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At least 19 recordsLinked to original sources
PubMed2003

Retinal vasculitis.

Retinal vasculitis represents a group of diseases characterized by inflammation affecting the retinal vasculature. It is an uncommon disorder that may occur as an isolated disease or more commonly in association with other ocular diseases or a variety of systemic diseases. With a wide variety of disease associations, a search for an underlying etiology should be undertaken based on a meticulous history, review of systems, and physical examination. The laboratory evaluation of patients with retinal vasculitis is an essential component of the work-up to facilitate detection of any underlying disease or to establish a limited differential diagnosis. The management of infectious causes of retinal vasculitis consists of antimicrobial therapy while noninfectious retinal vasculitis is managed with corticosteroids and/or immunosuppressive agents. Because retinal vasculitis is an uncommon disease, there are only a limited number of publications over the past year related to this topic.

Eye Diseases↗
PubMed2003

The pathology and pathogenesis of retinal vasculitis.

Retinal vasculitis is a rare, but potentially blinding intraocular inflammatory condition with diverse aetiology. Although commonly idiopathic, it has a strong association with systemic inflammatory diseases known to involve other areas of the central nervous system, most notably Behcet's disease, sarcoidosis, systemic lupus erythematosis and multiple sclerosis. This article describes the clinicopathologic features of retinal vasculitis and its visually damaging sequelae, reviewing available human histopathologic studies and work with experimental models to discuss the pathogenesis and immunopathology. Evidence indicates that noninfective retinal vasculitis is an autoimmune condition that may be induced by antecedent infection with microbes cross-reacting with putative autoantigens, influenced by genetic susceptibility of both HLA associations and cytokine polymorphisms. The growing understanding of the cellular mechanisms involved in the effector immune response is already providing a rationale for more specific therapeutic approaches.

Humans↗
PubMed2003

Serum levels of chemokines correlate with disease activity in patients with retinal vasculitis.

Retinal vasculitis (RV) is characterised pathologically by migration of leucocytes across the blood-retinal barrier leading to oedema and photoreceptor cell dysfunction. Chemokines are a family of small molecules involved in leucocyte migration. In this study, levels of chemokines were measured in serum from patients with RV and correlated with disease activity and drug treatment. Serum samples (n= 100; 25 active, 75 inactive) were obtained from 50 patients with RV, and levels of the chemokines MIP-1alpha, macrophage inflammatory protein-1beta (MIP-1beta) and monocyte chemoattractant protein-1 (MCP-1) were measured by ELISA. For longitudinal analysis levels of the same chemokines were measured in six consecutive serum samples from 10 of the above patients. Chemokine levels were correlated with disease activity and current drug treatment for each sample. Sera from 20 healthy individuals were used as control samples. Serum levels of MIP-1beta were significantly raised in patients with RV, whether active or not, compared to healthy controls (P= 0.04). Levels of MIP-1beta and MCP-1 correlated with disease activity in some patients and with prednisolone levels in patients on this treatment alone. MIP-1alpha levels were not detectable in all samples but were present in significantly more samples from patients with active or inactive RV compared with healthy controls. Serum levels of the chemokines MIP-1beta and MIP-1alpha, but not MCP-1 were raised in patients with retinal vasculitis. Longitudinal analysis suggested that MIP-1beta and MCP-1 levels were controlled by drug treatment, particularly prednisolone. These data demonstrate that chemokines are involved in the pathogenesis of RV and may act as novel therapeutic targets.

Chemokine CCL2↗
PubMed1989

[Retinal vasculitis].

Retinal vasculitis is an inflammatory permeability disorder of the retinal vascular wall affecting chiefly the veins and capillary vessels. It is diagnosed at ophthalmoscopy which demonstrates vascular sheathing and even better at fluorescein angioscopy which shows the colouring agent diffusing from the vessels. As regards its aetiology and treatment, retinal vasculitis is disconcerting. Except in those cases where a systemic disease can be blamed, the condition is isolated, usually chronic and often recurrent. It may result in visual impairment or, exceptionally, blindness.

