Retinal Vasculitis

Overview

Retinal vasculitis is inflammation of the blood vessels in the retina, the light-sensing layer at the back of the eye. When these vessels become inflamed, they can leak, become blocked, or develop areas of poor blood flow. This can damage the retina and affect vision. The condition may involve the arteries, the veins, or both.

Retinal vasculitis is often a sign of a wider problem. It can occur on its own (limited to the eye) or as part of a body-wide autoimmune or inflammatory disease, an infection, or, less often, certain cancers. Because the underlying cause guides treatment, evaluation usually looks both at the eye and at the rest of the body. With appropriate treatment, inflammation can often be controlled and vision protected.

Symptoms

Symptoms depend on which part of the retina is affected and how severe the inflammation is. They may include:

• Blurred or reduced vision
• Floaters (spots or threads drifting across the vision)
• Dark areas or blind spots in the field of vision
• Decreased ability to see fine detail if the central retina is involved

Retinal vasculitis is usually painless. Some people have mild symptoms while others notice significant vision changes. Because it can occur with other eye inflammation, redness or light sensitivity may also be present. Any new or worsening vision change should be checked promptly by an eye specialist.

Causes

Retinal vasculitis has many possible causes, which fall into several groups:

• Autoimmune and inflammatory diseases: Such as Behçet disease, sarcoidosis, lupus, and multiple sclerosis-related inflammation.
• Infections: Including tuberculosis, syphilis, viral infections, and toxoplasmosis.
• Eye-limited inflammation: Some cases are confined to the eye without a body-wide cause.
• Other causes: Rarely, certain cancers or reactions to medications.

In some cases no specific cause is found despite thorough evaluation.

Risk Factors

• Known autoimmune or inflammatory disease
• Certain infections, including tuberculosis or syphilis
• A history of uveitis (eye inflammation)
• Conditions that affect the immune system

Diagnosis

Diagnosis involves examining the eye and searching for an underlying cause:

• Dilated eye exam: Reveals inflamed vessels, leakage, and signs of poor blood flow in the retina.
• Fluorescein angiography: A dye study that highlights leaking or blocked retinal vessels and areas of reduced flow.
• Optical coherence tomography (OCT): Detailed images of the retina to check for swelling.
• Blood tests and screening: To look for autoimmune disease or infection.
• Imaging or other tests: Chest imaging or specialist evaluation to find systemic causes.

Treatment

Treatment aims to control inflammation, treat any underlying cause, and protect vision. An eye specialist, often with other doctors, guides care.

• Corticosteroids: Given as drops, injections, or by mouth to reduce inflammation.
• Immune-modulating medicines: For more severe or recurring cases, or when steroids alone are not enough.
• Treating the cause: Antibiotics or antiviral medicines for an infection, and treatment of the underlying autoimmune disease.
• Laser or other eye treatments: For complications such as abnormal new blood vessels.

Because retinal vasculitis can recur, ongoing monitoring is usually needed. Early, appropriate treatment offers the best chance of preserving vision.

Prevention

• Manage any underlying autoimmune or inflammatory condition with your care team
• Treat infections promptly
• Attend regular eye exams if you have a condition that affects the eyes
• Report any new vision change, floaters, or blind spots without delay
• Take prescribed medicines as directed and keep follow-up appointments

When to See a Doctor

See an eye specialist promptly if you notice:

• New or worsening blurred vision
• New floaters or a shower of spots in your vision
• Dark areas or blind spots in your sight
• Vision changes if you have an autoimmune disease or eye inflammation

Sudden major vision loss, a curtain coming across the vision, or many sudden flashes and floaters can signal an urgent retinal problem and need prompt evaluation.

Related Topics

Frequently Asked Questions

References

1. American Academy of Ophthalmology. Retinal vasculitis and uveitis.
2. National Eye Institute (NEI). Uveitis.
3. MedlinePlus, U.S. National Library of Medicine. Uveitis.
4. American Uveitis Society. Retinal vasculitis.