Retinal vasculitis
Retinal vasculitis | |
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Specialty | Neurology |
Retinal vasculitis is inflammation of the vascular branches of the retinal artery, caused either by primary ocular disease processes, or as a specific presentation of any systemic form of vasculitis such as Behçet's disease, sarcoidosis, multiple sclerosis, or any form of systemic nectrozing vasculitis such as temporal arteritis, polyarteritis nodosa, and granulomatosis with polyangiitis, or due to lupus erythematosus, or rheumatoid arthritis.[1][2] Eales disease, pars planitis, birdshot retinochoroidopathy (autoimmune bilateral posterior uveitis), and Fuchs heterochromic iridocyclitis (FHI) can also cause retinal vasculitis.[1] Infectious pathogens such as Mycobacterium tuberculosis, visceral larva migrans (Toxocara canis & Toxocara cati) can also cause retinal vasculitis.[1]
Symptoms
Retinal vasculitis presents as painless, decrease of visual acuity (blurry vision), visual floaters, scotomas (dark spot in vision), decreased ability to distinguish colors, and metamorphopsia (disrtion of images such as linear images).[1]
Findings
Ophthalmic examination may reveal neovascularization (creation of new vessels in the retina), retinal vessel narrowing, retinal vessel cuffing, retinal hemorrhage, or possible vitritis (inflammation of the vitreous body) or choroiditis (inflammation of the choroid).[1]
Diagnosis
Retinal vasculitis is very rare as the only presenting symptom. Often there is sufficient systemic evidence to help the physician decide between any one of the aforementioned possible systemic diseases. For those patients who present with only vasculitis of the retinal vessels, great investigative effort (Chest X-ray, blood test, urinary analysis, vascular biopsy, ophthalmology assessment, etc.) should be undertaken to ensure that a systemic disease is not the hidden culprit.
Diseases associated with retinal vasculitis
- Behçet's disease
- Sarcoidosis
- Multiple sclerosis
- Temporal arteritis
- Polyarteritis nodosa
- Granulomatosis with polyangiitis
- Lupus erythematosus
- Rheumatoid arthritis
- Eales disease
- Idiopathic Retinal Vasculitis Aneurysms and Neuroretinitis
- Q fever
- Common Variable Immune Deficiency [3]
Sources
- ^ a b c d e Lynn K. Gordon, M.D., Ph.D. (January 2003). "Retinal Vasculitis". American Uveitis Society. Retrieved December 10, 2010.
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: CS1 maint: multiple names: authors list (link) - ^ Bolster, Marcy B.; Collier, Virginia U.; Bass, Anne R.; Brasington, Richard D.; Brown, Alan N.; Jonas, Beth; Staudt, Leslie S. (2009). Medical Knoweldge Self-Assessment Program (MKSAP-15): Rheumatology. ACP (American College of Physicians). pp. 71–3. ISBN 978-1-934465-30-1.
- ^ J. C. van Meurs, S. Lightman, P. W. T. De Waard et al., “Retinal vasculitis occurring with common variable immunodeficiency syndrome,” American Journal of Ophthalmology, vol. 129, no. 2, pp. 269–270, 2000.