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post uveitis Flashcards

1
Q

Different types of unifocal chorioretinitis

A

Toxoplasmosis, Candida, Sarcoid, TB

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2
Q

Name the multifocal chorioretinitis

A

POHS, birdshot, AMPPPE, MEWS, PIC, Sarcoid, lymphoma, TB

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3
Q

Name the diffuse chorioretinitis

A

CMV, acute retinal necrosis, progressive outer retina necrosis, Serpig

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4
Q

Name the non-specific panuveitis diseases

A

Sympathetic, sarcoid, lymphoma, syphilis, Behcet’s, idiopathic

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5
Q

Features of toxoplasmosis

A
  • Protozoan: toxoplasma gondii
  • origin: cats
  • Congenital: pregnant female –> transplacental to foetus
    - atrophic scar, possible recurrence, satellite lesion (cystic rupture), can be bilateral
  • Acquired: child or adult in environment
    - benign, self-limiting, 20% develop systemic infection (flu-like)
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6
Q

Features of toxocariasis

A
  • Parasite: toxocariasis (dogs)
  • systemic infection - fever, pulmonary effects, neurological effects
  • children (80% <16years)
  • granuloma - cause dragged disc, unilateral, white elevated lesion
  • vitritis
    peripheral retinitis
    endophthalmitis
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7
Q

Features of Sarcoidosis

A
  • vitritis - vitreous ‘snowballs’ = clumps of cells and protein
    Retina: granuloma, CMO, periphlebitis, peripheral neovasc, candle wax exudate (peri-venous sheathing), disc swelling/ optic atrophy
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8
Q

Features of Behcet’s disease

A
  • Diffuse vascular leakage, retinal vasculitis (periphlebitis)
  • Retinitis: white necrotic infiltrates, haemorrhage, poor visual prognosis
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9
Q

Features of ocular histoplasmosis

A
  • Fungus infection (mainly lung disease)
  • multifocal choroiditis - punctate atrophic lesions = histo-spots
  • macula lesion - stimulate CSR –> neovasc, disciform-like scar
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10
Q

Features of cytomegalovirus (CMV)

A
  • Herpes virus type 5
  • untreated CMV retinitis –> retinal necrosis & RD
  • bilateral (10-20%) , macula involvement (50%)
  • vasculitis (ketchup on cottage cheese), mild vitritis, RD, optic atrophy
  • MX: gancyclovir (IV)
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11
Q

Features of HIV retinopathy

A
  • Microangiography (NFL occlusions)

- CWPs (w/o evidence of hypertension or diabetes)

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12
Q

Features of acute retinal necrosis (ARN)

A
  • necrotising retinitis
  • HSV1 (younger)
  • HSV2 + VZV (older)
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13
Q

Features of progressive outer retinal necrosis (P ORN) = viral

A
  • aggressive reaction to VZV
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14
Q

Features of kaposi’s sarcoma

A

Vascular tumours in HIV

Herpes virus type 8

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15
Q

Features of syphilis

A

= STD, subsides
- untreated –> spreads via blood to organs –> inflammation
- Tertiary: neuro-syphilis (cranial, visual pathway, oculomotor pathway)
- cardiovascular: aneurysm, vessels
- Localised granulomas
- congenital syphilis: interstitial keratitis, salt & pepper fundus
- Anterior uveitis: granulomatous mainly
Posterior uveitis: retinal vasculitis, chorioretinitis
- optic disc swelling (papiiloedema or papillitis)

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16
Q

Features of TB

A
  • choroidal granuloma +/- active pulmonary TB (lung symptoms)
17
Q

Features of cat scratch disease

A
  • bacterial infection via infected cats
    systemic effects: malaise, fever, lymphadenopathy, anorexia
    Ocular effects: Parinaud’s oculoglandular syndrome, neuro-retinitis, vasculitis, choroidal granuloma, intermediate uveitis, sensory RD, associated ant uveitis
18
Q

Features of sympathetic ophthalmia

A
  • bilateral granulomatous uveitis
    Due to trauma in 1 eye – excites inflammation in other eye
  • anterior uveitis (mutton fat KP, granulomatous)
  • posterior: accumulations b/w RPE and BM, papilitis, choroidal lesions
19
Q

What are the white dot syndromes

A
  • Acute multifocal posterior pigment placoid epitheliopathy (AMPPPE)
  • Multiple evanescent white dot syndrome (MEWDS)
  • Birdshot retinochoroidopathy
  • Acute retinal pigment epithelitis
  • Punctate inner choroidopathy
  • Serpiginous choroidopathy
  • Ophthalmomyasis
20
Q

Features of acute multifocal posterior pigment placoid epitheliopathy (AMPPPE)

A
  • Bilateral, <30 years
  • Choroidal vasculitis –> secondary RPE dysfunction
  • many large plaque-like lesions (RPE level)
  • symptoms: temporary vision loss, central/paracentral scotoma, sudden blurred vision, photopsia
  • Angio: dark hypofluorescence –> slow hyperfluorescence
  • Spontaneous recovery
21
Q

Features of multiple evanescent white dot syndrome (MEWDS)

A
  • Young women, unilateral
  • Signs: many white small lesions - deep retina/RPE, cells in vitreous
  • symptoms: sudden VA drop, possible RAPD
  • self-limiting +/- chorioretinal scar
22
Q

Features of birdshot retinochoroidopathy

A
  • Bilateral, chronic inflamm disease
  • older white female, uncommon
  • Signs: scattered lesions, diffuse vitritis
  • Symptoms: blurred vision, disturbed CV, night vision difficulty, floaters, no pain, photopsia
    20% - self-limiting
    80% - exacerbates - poor VA
23
Q

Features of acute retinal pigment epithelitis

A
  • presumed viral aetiology
  • young px
  • symptoms: acute VA decrease/ metamorphopsia
  • signs: RPE changes, CSR occassionally, abnormal EOG
23
Q

Features of acute retinal pigment epithelitis

A
  • presumed viral aetiology
  • young px
  • symptoms: acute VA decrease/ metamorphopsia
  • signs: RPE changes, CSR occassionally, abnormal EOG
24
Q

Features of punctate inner choroidopathy

A
  • Young myopic women
  • no intraocular inflammation (AC cells)
    Lesions: deep, yellow, resolves few weeks
  • CNV risk, atrophic/ pigmented
  • blurred vision, light flashes, paracentral scotoma
25
Q

Features of

A
26
Q

Features of serpiginous choroidopathy

A
  • idiopathic bilateral progressive inflammation
  • 4-6th decade
  • lesions begin near disc
  • white subretinal infiltrates - spread outwards like snake (often to macula)
  • Vitritis/ mild anterior uveitis
  • remission/reactivation - satellites
27
Q

Features of ophthalmomyasis

A
  • Interna (penetrate eye) vs. externa (infest cornea, conj)
  • Intraocular infestation of fly larvae
  • Ant and post segment
  • subretinal space tracking
28
Q

How to manage posterior uveitis

A

Infectious: antibiotic therapy (+ steroid?)
Non-infectious: immunosuppression, steroid, cyclosporin, methotrexate
Systemic tx

29
Q

Discuss intermediate uveitis / Pars Planitis

A
  • Chronic, bilateral (95%)
  • Limited CB inflammation, few systemic assoc.
  • Floaters, blurred vision, dx of exclusion
  • Signs: exudation into vitreous, cells in vitreous
  • “Snowball/ cottonball” - inferior vitreous
  • “Snow banking”

dis (7 decks)

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