Retinitis classification: Difference between revisions

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{{‪Retinitis‬}}
{{‪Retinitis‬}}
{{CMG}}
{{CMG}}{{AE}}{{IMD}}


==Overview==


==Overview==
Retinitis may be classified according to the underlying cause for the disease. There are two major classifications 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==




===Retinitis Pigmentosa===
===Genetic Disorders===
 


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*Occurs early on during the clinical course of Retinitis Pigmentosa.  
*Occurs early on during the clinical course of Retinitis Pigmentosa.  
*Night blindness occurs due to the loss of rod function.  
*[[Nyctalopia|Night blindness]] occurs due to the loss of [[Rod cell|rod]] cell function.  
*Nyctalopia can be an indicator of the eventually clinical severity of the complications associated with retinitis.  
*[[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.  
*Early onset of severe complications typically indicates more severe complications later on during the clinical course.<ref name="US LIB">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm </ref>
 
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Fundus
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Fundus disorders
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*Defective rod cell response, although fundus appears normal
*Defective [[rod cell]] response, although [[Fundus (eye)|fundus]] appears normal
*Arteriolar narrowing
*Arteriolar narrowing
*Intraretinal pigmentation  
*Intraretinal pigmentation  
*Loss of pigment in pigment epithelium
*Loss of [[Retinal pigment epithelium|pigment]] in [[Retinal pigment epithelium|pigment epithelium]]
*Intraretinal clumping due to the accumulation of melanin  
*Intraretinal clumping due to the accumulation of melanin<ref name="US LIB">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm </ref>
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Visual acuity
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Visual acuity disorder
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*Macular lesions
*[[Macular|Macular lesions]]
*Defective cone cell function
*Defective [[Cone-rod dystrophy|cone-rod cell function]]
*Loss of central acuity
*Loss of [[Visual acuity|central acuity]]<ref name="US GEN">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.genome.gov/13514348 </ref>
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Sector RP
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Sector RP
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*Changes may be observed in specific halves or quadrants of the fundus
*Changes may be observed in specific halves or quadrants of the fundus
*Less severe defects in the visual field
*Less severe defects in the visual field
*Sectorial disease with the long term potential of widespread disease
*Sectorial disease with the long term potential of widespread disease<ref name="US GEN">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.genome.gov/13514348 </ref>
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Retinitis Pigmentosa and Pregnancy
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Retinitis pigmentosa progression with Pregnancy
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*Women previously diagnosed with retinitis pigmentosa may  report an overall decrease in vision during pregnancy.  
*Women previously diagnosed with retinitis pigmentosa may  report an overall decrease in vision during pregnancy.<ref name="US LIB">Retinitis Pigmentosa. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001029.htm </ref>
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===Cytomegalovirus Retinitis===
===Infectious Agents===
 
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! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF| Infectious Agent}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Clinical Manifestations}}
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | Cytomegalovirus
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*Physical evidence of a [[Cytomegalovirus (patient information)|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 [[lesions]] may be present in close proximity to the vortex veins as well as the [[ora serrata]].<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>
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Tuberculosis
| style="background: #DCDCDC; padding: 5px;" | 
*[[Granulomas|Caseating granulomas]]
*Multiple [[choroidal]] tubercles- small grayish [[nodules]] located on the posterior pole of the eye
*Yellow [[necrotizing]] [[Granuloma|granulomas]]<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>|-
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Fungal
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====''Candida albicans''====
*Visibly hazy [[vitreous]]
*White circumscribed [[lesions]]<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>
 
====''Aspergillus fumigatus''====
*Yellow subretinal infiltrates
*Retinal infiltrates
*Fungal [[hyphae]] are located throughout the eye - suggestive of pulmonary involvement<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>
 
====''Cryptococcus neoformans''====
*Yellowish-white [[lesions]] located on the [[fundus]] of the eye
*Mutton-fat keratic [[precipitates]]<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>
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Toxoplasmosis
| style="background: #DCDCDC; padding: 5px;" |
*Localized areas of infiltrate
*Active [[lesions]] are adjacent to initial [[scarring]]<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>
 
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Syphilis
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*[[Hemorrhagic]] areas
*Flare visible in anterior and posterior portions<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>
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==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Infectious disease]]

Latest revision as of 18:36, 18 September 2017

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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 classifications 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 cell 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
Visual acuity disorder
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 lesions may be present in close proximity to the vortex veins as well as the ora serrata.[1]
Tuberculosis
Fungal

Candida albicans

Aspergillus fumigatus

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

Cryptococcus neoformans

Toxoplasmosis
Syphilis

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
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