What Is Posterior Uveitis?

Common Causes

Posterior uveitis has a wide differential, and clinicians often separate infectious from noninfectious causes. Infectious etiologies are critical to identify because they need targeted antimicrobial therapy. Noninfectious causes may involve autoimmune or systemic inflammatory disease.

• Toxoplasmosis retinochoroiditis
• Herpes viruses, syphilis, or tuberculosis in selected cases
• Sarcoidosis, Behcet disease, or other inflammatory disorders
• Idiopathic posterior uveitis after evaluation

Symptoms

Symptoms often include floaters, blurred vision, reduced contrast, and scotomas. Some patients notice distortion if the macula is involved. Pain and redness can be mild or absent compared with anterior uveitis, which can delay diagnosis. New flashes, a curtain-like shadow, or sudden vision loss requires urgent evaluation.

Diagnosis and Testing

Diagnosis relies on a dilated retinal exam and often includes imaging such as optical coherence tomography to assess the macula and fluorescein angiography to evaluate leakage or vasculitis. Fundus photography helps document lesion appearance and response to treatment. Laboratory testing is targeted based on the pattern of disease and risk factors to rule out infections and systemic inflammatory conditions. Management is often coordinated by a retina or uveitis specialist when disease is significant.

Treatment and Follow Up

Treatment depends on the cause and severity. Infectious posterior uveitis is treated with organism-specific therapy, and anti-inflammatory medication is added cautiously when appropriate. Noninfectious posterior uveitis may require corticosteroids delivered locally or systemically and sometimes immunomodulatory therapy for long-term control. Follow-up is important to monitor for complications such as macular edema, scarring, cataract, or glaucoma.