Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ The terms choroiditis, retinitis, and retinochoroiditis denote the tissue layers primarily involved in posterior uveitis Infectious agents are the most common cause of posterior uveitis in the pediatric population +++ Clinical Findings ++ Children with posterior uveitis often present with systemic manifestations of a congenital infection Congenital rubella presents with deafness, developmental delay, cataracts, "salt and pepper" retinopathy, and hearing and cardiac disorders Active toxoplasmosis Produces a white lesion appearing as a "headlight in the fog" owing to the overlying vitreitis Inactive lesions have a hyperpigmented border Contiguous white satellite lesions suggest reactivation of disease Ocular candidiasis/endogenous endophthalmitis typically occurs in an immune compromised host or a premature infant in the intensive care nursery receiving hyperalimentation Candidal chorioretinitis appears as multifocal, whitish yellow, fluffy retinal lesions that may spread into the vitreous and produce a so-called cotton or fungus ball vitritis Acute retinal necrosis syndrome Caused most often by varicella-zoster virus and occasionally by HSV May present with vision loss and a red and painful eye CMV infection is the most common cause of retinitis in immunocompromised children, especially those with hematopoietic stem cell transplantation or HIV infection CMV retinitis appears as a white retinal lesion, typically but not always associated with hemorrhage, or as a granular, indolent-appearing lesion with hemorrhage and a white periphery Cotton-wool spots (nerve fiber layer infarcts) also commonly occur in HIV-positive patients In toddlers and young children, Toxocara canis or Toxocara cati infections (ocular larva migrans) occur from ingesting soil contaminated with parasite eggs Disease is usually unilateral Red injected eye, leukocoria, and decreased vision are common +++ Diagnosis ++ Serologic analysis and retinal examination by an ophthalmologist are used to identify the cause of posterior uveitis Acute retinal necrosis syndrome Ophthalmoscopy may show Unilateral or bilateral patchy white areas of retina Arterial sheathing Vitreous haze Atrophic retinal scars Retinal detachment Optic nerve involvement In toddlers and young children, Toxocara canis or Toxocara cati infections Funduscopic examination may show endophthalmitis (vitreous abscess) or localized granuloma Diagnosis is based on the appearance of the lesion and serologic testing using ELISA for T canis and T cati +++ Treatment ++ Congenital toxoplasmosis infections must be treated with systemic antimicrobials Other infectious agents such as Candida, varicella, and CMV require systemic and/or intraocular injections of antimicrobial agents and may require retinal surgery Treatment of toxocariasis includes periocular corticosteroid injections and vitrectomy GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPediatrics 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPediatrics Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options