Photo Credit: EyeEm
The following is a summary of “Defining Retinal Vasculitis,” published in the June 2024 issue of Ophthalmology by Davis et al.
Researchers conducted a retrospective study evaluating the appropriateness of using retinal vasculitis as the diagnostic term for various conditions.
They obtained expert opinions and reviewed literature focused on retinal vasculitis’s current classification and pathology. They examined a specific type of intraocular inflammation through the lens of established knowledge about the blood-retinal barrier in the neurovascular unit and how the structures respond to various stimuli. Additionally, the findings were correlated with multimodal imaging and known mechanisms of immunologically mediated diseases.
The result showed that a Medline search for the term “retinal vasculitis” yielded 2,041 citations, covering a range of disorders, including immunologic, genetic, neoplastic, infectious, drug-related, and ischemia-related conditions. Existing classification schemes and angiographic grading systems are primarily descriptive and need to adequately address pathological mechanisms, partly due to the lack of histologic confirmation. While optical coherence tomography (OCT) angiography improves retinal blood vessel imaging, it misses leakage, a crucial sign of inflammation, limiting its role in fully understanding the disease process. Identifying catastrophic retinal vascular occlusion after intravitreal injections as retinal vasculitis illustrated the speculative use of the term, applying it to complex and rare conditions without enough pathological evidence.
Investigators concluded that, pending further histologic or mechanistic evidence, the term “retinal vasculitis” should be limited to primary inflammation of the retinal vasculature, causing blood-retinal barrier disruption for leakage or occlusion in intraocular inflammation.
Source: ajo.com/article/S0002-9394(24)00239-3/abstract
