Intermediate uveitis: what is the natural course of the disease and its relationship with other systemic diseases?

This study examined the natural course of intermediate uveitis, to find a possible correlation with systemic diseases and to identify the ocular complications. Patients were classified according to follow-up time in three groups: A (1-5 years) 12 pts, B (6-10 years) 10 pts, C (11-15 years or more) 6 pts for a total of 28 patients (52 eyes). We studied the recurrences, the complications of the disease and the overall prognosis. Eight patients were found to be suffering from systemic diseases: sarcoidosis 2, Adamantiades-Behcet 2, multiple sclerosis 3 and Lyme disease 1. Cataract was found in 21 eyes (40.5%) and macular changes in 20 eyes (38.4%) but chronic cystoid macular edema persisted in only six cases (12.5%). Group C presented more complications than group B. Group A had the fewest. The frequency of recurrences was 1-5 for group A. 1-3 for group B and 1-2 for group C. Four patients received no therapy, 15 received steroids and nine received cyclosporine and steroids. In this series intermediate uveitis was bilateral in 85.8% of patients and related with systemic diseases in 28.5%. Recurrences appeared mainly during the first five years. The longer the presence of the disease the more frequent were complications and the final visual acuity depended mostly on the severity of the initial attack and the number of exacerbations.