Retinitis (patient information)

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Retinitis

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Retinitis?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Overview

Retinitis is inflammation of the retina in the eye. The disease may be classified according to the underlying cause for the disease. There are two major categories of underlying causes of retinitis, they are genetic disorders and infectious agents. The underlying cause for the disease may be established based on clinical presentation and manifestation of symptoms.[1][2]Progression of the disease may be defined by the rate of cellular breakdown of cone and rod cells. Further progression is defined by the degradation of pigment epithelium as well as retinal vessel attenuation and dysfunction of the optic nerve. Infectious diseases may also be responsible for causing reitinitis, as bacterial and viral infections may result in scarring and lesions across the retinal tissue.[1]

What are the symptoms of Retinitis?

Patients with retinitis may experience disturbances in color perception and night blindness. Other symptoms of retinitis include the loss of peripheral vision and cone-rod dystrophy. [2] Infectious diseases may cause retinal hemorrhaging or retinal tissue lesions.

What causes Retinitis?

Retinitis may be caused by multiple infectious agents including cytomegalovirus, taxoplasmosis, tuberculosis, syphilis, and candida. Retinitis Pigmentosa is classified as a genetic eye disease which occurs as a result of an inherited defect. [3]

Who is at highest risk?

Multiple risk factors are associated with the potential manifestation of retinitis. The most common risk factor responsible for the manifestation of retinitis is linked to a variety of unmitigated, rare genetic disorders that are vertically inherited from parents to offspring. [2] Other mitigated risk factors include infectious agents such as cytomegalovirus, taxoplasmosis, tuberculosis, and candida. Cytomegalovirus remains the number one risk factor for developing a progressive form of retinitis within HIV infected patients.

Diagnosis

The optical coherence tomography (OCT) and the fundus autofluorescence (FAF) techniques are most often used when diagnosing a genetic variation of retinitis. OCT may be used to acquire in situ retinal imaging for diagnosis of ocular diseases. FAF imaging is a non-invasive technique, dependent on the presence of lipofuscin pigments (lipofuscin is a by-product of lysosomes during the normal process of photoreceptor degradation.)[4]

When to seek urgent medical care?

A patient should seek medical attention if experiencing any symptoms. Medical attention is urgent when retinitis is caused by cytomegalovirus, toxoplasmosis, tuberculosis, syphilis, or candida infection.

Treatment options

There is no single medical therapy to treat all types of retinitis. Due to the many underlying causes of retinitis, treatment is administered directly according to the underlying cause. These treatments will vary from vitamin therapy and preventative strategies to a long list of potential antimicrobial therapies.

Where to find medical care for Retinitis?

If retinitis is suspect, a patient should immediately contact their primary care physician and/or Ophthalmologist.

Prevention

There are no primary preventive measures available for retinitis that results from the genetic disorder, retinitis pigmentosa.[5] However, retinitis that results from cytomegalovirus may be prevented through upholding specific preventive strategies for cytomegalovirus. These strategies include avoiding the bodily fluids and items might come in contact with infected individuals. Furthermore, similar strategies and precautions may be taken in order to prevent fungal, bacterial, and parasitic infections that could potentially result in retinitis.[6][7][8]

What to expect (Outlook/Prognosis)?

If left untreated, patients with retinitis may progress to develop limited vision, night blindness, and blindness. Retinitis as a result of an infectious agent may imply far more serious complications including respiratory or central nervous system infections. The prognosis is usually good for individuals with retinitis resulting from an infectious agent. Most often the symptoms and complication will subside with proper treatment. Certain infections such as tuberculosis and cytomegalovirus require closer attention during and after treatment. Retinal genetic disorders, unfortunately, lack treatment. Thus individuals suffering from retinal genetic disorders, such as retinitis pigmentosa, will most likely experience mild to severe vision loss.

Possible complications

Common complications may vary according to the underlying cause of the disease. Retinal genetic disorders, such as retinitis pigmentosa, will often lead to highly restricted tunnel-like vision.

Sources

  1. 1.0 1.1 Infectious Retinitis: A Review. YACHNA AHUJA, MD · STEVEN M. COUCH, MD · RAYMUND R. RAZONABLE, MD · SOPHIE J. BAKRI, MD. http://www.retinalphysician.com/articleviewer.aspx?articleID=102293. Accessed April 13, 2016.
  2. 2.0 2.1 2.2 Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm
  3. Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.genome.gov/13514348
  4. Diagnostic imaging in patients with retinitis pigmentosa. Mitamura Y, Mitamura-aizawa S, Nagasawa T, Katome T, Eguchi H, Naito T. Diagnostic imaging in patients with retinitis pigmentosa. J Med Invest. 2012;59(1-2):1-11. http://www.ncbi.nlm.nih.gov/pubmed/22449988. Accessed April 19, 2016.
  5. GeneReviews. Retinitis Pigmentosa Overview. http://www.ncbi.nlm.nih.gov/books/NBK1417/
  6. Cytomegalovirus Prevention. Center for Disease Control and Prevention. http://www.cdc.gov/cmv/prevention.html
  7. Sexually Transmitted Diseases. Centers for Disease Control and Prevention. http://www.cdc.gov/std/syphilis/ Accessed on April 19, 2016.
  8. Parasitic Diseases. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/toxoplasmosis/prevent.html Accessed on April 19, 2016.

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