Intermediate uveitis (also known as pars planitis or cyclitis)

This is a chronic uveitis of unknown cause. The inflammation is most marked in the middle part of the uveal tract of the eye. This middle part, the pars plana, is that part of the eye between the ciliary body and the retina.

Symptoms

Floaters (both eyes in 75%)
Reduced vision due to floaters
Reduced vision due to cystoid macular oedema (waterlogging in the retina)
Usually painless, white, quiet eye
In rare occasions aching eyes and sensitivity to light

Onset / Epidemiology

Teens to early adulthood
Equally affects men and women
Not inherited

Clinical features which can be seen by an ophthalmologist

Minimal anterior chamber cells
No posterior synechiae
"Snow balls" and "snow banking" at the pars plana
Cataract
Retina - in rare instances a periphlebitis, cystoid macular oedema (CMO), or disc oedema may be found
In rare cases tractional retinal detachment may occur

Frequency of complications

Cataract - Occurs in 30 - 40%
Cystoid macular oedema (CMO) - 20 - 50%
Multiple sclerosis - develops at some point in about 20% of sufferers of intermediate uveitis

Tests

The diagnosis of intermediate uveitis is on the clinical judgement of the ophthalmologist. There is no specific test. However, tests may be requested to exclude other causes of uveitis such as

Blood tests
Chest X-rays
Angiography

Follow-up

Every few months to yearly depending on complications

Treatment

In many cases visual acuity is not markedly decreased and therefore no treatment is necessary

If the visual acuity is markedly decreased, treatment may include

Injection of steroids around the eye
Oral acetazolomide (Diamox)
Oral steroids (Prednisolone)
Oral cyclosporin
Cataract surgery

Cause

Unknown. Some experts suggest it may be due to auto-antibodies against the vitreous base.

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