Fluorescein Angiography↗
PubMed2002

[Retinal vasculitis].

Retinal vasculitis is one of the frequently cause of impair of visual acuity. The vein is involved most of time, and the artery is involved less. Sometimes, the vein and artery are involved together. The types and cause of the disease are complex. In recent years, ophthalmologists have gotten some new achievements on the study of the disease, and some arguments just like naming, diagnosing and treatment still exist. Now we review all the achievement and arguments of the naming, clinic, pathology, etiology, experiment, diagnosing, treatment of the disease.

Humans↗
PubMed1979

Acute severe uveitis with retinal vasculitis and retinal detachment.

5 adult patients (7 eyes) with acute severe uveitis with retinal vasculitis and retinal detachment of unknown etiology were studied. Yellowish exudations which appeared in the peripheral fundus rapidly extended posteriorly, and there was a patchy perivasculitis, white sheathing and obliteration of the retinal vessels. The absorption of these yellowish exudations was followed by atrophy of the retina and the choroid. Secondary detachment of the retina then developed, and the visual acuity remained poor in most cases.

Acute Disease↗
PubMed2001

Unilateral retinal vasculitis, branch retinal artery occlusion and subsequent retinal neovascularization in Crohn's disease.

PURPOSE: To report on a case of Crohn's disease and unilateral retinal vasculitis, branch retinal artery occlusion and subsequent retinal neovascularization. METHODS: We examined a 38-year-old woman with severe left visual loss and biopsy-proven Crohn's disease diagnosed four years prior to the ocular involvement. A Heidelberg scanning laser ophthalmoscope was used for fundus fluorescein angiography and indocyanine green angiography. Retinal neovascularization was detected during the follow-up. RESULTS: Successful regression of retinal neovascularization was achieved after argon green laser panretinal photocoagulation in addition to oral steroid and salazopyrine. CONCLUSION: Retinal vascular involvement is a rare ocular feature of Crohn's disease and may result in retinal neovascularization that may necessitate prompt laser photocoagulation.

Adult↗
PubMed1995

Idiopathic retinal vasculitis, aneurysms, and neuro-retinitis. Retinal Vasculitis Study.

PURPOSE: The authors describe the clinical feature of ten patients with a new syndrome characterized by the presence of retinal vasculitis, multiple macroaneurysms, neuro-retinitis, and peripheral capillary nonperfusion. METHODS: The authors evaluated ten patients identified to have clinical features compatible with the syndrome of idiopathic retinal vasculitis, aneurysms and neuroretinits (IRVAN). Clinical examination findings, sequential funds photographs (when available), fluorescein angiograms, systemic investigations, response to therapy, and visual outcomes were reviewed. RESULTS: Seven eyes of four patients sustained a marked decrease in visual acuity of 20/200 or worse. Visual loss was due to a combination of an exudative maculopathy and sequelae of retinal ischemia. Capillary nonperfusion was seen in all ten patients and was severe enough to warrant panretinal laser photocoagulation in six patients. Systemic investigations were uniformly noncontributory. Oral prednisone appears to have little beneficial effects on patients with this disorder. CONCLUSIONS: Patients with IRVAN have characteristic retinal features that readily identify this syndrome. An increased awareness of this rare syndrome may help to identify sight-threatening complications at an earlier stage. The authors caution against extensive medical investigations.

Adult↗
PubMed2003

Extensive dynamics in location, shape, and size of aneurysms in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome. Idiopathic retinal vasculitis, aneurysms, and neuroretinitis.

PURPOSE: To describe an unusual case of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome with rapid dynamics in the number and appearance of the aneurysms. DESIGN: Observational case report. METHODS: Clinical and angiographic data of the patient were reviewed. RESULTS: In the course of only 6 months, preexisting retinal aneurysms resolved while new ones appeared. Changes were observed in the shape and size of preexisting lesions. The resolution of lesions in eyes previously untreated by laser is reported for the first time. CONCLUSIONS: Vascular lesions in IRVAN syndrome may show an unusually rapid turnover. The resolution of aneurysms is a part of the natural course of the disease and may occur without previous retinal laser photocoagulation.

