Retinal vasculitis and cystoid macular odema vitreous cells

740

Wegeners Granulomatosis – Itis a granulomatous necrotizing vasculitic condition that primarily affects upper and lower respiratory tracts and kidneys. In addition to retinal vasculitis, other clinical findings
include	necrotizing	scleritis,

			Fig. 3: Fundus photograph of a 31 yr old lady
			with systemic lupus erythematosus showing
			vaso occlusive retinopathy with dilated tortuous	arterialitis

anorexia and low-grade fever. They may also have arthritis, facial rash,

Tuberculosis – Though choroiditis is the most common ocular feature of tuberculosis but periphlebitis is also commonly present. It occurs either by direct infection or by hypersensitivity reaction to Mycobacterial antigens. It is associated with vitritis and retinal hemorrhages and may lead to branch or central retinal vein occlusion leading to neovascularization and vitreous hemorrhage.

acute lesions. Perivasculitis is believed to be caused by an Arthus – type reaction. Locally produced antigens diffuse into the vessel walls and react with circulating antibodies, activate complement and recruit inflammatory cells that form a perivascular cuff. Focal periarterial exudates or plaques, called Kyrieleis arterialitis are also seen near the active focus and these lesions do not cause vascular obstruction or leakage.

caused by herpes simplex and

choroid.

Cytomegalovirus

Intermediate

uveitis

DOS Times - Vol. 12, No. 1

July, 2006

741


		alterations	and
Fig.5: Fundus photograph showing multiple skip	Fig.6: Fundus photograph of a patient with	alterations	and
Fig.5: Fundus photograph showing multiple skip	Fig.6: Fundus photograph of a patient with
lesions of vascular cuffing (taches de bougie)	cytomegalovirus retinitis showing fluffy white

in a case of sarcoidosis	retinal necrosis with hemorrhages and vascular
in a case of sarcoidosis

Birdshot retinochoroidopathy is a bilateral panuveitis where fundus examination shows cream colored, deep, round lesions, retinal vasculitis and cystoid macular odema.

aqueous or vitreous cells, aqueous flare, keratic precipitates, posterior synechiae and posterior subcapsular cataract.


reported	in	herpes,	rubella,
Pathogenesis Retinal vasculitis is presumed to be an immuno-logically mediated condition. It is an autoimmune phenomenon and various studies have shown the presence of CD4 +ve T cells within and surrounding the retinal vessels in patients with retinal vasculitis. Thus, cell mediated immunity plays a major role in the pathogenesis, however humoral immunity and immune complex formation can also be involved.
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