Idiopathic Neuroretinitis: A Case Study and Differentials Discussion

Introduction. Posterior uveitis is an entity attributed to both infectious and non-infectious agents. Due to the numerous etiologies of neuroretinitis, it is important that ophthalmic physicians are able to diagnose these conditions using both clinical evaluation and supporting ancillary testing. Case Presentation. Presented is an atypical case of idiopathic posterior-uveitis in an otherwise healthy, black 15-year-old female. The patient presented with flu-like symptoms and painful, red eyes with blurry vision bilaterally. Clinical presentation included bilateral diffuse conjuctival injection, vitreous cells, peripheral creamyplacoid chorioretinal lesions, disc edema, and macular pucker. Deviation From the Expected. All serological and radiologic examination findings were unremarkable, suggesting no systemic or infectious etiology. Posterior uveitis is commonly attributed to infectious or non-infectious disease. Discussion. Ancillary testing was used to confirm the presence of optic disc swelling and macular pucker. Due to the idiopathic nature of this case, the patient was initiated on an oral steroid schedule without antibiotic, which resulted in an improvement in patient comfort, visual acuities, and improved clinical presentation. Conclusion. Due to the myriad of infectious and non-infectious etiologies, careful clinical assessment and use of proper ancillary testing is essential in making the diagnosis of posterior uveitis.