Adult↗
PubMedDate not supplied

[Conservative therapy of isolated retinal vasculitis].

Isolated retinal vasculitis (IRV) is a form of retinal vasculitis without other types of eye inflammation or systemic vasculitis. Treatment of IRV is a difficult problem. We report the results of treatment of 43 IRV patients (25 men and 18 women, mean age 32.5 +/- 5.5 years with a range of 22-42 years). The main therapy for IRV were corticosteroids. They were used by pulse therapy, orally and locally (periocular injections). Improvement of visual acuity was more pronounced in patients treated by pulse therapy (0.35 +/- 0.15) than in those treated orally (0.16 +/- 0.06, p = 0.0132) and parabulbarly (0.06 +/- 0.12, p = 0.0009). Resorption of retinal perivascular exudate was sooner achieved by steroid pulse therapy than by oral treatment (8.1 +/- 2.2 days vs. 17.9 +/- 2.8 days, p < 0.0000) or periocular injection of steroids (30.9 +/- 7.1 days, p < 0.0000). Prednisolone (10-20 mg) was prescribed for 4-12 months in order to prevent IRV recurrences. Steroid-resistant patients were treated with cyclosporin A (5 mg/kg). The treatment was supplemented by fibrinolytics, angioprotectors, and antioxidants.

Acute Disease↗
PubMed1991

Retinal vasculitis--a primer.

Retinal vasculitis is a diagnosis that is generally suggested by an ophthalmologist. Frequently patients with the disorder are referred to nonophthalmologists for further diagnostic evaluation or treatment. The criteria for defining vasculitis differ greatly between ophthalmologists and other physicians. To facilitate collaboration between ophthalmologists and their colleagues, we have sought to clarify the term "retinal vasculitis" by discussing its subcategories, the potential role of antiphospholipid antibodies, and the etiology of retinal vasculitis. We offer guidelines for evaluating the disorder and treating patients.

Humans↗
PubMed1995

Retinal vasculitis in Lyme borreliosis.

We observed retinal vasculitis in seven patients with clinical and serologic evidence of Borrelia burgdorferi infection. Three patients presented with abrupt loss of vision due to acute retinal vasculitis. Funduscopy demonstrated engorged veins, hemorrhages, perivenous infiltrates and retinal white spots. Fluorescein angiography showed leakage from the veins, from the white spots and from the optic disc. Moreover arterial occlusions were observed in two patients. Four patients had signs of chronic uveitis with vitritis, cystoid macular oedema and retinal vasculitis, which was associated with neovascularization and vitreous hemorrhage in one patient, and with optic neuritis in another patient. Six patients received antibiotic treatment and three patients received systemic corticosteroids. Marked improvement in the three acute retinal vasculitis cases occurred within several weeks, the fundus changes disappeared in another few months, and no recurrences were observed. The final visual acuity was excellent in these patients, although optic disc pallor and visual field loss persisted in one case. In the four patients with chronic uveitis visual blurring improved following antibiotic treatment and the retinal vasculitis and vitritis slowly regressed. The proliferative retinopathy of one patient required panretinal laser treatment.

Adult↗
PubMed1997

Retinal vasculitis.

Inflammation of the retinal vasculature may occur as a manifestation of an infectious disease, as part of a systemic inflammatory disease, or as part of an isolated retinal disease, and can result in severe and permanent visual loss. The search for a cause in patients with retinal vasculitis requires appropriate systemic evaluation and testing. Discrimination between the infectious or noninfectious etiology of retinal vasculitis is important because the treatment is different.

Fluorescein Angiography↗
PubMed2003

Human T-cell lymphotropic virus type 1-associated retinal vasculitis in children.

