Ischemic retinal vasculitis and its management.
Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet's disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet's disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.
Moorfields Eye Hospital, City Road, London EC1V 2PD, UK ; UCL Institute of Ophthalmology, London EC1V 9EL, UK.
Lazha
0000-0002-7469-2500
L
Talat
Moorfields Eye Hospital, City Road, London EC1V 2PD, UK ; UCL Institute of Ophthalmology, London EC1V 9EL, UK.
Sue
S
Lightman
Moorfields Eye Hospital, City Road, London EC1V 2PD, UK ; UCL Institute of Ophthalmology, London EC1V 9EL, UK.
Oren
0000-0002-1015-1641
O
Tomkins-Netzer