RARE DISEASE
Infectious posterior uveitis
Infectious posterior uveitis
Infectious posterior uveitis
Drug discovery
0
drugs
With orphan designations
Overview
Infectious posterior uveitis (IPU) is a rare but vision-threatening inflammation of the choroid and retina caused by pathogens such as Toxoplasma gondii, herpesviruses, syphilis, tuberculosis, or fungal/parasitic infections [1][6][11]. It presents with floaters, photopsia, and vision loss, often with retinal infiltrates, vasculitis, or macular edema [1][16]. Diagnosis requires targeted microbiological testing, and treatment combines antimicrobial therapy with corticosteroids to mitigate inflammation and prevent complications like retinal detachment or glaucoma [11][18].
Burden
Accounts for ~15% of blindness in the US/Europe [17], with posterior uveitis linked to worse vision-related quality of life than anterior forms [4].
Direct annual costs average $12,149 per US patient (vs. $7,834 for anterior uveitis) [4].
Chronic inflammation causes cumulative damage (e.g., cataracts, glaucoma) in >50% of cases [1][16].
Therapies
Antimicrobials: Pathogen-specific agents (e.g., pyrimethamine-sulfadiazine for toxoplasmosis, antivirals for HSV/VZV) [11][18].
Steroids: Low-dose systemic corticosteroids initiated 48–72 hours after antimicrobials to control inflammation [18].
Surgical Intervention: Required for complications like retinal detachment or refractory vitreous opacities [1][16].
Categories: rare ophthalmic disorders
Research Papers
330 drug discovery papers about Infectious posterior uveitis, with 3 first-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
330 drug discovery papers about Infectious posterior uveitis, with 3 first-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
2026-07-13 | Ocular Toxoplasmosis: Bridging Clinical Diagnosis and Evidence-Based Management
Background: Ocular toxoplasmosis is one of the most common infectious causes of posterior uveitis and may lead to recurrent inflammation and visual impairment. It most often presents as necrotizing retinochoroiditis, but the clinical picture depends on lesion location and immune status. Aim: This review summarizes current evidence on clinical manifestations, diagnosis and treatment of ocular toxoplasmosis. Material and methods: A narrative review of PubMed and Scopus publications from 2002–2025 was performed, focusing on clinical presentation, diagnostic methods and therapeutic management. Results: Ocular toxoplasmosis usually presents as focal retinochoroiditis with vitritis and, less commonly, anterior uveitis. Immunocompromised patients may develop bilateral, multifocal or extensive lesions. Diagnosis is primarily clinical and may be supported by serology, multimodal imaging, PCR testing and assessment of intraocular antibody production in uncertain cases. Conventional therapy with pyrimethamine, sulfadiazine and corticosteroids remains effective, while trimethoprim-sulfamethoxazole offers comparable efficacy with a more favorable safety profile. Intravitreal clindamycin with dexamethasone may be considered when systemic treatment is contraindicated. Conclusions: Early diagnosis and individualized treatment are essential to reduce irreversible retinal damage. Current therapies control active inflammation but do not eradicate latent infection or reliably prevent recurrence.
2026-06-13 | Real-World Anatomical Outcomes of Suprachoroidal Triamcinolone Acetonide Injections in a Large Retinal Practice over a 4-Year Period.
To evaluate the clinical role, durability, anatomical response, and safety for suprachoroidal triamcinolone acetonide (SCTA) (Xipere) in routine clinical practice. Data were manually extracted from health records at a high-volume retina practice in Cleveland, Ohio. All patients with noninfectious inflammatory macular edema undergoing SCTA (≥1 billing code) between October 25, 2021, and July 17, 2025, were included. Patients with known systemic autoimmune or infectious associations were excluded. Unique eyes were defined by MRN + laterality, with "OU" entries split into OD/OS. Patient demographics, underlying diagnosis categorization, time between first and second injection (for eyes with ≥2 injections) were summarized. Pre- versus post-treatment central retinal thickness (CRT) and intraocular pressure (IOP) were compared via paired t-tests. A total of 177 patients (195 eyes) received 340 SCTA injections for macular edema associated with an underlying diagnosis of intermediate uveitis (10%), pseudophakic cystoid macular edema (31%), and posterior uveitis (59%). The time between first and second injection was approximately 5 months [SD ± 72.5; median 144 (min 35, max 427)]. From baseline to follow-up, mean CRT decreased by 103 µm [95% CI: (-122,-83.2), P < 0.001], while IOP increased minimally [mean difference 0.7 mmHg, 95% CI: (-0.02, 1.43), P = 0.057]; and was medically managed when elevated. In this real-world cohort, findings suggest that SCTA achieves robust anatomical improvement, a favorable IOP profile, and prolonged durability across patients with inflammation-related macular edema.