PURPOSE: To describe predominant retinal vasculitis in children carrying human T-cell lymphotropic virus type 1 (HTLV-1). METHODS: The authors examined clinical records of patients with HTLV-1-associated uveitis between 1987 and 2001 in Kagoshima University Hospital and reviewed cases of extensive, smoldering retinal vasculitis. RESULTS: Three previously healthy teenagers noted mild visual symptoms and presented with extensive sheathing of retinal vessels, complicated by mild anterior segment inflammation. The retinal vascular disease responded poorly to systemic corticosteroids, had a smoldering course with persistent sheathing of retinal vessels, and eventually resulted in diffuse chorioretinal degeneration. Results of laboratory studies were unremarkable except for the presence of serum antibodies to HTLV-1. One patient developed HTLV-1-associated myelopathy 11 years after the onset of ocular disease. CONCLUSIONS: The retinal vasculitis differed from the retinal vascular changes commonly seen in HTLV-1-associated uveitis. The authors suggest a clinical disease HTLV-1-associated retinal vasculitis that affects young HTLV-1 carriers, characterized by smoldering retinal vasculitis with ultimate retinal degeneration.

Adolescent↗
PubMed1977

Circulating immune complexes in retinal vasculitis.

Seventeen patients with retinal vasculitis, eleven with the peripheral type (Eales' disease) and six with the central type, were investigated to detect the presence of circulating immune complexes (IC) which might then be related to the pathogenesis of their disease. A systemic disease process was identified in six. IC in serum were inferred by the presence of complement (C) activation, rheumatoid factor, Clq or monoclonal rheumatoid factor precipitins, anticomplementary activity, elevated cryoglobulins, inhibition of erythrocyte-antibody (IgG-EA) rosette formation, increased numbers of peripheral blood lymphocytes bearing surface Ig, and spontaneous neutrophil chemotatic activity in plasma. Two or more parameters were positive in thirteen of seventeen patients, with chemotactic activity (69%) and inhibition of EA-rosette formation (59%) being the most frequently positive tests. No immunological differences were detected between the peripheral and central retinal-vasculitis groups. Several IC systems may operate in a give patient.

Adult↗
PubMed1991

Retinal vasculitis in Lyme borreliosis.

Three patients with retinal vasculitis are reported who were found to be seroreactive for Lyme borreliosis. Careful investigation revealed no other apparent etiology for the angiitis, and improvement of the retinal vasculitis on tetracycline therapy was documented by fluorescein angiography in one of them. Two cases of retinal vasculitis were presented at the International Conference on Lyme Borreliosis in Stockholm 18-21 June 1990, and two cases of cerebral vasculitis due to Borrelia burgdorferi have been published. To our knowledge, this is the first published report of retinal vasculitis occurring in patients seroreactive for Lyme borreliosis. Although further investigation will be necessary to prove a cause-and-effect relationship, ophthalmologists encountering patients with otherwise unexplained cases of retinal vasculitis, or Eales disease, are encouraged to study these patients carefully for the possibility of Borrelia burgdorferi infection.

Adult↗
PubMed1999

The pituitary-adrenal axis in idiopathic retinal vasculitis.

AIMS: To determine whether patients with idiopathic retinal vasculitis have altered production of cortisol and dehydroepiandrosterone sulphate (DHEA-S), and whether differences in these variables occur between those who are sensitive (SS) and resistant (SR) to steroids. METHODS: 20 patients with retinal vasculitis (off treatment) and 10 control subjects were prospectively recruited. Morning cortisol and DHEA-S levels were measured, and cortisol secretion rates and short synacthen tests (SST) carried out in patients before treatment, when on prednisolone 20 mg/day, and in controls. RESULTS: There were no differences in any variables between patients and controls. For retinal vasculitis patients pretreatment, the SST was lower in SR patients (p=0.02). More of the SR patients had ischaemic retinal vasculitis ( p<0.001). CONCLUSIONS: Cortisol and DHEA-S are not involved in the pathogenesis of retinal vasculitis. SR in retinal vasculitis may be associated with a defective hypothalamic-pituitary-adrenal axis.

Adult↗