Therapy Insight: The Recognition and Treatment of Retinal Manifestations of Systemic Vasculitis

Petros Aristodemou; Miles Stanford

Disclosures

Nat Clin Pract Rheumatol. 2006;2(8):443-451. 

In This Article

Retinal Findings in Medium-vessel Vasculitis

Vessels of medium and small caliber are affected by polyarteritis nodosa, which is a necrotizing vasculitis. The eye can be affected by the vasculitic process or by systemic hypertension. In the posterior segment, vasculitis most frequently involves the posterior ciliary arteries and choroidal vessels. This involvement can result in an anterior ischemic optic neuropathy similar to that seen in giant cell arteritis.[13] Retinopathy with cotton-wool spots, exudation, macular star (a star-shaped pattern of lipid exudates at the posterior pole of the eye), and/or vascular tortuosity have all been described.[14] Treatment for these retinal signs is largely treatment for the underlying disease. As with AION in giant cell arteritis, prompt, high-dose immunosuppression is required to prevent visual loss in the other eye (Box 1).

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