Retinal vasculitis associated with primary ocular disorders
- Michael Tolentino, MD
Michael Tolentino, MD
- Director of Clinical Research
- Center for Retina and Macular Disease
- Associate Professor, Ophthalmology
- University of Central Florida
- Reza Dana, MD, MPH, MSc
Reza Dana, MD, MPH, MSc
- Claes Dohlman Professor of Ophthalmology
- Harvard Medical School
- Section Editors
- Peter A Merkel, MD, MPH
Peter A Merkel, MD, MPH
- Section Editor — Vasculitis
- Chief, Division of Rheumatology
- University of Pennsylvania
- Jonathan Trobe, MD
Jonathan Trobe, MD
- Section Editor — Ophthalmology
- Professor of Ophthalmology and Visual Sciences
- Professor of Neurology
- University of Michigan Kellogg Eye Center
Retinal vasculitis is characterized by inflammation of the vessels of the retina . Positive findings on fluorescein examination may be diagnostic, with fluorescein angiography demonstrating vascular leakage, perivascular staining, and capillary nonperfusion.
The detection and characterization of retinal vasculitis may help in the diagnosis and management of a variety of disorders associated with ocular inflammation. These include systemic autoimmune disorders, some infectious diseases, and certain ocular processes.
The clinical features of retinal vasculitis occurring in association with ocular disorders will be reviewed here. Retinal vasculitis due to systemic autoimmune disorders and infectious agents and a classification of the vasculitides are discussed separately. (See "Retinal vasculitis associated with systemic disorders and infections" and "Overview of and approach to the vasculitides in adults".)
The classic symptom of retinal vasculitis is a painless decrease in vision. Other symptoms may include a blind spot from ischemia-induced scotomas or floaters from vitritis. With macular involvement, patients may present with metamorphopsia (change in shape of an object) or abnormalities in color vision. Retinal vasculitis can also be asymptomatic.
Physical examination — Abnormalities in the retinal vessels may be observed upon physical examination. Funduscopic findings include visible accumulation of inflammatory cells along vessel walls (vascular sheathing) (picture 1). The peripheral vessels are often more involved than central arterioles and venules, and there are frequently skip areas. With certain disorders such as sarcoidosis, lesions resembling candlewax drippings or extensive perivascular inflammation may also be observed.
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