Intermediate Uveitis: Spotlight on Symptoms, Signs, and Potential Complications

Summary

This educational video by Dr. Amrit delves into intermediate uveitis (UVITIS), a type of eye inflammation. It explains the classification of UVITIS based on the affected part of the uveal tract, the chronic and insidious nature of intermediate UVITIS, and its relapsing course. The lecture also covers the history, causes, symptoms, and signs of the condition, including the presence of snowballs and snow banking in the vitreous. It highlights the importance of scleral depression in examination and the potential complications, such as macular edema and retinal detachment, providing a comprehensive overview for medical professionals.

Takeaways

• 😀 The script is a lecture by Dr. Amrit on intermediate uveitis (UVitis), a type of eye inflammation.
• 🔍 Uveitis can be classified into three types based on the part of the uveal tract affected: anterior, intermediate, and posterior.
• 🏥 The International Uveitis Study Group (IUSG) and the Standardization of Uveitis Nomenclature (SUN) Group have established criteria for classifying uveitis.
• 📚 Intermediate uveitis is characterized by chronic inflammation with an insidious onset, primarily affecting the vitreous and the intermediate part of the eye.
• 👨‍⚕️ The lecture discusses the historical development of the understanding of intermediate uveitis and the various terms used to describe it.
• 🧬 Intermediate uveitis can be idiopathic or associated with systemic disorders, with a significant portion of cases having no identifiable cause.
• 👶 The condition is particularly relevant in pediatric populations, where it accounts for a large percentage of uveitis cases.
• 🌐 Causes of intermediate uveitis include both infective and noninfective etiologies, such as tuberculosis, syphilis, and sarcoidosis.
• 👁️ Symptoms of intermediate uveitis include insidious onset of blurred vision and floaters, often without significant pain or photophobia.
• 🔬 Clinical signs of the condition include the presence of snowballs and snow banking, which are indicative of severe inflammation.
• 💡 The lecture emphasizes the importance of scleral depression in examination to detect peripheral signs of intermediate uveitis.

Q & A

What are the three types of UVEITs based on the inflammation part of the uveal tract?

The three types of UVEITs are anterior, intermediate, and posterior. Anterior UVEIT affects the iris and ciliary body, intermediate UVEIT primarily affects the area near the anterior vitreous, and posterior UVEIT affects the retina and choroid.

What is the definition of intermediate UVEIT according to the SUN Working Group?

The SUN Working Group defines intermediate UVEIT as a disease where the major site of inflammation is the vitreous, with minimal to no anterior segment or chorioretinal inflammatory signs.

Who first described what was likely intermediate UVEIT, and what term did they use?

Fuchs first described what was likely intermediate UVEIT in 198, using the term 'chronic cyclitis' to describe the inflammation of the ciliary body.

What term did Charles Sheehan use to describe the clinical description of intermediate UVEIT?

Charles Sheehan used the term 'intermediate UVEIT' to describe the clinical condition, and he also mentioned peripheral vascular abnormalities and exudation along the pars plana.

What is the difference between intermediate UVEIT and pars planitis according to the SUN Group?

According to the SUN Group, the difference lies in the cause of the inflammation. Intermediate UVEIT can be idiopathic or associated with systemic disorders, while pars planitis specifically refers to idiopathic inflammation with snow banking and snowball formation.

What percentage of all uveitis cases are intermediate UVEIT, and what is its significance in the pediatric population?

Intermediate UVEIT accounts for 15% of all uveitis cases. In the pediatric population, it is the second most common type of uveitis, accounting for up to about 25% of cases.

What are the common symptoms of intermediate UVEIT?

Common symptoms of intermediate UVEIT include insidious onset of blurred vision, usually accompanied by vitreous floaters, and very mild to almost no pain, photophobia, or redness.

What are the major infective causes of intermediate UVEIT?

The major infective causes of intermediate UVEIT include tuberculosis, syphilis, Lyme disease, cat scratch fever, toxocariasis, and HTLV-1 infection.

What is the significance of snow balls and snow banking in intermediate UVEIT?

Snow balls and snow banking are signs of severe inflammation in intermediate UVEIT. Snow balls are focal collections of inflammatory cells and exudates in the peripheral retina, while snow banking is the formation of fibrovascular exudative plaque-like material in the pars plana region or peripheral retina.

What is the importance of scleral depression in examining intermediate UVEIT?

Scleral depression is important in examining intermediate UVEIT to observe and detect snow balls and snow banking, which are usually present in the peripheral part of the retina around the pars plana and pars plana region.

What are the possible complications of intermediate UVEIT?

Possible complications of intermediate UVEIT include cystoid macular edema, cataract, hypotony, optic neuritis, peripheral vasculitis, neovascularization, retinoschisis, and retinal detachment.