Original Research Article DOI: 10.18231/2395-1451.2017.0035 Indian Journal of Clinical and Experimental Ophthalmology, April-June,2017;3(2): 138-141 138 Etiopathogenesis of posterior segment inflammation in a tertiary referral institute Gopal S. Pillai 1,* , Natasha Radhakrishnan 2 , Sandhya A. Menon 3 1 Professor & HOD, 2 Associate Professor, 3 Consultant in Retina, Dept. of Ophthalmology, Amrita Institute of Medical Sciences, Kochi *Corresponding Author: Email: gopalspillai@gmail.com Abstract Aim: To analyze the causes and characteristics of posterior segment inflammation in the Vitreo-retinal department in a multispecialty hospital. Methods: This is a retrospective study on 97 patients who presented with manifestations of posterior segment inflammation in a multispecialty hospital in the last 2 years were included in the study. They were analysed with respect to aetiology, clinical manifestations, intervention done and response to treatment. Results: Posterior segment inflammation was most commonly seen as a manifestation toxoplasmosis (18.6%) followed by systemic vasculitic disorder like SLE (16.5%). Other common causes included infections like tuberculosis, (9.3%) endogenous (bacterial and fungal endophthalmitis (12.4%) and viral retinitis. Others were VKH, vasculitis with unknown etiology, Behcets disease and sarcoidosis Conclusions: We found toxoplasmosis to the commonest single etiological agent. There was a significantly higher incidence of posterior segment involvement due to systemic vasculitis in our study population which is hitherto been unreported in other study populations. Keywords: Posterior Uveitis, Vasculitis, Endophalmitis, Inflammation. Introduction Uveitis is a complex intraocular inflammatory disease resulting from several etiological entities. Causes of uveitis vary in different populations. Infectious uveitis occur in greater frequency in the developing world while noninfectious forms predominate in the developed countries. (1-9) Most of the studies describing the patterns of uveitis represent cases in exclusive eye care institutions. Few studies tend to analysis uveitis in association with systemic disease. (7,8) Here, we attempt to characterize posterior segment inflammatory disease in our institution, which is a large tertiary care multispecialty hospital. Systemic diseases with posterior segment involvement like the specific vasculitic entities and endogenous endophthalmitis are included in the study. The purpose of current study is to analyze the causes and characteristics of posterior segment inflammation in the Vitreo Retinal department in a multispecialty hospital. Materials and Methods The clinical records of all patients with posterior segment inflammation seen in the last 2 years at our centre were analyzed retrospectively. Information regarding age, gender, laterality, details of ocular examination, investigations done and final diagnosis were recorded. The data also included systemic associations if any, intervention done and response to treatment. Patients with post cataract surgery endophthalmitis, inflammation secondary to trauma or surgery and patients with less than 6 months of follow up were excluded from the study. Patients presenting with endogenous endophthalmitis were included. It was conducted according to the provisions of the Declaration of Helsinki in 1995. Ocular examination included detailed slit lamp, intraocular pressure measurements and fundus examination. Routine investigations included complete blood counts, ESR, Mantoux test, serology for toxoplasma and HIV, ANA titres, serum calcium and serum ACE and X ray chest. A Fundus Fluorescein angiogram, Optical Coherence Tomogram, ultrasound B Scan and additional tailored laboratory investigations were done whenever necessary. Our study included intermediate, posterior and panuveitis based on the International Uveitis Study Group criteria. (10) We also included cases of retinal vasculitis as it involves inflammation of retinal vasculature. Standard diagnostic criteria were employed for specific uveitic entities. An internist was consulted whenever needed. The final etiological diagnosis was based on clinical features, laboratory investigations and systemic evaluation. Results Of the data of 124 cases collected for the study, 27 cases were excluded based on the exclusion criteria. Therefore a total of 97 cases were included in the analysis. There were 52 cases of infectious uveitis and 45 cases of noninfectious uveitis. The mean age of the infectious uveitis group was 40.02 years (Range-6-68 years) and the noninfectious uveitis group was 35.78 years (Range-12-74 years). The mean age of the whole study group was 38.05 years. Analysis of sex distribution showed 55.7% males and 44.3% females among the total cases. Among the infectious cases there were 61.5% males and 38.5% females. Among the noninfectious cases there was a slight female preponderance (48.9% males and 51.1% females). Of the infectious cases 82.7% was unilateral and 17.3% was bilateral while among noninfectious cases 73.3% was bilateral and 26.7 % unilateral. We arrived at an etiological diagnosis of all cases based on morphology of the lesions and ancillary tests except two cases of endogenous endophthalmitis and 11 cases of vasculitis. Among the infectious uveitis lab investigations were positive in 57.7% cases and negative in 42.2% cases. The frequency of distribution of each is