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UVEITIS

Uveitis is categorized as Anterior Uveitis and Posterior Uveitis.

Anterior Uveitis(Granulomatous/Non-granulomatous)

Uveitis is swelling and irritation of the uvea, the middle layer of the eye. The uvea provides most of the blood supply to the retina.

Granulomatous Uveitis Common in Tuberculosis, Sarcoidosis. Anterior Uveitis can be treated with Topical steroids. Severe cases may require oral steroids.


Non-granulomatous Uveitis Common in Autoimmune disorders like Ankylosing spondylosis, HLA B27 positive patients, Wegener's granulomatosis, rheumatoid arthritis.


Prognosis

With proper treatment, most attacks of the anterior uveitis go away in a few days to weeks. However, relapses are common.

Inflammation related to posterior uveitis may last from months to years and may cause permanent vision damage, even with treatment.

Posterior Uveitis

Posterior Uveitis affects the back part of the uvea and involves primarily the choroid, a layer of blood vessels and connective tissue in the middle part of the eye. This type of Uveitis is called choroiditis.


1. Parsplanitis: This is characterized by inflammation of the (pars plana) between the colored part of the eye (iris) and the choroid. This may lead to blurred vision; dark, floating spots in the vision; and progressive vision loss.Should be treated with Oral /intravitreal steroids.


2. VKH syndrome: Vogt-Koyanagi-Harada (VKH) disease is a multisystemic disorder characterized by granulomatous pan Uveitis with exudative retinal detachments that is often associated with neurologic and cutaneous manifestations. Fundus picture shows Disc edema, Macula with multiple serous detachments with exudative retinal detachments. Should be treated with Oral steroids and Immunosuppressive drugs.


3. Posterior Scleritis: Fundus findings included serous retinal detachment, choroidal folds, retinal folds, subretinal mass, choroidal detachment, disc edema, and macular edema causing severe visual impairment. There was associated anterior scleritis also.Confirmed with FFA, OCT, B-scan.should be treated with oral steroids and immunosuppressive drugs.


4.  Multifocal Choroiditis/GHPC: This is an idiopathic inflammatory disorder of unknown etiology affecting the choroid, retina, and vitreous of the eye that presents asymmetrically, causing decreased vision. Acute cases should be treated with oral Steroids which leaves a permanent scar after healing.


5. Eales Disease: This is an idiopathic obliterative vasculopathy that usually involves the peripheral retina of young adults. characterized by avascular areas in the retina periphery, followed posteriorly by microaneurysms, dilatation of capillary channels, tortuosity of neighboring vessels, and spontaneous chorioretinal scars.


6. Viral Retinitis: (ARN/PORN) Most common causes include CMV,HIV 1,2.Fundus shows multiple haemorrhages with cotton wool spots can be treated with oral or intravenous antivirals along with oral steroids.

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