Summary about Disease
Retinal vasculitis is an inflammatory condition affecting the blood vessels of the retina. This inflammation can lead to damage and blockage of these vessels, potentially causing vision loss. It can occur as an isolated ocular condition or be associated with systemic inflammatory or infectious diseases.
Symptoms
Common symptoms of retinal vasculitis include:
Blurred vision
Floaters (dark spots or specks in your vision)
Decreased vision
Vision loss (in severe cases)
Eye pain (less common)
Causes
The causes of retinal vasculitis are varied and can include:
Infections: Herpes viruses (e.g., herpes simplex, varicella-zoster), syphilis, tuberculosis, toxoplasmosis, HIV.
Autoimmune Diseases: Systemic lupus erythematosus (SLE), Behçet's disease, sarcoidosis, rheumatoid arthritis, inflammatory bowel disease.
Idiopathic: In many cases, the cause remains unknown (idiopathic retinal vasculitis).
Other: Multiple sclerosis, lymphoma, Eales' disease.
Medicine Used
Medications used to treat retinal vasculitis depend on the underlying cause and severity of the inflammation. Common treatments include:
Corticosteroids: Prednisone (oral), dexamethasone (eye drops or injections) to reduce inflammation.
Immunosuppressants: Azathioprine, methotrexate, cyclosporine, mycophenolate mofetil for more severe or chronic cases, particularly those associated with autoimmune diseases.
Anti-VEGF Injections: Bevacizumab, ranibizumab, aflibercept to treat neovascularization (abnormal blood vessel growth) and macular edema.
Antiviral/Antibacterial Medications: Used to treat infections causing the vasculitis (e.g., acyclovir for herpes viruses).
Other: Treatment of underlying systemic conditions.
Is Communicable
Retinal vasculitis itself is not communicable. However, if the underlying cause is an infectious disease (e.g., syphilis, tuberculosis), that underlying infection is communicable. The retinal vasculitis is a consequence of the infection, not directly contagious.
Precautions
Precautions depend on the underlying cause of the retinal vasculitis:
Infectious causes: Follow standard infection control measures (hand hygiene, avoiding close contact) to prevent spread of the underlying infection.
Autoimmune causes: Manage the underlying autoimmune disease as directed by a physician. This may involve lifestyle changes, medications, and regular monitoring.
General: Regular eye exams are crucial for monitoring the condition and detecting any complications. Avoid smoking, as it can worsen vascular diseases.
How long does an outbreak last?
The duration of a retinal vasculitis "outbreak" or episode varies greatly depending on the cause, severity, and response to treatment. It can range from weeks to months, or even become a chronic, recurring condition. Prompt diagnosis and treatment are essential to minimize long-term damage.
How is it diagnosed?
Diagnosis of retinal vasculitis typically involves:
Comprehensive Eye Exam: Including visual acuity testing, slit-lamp examination, and dilated fundus examination.
Fundus Photography: To document the appearance of the retina.
Fluorescein Angiography (FA): A dye is injected into the bloodstream to visualize blood flow in the retina and identify areas of inflammation or blockage.
Optical Coherence Tomography (OCT): Provides detailed cross-sectional images of the retina to assess for macular edema or other retinal changes.
Blood Tests: To rule out underlying infections (e.g., syphilis, TB, HIV) and autoimmune diseases (e.g., ANA, rheumatoid factor, ACE level).
Other Imaging: May be required to identify the underlying cause.
Timeline of Symptoms
The timeline of symptoms can vary, but generally:
Initial Phase: Gradual or sudden onset of blurred vision, floaters, or decreased vision.
Progression: Symptoms may worsen over days to weeks if untreated.
Complications: Development of neovascularization, macular edema, retinal detachment, or vision loss may occur if the vasculitis is severe or chronic.
Treatment Response: Improvement in symptoms may be seen within days to weeks of starting appropriate treatment. The time frame depends on treatment and underlying cause.
Important Considerations
Retinal vasculitis can lead to permanent vision loss if left untreated.
Early diagnosis and treatment are crucial for preserving vision.
A thorough evaluation is necessary to identify the underlying cause and guide treatment.
Long-term follow-up is often required to monitor for recurrence or complications.
Patients should adhere to their treatment plan and report any changes in their vision to their ophthalmologist promptly.