2026-03-13 | Combined PCR Positivity for Mycobacterium tuberculosis Complex and Nontuberculous Mycobacterium Species in Patients Treated for Tubercular Panuveitis.
Intraocular dual infection by Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) is rarely reported. This study describes the clinical features, aetiology, and treatment outcomes of patients with dual infection from MTBC and NTM-related uveitis. A retrospective study was conducted on 146 clinically suspected tubercular uveitis (TBU) patients who underwent diagnostic or therapeutic pars plana vitrectomy as plan of laboratory diagnosis-based management between June 2023 and December 2024. Undiluted vitreous samples were analysed with nested MTBC-NTM multiplex real-time PCR assay kit. Six out of 146 patients (4.11%) were found infected with dual infection from MTBC and NTM. All six cases showed severe clinical presentation characterised by bilateral panuveitis (5/6 patients), with significant structural sequelae. Optic atrophy was universal and occurred more frequently than in isolated TBU, while complicated cataract and hypotony-related maculopathy were also common. Despite the dual etiology, all patients achieved inflammatory resolution and visual recovery (mean BCVA improving from 20/400 to 20/100) following standard anti-tubercular therapy (ATT) and corticosteroids, with no recurrence during follow-up. Concurrent MTBC and NTM infection drives a distinct, aggressive form of panuveitis characterized by optic nerve pallor, anterior segment complications of complicated cataract or uveitic membranes and maculopathy. Despite this severity, standard ATT remained an effective first-line strategy, likely either due to therapeutic cross-coverage against NTM or MTBC being the primary driver of uveitis in the present study. The concurrent positivity also highlights the need for vitreous molecular profiling and further research in co-infections in infectious posterior uveitis.
2026-01-28 | [Ocular toxoplasmosis in adults : Refresher course].
Ocular toxoplasmosis is the leading cause of infectious posterior uveitis worldwide and a daily challenge for ophthalmologists. Most cases of ocular toxoplasmosis are acquired postnatally, mainly through ingestion of contaminated meat or contact with cat feces. The diagnosis relies on clinical findings such as focal retinochoroiditis, vitritis and retinal scarring. The treatment can include antiparasitic drugs and in selected cases requires the combination with corticosteroids. The recurrence rates are high, particularly in older or immunocompromised patients. Early diagnosis and individualized treatment strategies significantly improve the prognosis and visual function.
2025-10-01 | SOME ASPECTS OF THE EPIDEMIOLOGICAL CHARACTERISTICS OF UVEITIS AND UVEITIC GLAUCOMA IN THE REGIONS OF AZERBAIJAN
Purpose – to evaluate some aspects of the epidemiological characteristics of uveitis and uveitic glaucoma (UG) in the regions of Azerbaijan. Material and methods The study was conducted based on a retrospective clinical, epidemiological, and etio-pathogenetic analysis of the clinical and electronic databases (1C-EMS) of patients who presented with uveitis and UG to the National Ophthalmology Centre named after Academician Zarifa Aliyeva and its Masally, Ganja, and Sheki branches between 2008 and 2025. Methods of examination: ophthalmological, general clinical, laboratory, statistical. Results The analysis revealed that the majority of 2,877 patients diagnosed with uveitis who applied to the National Ophthalmology Centre named after Academician Zarifa Aliyeva and its branches during 2008-2025 were between the ages of 19 and 70 (91.4%) (35.5% in the acute stage, 64.5% in the chronic stage). Most of them applied to the Centre in Baku - 2,179 (75.7%), and 698 people (24.3%) applied to the branches. Overall, patients with uveitis accounted for 0.41% of all applications. Compared by the years, the highest number of patient applications with uveitis was recorded in Baku in 2018 and 2024, in Masally in 2017 and 2022, in Ganja in 2017 and 2024, and in Sheki in 2020. Men with uveitis applied more often to Baku (55.3%) and Masally (67.5%), while women applied more often to Ganja (62.4%) and Sheki (61.1%) branches. It was found that uveitis of non-infectious etiology (59.4%) and posterior anatomical localization (37.8%) were more frequent. Uveitic ocular hypertension (UOH) was detected in 837 (29.1%) of the 2,877 patients, and uveitic glaucoma (UG) was found in 346 (12.03%). UOH was mainly observed during anterior uveitis (in 657 patients, 78.5%), while UG was