Purpose
Retinal vasculitis (RV) are a significant cause of chronic and severe intraocular inflammation, a topic on which few studies have been published. This retrospective and observational study aims at determining the clinical, angiographic and etiological characteristics of a RV cohort.
Methods
Between May 2012 and May 2014 we retrospectively included from an angiographic database77 patients with RV, with at least a 6 month follow-up, who all had a record in Internal Medicine.
Results
Mean age at diagnosis was 35.1 years and mean follow-up was 29.1 months. The average time between the onset of symptoms and the first examination was 4.3 months and 68.9% of patients consulted for decreased visual acuity. At first visit we observed pan-uveitis in 44% of cases and the disease was bilateral in 75% of cases. For 64.7% of patients, RV were only diagnosed by angiography and were therefore not reported in the examination of the fundus. On fluorescein angiography, venous lesions and ischemic forms accounted respectively for 90.7% and 34.8% of cases. The most common complication was macular edema (65.3%). After etiological record, 44% of RV remained idiopathic, 32% were related to local ophthalmic pathologies, 9.3% were due to systemic vasculitis, and 9.3% to systemic inflammation. The most common etiology was Birdshot chorioretinopathy (9.3%). We treated with systemic corticosteroids 85.9% of patients, with addition of immunosuppressive therapy for 53.7% of them. Unilateral or bilateral visual impairment defined by a visual acuity lower or equal to 20/70 concerned 23.9% of patients at the last visit.
Conclusions
Few series describe the epidemiology of RV. In our study, inclusion of patients based on an angiographic criterion is original, and the fact that no RV was clinically visible in two thirds of patients confirms its relevance. Our study compares to other published data regarding clinical and angiographic characteristics of RV and differs by the high proportion of idiopathic RV and scarcity of infectious RV. In our series, RV affect mostly young people and have potentially serious functional consequences. RV remain idiopathic in almost half of our cases. Early diagnosis of RV requires the realisation of an angiography in any intermediate or posterior uveitis.