Differential diagnosis of intermediate uveitis and pars planitis

intermediate uveitis and pars planitis, and list the differential diagnosis associated with these findings

Intermediate uveitis refers to ocular inflammation primarily affecting the anterior vitreous, pars plana (the area immediately posterior to the ciliary body where white blood cells may accumulate), and peripheral retina. It typically affects children and young adults, is bilateral in 80% of cases, and tends to be chronic with periods of exacerbation and remission. The hallmark finding is vitritis that can be associated with aggregates of exudates referred to as “snowballs” or “snowbanks” in the pars plana region. When anterior segment inflammation is present, it is typically only mild to moderate. Peripheral retinal vasculitis and cystoid macular edema resulting in visual loss may occur.

When the condition is idiopathic and pars plana exudation (“snowballs” or “snowbank”) occurs, it is referred to as pars planitis, which accounts for >50% of intermediate uveitis cases.

The differential diagnosis includes sarcoidosis, multiple sclerosis, infectious etiologies (Lyme disease, syphilis, herpes-family viruses, TB, Whipple’s disease, rickettsiosis, human T-cell lymphotropic virus type 1, and toxocariasis), and Behçet’s disease.

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