Retinal vasculitis – Clinical manifestations and outcome at tertiary eye care centre in south India

Abstract

To study the various causes, clinical presentation, management and outcome of the retinal vasculitis cases at tertiary eye care centre. Tertiary eye care centre, Telangana State, South India. Retrospective Interventional Study. Jan 2016 to Dec 2020. Fifty one patients of retinal vasculitis presented with various clinical manifestations were examined in detail and managed. Data collected from medical records. All young patients of different age group presented with retinal vascular changes are included in the study. Patients underwent examination and laboratory workup. Few patients showed ocular and systemic investigations were with in the normal limits. These patients were considered as idiopathic cases. BCVA, slit lamp examination, fundus examination, FFA, OCT, B SCAN in hazy media and documentation done in all cases. Bilateral presentation was common, some presented with aggressive disease in both eyes (early and delayed presentation). Common presentation was blurred vision and sudden drop of vision. Few patients showed tuberculin skin test positive and managed as presumed ocular tuberculosis. Patients who were HIV positive managed with HART, prognosis was poor in these patients. Medical and surgical management done based on the stage of presentation, oral steroids, laser therapy, anti VEGF followed by pars plana vitrectomy with or with silicone oil tamponade done. Oral steroids were started after physician clearance and tapered based on the activity of the disease. Patients followed regularly every month till the activity ceases in medically managed cases and in operated cases we followed till the silicone oil is removed from the eye. Few patients presented with the reactivity of the disease were managed again based on the presentation. Results were good in idiopathic cases, patients presented with inflammatory and ischemic stages also showed good outcome. Patients presented with proliferative stage showed fair outcome, patients presented with severe proliferative stage showed poor prognosis. Retinal vasculitis is one of the ocular condition which can cause vision loss in young adults, if present in early stage, can be managed medically. Prognosis is good in early stages. Recurrent vitreous haemorrhage, tractional retinal detachment, combined retinal detachment were common presentations. Infective cases showed more proliferative changes. Risk of neovascular glaucoma is one of the cause of blindness.