Menia Nitin Kumar, Alcibahy Yasmine, Pichi Francesco, Neri Piergiorgio, Agarwal Aniruddha
Department of Ophthalmology, All India Institute of Medical Sciences, Jammu, India.
Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB), Busaiteen, Bahrain.
Ophthalmologica. 2024 Jun 5:1-14. doi: 10.1159/000539608.
Retinal vasculitis (RV) signifies the inflammation of various retinal vessels. Noninfectious RV differs from infectious RV with regard to its pathogenesis and treatment. It can have varied clinical presentations and may be associated with systemic vasculitic diseases.
Noninfectious RV can be caused due to type-III hypersensitivity reactions, increased expression of intracellular adhesion molecules, and genetic susceptibility. Noninfectious RV is primarily classified on the basis of the type of retinal vessels involved. It can be further classified as an occlusive or nonocclusive. RV can be a major association of systemic diseases like Behcet's disease, sarcoidosis and systemic lupus erythematosus. Newer modalities, like ultra-widefield fundus fluorescein angiography, can help in the management of RV. Effective treatment of noninfectious RV requires anti-inflammatory and immunosuppressive therapy. The patients may require treatment with high-dose corticosteroids and biological agents. Anti-vascular endothelial growth factor injections and laser photocoagulation may be indicated to treat the occlusive disease. Prompt treatment may prevent complications like vitreous hemorrhage, neovascular glaucoma, and tractional retinal detachment. The treatment more often requires a multidisciplinary approach.
This review provides a comprehensive update on the various causes of noninfectious RV, including both systemic and isolated ocular conditions. It also details various complications and management strategies for this condition.
视网膜血管炎(RV)是指各种视网膜血管的炎症。非感染性RV在发病机制和治疗方面与感染性RV不同。它可有多种临床表现,且可能与全身性血管炎疾病相关。
非感染性RV可由III型超敏反应、细胞间黏附分子表达增加及遗传易感性引起。非感染性RV主要根据受累视网膜血管的类型进行分类。它可进一步分为闭塞性或非闭塞性。RV可能是白塞病、结节病和系统性红斑狼疮等全身性疾病的主要关联病症。超广域眼底荧光血管造影等新方法有助于RV的管理。非感染性RV的有效治疗需要抗炎和免疫抑制治疗。患者可能需要高剂量皮质类固醇和生物制剂治疗。抗血管内皮生长因子注射和激光光凝可能用于治疗闭塞性疾病。及时治疗可预防玻璃体出血、新生血管性青光眼和牵拉性视网膜脱离等并发症。治疗通常需要多学科方法。
本综述全面更新了非感染性RV的各种病因,包括全身性和孤立性眼部疾病。它还详细介绍了该病症的各种并发症和管理策略。