Retinal vasculitis is a disease that causes painless damage to the smallest blood vessels of the retina, the area of the eye responsible for light perception. This condition may be associated with primary eye diseases or with inflammatory or infectious diseases that are systemic, meaning that they may affect other areas of the body. Retinal vasculitis is most often associated with two systemic inflammatory diseases, sarcoidosis and Behcet's disease, as well as the auto-immune disease multiple sclerosis.
Retinal vasculitis can cause long-term damage, ranging from minimal to complete blindness. Common symptoms include blurring of vision, an alteration in color perception, and metamorphopsia, which causes a distortion of straight lines as well as other images. Scotomas, or blind spots, and floaters, small dark shapes that appear in the field of vision, are also commonly experienced by patients with retinal vasculitis. In some cases, however, patients may experience no symptoms of the disease.
A diagnosis of retinal vasculitis is made based on typical findings observed using a ophthalmoscope and an angiogram, an x-ray that utilizes a contrast dye to highlight areas of the retina. Typical diagnostic findings may include vascular sheathing, a yellowish-white area of accumulation of inflammatory cells along the walls of the blood vessels, as well as vitreous hemorrhage, an infiltration of blood into the vitreous, which is the clear substance that encompasses the area of the eye that lies between the lens and the retina. Other common findings may include a narrowing of the blood vessels of the retina and the growth of new blood vessels.
Treatment for retinal vasculitis depends on the patient's symptoms. A patient may simply be observed, if the inflammation is still mild and the patient's vision has not been affected. Corticosteroid eye drops and periocular corticosteroid injections may also be prescribed, if extensive retinal damage is not seen on the angiogram. In severe cases, more aggressive systemic therapy is administered orally or intravenously to help control the disease. Aggressive therapy may be called for if the patient has experienced a loss of eyesight or shows evidence of macular edema, a swelling of the central area of the retina.
The prognosis for patients diagnosed with retinal vasculitis varies greatly between patients, and can be highly unpredictable. While some patients never experience significant damage related to the disease, others will suffer a total loss of eyesight despite the most aggressive therapies. Although most patients diagnosed with retinal vasculitis do not have an associated system disease, all patients should receive a thorough evaluation, including key radiological and laboratory testing, at the time of diagnosis.