Chorioretinitis –Aetiology, features and treatment
Posterior uveitis (inflammation of choroid or retina or both)
Causes: (1/10 unknown)
Toxoplasmosis (parasite). Serpiginous Choroidopathy is related to uveitis – a rare condition that affects the part of the uvea called the choroid. It can affect the vitreous body and cause lesions on the retina that result in vision loss. Tuberculosis (even abscesses) Cytomegalovirus Retinitis (CMV Retinitis) (immunocompromised people) Lupus , Birdshot Retinochoroidopathy (autoimmune disease), Sarcoidosis Acute Retinal Necrosis causes retinal detachment and vision loss Behcet’s Disease(rare) Syphilis
DD painless, no redness
- mainly visual disturbances, multifocal or focal and that oedema can affect the retina then also thus light falling on the photoreceptors image will be distorted,
- if crowding occurs because of the oedema pushing receptors to one side (accumulation )image will appear larger , it can also cause them to separate it (DD macropsia, micropsia ; appear larger/ smaller)
- Commonly blurring of vision if inflammation is closer macular complications of posterior is cataract.
- vitreous also affected; floaters (opacities) can also be seen here
Sign by slitlamp and indirect ophthalmoscopy
(Vitreous choroid and retina) shows the above mentioned signs (vitreous, chirid retina, optic nerve)
Vitritis -vitreous inflammation
normally its clear but with inflammation of the choroid and retina exudation occurs thus cells will now be present even membranes etc. → opacification, you may not even see the optic disk at all DD)
Normally choroid makes fundus seem red but now it may appear yellowish white due to infiltrate thus elevating the retina lying on top , retina itself may be infiltrated and perivascular cuffing , optic nerve may be involved directly leading to Papillitis) (ALL DD)
After healing scarring can be seen which are white +black
Intermediate & posterior can show very similar signs but in posterior involvement of fundus is greater