicated, immunosuppressive agents such as methotrexate or azathioprine may be used.

Corticosteroids

• Topical corticosteroids for mild cases
• Oral corticosteroids for more severe inflammation
• Periocular injections for localized treatment

Immunosuppressive Therapy

• Methotrexate
• Azathioprine
• Biologic agents in refractory cases

Prognosis

The prognosis for intermediate uveitis varies depending on the underlying cause and the response to treatment. With appropriate management, many patients can achieve good visual outcomes. However, complications such as cataract, glaucoma, and macular edema can affect the prognosis.

See Also

• Uveitis
• Vitreous body
• Retina
• Ciliary body