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Updated: Feb 6, 2026
Primed Mycobacterial Uveitis PMU as a Model for Post-Infectious Uveitis
Published on: December 17, 2021
Clinical features of infectious posterior segment uveitis
Crystal Sin Yi Cheung1, Adam Jekielek2, Nupura Bakshi3
1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
Objective:
To assess the clinical findings and microbiology investigations in patients with suspected infectious posterior segment uveitis (PSU).
Design:
Retrospective case study.
Methods:
Between January and December 2014, medical records of 270 patients with PSU were reviewed. Baseline ocular examination, presumed and final diagnoses, microbiology investigations from aqueous or vitreous fluid, and peripheral blood were reviewed.
Results:
Infectious PSU was suspected in 28 patients among 270 PSU cases (10.4%, 28/270), and 11 cases were of infectious origin (4.1%, 11/270). Six patients were immunocompromised: 5 patients in the confirmed infectious PSU group (45.5%, 5/11) and 1 in the confirmed noninfectious group (5.9%, 1/17; p = 0.002). Initial visual acuity was 1.8 ± 0.35 logMAR and 0.9 ± 0.23 logMAR for patients with confirmed infectious and noninfectious PSU, respectively (p = 0.04). Anterior chamber reaction was worse in patients with confirmed infectious PSU (1.8 ± 0.49) than confirmed noninfectious cases (0.5 ± 0.1; p = 0.003). The frequency of chorioretinitis among patients with confirmed infectious and noninfectious PSU is 54.5% (6/11) and 11.8% (2/17; p = 0.03), respectively. Onset of confirmed infectious uveitis was more acute (≤6 weeks in duration) than noninfectious cases (p = 0.0015). Among the 11 patients with positive blood culture or serology, 6 had anterior and vitreous chamber fluid analysis. The rate of positive cultures and PCR is 16.7% (1/6) for aqueous humour and 50% (3/6) for vitreous samples.
Conclusions:
Clinical features more suggestive of infectious PSU include immunosuppression, worse initial visual acuity, acute onset, worse anterior chamber reaction, and chorioretinitis. Further studies are needed to enhance the diagnostic yields of aqueous and vitreous fluid analyses.
Insights
Infectious posterior segment uveitis (PSU) was confirmed in 4.1% of cases, often linked to immunosuppression and presenting with poorer vision and acute onset. Microbiology tests on vitreous samples showed higher diagnostic yield for infectious PSU.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Posterior segment uveitis (PSU) can have infectious or non-infectious etiologies.
- Accurate diagnosis is crucial for appropriate management and visual outcomes.
Purpose of the Study:
- To evaluate clinical findings and microbiology investigations in patients with suspected infectious posterior segment uveitis (PSU).
Main Methods:
- Retrospective case study of 270 patients with PSU between January and December 2014.
- Reviewed ocular examinations, diagnoses, and microbiology results from aqueous/vitreous fluid and blood.
- Compared clinical features and diagnostic yields between infectious and non-infectious PSU groups.
Main Results:
- Infectious PSU was confirmed in 4.1% of cases (11/270).
- Immunosuppression (45.5%), worse initial visual acuity, acute onset, and chorioretinitis were more frequent in infectious PSU.
- Vitreous fluid analysis yielded positive results in 50% of infectious cases, compared to 16.7% for aqueous humor.
Conclusions:
- Immunosuppression, acute onset, poorer visual acuity, and chorioretinitis suggest infectious PSU.
- Vitreous fluid analysis offers a higher diagnostic yield for infectious agents in PSU.
- Further research is needed to improve diagnostic accuracy of ocular fluid analyses.
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