Differential diagnosis of posterior uveitis
Posterior uveitis describes inflammation of the choroid or retina, often associated with an overlying vitritis. Toxoplasmosis retinitis is the most common identifiable cause. Other causes include Behçet’s disease, sarcoidosis, VKH disease, birdshot retinochoroidopathy, multifocal choroiditis, punctate inner choroiditis, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), autoimmune retinopathy, cancer-associated retinopathy, retinal vasculitis, serpiginous choroiditis, sympathetic ophthalmia, presumed ocular histoplasmosis syndrome, herpes-family viruses (HSV, VZV, and CMV), TB, and syphilis. TORCH organisms, Blau syndrome, and toxocariasis may be causes in the pediatric population.
Birdshot retinochoroidopathy is an idiopathic cause of posterior uveitis that is characterized by multiple, discrete, cream-colored spots throughout the retina and choroid (primarily distributed around the optic nerve). It is highly associated with HLA-A29.
