Retinitis pathophysiology

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Overview

Pathophysiology

Retinitis Pigmentosa

  • Retinitis pigmentosa is an umbrella term for multiple genetic, retinal disorders.
  • Retinal genetic disorders include; night blindness, visual acuity, a fundus appearance, posterior subscapular cataracts, vitreous particle formation, sector retintis, pregnancy based retinitis. [1]

Night blindness, Visual acuity, and Fundus appearance

  • Night blindness results from the loss of rod function in the early portion of the clinical course.
  • Visual acuity refers to the loss of central acuity correlating to severity of the disease's progression.
  • Central acuity has been connected to the macular lesions present in the early clinical course of the disease.
  • A fundus appearance often refers to the clinical stage.
  • Fundus appearance in earlier stages include defective rod responses.
  • Progression of retinitis will result in the narrowing of arteriolar portion of the fundus, accompanied by intraretinal pigmentation, and disturbances, often degradation pigments in the pigment epithelium.
  • Pigment degradation in the pigment epithelium is an indicator of further degeneration of photoreceptors. This interruption will often manifest in clumping of melanin in odd, coarse configurations.
  • Further degradation will result in retinal vessel attenuation and dysfunction of the optic nerve. [1]

Cytomegalovirus

  • Retinitis, caused by cytomegalovirus (CMV), involves the infection of all layers of the retinal tissue.
  • Spread of the the infection will occur at approximately 24 nanometers per day.
  • Primarily infected areas include the RPE and the subjacent choroid.
  • Infection will consist of a vast amount of cellular necrosis across the retina; with the enlargement of infected cells, evidently hosting viral inclusions.
  • CMV retinitis, post-treatment, will commonly persist on the previously scarred, retinal tissue.
  • Progression of infection may result in the development of small holes across previously scarred and healed tissue.
  • Formation of these tiny holes may result in rhegmatogenous retinal detachments. [2]

References

  1. 1.0 1.1 GeneReviews. Retinitis Pigmentosa Overview. 2013; Abigail T Fahim, MD, PhD, Stephen P Daiger, PhD, and Richard G Weleber, MD, DABMG, FACMG. http://www.ncbi.nlm.nih.gov/books/NBK1417/ Accessed April 12, 2016.
  2. American Academy of Ophthalmology. Pathophysiology of CMV Retinitis. http://www.aao.org/focalpointssnippetdetail.aspx?id=bc891841-b847-4210-a66b-2bb28d1ef1bf. Accessed April 12, 2016.

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