Study on etiology, clinical course and visual outcome of retinal vasculitis

Saravanan, R (2006) Study on etiology, clinical course and visual outcome of retinal vasculitis. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Retinal Vasculitis is a non specific immunologic reaction of retinal arterioles or venules to various antigenic stimuli that may occur in many different systemic and local disease states. It may be defined, however, to be present when there are vascular leakage and staining of vessel walls on fundus fluorescein angiography, with or without clinical appearance of fluffy, white perivascular infiltrates in an eye with evidence of inflammatory cells in the vitreous body or aqueous humor. Retinal vasculitis may or may not be symptomatic. Inflammation of peripheral retinal blood vessels is typically asymptomatic, but inflammation involving macular retinal blood vessels frequently causes decreased visual acuity and focal scotomas. Associated vitreous inflammatory cells can give rise to floaters. The signs of vascular sheathing or cuffing can be found in inflammatory vascular disorders as well as in ischemic vasculopathies without inflammation. These two conditions should not be confused, as the approach to the diagnosis is different. If vascular sheathing is accompanied by vitreous cells, adjacent intra retinal edema, or infiltrates, it is more likely to be inflammatory in orgin. Fundus fluorescein angiography is useful in evaluating the severity and extent of disease. Mildly inflamed vessels usually only show staining with fluorescein, whereas in more severe inflammation, dye leakage occurs as well. In occlusive vasculitis, capillary fallout is seen. If untreated, neovascularization, vitreous hemorrhage, and tractional retinal detachment may ensue. AIM OF THE STUDY: To determine the various etiological pattern of retinal vasculitis. To determine the various ophthalmoscopic features at presentation. To assess visual outcome in various etiological retinal vasculitis. MATERIALS AND METHODS: It was a prospective study of patients who attended the retina and uvea service at Ophthalmology Department Government Rajaji Hospital Madurai. All cases of Retinal Vasculitis were taken up for study, irrespective of other ocular or systemic manifestation. A standard proforma was used to collect and document all the details regarding the cases included in the study. The detailed information regarding history and specific questions about presence of possible multisystem inflammatory disorders were asked. CONCLUSION: Within the limitations of this study, examination of these 41 patients has shows, different pattern of retinal vasculitis. And it is mandatory for all cases of retinal vasculitis to be examined in detail in order to look for ocular involvement other systemic involvement and to do a complete work up of investigation procedures. This will certainly help to classify the retinal vasculitis. It is evident that when case of idiopathic retinal vasculitis are detected early and treated adequately the incidence of vision threatening complication are considerable minimized. Vasculitis associated with human Immuno deficiency virus had a worse outcome due to rapid progression despite therapy. More follow up period is necessary to describe the complications of the disease and also to analyze whether case of Idiopathic Retinal Vasculitis develop any systemic feature would lead on to a specific diagnosis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: retinal vasculitis; etiology; visual outcome
Subjects: MEDICAL > Ophthalmology
Depositing User: Devi S
Date Deposited: 28 Sep 2017 10:25
Last Modified: 28 Sep 2017 10:25

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