found in the chronic stage of uveitis (66.5%). The fact that 40.2% of patients with UG present at an extremely advanced stage of the disease necessitates the selection of radical surgical treatment methods. Any surgical intervention performed on patients with uveitis can also lead to exacerbation of the postoperative inflammatory process. Conclusion Most of the uveitis cases were of non-infectious etiology (59.4%) and posterior anatomical localization (37.8%), with UOH recorded in 29.1% and UG in 12.03%. The detection of UG in the primary chronic uveitis (66.5) and the extremely advanced stage (40.2%) forces the choice of radical surgical treatment methods. In order to reduce the risk of developing UG, it is advisable to choose a multidisciplinary approach to the dispanserization, examination, and treatment of patients with uveitis, to constantly monitor patients with UOH, and to provide appropriate hypotensive and neuroprotective complex treatment in a timely manner, in addition to anti-inflammatory treatment. Key words: uveitis, uveitic glaucoma, epidemiological characteristics
2026-07-13 | Ocular Toxoplasmosis: Bridging Clinical Diagnosis and Evidence-Based Management
Background: Ocular toxoplasmosis is one of the most common infectious causes of posterior uveitis and may lead to recurrent inflammation and visual impairment. It most often presents as necrotizing retinochoroiditis, but the clinical picture depends on lesion location and immune status. Aim: This review summarizes current evidence on clinical manifestations, diagnosis and treatment of ocular toxoplasmosis. Material and methods: A narrative review of PubMed and Scopus publications from 2002–2025 was performed, focusing on clinical presentation, diagnostic methods and therapeutic management. Results: Ocular toxoplasmosis usually presents as focal retinochoroiditis with vitritis and, less commonly, anterior uveitis. Immunocompromised patients may develop bilateral, multifocal or extensive lesions. Diagnosis is primarily clinical and may be supported by serology, multimodal imaging, PCR testing and assessment of intraocular antibody production in uncertain cases. Conventional therapy with pyrimethamine, sulfadiazine and corticosteroids remains effective, while trimethoprim-sulfamethoxazole offers comparable efficacy with a more favorable safety profile. Intravitreal clindamycin with dexamethasone may be considered when systemic treatment is contraindicated. Conclusions: Early diagnosis and individualized treatment are essential to reduce irreversible retinal damage. Current therapies control active inflammation but do not eradicate latent infection or reliably prevent recurrence.
2026-06-13 | Real-World Anatomical Outcomes of Suprachoroidal Triamcinolone Acetonide Injections in a Large Retinal Practice over a 4-Year Period.
To evaluate the clinical role, durability, anatomical response, and safety for suprachoroidal triamcinolone acetonide (SCTA) (Xipere) in routine clinical practice. Data were manually extracted from health records at a high-volume retina practice in Cleveland, Ohio. All patients with noninfectious inflammatory macular edema undergoing SCTA (≥1 billing code) between October 25, 2021, and July 17, 2025, were included. Patients with known systemic autoimmune or infectious associations were excluded. Unique eyes were defined by MRN + laterality, with "OU" entries split into OD/OS. Patient demographics, underlying diagnosis categorization, time between first and second injection (for eyes with ≥2 injections) were summarized. Pre- versus post-treatment central retinal thickness (CRT) and intraocular pressure (IOP) were compared via paired t-tests. A total of 177 patients (195 eyes) received 340 SCTA injections for macular edema associated with an underlying diagnosis of intermediate uveitis (10%), pseudophakic cystoid macular edema (31%), and posterior uveitis (59%). The time between first and second injection was approximately 5 months [SD ± 72.5; median 144 (min 35, max 427)]. From baseline to follow-up, mean CRT decreased by 103 µm [95% CI: (-122,-83.2), P < 0.001], while IOP increased minimally [mean difference 0.7 mmHg, 95% CI: (-0.02, 1.43), P = 0.057]; and was medically managed when elevated. In this real-world cohort, findings suggest that SCTA achieves robust anatomical improvement, a favorable IOP profile, and prolonged durability across patients with inflammation-related macular edema.
2026-03-13 | Combined PCR Positivity for Mycobacterium tuberculosis Complex and Nontuberculous Mycobacterium Species in Patients Treated for Tubercular Panuveitis.
