How is retinal vasculitis diagnosed?

summary

Retinal vasculitis is a kind of inflammatory disease involving retinal vessels. The typical manifestations were gray white vascular sheath, exudation, hemorrhage, retinal edema and so on. Most of them are involved in both. Ocular or systemic diseases often accompanied with retinal vasculitis include intermediate uveitis, viral retinitis, systemic lupus erythematosus, Takayasu arteritis, sarcoidosis, etc. So, in life, we should pay attention to it, the following specific talk about retinal vasculitis how to diagnose?.

How is retinal vasculitis diagnosed?

First, retinal phlebitis and periretinal phlebitis are common types of retinal vasculitis. The main clinical manifestations are the sheath around the blood vessel or the sheath lining the inner wall of the vein. Any retinal vein from the optic disc to the peripheral retina can be involved, either segmental or whole process. If the inflammation persists, secondary changes will appear, such as vitreous degeneration of blood vessels, stenosis or occlusion of lumen, thrombosis, necrosis or even rupture of blood vessel wall, which can lead to retinal hemorrhage, edema, exudation, telangiectasia, retinal neovascularization membrane formation of microaneurysm, etc. Such as retinal vascular bleeding or neovascular bleeding, can lead to proliferative vitreoretinopathy, proliferative lesions traction can lead to retinal detachment.

Second, the manifestation of retinal arteritis has great variation in clinic. Immune complex deposits in the anterior arterioles of capillaries, resulting in micro infarction and cotton flocculus. This change can be seen in systemic lupus erythematosus, dermatomyositis and retinal arteritis caused by some infectious factors. Inflammation of small artery branches can be manifested as nodular leukoplakia around the vascular lumen, but not beyond the arterial wall. This type can be seen in ocular toxoplasmosis, syphilis, tuberculosis, and herpes zoster virus retinopathy. The plaque changes subside slowly, leaving no trace or slight scar. Arteritis can lead to irregular white sheath of artery, which can be segmental or whole course. Severe arteritis can completely interrupt blood flow and cause massive retinal necrosis and hemorrhage. This kind of severe retinal arteritis can be seen in nodular arteritis, Wegner granuloma, Churg Strauss syndrome, giant cell arteritis, Takayasu disease, retinitis caused by herpes simplex virus and herpes zoster virus or acute retinal necrosis syndrome.

Third: Patients with blurred vision, visual deformation, eye shadow and other symptoms, vision loss is generally not obvious, but in the macular involvement can have a significant decline in vision. There were no obvious changes of hemorrhage and exudation, vascular sheath and neovascularization in the retina, but mild retinal edema, cystoid macular edema and proliferative changes in patients with chronic inflammation. Fundus fluorescein angiography revealed extensive retinal microvascular leakage.

matters needing attention

The prognosis of retinal vasculitis mainly depends on the etiology and type, the severity of inflammation, whether there are complications and whether the correct treatment is given. If the patient has mild peripheral periretinal phlebitis, it usually does not need treatment, and the visual prognosis is good.