Retinal vasculitis is an inflammation of the retinal vessels(arteries and veins) typically brought on by primary ocular disease processes. It can also be caused by a specific manifestation of any systemic vasculitis, such as Behçet’s disease, sarcoidosis, multiple sclerosis, or any form of systemic necrotizing vasculitis.

It has been described as vascular leakage and staining of vessel walls on fluorescein angiography — irrespective of the clinical appearance of fluffy, white perivascular infiltrates in an eye — with signs of inflammatory cells in the vitreous body or aqueous fluid.

Retinal vasculitis is typically classified into conditions localized to the retina and systemic conditions affecting the eye. These include a few viral diseases, systemic autoimmune conditions, and specific ocular conditions.

What Causes Retinal Vasculitis?

There are two distinct types of causes of retinal vasculitis, namely, primary and secondary causes. This depends on whether the vessel is the primary target of the inflammatory process or a secondary one.

Primary Causes of Retinal Vasculitis

(a) Localized to the eye:

  • Idiopathic
  • Intermediate Uveitis of the Pars Planitis type
  • Frosted Branch Angiitis
  • Idiopathic Retinal Vasculitis, Aneurysms and Neuroretinitis (IRVAN)

(b) Involves the eye and other organs:

  • Giant Cell Arteritis
  • Takayasu Arteritis
  • Polyarteritis Nodosa
  • Wegener’s Granulomatosis

Secondary Causes of Retinal Vasculitis

(a) Localized to the eye:

  • Ocular Sarcoidosis
  • Birdshot Chorioretinopathy Retinal Vasculitis
  • Necrotic Herpetic Retinopathies (Herpes Simplex, Varicella Zoster Virus)
  • Toxoplasmic Retinochoroiditis
  • Tuberculosis
  • DUSN (Diffuse Unilateral Subacute Neuroretinitis)
  • Primary Ocular Lymphoma

(b) Associated with systemic involvement:

  • Sarcoidosis
  • Behçet’s Disease
  • Multiple Sclerosis
  • Systemic Lupus Erythematosus (SLE)
  • Spondyloarthritis with HLA-Associated Uveitis
  • Inflammatory Bowel Diseases
  • Relapsing Polychondritis
  • Tuberculosis
  • Syphilis
  • Lyme Disease
  • Viral (Cytomegalovirus, HIV, West Nile)
  • Intravenous Immunoglobulins
  • Inhalation of Methamphetamine
  • Cancer-Associated Retinopathy
  • Oculocerebral Lymphoma

Retinal Vasculitis Diagnosis

When retinal vasculitis is the only condition, it is extremely uncommon. There is often enough systemic data to allow the doctor to determine any of the above-mentioned potential systemic disorders.

If a patient solely has vasculitis of the retinal vessels, further investigation (including a chest X-ray, blood test, urine analysis, vascular biopsy, ophthalmology evaluation, etc.) should be carried out to rule out a systemic disease as the hidden cause.

Retinal Vasculitis Symptoms

Here are some of the symptoms associated with retinal vasculitis:

  • Blurry vision (painless)
  • Visual floaters
  • Scotomas (a dark spot in your vision)
  • Decreased ability to distinguish colours
  • Metamorphopsia (distortion of the shape of objects)

Retinal Vasculitis Treatment

Treatment of retinal vasculitis depends on whether it is unilateral or bilateral, its severity, and whether there is an underlying disease. Any method of uveitis treatment aims to prevent complications that could endanger vision, alleviate patient discomfort, and, if possible, treat the underlying condition.

Three primary goals can be identified for retinal vasculitis treatment: suppression of inflammation, diagnosis and treatment of any specific diseases, and management of any consequences.

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