A STUDY ON AETIOLOGY, CLINICAL COURSE AND VISUAL OUTCOME OF RETINAL VASCULITIS

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A STUDY ON AETIOLOGY, CLINICAL COURSE AND VISUAL OUTCOME OF RETINAL VASCULITIS

Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 43

Abstract

BACKGROUND Duke- Elder regarded Eales disease as clinical manifestation of inflammatory retinal vessel occlusion or periphlebitis. Eales disease occurs frequently in India finding difficult to distinguish this condition from other type of retinal vasculitis. Retinal vasculitis is a nonspecific 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 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 humour. Retinal vasculitis may or may not be symptomatic. Inflammation of peripheral retinal blood vessels is asymptomatic butinvolving macular retinal blood vessels causes decreased visual acuity and focal scotomas and floaters in vitreous inflammatory cells. The signs of vascular sheathing or cuffing can be found in inflammatory vascular disorders as well as in ischemic vasculopathies without inflammation. If vascular sheathing is accompanied by vitreous cells, adjacent intra retinal oedema or infiltrates. It is more likely to be inflammatory in origin. The aim of this study was to determine the various etiological pattern, ophthalmoscopic features and to assess the visual outcome of retinal Vasculitis. MATERIALS AND METHODS A prospective study of 41 patients who attended the retina and uvea service at Ophthalmology Department Government Rajaji Hospital, Madurai. RESULTS A total of 41 cases were included in the study out of which commonest cause was associated with Idiopathic retinal vasculitis- 19 cases (46.34%).other causes are Tuberculosis-10 cases (24.39%). Systemic lupus erythematosus-4 cases (9.75%) Intermediate uveitis-1 case (2.43%) and Human immune deficiency virus -7 cases(17.7%).A slight male preponderance (58.53%) in compare to female( 41.46%).Commonest age group between second and third decade of life and bilateral in most cases. Acute and chronic have an equal proportion. Defective vision was the main complaint. In idiopathic retinal vasculitis posterior segment finding of vascular sheathing in 14 eyes (46.6%) neovascularization 8 eyes (26.6%) and vitreous haemorrhage in 6 eyes (20%). Corticosteroids were the main stay of treatment. Pulse therapy as IV Methyl prednisolone Ig for 3 days followed by oral prednisolone 1 mg/kg/day tapered gradually. CONCLUSION The study shows, different pattern of 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 Immunodeficiency virus had a worse outcome due to rapid progression despite therapy

Authors and Affiliations

Saravanan R, Gokila M. S, Maheswari P. S, Chitra M. R

Keywords

Retinal Vasculitis Human Immune Deficiency Virus Systemic Lupus Erythematosus.

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EP ID EP219928
DOI 10.18410/jebmh/2017/524
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