Intraocular dual infection by Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) is rarely reported. This study describes the clinical features, aetiology, and treatment outcomes of patients with dual infection from MTBC and NTM-related uveitis. A retrospective study was conducted on 146 clinically suspected tubercular uveitis (TBU) patients who underwent diagnostic or therapeutic pars plana vitrectomy as plan of laboratory diagnosis-based management between June 2023 and December 2024. Undiluted vitreous samples were analysed with nested MTBC-NTM multiplex real-time PCR assay kit. Six out of 146 patients (4.11%) were found infected with dual infection from MTBC and NTM. All six cases showed severe clinical presentation characterised by bilateral panuveitis (5/6 patients), with significant structural sequelae. Optic atrophy was universal and occurred more frequently than in isolated TBU, while complicated cataract and hypotony-related maculopathy were also common. Despite the dual etiology, all patients achieved inflammatory resolution and visual recovery (mean BCVA improving from 20/400 to 20/100) following standard anti-tubercular therapy (ATT) and corticosteroids, with no recurrence during follow-up. Concurrent MTBC and NTM infection drives a distinct, aggressive form of panuveitis characterized by optic nerve pallor, anterior segment complications of complicated cataract or uveitic membranes and maculopathy. Despite this severity, standard ATT remained an effective first-line strategy, likely either due to therapeutic cross-coverage against NTM or MTBC being the primary driver of uveitis in the present study. The concurrent positivity also highlights the need for vitreous molecular profiling and further research in co-infections in infectious posterior uveitis.
2026-01-28 | [Ocular toxoplasmosis in adults : Refresher course].
Ocular toxoplasmosis is the leading cause of infectious posterior uveitis worldwide and a daily challenge for ophthalmologists. Most cases of ocular toxoplasmosis are acquired postnatally, mainly through ingestion of contaminated meat or contact with cat feces. The diagnosis relies on clinical findings such as focal retinochoroiditis, vitritis and retinal scarring. The treatment can include antiparasitic drugs and in selected cases requires the combination with corticosteroids. The recurrence rates are high, particularly in older or immunocompromised patients. Early diagnosis and individualized treatment strategies significantly improve the prognosis and visual function.
2025-10-01 | SOME ASPECTS OF THE EPIDEMIOLOGICAL CHARACTERISTICS OF UVEITIS AND UVEITIC GLAUCOMA IN THE REGIONS OF AZERBAIJAN
Purpose – to evaluate some aspects of the epidemiological characteristics of uveitis and uveitic glaucoma (UG) in the regions of Azerbaijan. Material and methods The study was conducted based on a retrospective clinical, epidemiological, and etio-pathogenetic analysis of the clinical and electronic databases (1C-EMS) of patients who presented with uveitis and UG to the National Ophthalmology Centre named after Academician Zarifa Aliyeva and its Masally, Ganja, and Sheki branches between 2008 and 2025. Methods of examination: ophthalmological, general clinical, laboratory, statistical. Results The analysis revealed that the majority of 2,877 patients diagnosed with uveitis who applied to the National Ophthalmology Centre named after Academician Zarifa Aliyeva and its branches during 2008-2025 were between the ages of 19 and 70 (91.4%) (35.5% in the acute stage, 64.5% in the chronic stage). Most of them applied to the Centre in Baku - 2,179 (75.7%), and 698 people (24.3%) applied to the branches. Overall, patients with uveitis accounted for 0.41% of all applications. Compared by the years, the highest number of patient applications with uveitis was recorded in Baku in 2018 and 2024, in Masally in 2017 and 2022, in Ganja in 2017 and 2024, and in Sheki in 2020. Men with uveitis applied more often to Baku (55.3%) and Masally (67.5%), while women applied more often to Ganja (62.4%) and Sheki (61.1%) branches. It was found that uveitis of non-infectious etiology (59.4%) and posterior anatomical localization (37.8%) were more frequent. Uveitic ocular hypertension (UOH) was detected in 837 (29.1%) of the 2,877 patients, and uveitic glaucoma (UG) was found in 346 (12.03%). UOH was mainly observed during anterior uveitis (in 657 patients, 78.5%), while UG was found in the chronic stage of uveitis (66.5%). The fact that 40.2% of patients with UG present at an extremely advanced stage of the disease necessitates the selection of radical surgical treatment methods. Any surgical intervention performed on patients with uveitis can also lead to exacerbation of the postoperative inflammatory process. Conclusion Most of the uveitis cases were of non-infectious etiology (59.4%) and posterior anatomical localization (37.8%), with UOH recorded in 29.1% and UG in 12.03%. The detection of UG in the primary chronic uveitis (66.5) and the extremely advanced stage (40.2%) forces the choice of radical surgical treatment methods. In order to reduce the risk of developing UG, it is advisable to choose a multidisciplinary approach to the dispanserization, examination, and treatment of patients with uveitis, to constantly monitor patients with UOH, and to provide appropriate hypotensive and neuroprotective complex treatment in a timely manner, in addition to anti-inflammatory treatment. Key words: uveitis, uveitic glaucoma, epidemiological characteristics
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