Retinitis classification: Difference between revisions

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==Overview==
==Overview==


Retinitis 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.<ref name="ret phys">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. </ref>
Retinitis 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.<ref name="ret phys">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. </ref><ref name="US LIB">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm </ref>


==Classification==
==Classification==

Revision as of 13:43, 20 April 2016

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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 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]

Classification

Genetic Disorders

Classification Clinical Manifestations
Nyctalopia
  • Occurs early on during the clinical course of Retinitis Pigmentosa.
  • Night blindness occurs due to the loss of rod function.
  • Nyctalopia can be an indicator of the eventually clinical severity of the complications associated with retinitis.
  • Early onset of severe complications typically indicates more severe complications later on during the clinical course.[2]


Fundus disorders
  • Defective rod cell response, although fundus appears normal
  • Arteriolar narrowing
  • Intraretinal pigmentation
  • Loss of pigment in pigment epithelium
  • Intraretinal clumping due to the accumulation of melanin[2]
Visual acuity disorder
  • Macular lesions
  • Defective cone cell function
  • Loss of central acuity[3]
Sector RP
  • Changes may be observed in specific halves or quadrants of the fundus
  • Less severe defects in the visual field
  • Sectorial disease with the long term potential of widespread disease[3]
Retinitis pigmentosa progression with Pregnancy
  • Women previously diagnosed with retinitis pigmentosa may report an overall decrease in vision during pregnancy.[2]

Infectious Agents

Infectious Agent Clinical Manifestations
Cytomegalovirus
  • Physical evidence of a cytomegalovirus presence in one of both eyes will generally clinical present in the form of lesions, adjacent retinal vessels.
  • These lesions may impinge upon the fovea and the optic nerve. Furthermore they are usually discovered in close proximity to both.
  • Further extending legions may be present in close proximity to the vortex veins as well as the ora serrata.[1]
Tuberculosis
  • Caseating granulomas
  • Multiple choroidal tubercles- small grayish nodules located on the posterior pole of the eye
  • Yellow necrotizing granulomas[1]|-
Fungal

Candida albicans

  • Visibly hazy vitreous
  • White circumscribed lesions[1]

Aspergillus fumigatus

  • Yellow subretinal infiltrates
  • Retinal infiltrates
  • Fungal hyphae are located throughout the eye - suggestive of pulmonary involvement[1]

Cryptococcus neoformans

  • Yellowish-white lesions located on the fundus of the eye
  • Mutton-fat keratic precipitates[1]
Toxoplasmosis
  • Localized areas of infiltrate
  • Active lesions are adjacent to initial scarring[1]
Syphilis
  • Hemorrhagic areas
  • Flare visible in anterior and posterior portions[1]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 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 2.3 Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm
  3. 3.0 3.1 Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.genome.gov/13514348