INTERMEDIATE UVEITIS: AN ATYPICAL PRESENTATION ASSOCIATED WITH RHEUMATOID ARTHRITIS

Betty Harville

Abstract

Intermediate uveitis (pars planitis, peripheral uveitis, chronic cyclitis) a condition of unknown etiology is characterized by intraocular inflammation consisting of cells and debris in the vitreous, exudate and snowbank formation along the pars plana and minimal anterior chamber reaction. Intermediate uveitis is primarily seen in young adults (ages 5-35), but can occur at any age. Both sexes are equally affected. No racial predilection can be identified. It generally occurs inferiorly and bilaterally. Intermediate uveitis has a bimodal distribution peaking at ages 5 to 15 and 25 to 35. Complications include cataract formation, cystoid macula edema, neovascularization with and without vitreous hemorrhage, and retinal detachment. Therapy ranges from observation to vitrectomy. A 42 year-old black female presented with decreased vision, mild pain and photophobia OS. Best corrected acuity OD 20/25, OS 20/80. IOP OD 14 and OS 12 mm Hg by Goldmann tonometry. Slit lamp examination revealed 1+ flare and trace cells OD and 2+ cells and flare OS. Vitreal floaters and inferior snowball opacities were noted OS. Intermediate uveitis subtype pars planitis was diagnosed and the patient was placed on prednisolone acetate 1% every two hours while awake and cyclopentolate 1% three times daily OS. The patient had no known ocular or systemic problems, therefore, laboratory workup was ordered. The laboratory panel was positive for elevated sed rate and elevated rheumatoid factor. The patient was subsequently referred to a rheumatologist. Follow-up examination revealed 2+ cells and flare OU and inferior snowbanking OU with cystoid macula edema noted OS. Best corrected acuity OD 20/20 and OS 20/50. The patient was subsequently placed on oral steroids and has responded well. A detailed discussion of this case along with color photos, laboratory workup, a table of associated diseases, and a schematic for management of intermediate uveitis will be presented in this poster.

Details

Year: 1996

Program Number: Poster 20

Resource Type: Scientific Program

Author Affiliation: Southern College of Optometry

Co-Authors: Brad Sutton, Troy Currier

Co-Author Affiliation: Southern College of Optometry, Omni Eye Services

Room: Exhibit Hall